Literature on Older Autistic Adults

In The Politics of Autism, I write about the everyday struggles facing autistic people and their families.  The struggles of autistic adults have not received enough scholarly attention.

Nicholas, D.B., Nelson, H., Shafai, F. et al. Examining the Lived Experiences of Older Autistic Adults: A Synthesis Review of Qualitative Literature. J Autism Dev Disord (2026). https://doi.org/10.1007/s10803-026-07343-y

This review reflects literature published from 2013 to 2024, with a focus on aging, older adulthood and autism. Themes in this literature addressed ways of being and sense of self (Hickey et al., 2018; Hwang et al., 2017; Moseley et al., 2020), relationship with others (Hickey et al., 2018; Mason et al., 2019; Hwang et al., 2017, 2023), pathways to meaning and enjoyment (Hickey et al., 2018; Hwang et al., 2017, 2023; Mason et al., 2019; Moseley et al., 2020; Waldron et al., 2022), and daily life at home or in the community (Hickey et al., 2018; Hwang et al., 2017, 2023; Mason et al., 2019; Moseley et al., 2020; Waldron et al., 2022). Notably, positive experiences and outcomes generally related to personal experience and meaning-making, whereas negative outcomes consistently were associated with healthcare challenges and service gaps.

The literature highlighted gaps in services and service provider knowledge about aging with autism (Barber, 2015; Heijnen-Kohl et al., 2022; Mansour et al., 2024; Moseley et al., 2020). Stigma and bias were noted to result in negative experiences with healthcare professionals (Mansour et al., 2024; Moseley et al., 2020), barriers to accessing supports (Moseley et al., 2020) and reduced individualized service provision (Hwang et al., 2023). Inaccurate diagnoses negatively impacted treatment plans and eligibility for needed services (Mansour et al., 2024), resulting in an overall dearth of systemic support (Barber, 2015; Hwang et al., 2017; Mansour et al., 2024; Moseley et al., 2020).

Reflecting on such gaps, improved support across the lifespan was strongly recommended, including the need to cultivate greater trust among autistic people in their healthcare providers, based on findings that earlier experiences influence later engagement and trust (Moseley et al., 2020). Training for service and healthcare providers was advocated (Trollor et al., 2022), with attention to processes of aging, autism and the experiences of older autistic adults (Barber, 2015; Heijnen-Kohl et al., 2022; Moseley et al., 2020).

The Employment Situation

 In The Politics of Autism, I discuss the employment of people on the autism spectrum.

Kelly Field at The Hechinger Report:

Today’s college graduates are entering one of the tightest job markets in years, as companies scale back entry-level hiring amid economic uncertainty and the explosion of artificial intelligence. Just under a third of 2025 graduates — and fewer than half of 2024 graduates — have found full-time employment related to their education, according to one recent report.

The market is even tougher for young adults with autism, who have long had one of the highest rates of joblessness among individuals with disabilities. Even before the hiring slowdown, more than 30 percent of autistic college graduates were unemployed, and about a quarter of those who did have jobs were in office- and administration-support roles, one study found.

One key reason: Autistic students often have trouble navigating traditional hiring processes, including interviews, which favor neurotypical candidates.

To help autistic students like Myers land jobs, some colleges are offering career-readiness classes and one-on-one career coaching; some are also working with employers to make their hiring and employment practices more inclusive. Drexel, which began providing career prep to students in its autism support program in 2017, has one of the oldest programs.

Some major corporations have also stepped up, forming partnerships with colleges to recruit neurodivergent students for internships and jobs.

...

It’s difficult to say how many students with autism are enrolled in college, in part because many students choose not to disclose their diagnosis to campus disability services — a prerequisite to receiving accommodations. The best estimate is that there are somewhere between 135,400 and 286,254 autistic college students, according to research by Bradley E. Cox, founder of the College Autism Network and an associate professor of higher, adult and lifelong education at Michigan State University.

"The Science Is Beautiful but the Industry Is Very Ugly"

The Politics of Autism includes an extensive discussion of autism service providers.  Private equity firms now own many of them.   Insurance mandates and Medicaid spending have contributed to the growth trend.

