Bruce, you are of course correct. But the argument is even stronger than what your wrote here.
First, yes, it's the rate of occurrence that matters - not just autism prevalence. Rate of occurrence, i.e. incidence, of autism is measured by the birth year cohort prevalence. And that's exactly what the CDC measured, even though they called it (plain) prevalence.
Second, not only is it true that the increased rate of occurrence cannot be fully explained by changes in diagnosis, awareness and genetics, the real question is whether ANY of it could actually have been caused by those factors. The evidence indicates they could not.
I could certainly explain all of that in detail. But I am keeping this short since it's just a comment.
Alex: Thank you for your thoughtful and expert comments. The CDC reports autism prevalence through repeated cross-sectional surveys, but what's being revealed looks very much like an increase in incidence. I also agree that the true rise in autism likely exceeds what the CDC reports, especially when you consider studies that try to adjust for diagnostic drift and earlier age of diagnosis.
My wife is a developmental pediatrician who has evaluated children for autism and related neurodevelopmental conditions for over 30 years. She has always tried to apply the diagnostic criteria consistently. Still, it’s hard to believe diagnostic practices haven’t shifted—especially when public funding for autism services has surged, while support for other neurodevelopmental conditions has remained flat or even declined. In British Columbia, families whose children younger than 6 years are diagnosed with autism are eligible for $22,000 annually for interventions; families whose children are 6 to 18 years are eligible for $6,000 annually.
I’ve only conducted a handful of studies on autism or autism traits, and don’t consider myself an expert in this area, but Irva Hertz-Picciotto's 2009 study convinced me the rise in autism is real—and substantial.
That’s why it’s long past time for an independent scientific committee—like the National Academies of Sciences, Engineering, and Medicine (NASEM)—to formally review the evidence and reach a conclusion. The failure to do so leaves a vacuum. Without clear, authoritative guidance, we continue to debate what the data mean while families, educators, and health systems face the consequences. Uncertainty is not neutral. It delays action, undermines trust, and keeps us from understanding what's really happening—and why.
Kristen: Thank you! I am thoroughly enjoying the freedom of writing outside of the usual format of science and medical journals. I hope you are doing well amid the political frenzy. Cheers from Bowen Island, Bruce
Glad to find you on here! New to Substack but increasingly compelled by the need for scientists to do more in the public communication realm (and always inspired by your work in this space). Will follow with interest!
Thank you for writing about this. I am also curious about the effects of the parents' exposures when they were in utero or early developmental years that can pass along to their children and increase risk or combine with genetic susceptibility as a tipping point. Keep up the good work and fight for all of us!
Thank you ElizW! I'll work on a future post of epigenetics. I am not an expert in epigenetics, but I can pull together some of the evidence showing how toxic chemicals alter the epigenome. Ananda Card also brought up the same topic.
Thanks so much for this...I was comforted to read of another grandparent probing the mystery of autism...and a Canadian researcher at my husband's alma mater. I'm a cross town UBCer. I was happy to see the Trump administration talking about autism...not for what they said, but for the many researchers who have responded. In all the articles that I have read I've not seen any discussion about the effect of the dysbiotic microbes found in the guts of children with autism. The Echo Consortium study has identified a predictive microbial signature seen as young as six weeks. The neurodamaging metabolic byproducts (i.e. p-creosol) are found in the blood of infants. Researchers at the University of Arizona are proposing a screening blood test at birth. They are hoping to have FDA approval for Microbial Transfer Therapy for Pitt Hopkins Disease by next year. They are then embarking on a larger study to confirm (or not) the beneficial effects seen treating children with autism with MTT. The question remains...where are the infants getting their dysbiotic population of microbes from? It seems reasonable to assume that these microbes are passed vertically to the immune naive fetus...the dysbiotic population colonizing and impairing neuronal development. While a great deal of focus is on the pollutants in our environment I think it is important to ask the questions...what are they doing to the microbes that are essential for a healthy life.
On another note...my grandson has profound non-verbal autism. Allopathic medications and ABA have not been helpful. After careful review of risks and rewards we started leucovorin 6 weeks ago. There are some promising changes but I think it is too early to form a conclusion yet.
