By Richard Frye, MD/PhD and John Slattery
Every April, the country is blanketed in puzzle pieces and platitudes. “Celebrate neurodiversity,” we’re told. The Centers for Disease Control and Prevention (CDC) even publishes photos of smiling children in its Autism and Developmental Disabilities Monitoring (ADDM) Network materials. But for millions of families living in the trenches with severe autism, there is nothing to celebrate. For them, Autism Awareness Month feels more like gaslighting than recognition.
We are in the middle of an autism epidemic. That word isn’t hyperbole—it’s a term used by the U.S. Health and Human Services Secretary himself. The latest ADDM report reveals that autism now affects 1 in 31 children, and a jaw-dropping 1 in 20 boys—numbers that should terrify every policymaker and parent in America.
To put this into perspective, in the early 2000s, the autism rate was 1 in 150. That’s a 384% increase in just two decades. This isn’t a slow creep—it’s an explosion. And no, contrary to what mainstream media continues to parrot, this isn’t simply because we’re “better at diagnosing” or “more aware.” That theory has worn thin.
Despite the dominance of genetics in ASD research funding, genetic studies have yielded limited improvements in prevention or treatment. Most autism-related mutations are not inherited but de novo. Instead of asking why these mutations appear, research often focuses narrowly on the mutations themselves.
The ADDM report debunks that excuse with hard data: the proportion of children with average or high IQs has gone down, while the percentage of children with severe intellectual disabilities (IQ < 70) has increased. Nearly two-thirds of children with autism today fall into this moderate-to-severe category. These are not quirky kids with social anxiety. These are children who are often nonverbal, prone to self-injury, elopement, and in some heartbreaking cases, violence.
Just ask the family of Victor Perez, a 17-year-old autistic boy from Idaho with cerebral palsy, who was shot nine times by police while holding a knife. Nonverbal and misunderstood, Victor died days later. He didn’t deserve a death sentence. But because of our national failure to understand and plan for severe autism, that’s exactly what he got.
Worse yet, we are seeing disproportionate impacts on children of color. Autism rates among Black, Hispanic, and Asian children are now as much as 40% higher than those in White children—and their cases tend to be more severe. The CDC claims this is because we’re “doing a better job” identifying autism in underserved communities. But that narrative dangerously ignores another possibility: that environmental or socioeconomic risk factors are driving up autism rates in these populations—and we’re not investigating them nearly enough.
A recent study in Nature Medicine points to one such factor: a maternal Western diet high in processed foods and sugars during pregnancy is linked to higher risks of both autism and ADHD in offspring. Other research highlights inflammation, oxidative stress, and environmental toxins as likely contributors. We cannot afford to ignore these red flags any longer.
Behind the data are real families. Parents lying awake at night, wondering what will happen if their child elopes and drowns—something that claimed the lives of over 80 children with autism in 2024 alone. Mothers and fathers watching their child slam their head into walls, unable to stop it. Families reeling from the unrelenting demands of care, terrified of the question that looms largest: “Who will take care of my child when I’m gone?”
The autism surge is not benign. It’s not a trend. It’s a humanitarian crisis. And we’ve wasted decades minimizing it. For families coping with severe autism, it’s hard not to feel betrayed—by institutions, by the media, and by a system more focused on optics than action.
But there is hope. For the first time in decades, we have a federal administration openly acknowledging the crisis. More research and support are needed. I want to share more details about this in future posts and give it the attention it deserves.
While important efforts are underway, there is help for parents and caretakers:
ASD challenges traditional medical models. It’s not a single-organ disorder but a complex, systemic condition involving the brain, immune system, gut, and mitochondria. The majority of children with ASD have multiple comorbidities, especially involving the immune and gastrointestinal systems. Our healthcare system, with its siloed specialties, struggles to manage these interconnected issues.
ASD is often characterized by a breakdown in the interaction between three major systems: mitochondrial function, the gut microbiome, and immune regulation—what we call “the trifecta.” Disruptions in any of these can trigger biological feedback loops that lead to neurodevelopmental disorders, especially in the growing fetus, infants, and toddlers whose systems are still developing. Environmental stress and nutritional deficiencies can exacerbate these vulnerabilities.
Interestingly, the same physiological abnormalities seen in children with ASD, including the folate receptor autoantibodies and mitochondrial abnormalities, often appear in their parents and siblings, suggesting inherited but non-Mendelian biological dysfunction. This points to the possibility of identifying biomarkers in parents and applying prenatal treatments to reduce ASD risk—something never considered at scale.
There is good news: safe, well-tolerated treatments exist that support mitochondrial health, reduce inflammation, and manage oxidative stress. For instance, recent clinical trials have shown that a simple, targeted multivitamin can improve mitochondrial function and reduce ASD symptoms.
One major breakthrough involves folate metabolism. Mitochondrial dysfunction and immune activation can prevent folate from reaching the brain. In 71% of children with ASD, antibodies block the folate receptor. Our team pioneered the use of leucovorin, a prescription folate, in treating ASD. Controlled trials confirm it significantly improves symptoms—and yet, awareness remains low.
The Neurological Health Foundation created the Healthy Child Guide to help women improve pregnancy outcomes. While routine screening exists for conditions like gestational diabetes, many key risks—such as vitamin D, iron deficiency and carnitine —are overlooked, even though they can significantly impact neurodevelopment.
Prenatal folate is critical. Unfortunately, most prenatal supplements contain folic acid, a synthetic form that doesn’t fully convert to bioactive folate. The buildup of unmetabolized folic acid (UMFA) has been linked to increased ASD risk. In contrast, bioactive folates like methylfolate and leucovorin effectively support fetal brain development. There is a company that has the first prenatal with the recommended daily allowances for expectant mothers.
Many mothers of children with ASD carry autoantibodies that block folate transport. Fortunately, bioactive folates can bypass this issue, even crossing the placenta when antibodies are present.
Other preventable risk factors are often ignored. Prenatal use of acetaminophen has been associated with ASD, ADHD, and language delays. pesticides, endocrine disruptors, and air pollutants increase inflammation and are rarely discussed during pregnancy. Yet simple steps like eating organic foods and using air and water filters could reduce these risks.
We’ve also learned that a healthy gut microbiome is essential to fetal brain development. Antibiotics and other medications can disrupt the maternal microbiome, potentially increasing ASD risk. While some prescriptions are necessary, many are used without considering long-term effects on the microbiome.
Next steps for helping the autism community:
The time for dismissiveness is over. We must launch a national response equal to the scale of the crisis—funding root cause and biomedical treatment research, expanding services for the severely affected, and committing to meaningful prevention strategies. Anything less is a betrayal of the most vulnerable among us.
Autism isn’t a marketing campaign. It’s a medical emergency. Let’s start treating it that way.
Dr. Richard Frye, MD/PhD and John Slattery, are the Chief Scientific Officer and Chief Operating Officer of the Autism Discovery and Treatment Foundation, which is dedicated to advancing our understanding of autism through biomarker and treatment research. Dr Frye has recently published the The Folate Fix which includes a dozen stories of parents who have recovered their child with simple safe treatment.
Moving Autism Forward by Team TACA 
Leave a comment