 Sarah Kliff and Margot Sanger-Katz at NYT:

A New York Times investigation has found that this rapid expansion has played out with little regulatory oversight and brought allegations of children being harmed by profit-motivated practices. In interviews, dozens of current and former clinic workers described how clinics frequently overprescribe hours — even recommending that some families remove children from school so they can receive more therapy.

Marquisha Richards worked at two private-equity-backed chains in Texas. She said she became disillusioned about how financial considerations repeatedly drove care decisions. “The science is beautiful, but the industry is very ugly,” she said.

Nationwide, Medicaid spending on autism therapy nearly tripled between 2020 and 2024. In some states it grew much faster: Colorado Medicaid now spends more on autism therapy than on all emergency department visits. North Carolina, which spent $121 million in 2022, projects it will spend over $1 billion next year.

...

Autism treatment did not become big business until the mid-2010s, after state laws began requiring insurers to cover it. Medicaid soon followed, and the industry boomed.

In North Carolina, the number of clinics owned by autism therapy providers grew from 61 in 2019 to 409 in 2026, according to data compiled by Daniel Arnold, a health economist at Brown University.

...

The clinics are enticing to health care investors: Demand is high and payment rates far exceed labor costs.

Medicaid often pays about $70 per hour ($83 in North Carolina) for therapy largely provided by workers with high school diplomas who earn around $20.

Private equity firms have acquired at least 500 clinics over the past decade. “There’s just huge opportunities to grow these businesses and help increase access to care,” said Jon Krieger, a managing partner at Calex, a financial firm that assists with autism clinic mergers and acquisitions. He estimates the market could grow to $90 billion.

...

Nationally, clinic visits have grown longer since private equity entered the business, from a median of four hours in 2019 to 5.5 hours in 2024, according to an analysis of 34 million Medicaid claims by the health data firm Trilliant.

1,952 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.

From CDC:

As of May 21, 2026, 1,952 confirmed* measles cases were reported in the United States in 2026. Among these, 1,943 measles cases were reported by 40 jurisdictions: Alaska, Arizona, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. A total of 9 measles cases were reported among international visitors to the United States.

There have been 29 new outbreaks** reported in 2026, and 93% of confirmed cases (1,815 of 1,952) are outbreak-associated (487 from outbreaks starting in 2026 and 1,328 from outbreaks that started in 2025).

For the full year of 2025, a total of 2,288 confirmed* measles cases were reported in the United States.

Hundreds have died from a serious outbreak in Bangladesh. Simon Ellery at CBS:

The CDC says most U.S. outbreaks begin when an unvaccinated traveler brings the virus home from a country experiencing a large outbreak.

According to the CDC, Mexico, Guatemala, parts of South Asia (where Bangladesh is) and Africa are experiencing worrying outbreaks.

CBS News medical correspondent Dr. Céline Gounder said Monday that this summer will bring a major challenge for U.S. health officials as thousands of fans visit for the soccer World Cup championship, which is being jointly hosted by the U.S., Mexico and Canada.

"My biggest concern for the World Cup is actually measles. It's not hantavirus, it is not Ebola. Measles is what has me concerned," Gounder said, noting outbreaks of the highly infectious disease "in different parts of the world."

 

Minnesota Fraud Charges

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.

The Minnesota investigations started under the Biden administration.

Sarah Kliff and Ernesto Londoño at NYT:

The Justice Department plans to announce criminal charges on Thursday against 15 people for attempting to defraud Minnesota Medicaid and other social service programs in the state of more than $90 million, according to documents prepared to be filed in court and obtained by The New York Times.

Among the defendants are an owner and an employee of autism clinics, who are charged with submitting $46.6 million in fraudulent claims to Medicaid, the public health plan that covers low-income people. Additional defendants will be charged with filing bogus claims to Medicaid for other services, including those that assist disabled people with obtaining housing and living independently.