Doreen: Thank you for your note and thoughtful comments. It’s troubling to see grandchildren struggle with activities we once took for granted, especially the social interactions that are so central to being human. I’ve followed some of the work on the microbiome, though I wouldn’t call myself an expert. Still, I think you are asking the right questions: what upstream risk factors or exposures contribute to a dysbiotic microbiome and, in turn, to the development of autism? Pollutants may well play a role. I advised on a study that found in utero arsenic exposure altered the microbiome, which was linked to smaller newborns and a higher risk of wheeze in children. Best regards, Bruce
Thanks Bruce for your work and your response. I'll continue my way down the microbiome rabbit hole...I find it fascinating. New research coming pretty regularly...the above link popped up this morning.
What about… epigentic influences after a 20th century of global lead poisoning. Take that and combine it with al the modern chemicals/plastics/pesticides…? Would be simple to figure that out (haha).
Ananda: A few studies have suggested that lead may increase some autistic behaviors, but I would be surprised if it is a major contributor since lead exposure has been declining at the same time autism was on the rise.
Indeed. But inherited epigentic changes would mean this generation’s kids wouldn’t need direct lead exposure to be more susceptible if the influence came from their parents (or more likely grandparents and great grandparents).
Phil: As an epidemiologist, I have no clinical training. But I believe we all end up the way we do through a mix of possible exposures—nutrients, pathogens, toxic chemicals (including alcohol)—interacting with our genes during development. I don’t know if we’ll ever be able to fully untangle those influences. But when exposure to a specific toxin, like alcohol, or infection, like rubella, is high—or a key nutrient is missing—it can produce a clear syndrome or recognizable pattern. Otherwise, most of us land somewhere along various spectra.
No mention of vaccines? You know, we all know, that hundreds of thousands (millions?) of parents report that their children were fine until they got their 2 month, 4 month, 6 month, or 18 month vaccine shot which resulted in fevers, seizures and diagnoses of autism. Many have video evidence of their normal happy and engaged children from the days before the vaccine and their non-responsive effect and loss of language in the week after the vaccine.
We also know that the first cases of autism (about a dozen) were identified in the late 1940s. Childhood vaccines for DPT began in the 1930s. In 1970, the incidence was 1:10k and blamed on "refrigerator moms".... vaccines began to become much more routine in the 1970s. But the autism explosion really began in the 1990s after the CDC began expanding the childhood vaccine schedule subsequent to the removal of Pharma liability for any vaccine on the schedule in 1986. And lets not forget the drastic change in OBGYN care about 2011 when we began giving pregnant women vaccines such as the DPT and flu shot.
The most significant environmental change for babies and young children has been the tsunami of vaccines injected into their bodies. Full stop.
Maggie, thank you for your comment. My research—and that of many of my colleagues in environmental epidemiology—points to toxic chemicals like air pollution, phthalates, pesticides, and Bisphenol A as key contributors, often interacting with common genes or nutrient deficiencies (e.g., folate). You can read more about this in my earlier posts.
There are hundreds of thousands of similar stories. This one is striking because it was healthy and normal fraternal triplets who never recovered. I believe that in their early teens, only one was even toilet trained.
Bruce good morning from Cincinnati (we're back visiting family)... sorry to restart an earlier topic - I'm having trouble playing nice with Bluesky, keep losing the post link.
My questions about FASD and ASD are less about direct causation, vs epigenetic confusions, as well as FASD cognitive deficits and emotional lability stuff adding to individual ASD baselines.
[eg, developmental verbal apraxia is a common FASD early delay that seems to be normalizing, esp boys]
And all that lost in the trouble around accurate pregnancy history of maternal use (esp early "before I knew", and "how dare you threaten my well-deserved daily glass of wine"). You cant stratify missing data
Please don’t discount the most insidious and universal pollutant, impossible to detect physically, impossible to avoid, yet being strengthened without any warning or permission……..the elephant, or should I say, the behemoth in the world…….the 5G++++invasion of the natural world!
Bruce, you are of course correct. But the argument is even stronger than what your wrote here.
First, yes, it's the rate of occurrence that matters - not just autism prevalence. Rate of occurrence, i.e. incidence, of autism is measured by the birth year cohort prevalence. And that's exactly what the CDC measured, even though they called it (plain) prevalence.
Second, not only is it true that the increased rate of occurrence cannot be fully explained by changes in diagnosis, awareness and genetics, the real question is whether ANY of it could actually have been caused by those factors. The evidence indicates they could not.
