RFK Jr. is Checked Out

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

Sheryl Gay Stolberg at NYT:

The secretary’s detachment from much of the work of the agency, along with the administration’s deep staff cuts and his attacks on career staff, have driven down morale, they say. It’s a dynamic that could threaten the department’s ability to protect Americans in a crisis, according to public health experts and former secretaries.

Critics say one of the most urgent problems is Mr. Kennedy’s failure to act more swiftly to address a leadership vacuum. There is no surgeon general. Around half of the 27 institutes and centers at N.I.H. are run by acting directors. The acting chief of the National Institute for Allergy and Infectious Diseases was recently fired, as was the nation’s top drug regulator.

The leader of the Food and Drug Administration quit last month under pressure over tobacco policy. Mr. Kennedy fired the C.D.C. director last August; it is now run on an acting basis by Dr. Jay Bhattacharya, who already has another huge job as director of the National Institutes of Health.

...

Every Tuesday at 10:30 a.m., the chiefs of the department’s 13 operating divisions gather in the secretary’s suite to update leadership on their activities. At the outset of his tenure, Mr. Kennedy was rarely there, either virtually or in person, according to three people familiar with his schedule. Since Mr. Klomp’s elevation, he now shows up once a month. But when he does attend, he often appears disengaged and spends the time scrolling on his phone, according to people in attendance. Several described him as “checked out.”

...

The Administration for Strategic Preparedness and Response, responsible for pandemic preparedness and for standing up field hospitals and quarantine facilities in Kenya, is currently run on an acting basis by John Knox, a former Los Angeles firefighter who founded the group Firefighters4Freedom during the pandemic to fight vaccine mandates.

It's Not Just Measles

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

Washington Post editorial:

And it’s not just measles. Cases of other vaccine-preventable illnesses such as whooping cough, rotavirus and Hemophilus influenza Type B are all rising as parents decline to give their kids shots. That’s not only dangerous for those children but also those who are too young to get immunizations, as well as immunocompromised people whose bodies are unable to mount a response to surging pathogens.

The decline in vaccination predates this administration, but rhetoric from officials, especially Health and Human Services Secretary Robert F. Kennedy Jr., supercharged skepticism toward vital public health tools. That’s prompted enormous backlash, including among Senate Republicans — so much so that the White House reportedly felt compelled to sideline Kennedy on the issue. The administration has also needed to withdraw multiple nominees for health agencies because of previous anti-vaccine comments.

Whether this shift is permanent remains to be seen. Last week, President Donald Trump issued an executive order directing agencies to pare back recommended childhood vaccines, even though similar changes announced in March by the Centers for Disease Control and Prevention were blocked in federal court.

At the same time, Kennedy is still reportedly pushing to craft new “research” to support his long-debunked claims that vaccines are unsafe.

The ultimate outcome of such efforts would be to make it harder for parents to access these medical innovations to keep kids safe. It would be like lining your house with kindling as wildfires spread nearby. Someone’s bound to get burned.

US on Track to Lose Measles Elimination Status

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

Nat Lash and Patricia Callahan at ProPublica:

To have any chance of keeping the [measles elimination] designation, the U.S. will need to make a strong case that measles didn’t spread endemically — from person to person in a continuous chain within the country for more than a year. If the Texas virus, for example, made its way across the Southwest to Utah and continued infecting people there, that would be a problem. But if cases in Utah were instead sparked by a patient who caught measles abroad, that would be a new chain, restarting the clock.

For clues, the Centers for Disease Control and Prevention is analyzing the full genetic code of measles viruses that infected patients. Last November, the CDC’s leader at the time said preliminary genomic analysis suggested the Utah cases were not directly linked to those in Texas. A spokesperson for the Department of Health and Human Services told ProPublica that the work was done by the state laboratories and the CDC is conducting a more comprehensive investigation.

ProPublica embarked on its own analysis, reviewing over 1,800 whole genome sequences, including those released as recently as last month, to compare the genetic fingerprints of measles viruses circulating in the U.S. and Canada. This showed that the measles virus still spreading in Utah as of this May is very closely related to the one that sickened Texans over a year ago.

ProPublica’s analysis isn’t a smoking gun that proves endemic spread. It’s impossible to tell from this information whether the virus spread from state to state or if it at some point left the country and was brought back by a sick traveler.

