Paracetamol, President Trump and the myths about autism

0:00How does a banana trigger a CIA-backed coup? Do AirPods herald the arrival of a new global order? What do LED lights say about the future of humanity? I'm Ed Conway, and in each episode of my new podcast, Stuff Matters, I take an object, crack it open, and reveal the world-shaping forces hidden inside. This is economics told through the things we think we understand. Search Stuff Matters on your podcast app to listen and follow. Coming up on the Sky News Daily with me, Neil Patterson. The President, paracetamol and a link to autism. Our science editor, Tom Clark, is here. Tom, is there conclusive evidence that paracetamol causes autism?

0:41No. Great, thanks for that. More after this. How does a banana trigger a CIA-backed coup? Do AirPods herald the arrival of a new global order? What do LED lights say about the future of humanity? I'm Ed Conway and in each episode of my new podcast Stuff Matters I take an object, crack it open and reveal the world-shaping forces hidden inside. This is economics told through the things we think we understand. Search Stuff Matters on your podcast app to listen and follow.

1:17Hi everyone, Neil here with the Sky News Daily. Do hope you're well. Though your blood pressure might well be sky high if you were listening to the US President Monday evening. And frankly, no wonder. Flanked by his health secretary, the anti-vaxxer Robert F. Kennedy Jr., Donald Trump told the world that paracetamol, sold as Tylenol in the United States, causes autism. No ifs, buts or maybes. Take paracetamol during pregnancy, he said, and your child's risk of autism significantly increases. Trouble is, as you're going to hear, on the best evidence available, it simply doesn't. So usually around about this point in the podcast, I'd sit back and play a bit of what we heard from the White House.

1:59But we're not in the business of amplifying pseudoscience or promoting outright falsehood. So instead, I had a quick troll through social media. Groundbreaking news. We have discovered that we think that maybe possibly Tylenol is linked to autism probably. Coming out about this Tylenol being a contributor to autism makes so much sense. When I was pregnant with my daughter, my doctor at the time, she was so big on not taking Tylenol. President Trump came out today and suggests there's a link between the use of Tylenol while pregnant and the rising autism cases. I personally don't take medicine when I'm pregnant.

2:41Look, there is the problem in a nutshell. It's often said that when When America sneezes, the world catches a cold. When the US president tells pregnant women they're giving their kids autism when they take paracetamol, well, at least some people are going to pay attention. So let's try and nail down exactly what is going on. Shortly, I'm going to be speaking to the author, Jessie Hewitson, about her family's experience of living with autism. But first, our science editor, Tom Clark, is here. Tom, let's just get this out of the way. Is there any conclusive evidence that Tylenol, that paracetamol causes autism?

3:15The key word there is conclusive. And I think it's the best thing to say is no, there isn't. There are studies which have shown a link, a correlation between mothers who took paracetamol while pregnant and the birth of a child diagnosed with autism. But there are other studies and I would argue better quality, larger studies that show the opposite. that there isn't a clear link between the two. And it's that correlation thing that's the tricky bit. And you can understand why, just looking at the raw numbers, Robert Kennedy Jr., the US Health Secretary, is obsessed with this issue because America consumes more paracetamol, they call it acetaminophenol, Tylenol's a popular brand name there, than any other country in the world.

4:03About 40 % of the global intake of paracetamol spend about$4 billion on it a year, I found out. and they also have increasing rates of autism. They've gone up significantly, 400 % over the last 25 years. There's a few studies that show that, you know, if you look at women who took it during pregnancy, there are a tiny bit more children with autism born to those women. That must mean something. But one of the biggest challenges in science, and you ask any epidemiologist or population public health person, that that's the devil, is how do you, when you're looking back on something, it is almost impossible to detangle what might be causing that correlation.

4:39And so far, no one has shown the cause. Let's try and just deal with some of the terms that we're using here. Correlation and causation are two separate things. So there is evidence that there is an increased risk. Is that right? That would be how they would define it, as an increased risk of having a child with autism if you took paracetamol. But we cannot be certain that it's the paracetamol that's causing the autism. And how do you know something is associated with something? You need to see a very clear pattern, and that is hard to do. One of the reasons that the regulators, and from what I understand, I feel much more confident in saying we really can't prove a link, and the link almost certainly isn't there.

5:17We can never say that for certain, but almost certainly isn't there, is the largest study done so far. It was based in Sweden, because in Sweden, unlike lots of countries, midwives record paracetamol use by mothers during their pregnancy, and they take notes on it. So they looked at two and a half million Swedish mothers and children. Wow, big data set. Yep. Out of those, 186 ,000 had had an autistic child. That's a very, very big sample size. The gold standard evidence that Donald Trump talked about yesterday was a study that collected other people's studies on this issue that showed correlations that totaled about 100 ,000 people in that.

5:55So this is a bigger study than all those other studies put together. what they found is when you look at siblings with and without paracetamol there is no impact of paracetamol on the birth outcome when it comes to autism but what more importantly they found there was also no relationship between the amount of paracetamol the mother took so if she took it once or twice or she took it every day throughout pregnancy because she had a particular condition logic dictates that the more paracetamol you take the more serious the impact would be and it found that that wasn't the case But it also explained why those other studies might be seeing a correlation that's not there.

