Autism, Tylenol, and Cause and Effect

By Cory Franklin

October 31, 2025

Did Robert F. Kennedy Jr. really say taking Tylenol during pregnancy causes autism and if he did, is that true?

In an October Cabinet meeting Kennedy’s actual words regarding pregnant mothers taking Tylenol were, “It’s not dispositive this causes autism, it’s so suggestive that anybody who takes this stuff during pregnancy unless they have to is irresponsible…(studies that show an association) is not proof, we’re doing studies to make the proof.”

A lot to unpack there. Kennedy never said Tylenol use during pregnancy causes autism even if his implication of causation is hard to ignore – and we’ll “make the proof” is not how science works (as an aside, women should consult their doctors about taking Tylenol during pregnancy).

But to be fair, RFK Jr. says a few things that are true, a lot more that are total nonsense, and some that have a bit of truth. The Tylenol statement would appear to fall under the last category – not indisputably true, but compelling enough to avoid being total nonsense.

Tylenol is not the cause of most autism and is quite possibly not even a cause of autism at all. Most cases of autism have nothing to do with Tylenol. But as Kennedy states, there are credible studies that make an association between the drug and autism in some cases.

Two important points here: First, an association between a medication and an observed effect is not necessarily causal – not even remotely so. You carry an umbrella because there is an association between the weatherman predicting rain and a rainy afternoon, but it does not rain because the weatherman predicts it.

Second, there are other large studies, equally if not more credible, that refute any association between Tylenol and autism. Although many experts seem to prefer these studies, whether because of politics or science, they do not vitiate the studies Kennedy quotes or definitely rule out an association.

This is simply the give and take of science, where the quality of conflicting studies must be evaluated and balanced before drawing final conclusions. The evidence thus far suggests that if any association exists, it must not be strong or other large studies would have replicated it.

This is not comparable to the vaccine/autism debate, in which a single widely publicized 1998 study claimed vaccines caused autism. That study, prominently published in the prestigious international journal Lancet, was later retracted and ultimately found to be fraudulent.

Virtually every study since has debunked that alleged association; it is reasonably certain that vaccines do not cause autism.

Where does that leave us in ascertaining the cause or causes of autism? Rates of reported autism have skyrocketed. Latest data indicate that more than 3% of eight-year-olds have some type of autism diagnosis, a fivefold increase since 2000. Some of this is attributable to greater awareness of the condition, better diagnostic techniques, and broader diagnostic criteria. Autism is now recognized, not as a single condition, but a spectrum disorder.

Those factors are crucial to the rise of the autism diagnosis but are unlikely to account completely for the dramatic increase. Additional causes are poorly understood and almost certainly multifactorial, including genetic components, premature birth, advanced parental age, and maternal health.

One theory implicates disorders in the bacterial environment of the child’s gastrointestinal tract, where certain intestinal metabolites may influence the nervous system and human behavior. Nothing is certain.

In answering such a complicated question as the rise in autism, with so many known variables and probably more unknown variables, it is logical that researchers examine the environment and factors such as medications.

This may explain why RFK Jr. reaches for a simple exposure like Tylenol. But the number of medications and other environmental exposures is virtually limitless, and there is no guarantee that the environment even plays a role in a disorder with such complex origins. Prediction: the debate over what causes autism will continue long after the current generation of scientists is gone.

Determining cause and effect is difficult: when cause A appears to result in effect B, an alternative explanation is that B is the cause and A is the effect.

A sports example: when the 1980s Chicago Bears were a powerhouse, a commonly cited statistic was that the Bears usually won when running back Walter Payton gained 100 yards. Simple cause and effect – give Payton the ball and the Bears should win. Accepted wisdom until it was noted that when the Bears were leading, they gave the ball to Payton more often to bleed the clock, thus resulting in him having more 100-yard rushing games.

Same results, but a reversal of initially perceived cause and effect. Does some unknown neurological syndrome during pregnancy that eventually causes autism give women more headaches, leading them to take Tylenol? Hence, an association with cause and effect reversed.