But given how similar the viruses are in the sequences ProPublica identified, it’s going to be difficult for the U.S. to prove measles isn’t endemic — “unless CDC has something up their sleeves,” said Dr. Alberto Severini, a retired molecular virologist and measles expert who spent two decades at Canada’s Public Health Agency.

...

During prior U.S. outbreaks, health and political leaders, with unwavering language, urged Americans to vaccinate their children and assured them the shots were safe.

Trump and HHS Secretary Robert F. Kennedy Jr. haven’t followed that playbook. Both have fueled doubts about the safety of the MMR shot, which guards against measles, mumps and rubella.

Researchers around the world have found the vaccine does not cause autism. Nevertheless, at a press conference on autism last fall, Trump said he had heard for years that there was a problem with the combination vaccine and urged parents to insist on separate shots for their kids — even though standalone shots don’t exist in the U.S.

Kennedy has said the vaccine offers protection from measles, but he also has repeatedly made the shot sound scarier than the disease.

Assisted Spelling

  Autism parents are highly vulnerable to quacks.

Arthur Allen at WP:

Assisted spelling is used to help nonverbal people communicate by pointing to letters on boards or using keyboards with physical help from another person.

...

But leading professional groups for autism science, as well as those representing psychologists and speech pathologists, point to research showing that these methods — premised on the idea that people with autism have the normal range of cognitive powers but are imprisoned in malfunctioning bodies — are flawed or fraudulent.

Other, validated methods enable nonspeakers to communicate through digital and analog pictures and letter boards. But assisted spelling isn’t autonomous communication, critics say: Consciously or not, the board holder may be influencing or responsible for the typed or pointed-at words — as with a Ouija board.

For many parents in Kennedy’s Make America Healthy Again community, the spelling controversy is angrily ringing the bells as the notion that vaccines cause autism — which they refuse to consider debunked. As some people see it: Established medicine damaged them with vaccines and now refuses to accept a helpful treatment.

...

“In this underfunded disability environment, I don’t want a single penny diverted to debunked interventions like spelling,” said Amy Lutz, a senior lecturer in history at the University of Pennsylvania and an autism support advocate who described her 27-year-old son as “profoundly autistic.”

It’s not only a waste of time, she said later in an interview, but “people subjected to spelling are not given access to evidence-based education. Every interaction turns someone like my son into a puppet, and I find that very objectionable.”

See a review of the literature from the Association for Science in Autism Treatment. 

Antivax Papers Under Fire

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.

Michelle R. Smith at The Guardian:

Three scientific papers that raised questions about vaccine safety and were used by the Trump administration to justify controversial changes to US vaccine policies have over the last two months been removed, retracted or placed under investigation by the journals that published them.

In some cases, the actions occurred years after scientists first raised alarms about the studies’ scientific merits.

Robert F Kennedy Jr, the US health secretary who has been a leader in the anti-vaccine movement for decades, relied on two of the studies that are now facing scrutiny for a 2023 book he co-wrote that argued unvaccinated children were healthier than children who had been vaccinated. The US Centers for Disease Control and Prevention (CDC) cited one of the papers when it changed its long-held position that vaccines do not cause autism, cutting against the scientific consensus. And all three papers were cited by a lawyer, Aaron Siri, who called for changes to the childhood immunization schedule before an influential federal vaccine advisory panel. Siri is the managing partner of Siri & Glimstad and has served as a lawyer for a prominent anti-vaccine group.

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[A paper] by Carolyn M Gallagher and Melody S Goodman, was published in 2010 in the Journal of Toxicology and Environmental Health, Part A, and found boys vaccinated for hepatitis B in their first four weeks of life were more likely to be diagnosed with autism.

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The CDC cited the hepatitis B paper in November when it changed its stance on a possible link between vaccines and autism at Kennedy’s direction. The reworked page now states at the top that “Studies supporting a link have been ignored by health authorities” and later cites the paper.

HHS did not respond to the Guardian’s questions about whether the CDC would update its page.

Morgan McSweeney, a scientist who posts on social media as Dr.Noc, was moved to make a six-minute video debunking the paper after seeing the CDC’s changes. The authors, relying on a small number of cases, said their findings suggested male newborns vaccinated with the hepatitis B vaccine had a higher risk of autism diagnosis.