6:30In other words, not a cause. So I think we can be really quite confident that paracetamol is not the bad guy when it comes to the rise in diagnosis of autism. The explanation for that, I think the much more logical one, the one that studies do support, is the fact that the age of mothers is getting older. We know that there is a relationship between maternal age and autism. We also know there's a relationship. It's not total, but it does have an impact. Low birth weight, premature birth. But also the way we diagnose autism has changed over the last 20 years significantly to include far more children.

7:06So if you look at that rise in the US and you look at when the DSM, which is the guidebook that psychiatrists use to diagnose these conditions, It has successively expanded the terms, the definition of what autism, a wide spectrum disorder is. Therefore, you take in more children. What is autism? It's a spectrum disorder. And I think it's why we now use terms like neurodiversity. There are people who have autistic traits of a very severe form and associated with those can be other problems. learning difficulties, epilepsy, much more profound disabilities. But to describe that as autism would be wrong.

7:49And at the other end of the spectrum, you have exceptionally high functioning, high intelligent individuals who thrive and succeed. And I think what would be very interesting here is what the five million Americans with autism and their families think about what Donald Trump was saying. OK, so when the president and the secretary for health in the United States stood up and said, Tylenol, paracetamol, they cause autism. That's just not true. We've heard RFK Jr. and Donald Trump say unhinged things about vaccines and about the scientific establishment and, you know, sort of left-leaning, woke scientific institutions in America.

8:27But there's always been a little caveat in there somewhere about, you know, we're not saying we're anti-vaccine or whatever. But this was just unhinged. I mean, I've never seen anything like it in terms of completely false statements about America's health. I mean, it was staggering. I literally couldn't believe it. I think a lot of people, they'd just gone one step further. It was just off the charts wrong. It wasn't just paracetamol. We also heard the pair of them banging on again about vaccines, but vaccines and a link to autism. This is very Andrew Wakefield, Lancet, nonsense from years past, isn't it?

9:04We heard Donald Trump say, you know, I've been following this closely for 20 years. How can he have been? Well, A, that can't be true. And secondly, I think what he said is, I want to drag things back to what they were like 20 years ago. In fact, it was maybe even a little bit more than that when we had, the world had, the massive collywobbles over the MMR vaccine because of a study that suggested a link to autism that went on to be thoroughly disproven by lots of scientists in lots of different parts of the world, in America, in the UK and elsewhere. So much so to the point, they ultimately proved that the person who'd done that study had made a lot of it up and he was struck off as a result.

9:40It was totally bad science, but more importantly, it led to kids dying. And that's the really significant thing. Children actually were harmed and died because of that science. And here we have a president long after, and it's taken about that long for MMR rates. In fact, I think it's fair to say, never recovered from that, but we were on a path to recovery. We've now seen that path reverse in America. Rates are now falling. And you have a president come out and say, once again, with complete absence of evidence, in fact, the contrary, far more evidence suggesting it's not true, saying that vaccines cause autism.

10:16No evidence, no proof, it's just dangerous. Children will die in America because of what he said. Thanks, Tom. Imagine just for a moment being the parent of an autistic child listening to Donald Trump on Monday. Well, Jesse Hewitson is the mother of two autistic boys, a columnist for the iNewspaper, and author of Autism, How to Raise a Happy Autistic Child. Oh, and she too is autistic. Jessie, what did you make of what you heard from the president? I mean, obviously, a lot of it is just complete nonsense, but it is also revealing. So, you know, Trump assumes autism as something to be feared or prevented, when in reality, the world needs more autism, not less.

11:00So I think in some ways, actually, Trump is perfectly highlighting with his kind of anti-science illogical approach why we need more people with my brain types. When you say that the world could benefit from having people with different brains, just explain a little bit more what you mean by that. So neurodiversity is a fact. It's recognising that it's a natural phenomenon that you have people who are autistic, ADHD and neurotypical brains. I mean, it's also recognition of the fact that there's no one right brain, so much in the same way that there's no one right sexuality or there's no one right ethnicity.

11:42It's the same with neurodiversity. So how then does it feel to, as someone with autism, to be identified by the President of the United States as someone with, in inverted commas, a condition that requires, in inverted commas, curing? I don't see myself as having a condition. I see myself as a normal human being. who just his brain processes information in different ways in some circumstances. I certainly don't feel like I need curing. I don't feel like my sons need curing. Mostly, I just kind of roll my eyes and it doesn't affect me too much. But when I stop and think about it, the Trump administration is approving drugs to be used to try and cure children.

12:25And that is really deeply worrying because, you know, there have been bogus trials in the past that have claimed to have cured autistic young people. But all they do is put massive pressure on autistic young people to mask. What masking is, is pretending that you're not autistic. And so basically the people with their checklist at the end of this experiment can say, ah, this person more closely resembles a neurotypical. therefore we've cured them, when really all you've done is introduced a huge level of shame that this person can't be themselves and they're putting all their energy into covering up who they really are and then the mental health outcomes are absolutely disastrous.