President Trump focused attention on fraud in Minnesota after news reports and a social media video from a conservative content creator last year. Administration officials cited fraud among the reasons for sending hundreds of federal agents to Minnesota to crack down on illegal immigration.

That operation set off fierce protests and led to the killings of two American citizens early this year. It also prompted the resignation of several experienced fraud prosecutors at the U.S. attorney’s office in Minnesota, hobbling investigations that had been underway for months.

In March, the White House started a broad initiative to combat fraud nationwide, an effort being led by Vice President JD Vance. Last week, Mr. Vance announced plans for the federal government to withhold $1.3 billion in federal payments to California because, he said, the state had failed to combat Medicaid fraud.

Fraud in Minnesota’s generous social safety net programs has been a concern for years. In 2022, it became a major scandal after federal prosecutors charged dozens of people accused of stealing hundreds of millions of dollars from a Covid-era program created to feed low-income children.

Since then, state and federal officials have uncovered significant fraud in several other programs run by state agencies. To date, the vast majority of people charged with wrongdoing are of Somali ancestry, a fact that Mr. Trump has noted with derision.

The new Justice Department charges focus on two autism clinics, Smart Therapy in Minneapolis and Star Autism in St. Cloud, Minn. The court documents describe one defendant, Shamso Ahmed Hassan, as having an ownership stake in both companies. It says that the other, Hanaan Mursal Yusuf, was an employee of Smart Therapy.

The charges describe a scheme where the two defendants along with unnamed co-conspirators “paid illegal cash kickbacks of approximately $300 to $1,500 per child” to families that enrolled their children in autism therapy services. The companies then billed Medicaid millions to treat those children for autism, according to the prosecutors’ charges.

The Leucovorin Surge

A number of posts discussed Trump's support for dubious notions about autism.

The history of autism "cures" is a history of dashed hopes and frequent danger.

Rothman JM, Kwan B, Longhurst CA, Jena AB. Rates of Leucovorin Prescriptions for Children With Autism. JAMA Netw Open. 2026;9(5):e2613286. doi:10.1001/jamanetworkopen.2026.13286

Our data suggest that leucovorin prescription rates rose sharply following the September 2025 announcement by White House leaders but began a steadier increase in February 2025, after being stable for 2 years. A recent analysis4 reported increased leucovorin prescriptions in children following the White House announcement. Our study extends these findings by examining a longer observation period and restricting the cohort to children with a prior ASD diagnosis, which reveals that the upward trend in prescribing began months before the announcement and was specific to the population of greatest clinical interest.

A February 17, 2025, CBS Evening News segment titled “Parents say off-label drug helped son with autism speak”6 described a family whose child was diagnosed with autism when aged 2.5 years and was prescribed off-label leucovorin when aged 3 years. According to his mother, he spoke his first word within days of starting the medication, and by age 5 years, he had enrolled in a mainstream kindergarten program. Following the CBS segment, the story received substantial media attention, and Autism Speaks, the largest autism nonprofit organization in the US, highlighted the news on their website on February 25, 2025.7

Our findings suggest that mainstream media information about leucovorin’s potential use in ASD and the 2025 announcement by White House leaders may be associated with substantial increases in leucovorin use in children with ASD. Although no large randomized clinical trials have been initiated to assess the safety and efficacy of leucovorin for ASD, an increasing number of patients are being prescribed the medication. Notably, on March 10, 2026, the FDA approved leucovorin for the treatment of cerebral folate transport deficiency due to confirmed FOLR1 gene variants.8 However, the FDA did not approve leucovorin for ASD. This regulatory decision warrants ongoing surveillance of leucovorin prescribing for children with ASD. This study has limitations, including reliance on prescription-level data without confirmation of medical indication, inability to assess patient-level clinical outcomes, and lack of adjustment for site-level variation in Epic Cosmos participation. The rapid increase in leucovorin use for ASD, the timing of which is associated with otherwise exogenous events, may offer a novel natural experiment to better understand the potential behavioral effects of leucovorin in ASD.