“This was a low-quality, very small study that was not replicated. So yeah, the CDC page now says that some studies supporting a link have been ignored by health authorities,” McSweeney said in the video, which now has more than 5m views between Instagram and TikTok. “And maybe that’s a little bit true, because the studies they’re showing here are worth less than a fart in the summer breeze.”

Measles and Vitamin A Poisoning

  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 June 4, 2026, 2,030 confirmed* measles cases were reported in the United States in 2026. Among these, 2,020 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 10 measles cases were reported among international visitors to the United States.

There have been 30 new outbreaks** reported in 2026, and 93% of confirmed cases (1,890 of 2,030) are outbreak-associated (558 from outbreaks starting in 2026 and 1,332 from outbreaks that started in 2025).

RFK has advocated vitamin A as an alternative treatment for measles.

Bischops AC, Nagorsen M, Madsen E, Majumder MS. Internet Searches for Vitamin A and Related Media Statements During the 2025 US Measles Outbreak. JAMA Netw Open. 2026;9(6):e2615013. doi:10.1001/jamanetworkopen.2026.15013.

The US is experiencing its largest measles outbreak since the disease’s elimination in 2000.1 Although vaccination remains the only proven prophylactic, vaccine hesitancy is rising.2 Within this climate of doubt, alternative medicines like vitamin A and cod liver oil have gained attention.3 Vitamin A may be administered under medical supervision to support measles recovery, but it does not prevent measles and can be toxic if dosed incorrectly.3 The same applies to cod liver oil, which contains high levels of vitamin A.4 Between January and March 2025, America’s Poison Centers reported a 38.7% increase in vitamin A exposures.3 This trend may have been influenced by public figures who have increasingly promoted vitamin A to treat measles.4

RFK Wants to Pry into Our Medical Records

 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.

 Amanda Seitz and Darius Tahir at KFF Health News:

U.S. health secretary Robert F. Kennedy Jr. is pursuing federal government access to most Americans’ medical records, in a quest to research a link between vaccines and autism — a connection the medical establishment studied for decades and flatly rejects.

The Department of Health and Human Services is seeking data from little-known state systems that allow hospitals and clinics to exchange detailed, identifiable patient information, KFF Health News has learned.

In private meetings, some public health leaders have objected to giving Kennedy’s team access to such data, raising doubts that it’s legal or that the information would even be useful.

They have also expressed concerns about allowing the federal government to peer into the minutiae of Americans’ medical records, which could mean viewing anything from doctors’ notes to prescription history. HHS has offered no insight into how it will protect or handle the personal health information it obtains.

But Kennedy told KFF Health News that medical records are key to investigating the cause of autism, vaccine safety, and chronic diseases. And millions of dollars in grant money has poured into a Nebraska nonprofit that has assisted Kennedy’s effort, according to state records.

IDEA Challenges

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. 

Ashley White at The Hill:

​​​A clear pathway for addressing these challenges can be seen in the Science of Reading Act, which seeks to align federal literacy funding with evidence-based practices “to ensure state literacy plans reflect these evidence-based approaches.” However, there is no “Science of Special Education” movement generating bipartisan legislation. There is no House committee unanimously passing a bill to strengthen IDEA’s core protections. Instead, there is silence — or worse, erosion.

States, meanwhile, are left holding the bag. Some have stepped up, investing state dollars to fill the federal gap. Others have not. The result is a patchwork of protections that varies wildly depending on where a child with a disability happens to live. This is precisely the inequity IDEA was designed to prevent. The staffing crisis compounds the challenge. Across the country, districts report critical shortages of special education teachers, school psychologists, speech-language pathologists, and related service providers. Caseloads have ballooned. Timelines for evaluations are missed. Individualized Education Programs are written but not implemented with fidelity. And in too many cases, the procedural protections that remain on paper have become aspirational rather than operational.

For families, the lived experience of special education in 2026 often feels like navigating a system designed to say no. Due process remains available in theory, but in practice, it is expensive, adversarial, and inaccessible to the families who need it most. The asymmetry of power between school districts and individual families has only grown as federal oversight has receded.

Predatory Providers

 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.

Christopher Weaver and Anna Wilde Mathews at WSJ:

The autism-therapy industry, once a tiny corner of pediatric care, has exploded into a multibillion-dollar business, fueled by rising diagnoses, new providers entering the market and laws requiring insurers to cover more services. It has also attracted predatory providers who bill for phantom services, pad hours and charge steep fees for care delivered by low-wage workers with minimal training.

