Connect with us

Science

RFK Jr. wants an answer to rising autism rates. Scientists say he’s ignoring some obvious ones

Published

on

RFK Jr. wants an answer to rising autism rates. Scientists say he’s ignoring some obvious ones

This week, the Trump administration announced that it was taking “bold action” to address the “epidemic” of autism spectrum disorder — starting with a new safety label on Tylenol and other acetaminophen products that suggests a link to autism. The scientific evidence for doing so is weak, researchers said.

Health and Human Services Secretary Robert F. Kennedy Jr. said federal officials “will be uncompromising and relentless in our search for answers” and that they soon would be “closely examining” the role of vaccines, whose alleged link to autism has been widely discredited.

Kennedy has long argued that rising diagnoses among U.S. children must mean more exposure to some outside influence: a drug, a chemical, a toxin, a vaccine.

“One of the things that I think that we need to move away from today is this ideology that … the autism prevalence increase, the relentless increases, are simply artifacts of better diagnoses, better recognition or changing diagnostic criteria,” Kennedy said in April.

Kennedy is correct that autism spectrum disorder rates have risen steadily in the U.S. since the U.S. Centers for Disease Control began tracking them, from 1 in 150 8-year-olds in 2000, to 1 in 31 in 2022, the most recent year for which numbers are available.

Advertisement

But physicians, researchers and psychologists say it is impossible to interpret this increase without acknowledging two essential facts: The diagnostic definition of autism has greatly expanded to include a much broader range of human behaviors, and we look for it more often than we used to.

“People haven’t changed that much,” said Alan Gerber, a pediatric neuropsychologist at Children’s National Hospital in Washington, D.C., “but how we talk about them, how we describe them, how we categorize them has actually changed a lot over the years.”

Defining ‘autism’

The term “autism” first appeared in the scientific literature around World War II, when two psychiatrists in different countries independently chose that word to describe two different groups of children.

In 1938, Austrian pediatrician Hans Asperger used it to describe child patients at his Vienna clinic who were verbal, often fluently so, with unusual social behaviors and at-times obsessive focus on very specific subjects.

Five years later, U.S. psychiatrist Leo Kanner published a paper about a group of children at his clinic at the Johns Hopkins Hospital in Baltimore who were socially withdrawn, rigid in their thinking and extremely sensitive to stimuli like bright lights or loud noises. Most also had limited verbal language ability.

Advertisement

Both Asperger and Kanner chose the same word to describe these overlapping behaviors: autism. (They borrowed the term from an earlier psychiatrist’s description of extreme social withdrawal in schizophrenic patients.)

This doesn’t mean children never acted this way before. It was just the first time doctors started using that word to describe a particular set of child behaviors.

For the next few decades, many children who exhibited what we understand today to be autistic traits were labeled as having conditions that have ceased to exist as formal diagnoses, like “mental retardation,” “childhood psychosis” or “schizophrenia, childhood type.”

Autism debuted as its own diagnosis in the 1980 third edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Assn.’s diagnostic bible. It described an autistic child as one who, by the age of 2½, showed impaired communication, unusual responses to their environment and a lack of interest in other people.

As the decades went on, the DSM definition of autism broadened.

Advertisement

The fourth edition, published in 1994, named additional behaviors: impaired relationships, struggles with nonverbal communication and speech patterns different from those of non-autistic, or neurotypical, peers.

It also included a typo that would turn out to be a crucial driver of diagnoses, wrote cultural anthropologist Roy Richard Grinker in his book “Unstrange Minds: Remapping the World of Autism.”

The DSM’s printed definition of autism included any child who displayed impairments in social interaction, communication “or” behavior. It was supposed to say social interaction, communication “and” behavior.

The error went uncorrected for six years, and the impact appeared profound. In 1995 an estimated 1 in every 500 children was diagnosed with autism. By 2000, when the CDC formally began tracking diagnoses (and the text was corrected), it was 1 in every 150.

Reaching underserved communities

In 2007, the American Academy of Pediatrics recommended for the first time that all children be screened for autism between the ages of 18 and 24 months as part of their regular checkups. Prior to that, autism was diagnosed somewhat haphazardly. Not all pediatricians were familiar with the earliest indicators or used the same criteria to determine whether a child should be further evaluated.