 

Gutting the Office for Civil Rights: Update

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

Project 2025 proposed to turn IDEA into a "no strings" block grant, effectively gutting the law and destroying protections that disability families have long relied upon. During the 2024 race, Trump denied any connection to the project, but now he proclaims it, praising OMB director Russ Vought "of Project 2025 fame."

Trump and Vought are now accomplishing their goal of ravaging the law. Instead of shifting it to a block grant, they have tried firing most of the staff who enforce it. 

BIANCA QUILANTAN and HANNAH PSALMA RAMIREZ at POLITICO write about the gutting of the Office for Civil Rights at the Department of Education:

Hundreds of civil rights staffers were let go during the government-wide reduction in force last year. Many did not return even after the department started calling workers back, while other employees have chosen to leave in recent months as Trump has repeatedly vowed to shutter the agency and change what work is prioritized.

The number of employees in the civil rights office has declined to 321 from about 575 in fiscal 2024, according to May data from the Office of Personnel Management. In December, when the agency tried to call workers back, the office had 403 workers, but that number has been continuously declining.


“There's been a steady parade of people leaving,” said Linda Mangel, who was an OCR enforcement director and resigned last year. “Even the people who weren't RIFed were so shaken by what was happening in the agency that they have steadily left. … It's like a sinking ship.”

...

The agency called back 247 workers of the roughly 575 office staffers, with 85 ultimately returning to work, according to a January report by the Government Accountability Office, the federal government’s watchdog.

Staffers have chosen not to come back or are leaving the agency because they retired, got new jobs and are concerned about job stability. But some are uncomfortable with the work.

“After my RIF, I saw some things that were coming out of OCR that I think are not lawful and I would not be comfortable doing,” said Beth Gellman-Beer, former Philadelphia regional OCR office director, who had worked at the agency since the George W. Bush administration. “I figured if I go back, I'll probably be asked to do something that I'm not going to be able to sign, and I'll get eliminated anyway.”

...

The strain the staffing cuts have left is evident: the office reached zero resolution agreements involving sexual harassment, sexual violence, seclusion or restraint, racial harassment or discriminatory school discipline in 2025, according to a report from Sen. Bernie Sanders’ staff. And it reached 91 percent fewer resolution agreements in 2025 than in 2017, the first year of the first Trump administration.

Autism, Eugenics, and RFK Jr.

 In The Politics of Autism, I write about the dangers of eugenics and euthanasia. 

Elster, N., Parsi, K., & Caplan, A. (2026). Laundering Public Health: Using Autism to Revive Eugenics. The American Journal of Bioethics, 1–3. https://doi.org/10.1080/15265161.2026.2659519.

“Better babies.” “Fitter families.” “Survival of the fittest.” “Three generations of imbeciles are enough.” These phrases are not merely historical reminders of the United States’ regrettable eugenic past but are appearing in an increasingly eugenic present. Eugenics may have seemed dormant, but has recently been reawakened by the alt-right, tech billionaires, and figures such as Robert F. Kennedy (RFK), Jr., Stephen Miller, and President Trump. Autism has become the most recent target of eugenic ideology.

The administration’s stoking fear of and offering feigned support for autistic children and their families has bolstered MAHA’s ongoing eugenic rhetoric about the “scourge” of autism. This harmful language continues despite scientific evidence supporting MAHA’s misplaced (and scientifically refuted) views about the causal roles of vaccines and Tylenol. Disastrous political ideologies of the 19th century dominate this administration’s policies, but none so perniciously as the ideology of eugenics as applied to autism.

...

Historically, those promoting eugenics have often couched their agenda in terms of public health, which is precisely what RFK, Jr. and his MAHA cronies have been doing through their rhetoric around autism. They are utilizing a public health rationale to peel back decades of laws and regulations aimed at increasing vaccination rates to reduce communicable disease globally with one narrow and bogus goal: eliminating autism. This is problematic because reducing vaccination rates will not eliminate autism. It will, however, greatly harm many individuals while endangering public health. And it will ultimately lead to an increase rather than decrease in morbidity and mortality—exactly what MAHA claims it wants to prevent.