13:07It all feels so regressive, doesn't it? What Donald Trump and RFK Jr. appear to be doing is turning the clock back in terms of our understanding of autism, of neurodiversity and associated conditions. I mean, it really harks back to the misery narrative that was really dominant when I wrote my book eight years ago. So when you received a diagnosis of autism, I found it really difficult. I mean, I didn't know I was autistic. I was quite depressed, actually. I assumed it meant that my son was going to have this like I think I assumed he was going to be very unhappy and that he was going to live some kind of lesser life.

13:44So I do think he's going back to that link of autism, as you say, deeply undesirable, something you definitely don't want for your child. And they are overtly discussing trying to cure it, really. They're saying they're going to address what's causing the epidemic and remove this. Now, what is causing the epidemic is better identification. and you know we've got very terrible mental health outcomes for autistic people including you know you're far more likely to commit suicide i think it's clear that what increases those chances are you not understanding who you are and not understanding why you struggle with certain things or having social differences and the sooner you understand those things and realize that doesn't make you a bad person uh you know you've just got certain differences the better And I suppose your point there goes to the idea that there is not a one size fits all definition or description of autism, that there are as many as there are autistic people out there.

14:47I think it's really important to really look at the contribution autistic people have made to humanity, really. you know, if we were able to go back in time and go into that sort of room where all the scientists were trying to figure out how to launch a rocket into the sky and take it to the moon, I'm absolutely certain that there would have been like a high level of autistic scientists in that room. Because of the attention to detail, we bring the logic and also our abilities to hyper focus on something which kind of can produce a, you know, very real magic. You know, I feel that autistic people and ADHD people have probably dragged humanity to a better place and yet sort of been historically pathologised and that, you know, this is what Trump is continuing to do.

15:35Do you feel that Donald Trump was blaming women? There's a long history of mother blame in autism and in the 1950s we saw the refrigerator mother theory that basically said that bad mothering was causing autism and And that it was mother's inability to connect with their children that created the autism. I mean, some mothers committed suicide over that because their guilt was so sort of overwhelming. I've read the phrase patriarchal scapegoating. But I think there is a tinge of sexism around this argument and always looking at what the mum's doing. It is also fair to say, isn't it, that what Trump and RFK Jr.

16:20did from the White House, it's dangerous. isn't it? Because there are women who will require paracetamol during the pregnancy. Absolutely. If you have a fever and you don't take paracetamol, there are bigger consequences. I guess my main message to mums would be, if you could see Trump's comments in the same vein as saying, you know, taking too much paracetamol is more likely to turn your child gay, I think you can start seeing how ludicrous the comments are. What would be your advice to a pair of parents, a mother, father who've just received an autism diagnosis for their child? And on that alone, they are incredibly worried.

17:02They are worried for their child. What can you say to them to kind of assuage that fear? I guess I would say, what are you worrying about? Like, I suspect what you're worrying about is having an unhappy child. And that absolutely is not a given if they're autistic. but also if it helps I sometimes think we conflate autism with learning disabilities we conflate autism with all sorts of things that shouldn't be conflated with and also I think it's very important to know that the the idea that autistic people aren't empathetic is just an absolute myth it's just not true what do you have to fear I mean there's lots of very very highly successful autistic people walking this planet, many of them who are very happy.

17:46I think just from a parenting perspective, it involves more parental input to have a happy neurodivergent child. And that is because of the way the structures are in terms of schooling. So it's perfectly possible to have a happy child, but it often requires more parental input. And I'm not saying it isn't challenging it is but I don't think I know any parents who once they get their head around things kind of at the end of it wish their child wasn't autistic because they love the child for who they are you know in the early days when I found out my son was autistic I'm ashamed to say I would have given huge amounts of money if a pill existed to take it away and now god that thought it gives me like makes me feel sick.

18:36It gives me the shivers because my eldest son is extremely bright. He's just like so thoughtful and lovely and such a great friend. And he always thinks about my point of view as a son. I mean, quite unusually so. And the idea that I wanted to change who he was, you know, it's absurd. So I would try and give people that message that you may feel something in an eject reaction now but that is based on centuries of misinformation and you know misery narrative but you know i promise you'll come out the other end and love your child exactly for who they are and and the autism is a key part of that and it's a key part of being wonderful jesse thank you as always if you've any concerns about your pregnancy or anything that you've heard on the podcast.

19:25Social media is rarely the answer. Do speak to your doctor. You can also find plenty more reassurance from Tom Clark over on the website, skynews.com. The Daily's back tomorrow. Till then, take care.

19:39How does a banana trigger a CIA-backed coup? Do AirPods herald the arrival of a new global order? What do LED lights say about the future of humanity? I'm Ed Conway, and in each episode of my new podcast, Stuff Matters, I take an object, crack it open, and reveal the world-shaping forces hidden inside. This is economics told through the things we think we understand. Search Stuff Matters on your podcast app to listen and follow.