Advertisement

Then in 2013, the fifth edition of the DSM took what had previously been four separate conditions — autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder — and collapsed them all into a single diagnosis: autism spectrum disorder.

The diagnostic criteria for ASD included a broad range of social, communication and sensory interpretation differences that, crucially, could be identified at any time in a child’s life. The term was no longer limited only to children whose development lagged noticeably behind that of their peers.

Since that definition was adopted, U.S. schools have become more proactive about referring a greater range of children for neurodevelopmental evaluations. The new DSM language also helped educators and clinicians better understand what was keeping some kids in disadvantaged communities from thriving.

“In the past, [autism was] referred to as a ‘white child’s disability,’ because you found so few Black and brown children being identified,” said Shanter Alexander, an assistant professor of school psychology at Howard University. Children of color who struggled with things like behavioral disruptions, attention deficits or language delays, she said, were often diagnosed with intellectual disabilities or behavioral disorders.

In a sign that things have shifted, the most recent CDC survey for the first time found a higher prevalence of autism in kids of color than in white children: 3.66%, 3.82% and 3.30% for Black, Asian and Latino children, respectively, compared with 2.77% of white children.

Advertisement

“A lot of people think, ‘Oh, no, what does this mean? This is terrible.’ But it’s actually really positive. It means that we have been better at diagnosing Latino children [and] other groups too,” said Kristina Lopez, an associate professor at Arizona State University who studies autism in underserved communities.

The severity issue

An autism diagnosis today can apply to people who are able to graduate from college, hold professional positions and speak eloquently about their autism, as well as people who require 24-hour care and are not able to speak at all.

It includes people who were diagnosed when they were toddlers developing at a noticeably different pace from their peers, and people who embraced a diagnosis of autism in adulthood as the best description of how they relate to the world. Diagnoses for U.S. adults ages 26 to 34 alone increased by 450% between 2011 and 2022, according to one large study published last year in the Journal of the American Medical Assn.

Kennedy was not correct when he said in April that “most cases now are severe.”

A 2016 review of CDC data found that approximately 26.7% of 8-year-olds with autism had what some advocates refer to as “profound autism,” the end of the spectrum that often includes seriously disabling behaviors such as seizures, self-injurious behavior and intellectual disability.

Advertisement

The rate of children with profound autism has remained virtually unchanged since the CDC started tracking it, said Maureen Durkin, a professor of population health science and pediatrics at the University of Wisconsin-Madison. Indeed, the highest rate of new diagnoses has been among children with mild limitations, she said.

For many researchers and advocates, the Trump administration’s focus on autism has provoked mixed emotions. Many have lobbied for years for more attention for this condition and the people whose lives it affects.

Now it has arrived, thanks to an administration that has played up false information while cutting support for science.

“They have attempted to panic the public with the notion of an autism epidemic as a threat to the nation, when no such epidemic actually exists — rather, more people are being diagnosed with autism today because we have broader diagnostic criteria and do a better job detecting it,” said Colin Killick, executive director of the Autistic Self Advocacy Network. “It is high time that this administration stops spreading misinformation about autism, and starts enacting policies that would actually benefit our community.”

This article was reported with the support of the USC Annenberg Center for Health Journalism’s National Fellowship’s Kristy Hammam Fund for Health Journalism.

Advertisement

Science

Can fire-resistant homes be sexy? ‘You be the judge,’ says this Palisades architect

Published

on

Can fire-resistant homes be sexy? ‘You be the judge,’ says this Palisades architect

At first glance, it looks like nothing more than a charming Spanish-revival, quintessentially Californian home — but this Pacific Palisades rebuild is constructed like a tank.

Every exterior wall of the steel-framed home is a foot-thick, fire-resistant barricade. The home is connected to a satellite fire monitoring service. Should a fire start in town, sturdy metal shutters descend to cover every window. An exterior sprinkler system can pump 40,000 gallons of water from giant tanks hidden behind the shrubs in the property’s yard. If the cameras and heat sensors around the house detect danger, the system can envelop the home in over 1,000 gallons of fire retardant and hundreds of gallons of fire-suppressing foam.

