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.
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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 15
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.
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
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.
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.
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.
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.
I do not understand the drastic response- is the preferred scenario where the government suspects a relationship and keeps it secret?
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!
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
I agree. I firmly believe there is no such thing as “settled science”. The very basis of science is to question.
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.
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.
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.
Humility is essential to good science. But humility is in short supply today.
Humility and hence impartiality are essential not only for Autism and or any research but for everyday life.-Nambi