Autism and Political Careers

In The Politics of Autism, I write:  "Support from the general public will be an important political asset for autistic people. Another will be their sheer numbers, since a larger population of identified autistic adults will mean more autistic voters and activists."  Previous posts have discussed autistic officeholders and political candidates in California,  New York, Georgia, Texas, and Wisconsin.

Friedman, Sally, Kennedy Cox, and Richard K. Scotch. 2026. "Autism and Political Careers: Navigating Political Leadership" Societies 16, no. 2: 67.   https://doi.org/10.3390/soc16020067.  Abstract:

Individuals on the autism spectrum have been stigmatized as not being expected to engage in certain activities, such as interpersonal interaction and communication, which are related to the capacity to exercise leadership and may have implications for their capacity to effectively function in political roles. In this paper, we profile four politicians (who happen to be state legislators) with autism who have beaten the odds with electoral success. We examine their routes to office, their range of activities, including how they represent autism, and the intersectionalities (in addition to autism) that impact their lives.

From the article:

More specifically, we profile four state legislators who self-identify as on the autism spectrum. Jessica Benham and Abigail Salisbury (both Democrats) currently represent the 36th and 34th districts, respectively, in Pennsylvania. Benham was first elected in 2020, and Salisbury in a special election in 2022. Briscoe Cain (R), in office since 2017, represents the 128th district in Texas and is running for Congress in one of the areas involved in the current mid-stream redistricting controversies. Yuh-Line Niou (D) represented the 65th district in New York between 2017 and 2022, when she engaged in what turned out to be an unsuccessful run for Congress. While these are the only elected officials our searches turned up as identified as autistic, as Cain’s story below shows, autism, under some circumstances, can be an invisible disability if or until an individual chooses to “come out.” Given the stigma, the choice not to divulge may make sense for many. Despite the notable stereotypes attached to people on the autism spectrum and acknowledging that the people studied here are “highly functioning,” these four legislators have, nonetheless, by virtue of their political careers, taken on leadership roles. As such, they are involved in the many and varied activities generally engaged in by state legislators. We focus below on their backgrounds/roots to political office, their “autism journey,” their activities as state representatives, and the several intersectionalities that are part of their lives.

 

Lawyers and Autistic Defendants

In The Politics of Autism, I discuss interactions between the justice system and autistic people.

Caliman, C. R., and C. M. Berryessa. 2025. “ Legal Defense of Autistic Defendants in the United States: A Qualitative Analysis of the Experiences of Legal Professionals.” Journal of Social Issues 81, no. 4: e70034. https://doi.org/10.1111/josi.70034. Abstract:

Autistic individuals encounter distinct barriers within the criminal-legal system, such as misinterpretations of their behaviors, a lack of accommodations, and systemic biases. Despite growing understanding of these challenges, research on how defense attorneys understand and advocate for autistic clients remains limited. This study explores how defense attorneys in the United States conceptualize autism and apply neurodiversity-informed strategies in their advocacy. Semi-structured interviews with 31 defense attorneys revealed that while most attorneys view autism through a medicalized lens, they acknowledge the need for better strategies to secure accommodations in court. Findings suggest that attorneys often rely on expert testimony and recognize the courtroom as primarily designed for neurotypical individuals. Gaps in training and understanding about neurodiversity may hinder effective defense strategies and limit access to justice for autistic defendants. This research highlights the urgent need for enhanced legal training and systemic reform to improve representation and legal experiences for autistic individuals.

From the article:

When applied to the representation of autistic clients, the assumptions underlying the adversarial model, such as a shared understanding of rational legal strategy, communication norms, and courtroom participation, can pose significant challenges. From a procedural perspective, defense attorneys must provide effective counsel by constructing the best possible defense strategy, negotiating plea deals when appropriate, and ensuring their clients are competent to stand trial. This requires legal expertise and an understanding of their clients’ ability to participate in legal proceedings (Smith 2013). Autistic individuals may experience sensory overload, difficulty with language, and distinct social communication styles that affect how they receive and process legal information (Faccini and Burke 2021; Taylor et al. 2009). For example, a client may nod in agreement while masking confusion or distress, leading attorneys to overestimate comprehension and proceed with legal strategies the client does not fully understand (Cooper et al. 2020).