Palisades resident and architect Ardie Tavangarian is so confident in his design that he even asked the fire department if they could start a controlled fire on the property to test it all out. (They said no.)

Tavangarian built a career designing multimillion-dollar luxury homes in Los Angeles, but after the Palisades fire destroyed 13 of his works — including his family’s home — he found another calling: how to design a house that can handle what the Santa Monica Mountains throw at it. And how to do it quickly and affordably.

Water tanks form part of a backup water supply in a newly built fire-resistant home in Pacific Palisades.

Advertisement

“Nature is so powerful,” he said, sitting on a couch in the new house, which he built for his adult twin daughters. “We are guests living in that environment and expecting, ‘Oh, nature is going to be really kind to me.’ No, it’s not. It does what it’s supposed to do.”

Tavangarian watched the Jan. 1 Lachman fire from his property not far from here; a week later that fire rekindled, grew into the Palisades fire, and burned through his house. But the painful details of the fire — the missteps of the fire department, the empty reservoir — didn’t matter when it came to deciding how to rebuild, he said. The reality is, many fires have burned in these mountains. Many more will.

A sprinkler on a roof.

A sprinkler on the roof is part of a house-wide sprinkler system.

For the architect, who has spent much of his 45-year career designing for luxury, hardening a home against wildfire has brought a new kind of luxury to his homes: peace of mind.

Advertisement

It’s a sentiment that resonates with fire survivors: Tavangarian says he’s received considerable interest from other property owners in the Palisades looking to rebuild their houses.

The metal shutters and advanced outdoor sprinkler system are the flashiest parts of Tavangarian’s home hardening project, and the efficacy of these adaptations is still up for debate. Because the measures have not yet been widely adopted, there are few studies exploring how much or little they protect homes in real-world fires.

Ardie Tavangarian stands inside a house.

Architect Ardie Tavangarian inside the house he designed.

Anecdotal evidence has indicated the effectiveness of sprinklers can vary significantly based on the setup and the conditions during the fire. Extreme wind, for example, can make them less effective. Lab studies have generally found shutters can reduce the risk of windows shattering.

These measures aren’t cheap, either. Sprinkler systems can cost north of $100,000, for example. However, Tavangarian said when all was said and done, the home he built for his daughters cost around $700 per square foot — less than what Palisades residents said they expected to pay, but more than what Altadena residents expected for their rebuilds.

Advertisement

Tavangarian also hopes to see insurers increasingly consider the home-hardening measures property owners take when writing policies, which he said could potentially offset the extra cost in a decade or less. As he explored getting insurance for the new home, one insurer quoted him $80,000 a year. After he convinced the company to visit the property, it lowered the quote to just $13,000, he said.

A living room inside a fire-resistant house, with metal heat shields drawn over the windows.

The house includes metal heat shields that can drop down if a fire approaches.

The home also has essentially all of the other less flashy — but much cheaper and well-proven — home hardening measures recommended by fire professionals: The underside of the roof’s overhang is closed off — a common place embers enter a home. The roof, where burning embers can accumulate, is made of fire-resistant material. The windows, vulnerable to shattering in extreme heat, are made of a toughened glass. There is virtually no vegetation within the first five feet of the home.

When asked if he felt he had compromised on design, comfort or aesthetics for the extra protection — one of the many concerns Californians have with the state’s draft “Zone Zero” requirements that may significantly limit vegetation within five feet of a home — Tavangarian simply said, “You be the judge.”

Advertisement
Continue Reading

Science

Commentary: My toothache led to a painful discovery: The dental care system is full of cavities as you age

Published

on

Commentary: My toothache led to a painful discovery: The dental care system is full of cavities as you age

I had a nagging toothache recently, and it led to an even more painful revelation.

If you X-rayed the state of oral health care in the United States, particularly for people 65 and older, the picture would be full of cavities.

“It’s probably worse than you can even imagine,” said Elizabeth Mertz, a UC San Francisco professor and Healthforce Center researcher who studies barriers to dental care for seniors.

Mertz once referred to the snaggletoothed, gap-filled oral health care system — which isn’t really a system at all — as “a mess.”