I could certainly explain all of that in detail. But I am keeping this short since it's just a comment.
Alex: Thank you for your thoughtful and expert comments. The CDC reports autism prevalence through repeated cross-sectional surveys, but what's being revealed looks very much like an increase in incidence. I also agree that the true rise in autism likely exceeds what the CDC reports, especially when you consider studies that try to adjust for diagnostic drift and earlier age of diagnosis.
My wife is a developmental pediatrician who has evaluated children for autism and related neurodevelopmental conditions for over 30 years. She has always tried to apply the diagnostic criteria consistently. Still, it’s hard to believe diagnostic practices haven’t shifted—especially when public funding for autism services has surged, while support for other neurodevelopmental conditions has remained flat or even declined. In British Columbia, families whose children younger than 6 years are diagnosed with autism are eligible for $22,000 annually for interventions; families whose children are 6 to 18 years are eligible for $6,000 annually.
I’ve only conducted a handful of studies on autism or autism traits, and don’t consider myself an expert in this area, but Irva Hertz-Picciotto's 2009 study convinced me the rise in autism is real—and substantial.
That’s why it’s long past time for an independent scientific committee—like the National Academies of Sciences, Engineering, and Medicine (NASEM)—to formally review the evidence and reach a conclusion. The failure to do so leaves a vacuum. Without clear, authoritative guidance, we continue to debate what the data mean while families, educators, and health systems face the consequences. Uncertainty is not neutral. It delays action, undermines trust, and keeps us from understanding what's really happening—and why.
As always- well written and a great summary!
Kristen: Thank you! I am thoroughly enjoying the freedom of writing outside of the usual format of science and medical journals. I hope you are doing well amid the political frenzy. Cheers from Bowen Island, Bruce
Glad to find you on here! New to Substack but increasingly compelled by the need for scientists to do more in the public communication realm (and always inspired by your work in this space). Will follow with interest!
Thank you for writing about this. I am also curious about the effects of the parents' exposures when they were in utero or early developmental years that can pass along to their children and increase risk or combine with genetic susceptibility as a tipping point. Keep up the good work and fight for all of us!
Thank you ElizW! I'll work on a future post of epigenetics. I am not an expert in epigenetics, but I can pull together some of the evidence showing how toxic chemicals alter the epigenome. Ananda Card also brought up the same topic.
Thanks so much for this...I was comforted to read of another grandparent probing the mystery of autism...and a Canadian researcher at my husband's alma mater. I'm a cross town UBCer. I was happy to see the Trump administration talking about autism...not for what they said, but for the many researchers who have responded. In all the articles that I have read I've not seen any discussion about the effect of the dysbiotic microbes found in the guts of children with autism. The Echo Consortium study has identified a predictive microbial signature seen as young as six weeks. The neurodamaging metabolic byproducts (i.e. p-creosol) are found in the blood of infants. Researchers at the University of Arizona are proposing a screening blood test at birth. They are hoping to have FDA approval for Microbial Transfer Therapy for Pitt Hopkins Disease by next year. They are then embarking on a larger study to confirm (or not) the beneficial effects seen treating children with autism with MTT. The question remains...where are the infants getting their dysbiotic population of microbes from? It seems reasonable to assume that these microbes are passed vertically to the immune naive fetus...the dysbiotic population colonizing and impairing neuronal development. While a great deal of focus is on the pollutants in our environment I think it is important to ask the questions...what are they doing to the microbes that are essential for a healthy life.
On another note...my grandson has profound non-verbal autism. Allopathic medications and ABA have not been helpful. After careful review of risks and rewards we started leucovorin 6 weeks ago. There are some promising changes but I think it is too early to form a conclusion yet.
Doreen: Thank you for your note and thoughtful comments. It’s troubling to see grandchildren struggle with activities we once took for granted, especially the social interactions that are so central to being human. I’ve followed some of the work on the microbiome, though I wouldn’t call myself an expert. Still, I think you are asking the right questions: what upstream risk factors or exposures contribute to a dysbiotic microbiome and, in turn, to the development of autism? Pollutants may well play a role. I advised on a study that found in utero arsenic exposure altered the microbiome, which was linked to smaller newborns and a higher risk of wheeze in children. Best regards, Bruce
https://www.nature.com/articles/s41522-025-00808-5
Thanks Bruce for your work and your response. I'll continue my way down the microbiome rabbit hole...I find it fascinating. New research coming pretty regularly...the above link popped up this morning.