The billing abuses run wide. Aetna said the number of investigations that found likely fraud or abusive billing by autism-therapy providers in its private-plan business shot up by 300% between 2024 and 2025—and is on track to rise by another 50% this year.

...

Autism-therapy spending has become one of the fastest-growing healthcare expenses for many private insurance plans, insurers, employers and auditors say. The boom has also made the therapy one of Medicaid’s fastest growing segments, according to a Journal investigation published in March. Medicaid claims data showed providers billed as much as $340,000 per patient a year, the Journal reported.

In the private insurance sector, annual spending on hands-on autism therapy for about 40 large employers covering 3.5 million people doubled to $108 million from 2021 to 2025, according to claims data analyzed by the Health Transformation Alliance. The coalition, which helps companies including Walgreens and American Express track and manage medical spending, said that reflects more patients, more hours of service and higher prices.

...

Most of the therapy is delivered by behavior technicians, who in many states need little more than a high-school degree and often earn as little as $20 an hour. By the end of 2025, about 535,000 people were registered as behavior technicians in a federal database of healthcare providers, an increase of 457% from 2019, an analysis by the Journal found.

The front-line workers are overseen by behavior analysts, more highly trained professionals who often have master’s degrees and licenses and can supervise multiple technicians.

 

Neurodiversity and Governance

In The Politics of Autism, I discuss the neurodiversity movement.   

Dana Lee Baker, "Lead Kindly Light: Neurodiversity, Autism, and Good Governance," Administration and Society Volume 58, Issue 4, https://doi-org.ccl.idm.oclc.org/10.1177/00953997261435918

Abstract

Human neurodiversity matters. Neurodivergence and neurodiversity are fundamental characteristics of the (human) population. The essential nature of this diversity means that the quality of government and governance is unavoidably affected by approaches taken to neuroinclusion in the cultural, political, and economic spaces of current societies. Public administration cannot avoid being both entangled with the construction of neuroinclusion and affected in practice by neurodivergence and neurodiversity. Using the case of autism politics and policy, this article explores selected examples of contestations in policy narratives, neuroethical policy gaps, and persistent myths surrounding neurodiversity and neuroinclusion affecting the practice of contemporary public administration.

Concluding thoughts:

The title of this article quotes a hymn written in 1833 with a first stanza that concludes, “I do not ask to see the distant scene; one step enough for me” (Newan, 1833).1 Although found in a message about faith, both working scientists and issue stakeholders struggle with time and progress in the manner these words reflect. Scientists and issue stakeholders work toward the potential for a better world. Turning attention to the light of transformational scientific discovery or social progress made manifest through perfected moral sentiment in public law almost always involves long-term acceptance of slow-deliberate effort toward a destination not witnessed by those who begin a journey. The formation of neuroethical policy gaps as exemplified in the autism politics of the twentieth and early 21st centuries raises the question of how to take next steps in public policy and interpretation of neuroscience, especially in moments where glimpses of the distant scene come into view. Incremental policymaking dominates most public policy making and defines periods in which sustained, supported progress can be made. Although the need for and attraction of punctuations in policy equilibriums exist, periods of normal policy operations also may allow for pubc administration innovation, including the testing of better practices.

As stated at the beginning of this article, realities of human neurodiversity and neuroinclusion matter, particularly as new findings disrupt our favorite stories about ourselves. They are also material. In recognizing neuroethical policy gaps, public administration can better aim for the clarification of democratic ideals in practice. In the context of the autism policy subsystem, worthy focus on ideals suffers if underlying assumptions about the brain misdescribe human neurology. Although realizing the goal of clarification will necessarily take some time, good practice of public administration requires that policy terms cannot fall into the category of “it meant something different every time she heard it” (Proehl, 2016, p. 86). With practice, we prevail. With patience and understanding, democratic intentions materialize.

Externalities: Spreading Measles

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.

 Teddy Rosenbluth at NYT:

A measles outbreak in Utah has sickened more than 670 people, including many children whose parents have chosen not to vaccinate them. But new data shows that people who can’t be vaccinated for various health reasons are also falling ill.

Since the outbreak began last summer, measles has infected 23 babies under age 1, the age when children typically receive the first dose of the measles, mumps and rubella shot. Twelve pregnant women have also been infected, including one who passed the virus on to her newborn, according to data from the state health department.