A particular problem in the case of Tylenol and autism is that much of the news media, and many expert scientists are critical or even openly hostile to RFK Jr., because he is a Trumper or they have had their budgets slashed.

This is a call for scientific objectivity, not a defense of RFK Jr. – he may well be wrong about Tylenol and autism – and about many other things as well.

But the skepticism scientists and the media now display toward Kennedy was often absent during the COVID pandemic.

Then, many public health officials and journalists advanced so-called certainties that later proved dubious or wrong: about the likely source of the virus, whether vaccination prevented acquisition and transmission of COVID, and the negative effects of prolonged school closures.

It’s past time to forgo politics and reestablish impartiality and humility, essential to discovering why autism is on the rise.

-30-

Dr. Cory Franklin

Cory Franklin, physician and writer, is a frequent contributor to johnkassnews.com. Director of Medical Intensive Care at Cook County (Illinois) Hospital for 25 years, before retiring he wrote over 80 medical articles, chapters, abstracts, and correspondences in books and professional journals, including the New England Journal of Medicine and JAMA. In 1999, he was awarded the Shubin-Weil Award, one of only fifty people ever honored as a national role model for the practice and teaching of intensive care medicine. 

Since retirement, Dr. Franklin has been a contributor to the Chicago Tribune op-ed page. His work has been published in the New York Times, New York Post, Washington Post, Chicago Sun-Times and excerpted in the New York Review of Books. Internationally, his work has appeared internationally in Spiked, The Guardian and The Jerusalem Post. For nine years he hosted a weekly audio podcast, Rememberingthepassed, which discusses the obituaries of notable people who have died recently. His 2015 book “Cook County ICU: 30 Years Of Unforgettable Patients and Odd Cases” was a medical history best-seller. In 2024, he co-authored The COVID Diaries: Anatomy of a Contagion As it Happened.

In 1993, he worked as a technical advisor to Harrison Ford and was a role model for the physician character Ford played in the film, The Fugitive.

Comments 42

  1. A very good and interesting article, very clearly and simply stated. “It’s past time to forgo politics and reestablish impartiality and humility, essential to discovering why autism is on the rise.” True. I’d say, more importantly, it’s past time to forgo politics and begin reestablishing the credibility of most of our major institutions: Science, Universities, Secondary Schools, Major Media, the court system, etc., etc.

    1. Mr. Horniacek: Fully agree, especially with your last sentence. Many so-called scientists fell all over themselves to overdo COVID because it was politically correct. The so-called scientists and government medical “authorities” allowed their judgement to be influenced by political considerations, and not only endorsed false information, but also covered up information that was contrary to the “party line” that they were all pushing. One of the enablers of the “great lie” caused the deaths of hundreds of elderly patients from COVID and now held up as the last hope for a non-Communist mayor of New York City. After all that they did in the name of science, we should trust the scientists? The so-called scientists proved themselves to be nothing but politicians, and lousy ones at that

      1. Mr. Lisicich- Everything you recounted there is true but nonetheless you are better off listening to the scientists than the politicians. The scientists won’t always be right but they are more likely to be right than all the crackpot alternative influencers out there.

        1. Bob. You are mistaken by assuming scientists speak with one voice. That is simply not true. For instance, Dr. Bhattacharya and the world renown medical statistician (and Greek American by the way), Dr. Ioannidis, were demonized for pointing out some of the falsehoods coming out of CDC, and NIH. I would also like to remind you that scientists possess the same human frailties as the rest of us deplorable. The NIH’s Dr.Moren’s admitted to Congress that he schooled his colleagues at NIH how to avoid or mislead FOIA inquiries. Think about that. A scientist employed by the tax payer, avoiding accountability to the taxpayer. Absolutely disgraceful.

          1. Bruce- I agree and did not mean to suggest that scientists speak with one voice, or even that the scientific consensus is always right. I’m merely stating that probability wise you are better off listening to the scientific consensus than, for instance, some random podcaster on the internet.
            If you get diagnosed with a very curable form of Lymphoma are you going to listen to the doctors at Mayo or treat it with magnet therapy and herbs?