What about… epigentic influences after a 20th century of global lead poisoning. Take that and combine it with al the modern chemicals/plastics/pesticides…? Would be simple to figure that out (haha).
Ananda: A few studies have suggested that lead may increase some autistic behaviors, but I would be surprised if it is a major contributor since lead exposure has been declining at the same time autism was on the rise.
Indeed. But inherited epigentic changes would mean this generation’s kids wouldn’t need direct lead exposure to be more susceptible if the influence came from their parents (or more likely grandparents and great grandparents).
Ananda: You are absolutely correct - and it would indeed be challenging to figure that out in humans.
Would be challenging to find a control group, that’s for sure.
Phil: As an epidemiologist, I have no clinical training. But I believe we all end up the way we do through a mix of possible exposures—nutrients, pathogens, toxic chemicals (including alcohol)—interacting with our genes during development. I don’t know if we’ll ever be able to fully untangle those influences. But when exposure to a specific toxin, like alcohol, or infection, like rubella, is high—or a key nutrient is missing—it can produce a clear syndrome or recognizable pattern. Otherwise, most of us land somewhere along various spectra.
Eating organic whole plant food with lots of fibre and avoid vaccines too. https://jowaller.substack.com/p/mmr-and-autism
No mention of vaccines? You know, we all know, that hundreds of thousands (millions?) of parents report that their children were fine until they got their 2 month, 4 month, 6 month, or 18 month vaccine shot which resulted in fevers, seizures and diagnoses of autism. Many have video evidence of their normal happy and engaged children from the days before the vaccine and their non-responsive effect and loss of language in the week after the vaccine.
We also know that the first cases of autism (about a dozen) were identified in the late 1940s. Childhood vaccines for DPT began in the 1930s. In 1970, the incidence was 1:10k and blamed on "refrigerator moms".... vaccines began to become much more routine in the 1970s. But the autism explosion really began in the 1990s after the CDC began expanding the childhood vaccine schedule subsequent to the removal of Pharma liability for any vaccine on the schedule in 1986. And lets not forget the drastic change in OBGYN care about 2011 when we began giving pregnant women vaccines such as the DPT and flu shot.
The most significant environmental change for babies and young children has been the tsunami of vaccines injected into their bodies. Full stop.
Maggie, thank you for your comment. My research—and that of many of my colleagues in environmental epidemiology—points to toxic chemicals like air pollution, phthalates, pesticides, and Bisphenol A as key contributors, often interacting with common genes or nutrient deficiencies (e.g., folate). You can read more about this in my earlier posts.
P.S. Dr. Toby Rogers has a lot of hyperlinks to science in his Substack articles. Start with this post: https://tobyrogers.substack.com/p/the-political-economy-of-autism
I have, Bruce. However, you are compounding the errors of omission in your source material.
I am reminded of several aphorisms:
1 - You don't find what you don't look for.
2 - People believe what they want to believe.
3 - Data does not lie, but scientists do.
If you haven't spent time watching videos from the parent interviews on CHD, yet, I suggest you begin with the one on the fraternal triplets who all shut down within hours of a single vax: https://live.childrenshealthdefense.org/chd-tv/events/vaxxed-stories/vaxxed-healthy-triples-all-show-signs-autism-within-hours-vaccination/
There are hundreds of thousands of similar stories. This one is striking because it was healthy and normal fraternal triplets who never recovered. I believe that in their early teens, only one was even toilet trained.
Maggie: Thank you.
Bruce good morning from Cincinnati (we're back visiting family)... sorry to restart an earlier topic - I'm having trouble playing nice with Bluesky, keep losing the post link.
My questions about FASD and ASD are less about direct causation, vs epigenetic confusions, as well as FASD cognitive deficits and emotional lability stuff adding to individual ASD baselines.
[eg, developmental verbal apraxia is a common FASD early delay that seems to be normalizing, esp boys]
And all that lost in the trouble around accurate pregnancy history of maternal use (esp early "before I knew", and "how dare you threaten my well-deserved daily glass of wine"). You cant stratify missing data
Please don’t discount the most insidious and universal pollutant, impossible to detect physically, impossible to avoid, yet being strengthened without any warning or permission……..the elephant, or should I say, the behemoth in the world…….the 5G++++invasion of the natural world!