While the state keeps only limited data on the number of immunocompromised residents who have fallen ill, pediatric infectious disease doctors also say they have cared for several immunocompromised children hospitalized with measles infections.

These patients still represent a minority of the unvaccinated people who have been sickened. Still, these findings are concerning because many of the groups who can’t get the vaccine are also at high risk of developing severe complications from the virus. Pregnant women, for example, are 10 times more likely to die from measles than those who are not pregnant. The virus can also cause women to miscarry or go into labor prematurely.

Young children are more likely to suffer severe complications from the virus. And babies who contract measles before their first birthday are at much higher risk of developing a rare condition called subacute sclerosing panencephalitis that can occur years after an initial infection. Dr. Andrew Pavia, a pediatric infectious disease specialist in Utah, described the complication — which can cause seizures, motor issues and eventually death — as “one of the most horrible things I’ve witnessed.”

Measles 2025. Authors: Lien Anh Ha Do, M.D., Ph.D. and Kim Mulholland. Published June 25, 2025. N Engl J Med 2025;393:2447-2458 DOI: 10.1056/NEJMra2504516. VOL. 393 NO. 24

When measles outbreaks occur, persons with compromised immunity, such as malnourished children, immunocompromised persons (e.g., persons who have human immunodeficiency virus [HIV] or are receiving cancer treatment), and pregnant persons are particularly vulnerable. Persons with HIV who are not immune to measles are at increased risk for more severe measles infection with pneumonia or encephalitis.

 

In a series of 23 pediatric cancer patients in China who had measles infection, 5 underwent ventilation, 1 had liver failure, and 4 died. These outcomes occurred even though 20 of the 23 patients had been vaccinated (including the 4 who died) and 21 had been treated with intravenous immune globulin.19

 Malnutrition and measles have a historical link, particularly in the context of humanitarian relief efforts. The bidirectional relationship between measles and malnutrition was described decades ago.20 Malnutrition is a primary contributor to death in 45% of fatal measles cases.21 Measles is worse in children who are already malnourished, and postmeasles effects can lead to malnutrition in children who were not malnourished before they were infected with measles.13 Measles can lead to or exacerbate vitamin A deficiency22 or a persistent nutritional deficit.23 Malnourished children have a poor response to measles vaccine and other vaccines.24,25

Although measles virus is not teratogenic, measles in pregnant persons can lead to fetal loss, intrauterine growth retardation, and premature delivery.26 The case fatality rate among pregnant persons with measles can range from 5% in areas where measles is endemic, such as in Asia and in sub-Saharan Africa, to 20 to 30% among fragile populations, such as refugee populations.27

 

1,983 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 28, 2026, 1,983 confirmed* measles cases were reported in the United States in 2026. Among these, 1,974 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 30 new outbreaks** reported in 2026, and 93% of confirmed cases (1,847 of 1,983) are outbreak-associated (517 from outbreaks starting in 2026 and 1,330 from outbreaks that started in 2025).

 Jessica McDonald at Factcheck.org:

When asked by a senator on April 22 what he was doing to reduce the number of measles cases and improve the MMR vaccination rate, Kennedy responded, “Improve the MMR. We promote the MMR. We have advised every child to get the MMR. That’s what we do.”

In the same hearing, Democratic Sen. Michael Bennet of Colorado similarly asked, “Are you taking the position, as your CDC director has taken, that the measles vaccine is vital to keeping American children healthy in this country? Are you taking that position today? That has not been your position.”

“That’s my position. I — we promote the measles vaccine,” Kennedy said. “The measles vaccine prevents measles in 97% of the people who take it. I’ve always said that. That’s what the science says.”

Kennedy had often noted the MMR vaccine’s effectiveness. But prior to last month, we could not find a single instance in which Kennedy offered vigorous, unqualified support for the vaccine, without including or later adding inaccurate or misleading information that might cause someone to rethink vaccination.

Workplace Experience

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

 A release from NEXT for Autism

:A new national survey from NEXT for AUTISM, a leading nonprofit dedicated to transforming services for autistic adults, offers one of the first comprehensive looks at workplace experience from the perspective of autistic employees themselves – revealing the everyday practices that support autistic employees – and the gaps that stand in the way.