But let me get back to my toothache, while I reach for some painkiller. It had been bothering me for a couple of weeks, so I went to see my dentist, hoping for the best and preparing for the worst, having had two extractions in less than two years.

Advertisement

Let’s make it a trifecta.

My dentist said a molar needed to be yanked because of a cellular breakdown called resorption, and a periodontist in his office recommended a bone graft and probably an implant. The whole process would take several months and cost roughly the price of a swell vacation.

I’m lucky to have a great dentist and dental coverage through my employer, but as anyone with a private plan knows, dental insurance can barely be called insurance. It’s fine for cleanings and basic preventive routines. But for more complicated and expensive procedures — which multiply as you age — you can be on the hook for half the cost, if you’re covered at all, with annual payout caps in the $1,500 range.

“The No. 1 reason for delayed dental care,” said Mertz, “is out-of-pocket costs.”

So I wondered if cost-wise, it would be better to dump my medical and dental coverage and switch to a Medicare plan that costs extra — Medicare Advantage — but includes dental care options. Almost in unison, my two dentists advised against that because Medicare supplemental plans can be so limited.

Advertisement

Sorting it all out can be confusing and time-consuming, and nobody warns you in advance that aging itself is a job, the benefits are lousy, and the specialty care you’ll need most — dental, vision, hearing and long-term care — are not covered in the basic package. It’s as if Medicare was designed by pranksters, and we’re paying the price now as the percentage of the 65-and-up population explodes.

So what are people supposed to do as they get older and their teeth get looser?

A retired friend told me that she and her husband don’t have dental insurance because it costs too much and covers too little, and it turns out they’re not alone. By some estimates, half of U.S. residents 65 and older have no dental insurance.

That’s actually not a bad option, said Mertz, given the cost of insurance premiums and co-pays, along with the caps. And even if you’ve got insurance, a lot of dentists don’t accept it because the reimbursements have stagnated as their costs have spiked.

But without insurance, a lot of people simply don’t go to the dentist until they have to, and that can be dangerous.

Advertisement

“Dental problems are very clearly associated with diabetes,” as well as heart problems and other health issues, said Paul Glassman, associate dean of the California Northstate University dentistry school.

There is one other option, and Mertz referred to it as dental tourism, saying that Mexico and Costa Rica are popular destinations for U.S. residents.

“You can get a week’s vacation and dental work and still come out ahead of what you’d be paying in the U.S.,” she said.

Tijuana dentist Dr. Oscar Ceballos told me that roughly 80% of his patients are from north of the border, and come from as far away as Florida, Wisconsin and Alaska. He has patients in their 80s and 90s who have been returning for years because in the U.S. their insurance was expensive, the coverage was limited and out-of-pocket expenses were unaffordable.

“For example, a dental implant in California is around $3,000-$5,000,” Ceballos said. At his office, depending on the specifics, the same service “is like $1,500 to $2,500.” The cost is lower because personnel, office rent and other overhead costs are cheaper than in the U.S., Ceballos said.

Advertisement

As we spoke by phone, Ceballos peeked into his waiting room and said three patients were from the U.S. He handed his cellphone to one of them, San Diegan John Lane, who said he’s been going south of the border for nine years.

“The primary reason is the quality of the care,” said Lane, who told me he refers to himself as 39, “with almost 40 years of additional” time on the clock.

Ceballos is “conscientious and he has facilities that are as clean and sterile and as medically up to date as anything you’d find in the U.S.,” said Lane, who had driven his wife down from San Diego for a new crown.

“The cost is 50% less than what it would be in the U.S.,” said Lane, and sometimes the savings is even greater than that.

Come this summer, Lane may be seeing even more Californians in Ceballos’ waiting room.

Advertisement

“Proposed funding cuts to the Medi-Cal Dental program would have devastating impacts on our state’s most vulnerable residents,” said dentist Robert Hanlon, president of the California Dental Assn.

Dental student Somkene Okwuego smiles after completing her work on patient Jimmy Stewart, 83, who receives affordable dental work at the Ostrow School of Dentistry of USC on the USC campus in Los Angeles on February 26, 2026.