Seclusion in Boxes

In The Politics of Autism, I discuss the use of restraint and seclusion, along with cases of abuse.

Emilie Munson at The Times-Union (Albany, NY):

A public school district in northern New York broke state education regulations at least six times when it chose to confine students with disabilities in padded, wooden boxes in the classroom, an investigation by the New York State Education Department found.

The state ordered the Salmon River Central School District to change its policies and special education practices by this fall and submit paperwork to demonstrate its compliance.

State investigators found five students with disabilities were placed in the large boxes "with the door held shut," an act that constitutes seclusion, a practice banned by education regulations in New York.

The release of the state report is the latest development in a monthslong saga that resulted in criminal investigations, the introduction of new legislation, condemnation from the governor and the departures of multiple school administrators in the district since mid-December, when photos of one of the crates emerged on Facebook.

The state's conclusions differ from the findings released by an attorney hired by the school district to conduct a review of the use of the boxes. That attorney determined the boxes had been used this school year on two students who usually chose to go into the boxes and stay there. The students "were never locked or confined in the boxes (doors were only closed by the students themselves)," the attorney, Kate Reid, wrote in a report.

Assemblyman Michael Cashman, a Democrat who represents the area that includes the school district, pointed to the differences between the state's report and the one produced by the attorney retained by the district, saying "it raises even more questions as to why such a large gap in findings was released."

"The NYSED investigation findings tell an absolutely abhorrent story of mistreatment of youth," he said. "These harms are amplified by the cultural context they unfolded within: many of the families in the school district are Indigenous, a group that has a long history with systemic abuse from schools."

The attorney hired by the district said the public school used two timeout boxes at Salmon River Elementary School and had a third at the St. Regis Mohawk Elementary School that was never used. The state report did not discuss which schools the five students subjected to timeout boxes attended.

The school district built at least one of the wooden timeout boxes, according to records obtained by the Times Union.

Kemp and Waitlist for Disability Services

The Politics of Autism includes an extensive discussion of insurance and Medicaid services for adults with intellectual and developmental disabilities.  Home and Community-Based Services (HCBS) are particularly important. 

Autism Speaks:

Autism Speaks is urging action after Governor Brian Kemp directed the state agency to implement only a fraction of the waiver expansion approved by the legislature, limiting progress on Georgia’s growing waitlist for disability services.

More than 8,000 Georgians with autism or other intellectual or developmental disabilities (I/DD) are waiting for home- and community-based services (HCBS), which help people live at home, access therapies, build skills, and participate fully in their communities. This year, following strong advocacy from families and individuals across the state, the legislature approved a budget allowing 900 individuals to move off the wait list for services. However, Governor Kemp is directing the state agency to use funds for just 100.

“For individuals with autism, access to home- and community-based services is a lifeline,” said David Sitcovsky, Vice President of Advocacy for Autism Speaks. “The legislature put forward a plan to begin addressing the waitlist for these services, but the Governor’s decision to scale back support will have lasting consequences for families across Georgia.”

Medicaid waiver programs such as Georgia’s NOW/COMP waivers are the primary pathway for individuals with autism to access essential services, including behavioral therapies, daily living supports, employment services, and respite care for families. These community-based services can also help prevent more costly outcomes, including crisis response, institutional care, emergency treatment, and caregiver burnout.

Autism Speaks is grateful to Senator Blake Tillery, Senator Ben Watson, Rep. Matt Hatchett, and Rep. Katie Dempsey for championing additional waiver slots in this year’s budget. We are committed to supporting their continued leadership and urge state leaders to build on the legislature’s proposal by identifying opportunities to increase waiver capacity before the next full budget cycle and making this a top priority in the next legislative session.

The state has identified 1,217 individuals who are in critical need of a waiver, and a recent statewide study showed that increases of up to 2,400 slots for three years would be needed to fully address and keep up with demonstrated need. “The Georgia legislature has already recognized both the scale of the need and a path forward,” Sitcovsky added. “It is critical that leaders act with urgency to build on that foundation so fewer families are left waiting year after year for services they urgently need.”