In response to these limitations, alternative frameworks such as therapeutic jurisprudence have emerged to expand how legal professionals conceptualize their roles. Rather than focusing solely on legal outcomes and adversarial performance, therapeutic jurisprudence encourages attorneys to consider how legal processes and strategies affect their clients' emotional, psychological, and cognitive well-being (Wexler 2004; Winick 1999). For defense attorneys working with neurodivergent individuals, this might mean advocating for courtroom accommodations, using adapted communication techniques, or helping secure external supports that foster more accessible legal participation (Berryessa and Caliman 2026). However, the extent to which attorneys should actively intervene in shaping their clients’ legal experience remains a debated ethical issue.

 

Vaccines and the Midterm

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

In mid-March, the US has already had more measles cases than in all of 2024.

Amanda Seitz and Stephanie Armour at KFF:

Trump’s top pollster, Tony Fabrizio, cautioned in December that an embrace of Kennedy’s anti-vaccine policies could cost politicians their jobs this year.

Eight in 10 MAHA voters and 86% of all voters believe vaccines save lives, his poll of 1,000 voters in 35 competitive districts found.

“In the districts that will decide the control of the House of Representatives next year, Republican and Democratic candidates who support eliminating long standing vaccine requirements will pay a price in the election,” a memo on the poll stated.

The White House has since shaken up senior staffing at HHS, including removing Jim O’Neill from the deputy secretary role and his job as acting director of the Centers for Disease Control and Prevention, in which he curtailed the agency’s childhood vaccination recommendations. Ralph Abraham, a vaccine skeptic who as Louisiana’s surgeon general suspended its vaccination promotion program last year, stepped down as the CDC’s principal deputy director in late February.

Jay Bhattacharya, a doctor who said in congressional testimony that he doesn’t believe vaccines cause autism, is now running the CDC in addition to directing the National Institutes of Health.

Though Trump himself has frequently espoused doubts and mistruths about vaccines, polling around anti-vaccine policy has undoubtedly shaken the White House’s confidence during a tough midterm election year, said former U.S. Rep. Larry Bucshon, an Indiana Republican and retired doctor who left Congress last year.

Bucshon said Republicans can’t risk alienating voters, especially parents of young children who might be moved by Democratic attack ads on the topic at a time when hundreds of measles cases are popping up across the U.S.

“That’s the reason you’re seeing the White House get nervous about it,” Bucshon said. “This is just the political reality of it.”

1,362 Measles Cases

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   

 Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Jim Wappes at CIDRAP

The US measles total grew by 81 cases this week, to 1,362 confirmed infections, the Centers for Disease Control and Prevention (CDC) said today in its weekly update.

In addition, yesterday local and federal officials detailed New Mexico’s response to its 99-case measles outbreak last year, including a 55% increase in uptake of the measles, mumps, and rubella (MMR) vaccine, according to a paper in Morbidity and Mortality Weekly Report (MMWR).

The CDC confirmed 2,284 measles cases for all of last year, which was a 35-year high. The country could well exceed that total before summer. The United States will likely lose its measles elimination status—which it gained in 2000—in November, when officials assess all the new data.

The CDC said all but nine of the 2026 cases are from 30 states and New York City, with the rest travel-related. With two new outbreaks confirmed this week, the nation now has 14 outbreaks this year. Of all confirmed cases, 94% are associated with an outbreak.

Leucovorin Walkback

 A number of posts discussed Trump's support for discredited notions about autism A September news conference was a firehose of lies.

Ariana Eunjung Cha and Rachel Roubein at WP:

Nearly six months ago, federal health officials gathered at the White House with President Donald Trump and vowed to “go bold” on autism. They sketched out plans for what they described as an “exciting treatment” for children with the condition — a decades-old drug, leucovorin, newly recast as a potential breakthrough.

“Hundreds of thousands of kids, in my opinion, will benefit,” Food and Drug Administration Commissioner Marty Makary said at the time.


But the administration is scaling back that vision. FDA announced Tuesday that it will expand approval for leucovorin, but only for a separate condition that some people with autism also have — not for autism itself.

...
“When we first started considering the ability to expand an indication for leucovorin, we did consider broadly whether there was data to support its use in a broader autism spectrum disorder population,” said a senior agency official.