(Genaro Molina / Los Angeles Times)

Under Proposition 56’s tobacco tax in 2016, supplemental reimbursements to dentists have been in place, but those increases could be wiped out under a budget-cutting proposal. Only about 40% of the state’s dentists accept Medi-Cal payments as it is, and Hanlon told me a CDA survey indicates that half would stop accepting Medi-Cal patients and many others will accept fewer patients.

Advertisement

“It’s appalling that when the cost of providing healthcare is at an all-time high, the state is considering cutting program funding back to 1990s levels,” Hanlon said. “These cuts … will force patients to forgo or delay basic dental care, driving completely preventable emergencies into already overcrowded emergency departments.”

Somkene Okwuego, who as a child in South L.A. was occasionally a patient at USC’s Herman Ostrow School of Dentistry clinic, will graduate from the school in just a few months.

I first wrote about Okwuego three years ago, after she got an undergrad degree in gerontology, and she told me a few days ago that many of her dental patients are elderly and have Medi-Cal or no insurance at all. She has also worked at a Skid Row dental clinic, and plans after graduation to work at a clinic where dental care is free or discounted.

Okwuego said “fixing the smiles” of her patients is a privilege and boosts their self-image, which can help “when they’re trying to get jobs.” When I dropped by to see her Thursday, she was with 83-year-old patient Jimmy Stewart.

Stewart, an Army veteran, told me he had trouble getting dental care at the VA and had gone years without seeing a dentist before a friend recommended the Ostrow clinic. He said he’s had extractions and top-quality restorative care at USC, with the work covered by his Medi-Cal insurance.

Advertisement

I told Stewart there could be some Medi-Cal cuts in the works this summer.

“I’d be screwed,” he said.

Him and a lot of other people.

steve.lopez@latimes.com

Advertisement
Continue Reading

Science

Diablo Canyon clears last California permit hurdle to keep running

Published

on

Diablo Canyon clears last California permit hurdle to keep running

Central Coast Water authorities approved waste discharge permits for Diablo Canyon nuclear plant Thursday, making it nearly certain it will remain running through 2030, and potentially through 2045.

The Pacific Gas & Electric-owned plant was originally supposed to shut down in 2025, but lawmakers extended that deadline by five years in 2022, fearing power shortages if a plant that provides about 9 percent the state’s electricity were to shut off.

In December, Diablo Canyon received a key permit from the California Coastal Commission through an agreement that involved PG&E giving up about 12,000 acres of nearby land for conservation in exchange for the loss of marine life caused by the plant’s operations.

Today’s 6-0 vote by the Central Coast Regional Water Board approved PG&E’s plans to limit discharges of pollutants into the water and continue to run its “once-through cooling system.” The cooling technology flushes ocean water through the plant to absorb heat and discharges it, killing what the Coastal Commission estimated to be two billion fish each year.

Advertisement

The board also granted the plant a certification under the Clean Water Act, the last state regulatory hurdle the facility needed to clear before the federal Nuclear Regulatory Commission (NRC) is allowed to renew its permit through 2045.

The new regional water board permit made several changes since the last one was issued in 1990. One was a first-time limit on the chemical tributyltin-10, a toxic, internationally-banned compound added to paint to prevent organisms from growing on ship hulls.

Additional changes stemmed from a 2025 Supreme Court ruling that said if pollutant permits like this one impose specific water quality requirements, they must also specify how to meet them.

The plant’s biggest water quality impact is the heated water it discharges into the ocean, and that part of the permit remains unchanged. Radioactive waste from the plant is regulated not by the state but by the NRC.

California state law only allows the plant to remain open to 2030, but some lawmakers and regulators have already expressed interest in another extension given growing electricity demand and the plant’s role in providing carbon-free power to the grid.

Advertisement

Some board members raised concerns about granting a certification that would allow the NRC to reauthorize the plant’s permits through 2045.

“There’s every reason to think the California entities responsible for making the decision about continuing operation, namely the California [Independent System Operator] and the Energy Commission, all of them are sort of leaning toward continuing to operate this facility,” said boardmember Dominic Roques. “I’d like us to be consistent with state law at least, and imply that we are consistent with ending operation at five years.”

Other board members noted that regulators could revisit the permits in five years or sooner if state and federal laws changes, and the board ultimately approved the permit.

Advertisement
Continue Reading

Trending