Based on responses from more than 400 currently or recently employed autistic adults across the U.S., the data finds that the most important factor shaping success for autistic employees isn't workplace policy – it's their direct manager.

 ta shows that employees are turning to managers, not HR, as their primary point of trust: 49% report disclosing their autism diagnosis to a manager or supervisor, compared to 44% who disclose to HR. Simultaneously, nearly 8 in 10 respondents say their manager trusts them, and that relationship shapes whether employees feel safe communicating how they work, accessing support, and contributing fully at work.

The report, Inside the Autistic Workforce: A National Survey of Autistic Employees on Their Workplace Experience – and What Employers Need to Know, was developed by NEXT for AUTISM in partnership with Sago and funded by the Anita Bhatia Foundation for Tomorrow. It captures insights from autistic employees working across industries – from data scientists and occupational therapists to bartenders, paramedics, and overnight restockers – and offers a clear blueprint for the conditions that help autistic employees contribute, perform, and stay at work. Uniquely, the survey was developed in collaboration with autistic and neurodivergent staff, advisors, and subject-matter experts to ensure that the questions and analysis reflected authentic workplace realities.

The findings challenge long-held assumptions about disclosure, accommodations, performance, and retention. They show that the conditions shaping workplace experience are often neither complex nor costly, but instead rooted in how managers communicate, build trust, and adapt to individual needs.

"Managers are the difference between success that's sustainable and success that quietly drains," said Gillian Leek, CEO of NEXT for AUTISM. "Autistic employees are already contributing across the workforce, but too often they're doing it while managing challenges that go unseen. When managers build trust and make it easier for employees to communicate how they work, that's when organizations get the full value of the talent they've hired."

Key findings from the survey include:

Many Autistic Employees Are Contributing at a Cost
While many respondents report strong workplace outcomes, the findings reveal a critical tension: performance is often sustained through significant, invisible effort.72% feel fairly compensated

• 70% say their role matches their abilities
• 73% feel supported and respected at work

At the same time:80% report masking and emotional exhaustion as a challenge
More than half cite sensory demands and communication overload as highly challenging

For many autistic employees, doing well at work doesn't come without a cost. Masking behaviors—suppressing natural responses, scripting interactions, and managing sensory overload—can consume as much mental energy as the job itself.

Managers Are the Difference Between Stability and Chronic Strain
Throughout the data, one factor stands out above all others: the direct manager.

Managers shape whether employees feel safe disclosing their diagnosis, asking for support, and working in ways that align with their strengths. In practice, this makes managers – not policies – the front line of inclusion, retention, and performance.

The practices autistic employees associate with effective managers: empathy, active listening, clear communication, willingness to accommodate, and consistent follow-through – are the fundamentals of competent leadership. In return, managers are rewarded with loyal, dedicated, and creative employees.

The Hidden Gap in Workplace Support
The survey highlights a gap between the availability of workplace support and employees' ability to access it.

• 41% don't know what supports are available without disclosing
• 36% are unfamiliar with the range of workplace accommodations once hired
• 31% are unfamiliar with legal rights to reasonable accommodations

As a result, many employees manage challenges independently, even when support is available. Nearly 7 in 10 respondents report relying on support outside of work to navigate workplace expectations and sustain employment.

Notably, respondents report turning to social media for workplace guidance and support at rates comparable to therapists and professional support providers.

Workplace Experiences Are Not Equal
Certain groups consistently report more acute challenges. Autistic women face a workplace environment that is consistently less responsive to how they communicate and what they need:54% are unsure how or when to disclose (vs. 32% of men)
53% feel safe being themselves at work (vs. 73% of men)
48% fear being labeled/stereotyped (vs. 35% of men)

A Clear Path Forward for Employers
The survey findings show that hiring is just the beginning. What shapes whether autistic employees contribute fully and stay in their jobs is the day-to-day reality of how workplaces actually operate. The report offers employer recommendations that can make an immediate difference:

• Equip managers to communicate clearly, build trust, and adapt to different working styles
• Make support visible before employees have to ask for it
• Build clear expectations, flexibility, and predictable structures into everyday work
• Listen to your autistic employees and treat their feedback as data, not complaints

"These are the fundamentals of how good workplaces operate," said Leek. "When organizations get this right, they don't just support autistic employees, they create environments where all people can succeed."

The full report is available at NEXTforAUTISM.org/SurveyReport. A companion infographic is available.