But a systematic review of the literature led the agency to focus elsewhere. The “strongest data,” officials said, were concentrated among patients with the genetic form of cerebral folate deficiency, a condition they estimate affects “less than one in a million” people.
...


The initial press conference in September where Trump and his aides touted the prospect of expanding the drug’s use triggered immediate pushback. The president separately blamed Tylenol for causing autism — a claim without a proven link — and many in the medical establishment questioned the idea of prescribing leucovorin for a much broader population. Professional societies and individual physicians alike warned that the evidence base was thin.

A decades-old drug typically used alongside chemotherapy, leucovorin has been tested for autism-related symptoms in only a handful of small clinical trials in the United States and abroad. Some studies suggested modest gains in speech and behavior. But the data fell far short of the rigorous, large-scale evidence the FDA generally requires before granting approval for a new use.

The largest of the leucovorin-autism studies was retracted by the European Journal of Pediatrics on Jan. 29; after the authors acknowledged some errors, the editors wrote that the publication “no longer has confidence in the validity of the results and conclusions reported in this article.”

Autism Business

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.   Scams plague the world of autism. Some involve shady or abusive providers.

Christopher Weaver, Tom McGinty, and Anna Wilde Mathews at The Wall Street Journal:

The business of providing therapy to children with autism has surged in recent years across the U.S., fueled by taxpayer-funded Medicaid payments. Some companies have found lucrative opportunities to capitalize on the growing need for such care, sometimes outpacing regulators’ oversight, the Journal’s analysis found.

The number of companies offering such therapy—individualized treatments meant to help patients manage behavior and develop daily living and social skills—almost doubled between 2019 and 2023. Direct payments from state Medicaid programs to autism therapy providers grew to $2.2 billion in 2023, from $660 million just four years earlier, according to the data. Private insurers administering Medicaid benefits paid hundreds of millions more.

That made applied behavior analysis, or ABA, as the therapy is called, the fastest-growing service in Medicaid, the state-run program for low-income and disabled people. Federal taxpayers financed about 70% of Medicaid spending during that period. Entrepreneurs and investors, including some private-equity firms, have piled into the business.

 ...

Indiana became the nation’s hotbed of the booming autism therapy industry, home to nine of the top 10 providers by per-patient spending in 2023. A big part of that was because the state started reimbursing providers 40% of whatever they billed. Unlike the fixed prices that most states use to cap costs, Indiana’s approach became a kind of blank check and therapy providers flooded in to take advantage of the generous reimbursements.

Medicaid spending on autism surged—from $21 million in 2017 to $611 million in 2023, according to a state report.

“Over time you saw an explosion of the children who were diagnosed and in billing practices that in my opinion were the epitome of abuse,” said Mitch Roob, the current secretary of the state’s Family and Social Services Administration and interim Medicaid director.

No one monitored providers’ billing practices during those years, said Roob, who was appointed last year. “If you’re a kid and no one was looking at the cookie jar and the lid was off, would you take another one?”

...

The state scrapped the old billing system in 2024, replacing it with a flat rate of $68 an hour for services paid for by the state. Officials are planning an additional 6% cut this year and also plan to cap lifetime hours of service at 4,000 per child.

IACC Cancels Meeting

In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

RFK Jr. has stacked it with his own type of people.

 Allison Parshall at Scientific American:

The government’s advisory board on autism research has cancelled a public meeting scheduled for March 19. This would have been the first public meeting of the Interagency Autism Coordinating Committee (IACC), a group that guides federally funded autism research, since health secretary Robert F. Kennedy, Jr., entirely overhauled the group’s membership in January. He appointed 21 new members, some of whom are vaccine skeptics.

The news of the cancellation broke on March 7, the same week that a group of autism experts formed an independent group to counter misinformation. This outside group, which calls itself the Independent Autism Coordinating Committee (I-ACC), scheduled a meeting on the same day as the federal IACC meeting. The rival group includes several former members of the federal advisory board.

Fraud

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.   Scams plague the world of autism. Some involve shady or abusive providers.

Wall Street Journal editorial:

Federal investigators are uncovering new layers of fraud in government programs, with a Minnesota man pleading guilty last week to bilking Medicaid by setting up a sham autism center. Meantime, a federal audit last week revealed how Medicaid autism treatment has become an open vault for fraud and abuse.

...

