When I read the recent TIME magazine special edition on autism, I felt a wave of frustration, sadness, and, honestly, deep concern. As a pediatric provider who has worked on the frontlines with children and families affected by autism for over a decade, I believe we need to bring both compassion and clarity to this national conversation—especially when the story we tell shapes public opinion, funding, and the future of care.
Let me start with agreement: autism is on the rise. In 2000, the CDC reported that 1 in 150 children were diagnosed with autism. Today, it’s 1 in 31. That number is staggering and demands serious inquiry. The TIME article acknowledges this increase, then pivots to explain it away with “broadened diagnostic criteria” and “heightened awareness.” While those factors may account for some of the increase, suggesting they account for all of it is, frankly, dismissive—and unscientific.
The article also acknowledges that while genetics play a role (estimated at 80%), environmental factors—like parental age, preterm birth, air pollution, and maternal health—also contribute. But from there, the discussion hits a wall. No meaningful exploration of how we might modify those environmental factors. No mention of prevention strategies or root-cause approaches. No mention of the mounting evidence that environment matters—before, during, and after birth.
That’s where my heart broke.
Because I’ve seen the power of environmental and functional interventions firsthand. I’ve watched children lose their words, their regulation, their joy—only to reclaim them through science-informed, individualized care. These are not miracles. These are the result of addressing chronic inflammation, immune dysregulation, mitochondrial dysfunction, toxic exposures, and nutrient deficiencies with real, evidence-based strategies.
Let me be clear: I am not talking about curing autism. I am talking about reducing suffering.
The article’s blanket endorsement of Applied Behavior Analysis (ABA) therapy as the only evidence-based treatment was another disservice. While ABA has a long-standing role in autism care, it is far from the only therapeutic modality. Where was the mention of speech-language therapy, occupational therapy, dietary interventions, environmental medicine, or Spelling to Communicate—a method many nonverbal children use to reveal their rich inner worlds?
And on the subject of folate, the article was not just incomplete—it was harmful. Recommending folic acid without nuance ignores the robust body of literature on folate receptor autoantibodies and cerebral folate deficiency. It fails to mention the work of Dr. Richard Frye, who has shown that folinic acid (not folic acid) can cross the blood-brain barrier and improve outcomes for children with these challenges. This isn’t fringe science—it’s peer-reviewed, published, and actionable. For some families, it’s been life-changing.
For the record: folic acid is a synthetic form of folate. It is not well utilized by many individuals with MTHFR polymorphisms or folate receptor antibodies. In these cases, unmet folate needs can impair methylation, neurotransmitter production, detoxification, and neurological development. Recommending folic acid alone, without considering bioavailability and individual biochemistry, is outdated and potentially detrimental.
And finally, we must speak to the spectrum.
Autism is not one thing. Level 1 autism—often what the public envisions—is vastly different from Level 2 or 3. Our practice primarily serves children with significant challenges: those who are nonverbal, self-injurious, or affected by seizures, aggression, or profound developmental delays. Lumping all these children into a single narrative, while simultaneously focusing only on the most “high-functioning” voices, is unjust.
We can do better. We must do better.
So here is my message, as a mother, clinician, and fierce advocate for children:
Yes, genetics matter. But so does environment.
Yes, the diagnosis is important. But so is asking why the symptoms emerged—and what we can do to ease them.
Yes, every child is different. But every child deserves the chance to thrive.
We are not helpless. We are not uninformed. And we are not done searching for answers.
Let’s move forward with science, open-mindedness, and above all, hope.
Peer Reviewed References:
Frye, R. E., Melnyk, S., & MacFabe, D. F. (2018). Folinic acid improves verbal communication in children with autism spectrum disorder and language impairment: A randomized double-blind placebo-controlled trial. Molecular Psychiatry, 23(2), 247–255. https://doi.org/10.1038/mp.2016.168
Panda, P. K., & Sharawat, I. K. (2024). Efficacy of oral folinic acid supplementation in children with autism spectrum disorder: A randomized controlled trial. European Journal of Pediatrics. Advance online publication. https://doi.org/10.1007/s00431-024-05523-6
Quadros, E. V., Sequeira, J. M., Marcus, S., & Ghosh, S. (2016). Folate receptor autoantibodies and autism spectrum disorders. Frontiers in Neuroscience, 10, 80. https://doi.org/10.3389/fnins.2016.00080
Rossignol, D. A., & Frye, R. E. (2014). Evidence of mitochondrial dysfunction in autism spectrum disorders: A systematic review and meta-analysis. Molecular Psychiatry, 19(3), 281–293. https://doi.org/10.1038/mp.2012.155
Sequeira, J. M., Ramaekers, V. T., Quadros, E. V., & Rothenberg, S. P. (2021). Cerebral folate deficiency, folate receptor autoantibodies, and leucovorin treatment in autism spectrum disorder: A systematic review and meta-analysis. Journal of Personalized Medicine, 11(11), 1199. https://doi.org/10.3390/jpm11111199
Winnefeld, M. (2021). Improving antioxidant capacity in children with autism: A review of interventions. Frontiers in Psychiatry, 12, 669089. https://doi.org/10.3389/fpsyt.2021.669089