While Governor Kemp’s directive represents a setback, Autism Speaks remains committed to working with state leaders to ensure that Georgia makes meaningful progress toward reducing its waiver wait list. We stand united with other advocates to elevate this issue and invite Georgians affected by autism to join us in this work by

sharing how Medicaid services impact them.

1,893 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.

CDC:

As of May 14, 2026, 1,893 confirmed* measles cases were reported in the United States in 2026. Among these, 1,884 measles cases were reported by 40 jurisdictions: Alaska, Arizona, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. A total of 9 measles cases were reported among international visitors to the United States.

Bischops A, Hulland E, Patzakis M et al. Will the USA lose its measles elimination status?
The Lancet, 407, 1679-1681

Four of seven indicators of sustained measles elimination status have already been missed, and the remaining three indicators are unlikely to be achieved (pending further epidemiological and genomic analyses; figure). In the 53 outbreaks, over 93 cases per 10 million people were reported. 94% of cases were transmitted locally, and most sequenced cases shared the same virus genotype. Although national case numbers decreased after a surge in April, 2025, they increased steeply in January, 2026, resulting in 285 (75·8%) of 376 days since January, 2025, with a median Rt estimate above the propagation threshold of 1·0 (appendix p 4). This estimate suggests that transmission was likely ongoing in the USA for the majority of the previous year. Even though our most recent Rt estimate (Feb 16, 2026) was below 1 (median 0·60, 95% CI 0·51–0·70), our projections suggest that case counts might ramp up again before the PAHO decision (appendix p 7). Our findings remained largely unchanged in sensitivity analyses for both Rt estimates and case projections (appendix pp 4–11). Short-horizon back checks for the daily incidence projections are shown in the appendix (pp 12–14). A negative binomial model that accounted for overdispersion in measles case counts produced Rt estimates similar to those from the presented Poisson-based model (appendix p 15).

In 2025, the USA had the largest number of annual measles cases since 1991. Although the current outbreak initially started with imported cases, most infections resulted from local transmission. This pattern likely reflects declining vaccination coverage, which—for kindergarteners in the 2024–25 school year—remained below the 95% required to achieve herd immunity against measles (>95% threshold). With confirmed cases in 45 states and ongoing transmission throughout the majority of the year, current trends suggest that the USA is nearing the loss of elimination status.

Yet Another Potential Correlate: Maternal Occupation History

 In The Politics of Autism, I discuss various ideas about what causes the condition.  Dozens of potential causes and correlates have been the subject of scientific and medical research.

Dickerson AS, Liu Y, Ladd-Acosta C, et al Associations between maternal occupational history and autism spectrum disorder diagnosis in offspring in Denmark Occupational and Environmental Medicine Published Online First: 12 May 2026. doi: 10.1136/oemed-2026-110912

Abstract

Objectives We investigated associations between maternal occupations and a diagnosis of autism spectrum disorder (ASD) in offspring.

Methods We obtained data for 1702 ASD cases born between 1973 and 2012 from the Danish National Patient Registry and matched each case to up to 100 population based controls based on sex and birth year (n=110 234). Mothers’ employment histories were obtained from the Danish Pension Fund Registry. Conditional logistic regression models were used to test associations between occupations held ever, 1 year before conception, during pregnancy and during infancy, adjusting for the mother’s age and history of neuropsychiatric disorders, parity and residential location.

Results There were increased odds of having a child with ASD for mothers who were employed before conception up to infancy in ground transportation (adjusted OR (aOR) 1.24, 95% CI 1.08 to 1.42; q=0.036), public administration (aOR 1.20, 95% CI 1.07 to 1.35; q=0.018) and military/defence occupations (aOR 1.59, 95% CI 1.39 to 1.82; q<0.001). Associations for judicial occupations and military/defence service were also apparent 1 year before conception and during pregnancy. We observed sex differences, with significant associations in male children for employment in ground transportation and defence occupations.