Minnesota is far from alone, judging by audits by the U.S. Health and Human Services Department’s Inspector General of Medicaid autism spending in other states. An IG audit released last week estimated that 99% of Colorado’s Medicaid payments in 2022 and 2023 for autism treatment were improper or likely improper, totalling $285.2 million.

Nearly all providers failed to submit the required documentation for at least some claims, and a quarter billed the state for treatment provided by staff without appropriate credentials. Many autism centers billed Medicaid at more than $50 an hour for autism “treatment” when children were playing games, napping or eating. Many provided little more than glorified day care.
...

The IG notes that the state failed to do a “postpayment review of payments” to verify compliance with state and federal requirements. Recent IG audits of autism treatment providers in Maine, Wisconsin and Indiana have turned up similar problems. Providers frequently billed for more hours of treatment than they provided, charging Medicaid as much as $256 an hour in Indiana.

Autism treatment was often “provided by staff who did not have the appropriate credentials” and “to children who did not receive the required diagnostic evaluations or treatment referrals,” the IG reported in its Indiana review. In Wisconsin, records from 19 of 22 audited providers showed that Medicaid was billed for time spent in recreational activities.

Maine Medicaid pays for clinical specialists to work with autistic children in their homes. Yet the IG found that roughly half of children lacked documentation of an autism diagnosis or evaluation, and some 20% of providers didn’t substantiate their credentials to provide therapy. Questionable autism payments totaled $68 million in 2023 alone.

Inclusion: It's Complicated

 In The Politics of Autism, I write about special education and inclusion.

Dwyer, P., Nosova, E., Kermond, C., & Leadbitter, K. (2026). Inclusion, but not necessarily integration: Centring student perspectives and needs in education. Autism, 0(0).

The concept of inclusion is central to educational research and policy, with international conventions recognising disabled children’s right to inclusive education (United Nations, 2006, art. 24). However, inclusion is defined and understood in many different ways (Cigman, 2007; Dwyer, 2023; Winzer, 2009). Sometimes, educational inclusion is a synonym for integration: physical placement of disabled and neurodivergent students alongside non-disabled and neurotypical students (e.g. Dalgaard et al., 2022), although this could involve autistic people merely being tolerated, or having to adapt to the majority’s preferences (Weaver et al., 2021). Today, the dominant definition of inclusion – especially in the Global North – could be called ‘integration plus’: integration with supports so that all students can fully participate in diverse school communities and experiences (e.g. Ferguson, 1995; Pellicano et al., 2018). However, making an environment work well for everyone is not easy, and some autistic young people have articulated the basis of a radically different understanding of inclusion that one might call ‘integration-agnostic’. They suggested that inclusion is about belonging, being supported and feeling valued, regardless of whether one’s peers are neurotypical/non-disabled or neurodivergent/disabled (Goodall, 2020). We argue that a similar integration-agnostic understanding has the potential to transform education systems by increasing meaningful inclusiveness.

Trump Got Pregnant Women to Take Less Tylenol

 A number of posts have discussed Trump's support for discredited notions about autism The Sept 22 White House news conference was a firehose of lies. The next month, he posted an unfounded warning about Tylenol.  RFK then tiptoed away from the idea that it definitely causes autism.  A BMJ lit review debunked the idea. A Lancet review did likewise.

Sydney Lupkin at NPR:

President Trump told pregnant women in September 2025 to avoid Tylenol because taking it would increase their babies' risk of autism: "Taking Tylenol is not good — I'll say it: It's not good."

Doctors and scientists quickly said the data didn't support the president's claim, but emergency room orders for Tylenol, or acetaminophen, for pregnant patients went down 10% in the months that followed, according to a new study in The Lancet. There was no change in the acetaminophen orders for comparable women who weren't pregnant.

"It happened overnight," says Dr. Jeremy Faust, an emergency physician at Brigham and Women's Hospital in Boston who led the study. The president's words "had an immediate impact on how much Tylenol or acetaminophen was being ordered in emergency departments."

It's not clear from the study whether patients declined to take Tylenol or doctors prescribed it less. Faust says it's probably some combination of the two.

"This is thousands of women not getting pain control or not getting fever reduction when they need it, when they want it, when they would benefit from it," Faust says.

The study was limited to emergency department visits and didn't account for women considering Tylenol at home. The data came from electronic health records from more than 1,600 hospitals.