  2. It is time to pay attention to our Politics and take care of the American people. So tired as to what is happening around us. Awful. You come to America to get a job and be part of it not use it.

  3. I spent over a decade as our district’s coordinator for transition from Early Intervention (EI, county health provided services for disabled children ages birth to three) to Early Childhood (EC, school district provided services for disabled children ages 3 through 5). During this time, the number of EI children coming to us with “potentially on the Autism Spectrum (ASD)” notations skyrocketed.

    In many of those cases, when our team met the family, the child (at 2 1/2 years old, mind you) firmly attached to an iPad and did not communicate save by screams whenever there was adult demand – including to walk, meaning the child was either in a stroller or carried everywhere. We were able to get the child out of the stroller, and the iPad away from them, and the screaming did end after a bit. Yes, many of those children did wind up with an eligibility of Developmental Delay or Autism. But that’s not the end of the story.

    Once in our program, we were language-rich. We used eye-contact. We did fun things with movement. And we saw dramatic improvement. By second grade, about half of those kids with the Develpmental Delay or Autism eligibilities no longer had them. Oh, they might have an Other Health Impairment, or Specific Learning Disability, but human interaction and demand that they had not consistently received prior to age 3 had notably altered their abilities.

    Now, does this mean that developmental delays and the Autism Spectrum are poor early parenting?

    NO!

    But it does suggest that babies and toddlers’ home lives can influence their behaviors and responses in a way that may mimic the Autism Spectrum. At conferences with others in a like position to mine, many of us saw the same things.

    Yes, the Autism Spectrum is real and the things Dr. Franklin noted are absolutely potential causes of actual Autism, and what I saw tends to be NOT. But sometimes what walks like a duck and quacks like a duck is simply a goose.

    1. I loved it when When RFK called out Bernie Sanders for accepting millions from pharmaceutical companies at his congressional confirmation. The media shills behind these companies while it makes billions in running their ads. Yet food makers have quietly announced their banning of petroleum based food dyes in the production of cereals, etc. There is a conscious shift in fast food outlets, most notably McDonalds to using tallow, aka lard in frying instead of polyunsaturatedgoop that they’ve been using. Expect many more outlets to follow. There are new COVID booster ads that ( at the end of the ad, in really fast talkspeak) that there is evidence that these vaccines may damage the lining of your heart. Public monies aka SNAP can no longer be used to buy junk foods causing early childhood diabetes and obesity. All of these are the results of Robert F Kennedys appointment as Health Czar. The fact that the media hasn’t stopped portraying him as a nutcase only goes to show you he must be doing something right. He is, just like Donald Trump transformative.

        1. Maybe we need to get back to basics. During WW2, when England was getting bombed from the Germans and food was being rationed to feed the soldiers, there was a very real fear of malnutrition among expecting mothers. English doctors advised these future moms to drink one pint of Guinness to maintain their weight. Guinness is brewed using only the best natural ingredients full of carbs, protein and other healthful nutrients. Everything you need to maintain a healthy weight. To my knowledge there was no explosion of autism during those dire times. Urban legend? Don’t know. I intend to honor these medical professionals by hoisting a few pints myself. Guinness. The best stuff in the world.

      2. Disagree- RFK Jr. is mostly a crackpot who should not be Secretary of HHS. He is woefully unqualified for the position and was appointed for only one reason- his endorsement of and unbending fealty to Donald Trump during the campaign.
        The American public deserves better. Really.

  4. I am the father of my smart, beautiful, but more importantly kind daughter who happens to have autism. When she was adopted from China some twenty nine years ago by me and my late wife, we had to make a quick decision whether to accept our daughter who showed some indications of possible autism (she was nine months old) or was it crib syndrome? We chose life. It has taken years of therapies (OT, PT, ST, ABA) with endless amounts of sitting in doctor’s waiting rooms and bushels of cash. Amy is the glory of my life and I believe that I did not choose her, that I was chosen to care for her. I am blessed.