Conclusions Associations between certain maternal employment categories with high toxicant or psychosocial stress exposure suggest future studies should focus on examining specific toxicant exposures common in those occupations and neurodevelopment in offspring. This is of particular concern for associations seen for occupations held several years before conception.

A partial list of other potential causes and correlates: 

1. Inflammatory bowel disease
2. Pesticides
3. Air pollution and proximity to freeways
4. Maternal thyroid issues
5. Autoimmune disorders
6. Induced labor
7. Preterm birth
8. Fever  
9. Birth by cesarean section;
10. Anesthesia during cesarean sections
11. Maternal and paternal obesity
12. Maternal diabetes
13. Maternal and paternal age
14. Grandparental age
15. Maternal post-traumatic stress disorder
16. Maternal anorexia
17. Smoking during pregnancy
18. Cannabis use during pregnancy
19. Antidepressant use during pregnancy
20. Polycystic ovary syndrome
21. Infant opioid withdrawal
22. Zinc deficiency
23. Sulfate deficiency
24. Processed foods
25. Maternal occupational exposure to solvents
26. Congenital heart disease
27. Insufficient placental allopregnanolone
28. Estrogen in the womb
29. Morning sickness;
30. Paternal family history
31. Parental preterm birth
32. Antiseizure meds
33. Location of forebears
34. Lithium
35. Aspartame
36. BPA
37. Brain inflammation
38. Maternal asthma
39. Infertility
40. Ultraprocessed foods
41. Household chemicals
42. Parental psychiatric disorders
43. Fluoride
44. Fatty acids in umbilical cord blood
45. Maternal inflammation during pregnancy
46. COVID-19
47. Wildfire smoke
48.  Sterol biosynthesis–inhibiting medications (SBIMs)

Governor Kemp Signs Rio's Law

In The Politics of Autism, I write:

[M]any police departments have trained officers and other first responders how to spot signs of autism and respond accordingly.  Some organizations have also published identification cards that ASD adults can carry in order to defuse potential conflicts. Virginia provides for an autism designation on driver licenses and other state-issued identification cards. Once again, however, the dilemma of difference comes into play. One autistic Virginian worries: “Great, so if I get into an accident, who’s the cop going to believe, the guy with the autistic label or the guy without it?” Clinical psychologist Michael Oberschneider is concerned about the understanding level of first responders: “I think many people still think of Rain Man or, more recently, the Sandy Hook Shooter, when they think of autism even though very few people on the autistic spectrum are savants or are homicidal and dangerous.”

A May 5 release from Georgia State Senator Brian Strickland:

This week, Sen. Brian Strickland (R–McDonough) celebrated Governor Brian Kemp’s signing of Senate Bill 433, also known as “Rio’s Law.” This landmark legislation aims to improve interactions between law enforcement officers and individuals with autism spectrum disorder or developmental disabilities.

Authored by Sen. Strickland, the bill creates a voluntary specialized license plate designation for individuals with autism spectrum disorder or developmental disabilities and their families, and requires specialized training for Georgia peace officers beginning January 1, 2027.

“Today is a major step forward for families across Georgia who simply want safer, more informed interactions with law enforcement,” said Sen. Strickland. “Rio’s Law is about compassion, understanding and ensuring officers have the tools and training necessary to recognize and appropriately respond to individuals with developmental disabilities. This legislation has been one of my top priorities because these families deserve to feel seen, protected and supported.”

Under SB 433, the Georgia Peace Officer Standards and Training Council will work alongside the Department of Community Health, the Department of Behavioral Health and Developmental Disabilities and nonprofit organizations to develop training on effective communication, behavioral recognition, de-escalation techniques and emergency response protocols involving individuals with autism spectrum disorder or developmental disabilities.

“Rio’s Law represents the kind of thoughtful, people-centered policy that can make a real difference in everyday lives,” Sen. Strickland added. “I’m grateful to my colleagues in both the Senate and House for unanimously supporting this effort, and I thank Governor Kemp for signing it into law.”

Senate Bill 433 takes effect on January 1, 2027. You can find more information about the measure here.