Dr. Caleb Alexander, an epidemiology professor at Johns Hopkins Bloomberg School of Public Health, says the response to Trump's White House announcement didn't surprise him.

"Words matter," he says. "And when they come from someone with as big an audience as the president of the United States, they can change prescriber and patient behavior."

Still, he says it's reassuring that the study found Tylenol use was returning to normal by December. He says it usually takes more than a single event to change prescribing patterns long term.

Although the president and his health team spoke in the fall about updating Tylenol's label, that hasn't happened. Tylenol consumption "improved" in December, Kenvue, the company that makes Tylenol, told investors last month.

IDEA Autism Numbers

In The Politics of Autism, I write about social services, special education, and the Individuals with Disabilities Education Act (IDEA)

From the Advocacy Institute:

The U.S. Dept. of Education has released new data on students with disabilities (eligible under the Individuals with Disabilities Education Act or IDEA). Section 618 of the IDEA requires that each state annually submit data about the infants and toddlers, birth through age 2, who receive early intervention services under Part C of IDEA, and children with disabilities, ages 3 through 21, who receive special education and related services under Part B of IDEA.

The new data show the number of IDEA-eligible children ages 3-21 in 2024 increased significantly from 2023, which also showed a 3% increase.

...

The distribution across IDEA’s 13 disability categories of school age students (ages 5 (in kindergarten) to 21) in 2024 showed increases in the autism, multiple disabilities and developmental delay categories while other categories remained relatively unchanged. The increase in the autism category accounted for 40% of the total increase in 2024. Autism now accounts for nearly 15% of all school age students with disabilities.

Low Confidence in RFK Jr.

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   

 Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Annenberg Public Policy Center (APPC) of the University of Pennsylvania survey, conducted Feb. 3-17, 2026, among a nationally representative sample of 1,650 U.S. adults. Highlights;

• :Career scientists vs. health agency leaders: Two-thirds of Americans (67%) have confidence in career scientists working at U.S. federal health agencies, compared with just 43% confidence in agency leaders overall.
• RFK Jr. and Dr. Oz: About 4 in 10 U.S. adults are confident Health and Human Services Secretary Robert F. Kennedy Jr. (38%) and Dr. Mehmet Oz (42%), administrator of the Centers for Medicare and Medicaid Services, are providing trustworthy information on public health – lower than the confidence people say they had in Dr. Anthony Fauci (54%), former head of the National Institute of Allergy and Infectious Diseases, when he was in office.
• Confidence in experts outside government: People have greater trust in major health and science associations outside government – such as the American Heart Association, American Academy of Pediatrics, American Medical Association, and National Academy of Sciences – than in U.S. health agencies.
• AAP vs. CDC: On vaccinating newborns for hepatitis B, Americans say they are more likely to accept the advice of the American Academy of Pediatrics than the CDC by nearly a 4-1 margin.
• Trust in CDC, FDA, NIH sinking: Year over year in February surveys, public trust in the CDC, FDA, and NIH dropped significantly from 2024 (74%-76%), the final year of the Biden administration, to 2025 (67%), the first year of this Trump administration – and fell again, now, in 2026 (60-62%).

Shadow IACC

In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

RFK Jr. has stacked it with his own type of people.

Lena H. Sun at WP:

A group of prominent scientists launched an independent autism advisory panel Tuesday over fears that Health Secretary Robert F. Kennedy Jr. has politicized the key federal autism advisory board he oversees.

The shadow committee will focus on developing a coordinated scientific agenda for autism research and will function as a counterweight to the advisory board Kennedy reshaped in January by appointing new members. Many of those members have echoed his controversial views, including promoting debunked claims linking vaccines to autism and advocating for unproven treatments.

The new independent group will do more than speak out against misinformation, Alison Singer, president of the Autism Science Foundation and member of the group, said in a statement Tuesday. The group will create a research agenda that reflects the progress and promise of autism science and report annually on key research advances, including basic research on genes and cells, environmental causes, early detection, therapeutics and services.

The new panel, to be called the Independent Autism Coordinating Committee, includes experienced scientists and advocates who have funded and conducted autism research for many decades, including two past directors of the National Institute of Mental Health, Joshua Gordon and Tom Insel. It is set to hold its first meeting on March 19, the same day as the federal panel.