    1. I just listened to Mike Rowes’s most recent podcast with Gavin de Becker. He covers a lot by way of providing background (such as the unmasking of Agent Orange, asbestos-laced talcum powder, etc) before moving on to vaccines & other government-regulated substances. He speaks to debunking & the process by which that happens (or doesn’t), I found it both fascinating & infuriating. Your comment struck a chord because – while a reasonable amount of skepticism is in my nature – this info (all accessible facts/data) made me realize the answer to the question you pose is, in many cases, “yes”. It’s a long-form interview – I listened over the course of three daily walks!

  6. As a conservative I am so happy RFK got appointed by Trump. Yes a Democrat. But I love how he is questioning vaccines with their mercury content, food dyes, and now this. Doesn’t matter whether Tylenol is the issue or not. “Scientists” need to investigate and find out why autism exploded

      1. My parents (Mom initially studied microbiology, and Dad chemistry) always told us to follow the science… until better science came along. And that if it WAS science, better WOULD come along.

        1. Rebecca, one must be careful. Pseudo-science masquerades as science, but isn’t the real thing and is often based on an agenda. These days, the good science can get overwhelmed by the sheer volume of pseudo-science.

      2. Karen, I disagree. Settled science is science that is reproducible on a large scale. F=MA or E=MC^2 is settled science within it’s context, e. g., nuclear reactions work and can be reproduced repeatedly.

  7. From what I can see the primary reason for the increase in autism is over-diagnosis. Even the slightest bit of unusual or eccentric behavior in 3- or 4-year-olds is diagnosed as level 1 or 2 autism. And surprise, a massive new industry for diagnosis and therapies has emerged. This is not to say that there are some more extreme cases that warrant special care, which in prior generations, like mine, were simply ignored. But like practically everything else today, we take an issue, blow it out of proportion, and make it worse.

    3. Mr. Stark
      U r totally correct. Bunch of psychologists, social workers, teachers, most of which have no medical training in diagnosis of autism. Most of these so called ‘autistic kids’ are spoiled brats who in the good old days would be taken to the shed by their father for a ‘talk’.
      But we don’t need fathers anymore. Right? When I was young and misbehaved, mom would say: wait till ur father gets home’ or if he was home, he’d give us that look. That corrected our behavior.
      Yes there true autistic kids but not as many as the press hypes.
      As far as RFK, JR goes: RFK=POS=FOS. Tylenol is safe, period. For myself, good old fashion aspirin is best. Time proven.

  8. Dear Doctor:

    I take great exception to one of your examples. To call the Chicago Bears an 80’s powerhouse is absurd. Yes, they did reach 3 NFC Championship games during the decade – winning one but losing two by a combined score of 51-3. Indeed, the 1985 Bears won the Super Bowl in an overwhelming fashion. However, their path in the playoffs had them defeating Phil Simms(who fumbled twice), Dieter Brock (a CFL import) and Tony Eason (who was out of the league 4 years later) in succession – in other words they dominated mediocre opponents. As a long suffering Bears fan I must insist that you recognize this error. The 49ers – with their 3 Super Bowl wins during the decade were the powerhouse of the 80’s as much as I hate to admit it. Giving the Bears organization too much credit for one great year is how we have come to find ourselves in our current situation.

    1. Josh:
      I’ll give you the Niners won three and the Redskins won two in the 1980s. Both great teams and powerhouses as well. My opinion is that the 85 Bears would have beaten any of those teams and had McMahon not gotten hurt (and Ditka not carried away) they might have won one or two more.
      You should know, Josh, that I say this as a long-time Packer fan back to the 1960s. Just trying to be fair.

      2. From a 60 year Packer fan,
        The 85 Bears were one of the greatest teams in the history of the NFL. I lived in the Chicago area then and still do. I hated them then, but I have great respect for them now.

  11. This time around Don has surrounded himself with good, qualified people, except for Kennedy Jr. I tend not to put stock in a public scold and this is no exception.
    The moronic AG of Texas just filed suit against the manufacturers of Tylenol. All Bobby did is open the door for the ambulance chasers to try to bleed the company dry, and get an effective pain med off the market.
    He should have been fired on the spot.

  13. The wide spectrum is the issue….some kids just think differently and they call it autism. Some are incredibly shy and they call it autism. Some are just jerks and the parents say it’s autism and not them ignoring any socialization or discipline. The Nuns dragged every kid through the grade, whether they wanted or not, making the kids on the spectrum learn how to function despite autism. The severe cases are probably as low as ever, but we seem to call every quirk and irregular behavior as autism…sometimes it is just a kid being themselves…smart, creative, weird and quiet.
    Thank god for weird people.

    1. EXACTLY!
      Forgot about the nuns. They could be worse than your parents.
      But the absolute best disciplinarians/teachers were the Jesuits. At Loyola Academy, were I went, there were strict codes of behavior we followed. No exceptions. Sadly the Jesuit teacher ranks are almost nonexistent with woke lay teachers in their place.

  14. Dr. Franklin (and John), thank you for your insightful column. While your focus is autism, it brings out a broader question about the state of science in our country, and more broadly, globally. As an engineer and food scientist by training, I have practiced the scientific method throughout my career. What is concerning is the corruption of science and abuse of it in the media, within government, academic research institutions and corporations. Your RFK quote and statement -“and we’ll “make the proof” is not how science works- encapsulates the issue succinctly. Our government funded “scientific research” for many years that was often “junk” or “pseudo-science” that usually could not be replicated, yet gets published as “peer reviewed” because of knowing the right people. I have seen numerous examples of statistically unsound conclusions made and called science. Fauci et. al made this very apparent during Covid, but it only showed the top of a dangerous iceberg beneath. RFK is no better than Fauci on the autism or food additives in that he is starting with an agenda and trying to prove it with “science”. As a food professional, I find the current FDA a mess on food science, but often the prior versions under Obama, Biden and Trump 1 were examples of a relatively unresponsive bureaucracy. At least the RFK shake-up is overturning thst bureaucracy. The issue is, replaced by what? I have read numerous scientific studies on food dyes (majority actually following the scientific method properly) and the link to health issues is weak and not truely cause and effect, and any connection appears to be tied to the genetics of the person intersecting with the use of the dye. The same goes for the ultraprocessed food debate RFK has kicked off. Now we have individual states legislating allowable food additives vs. a national approach, which is nuts, but a response to a lack of transparency for decades by the FDA. We are becoming more and more like the European Union in this regard, following the pattern called the “precautionary principle” that is a prime cause of the innovative stasis there. RFK’s HHS leadership isn’t helping, other than maybe being more transparent. The scientific method is under attack by political/social agendas and we need a return to freedom of speech and inquiry in all our research institutions, whether government, academic or corporations. How we get there? I doubt we have the fortitude to do so currently.

  15. Thank you Dr. Franklin. I think Mr. Lee was spot on; fair intelligent and in formed. Others remarked about the politicization of science. Unfortunately, everything has been politicized, monetized, and manipulated to funnel cash up to a relative handful of ghouls who don’t care if we live or die.

    As for Mr. Kennedy, I’m torn because he has some great perspective and has done some good things as secretary of HHS. He was irresponsible in how he handled this autism issue, and tends to be a bit of a grandstander.

    It is shameful how the government allows all of this waste of our treasure, and how we allow the media and cretinous politicians to divide us so.

    We may not know what definitively causes the myriad of illnesses and diseases, but we do know that the chemicals other garbage we sell as food are killing us. Kennedy has brought much attention to our food supply. I think more local sourcing is necessary. I think less preservative would be necessary if this was done. it would provide jobs and keep more family farms viable.

    We know regular exercise and a healthy diet, and a healthy social life are linked to wellness and longevity. Yet, our own government allows our citizens air, water, and food to be poisoned.

    Any way, thanks for a good cup of moderation and common sense. I also agree with you about the 1985 Bears. They should have won multiple titles. Injury to McMahon and letting Wilbur Marshall leave were the main things that did them in.

  16. For one who hates additives, dyes, pain medications, etc RFK stuffs, injects, swallows multiple drugs, hormones, so called vitamins to make his body look like a 30 year old weight lifter yet has a old face ravaged by drugs, alcohol etc. Not a good look Bobby.

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