RFK Jr. wrong about share of autistic population with severe limitations

Health and Human Services Secretary Robert F. Kennedy Jr. attracted notice — and in some quarters, outrage — for remarks about autism, a topic he’s clashed with scientists about for years.

Kennedy held an April 16 press conference pegged to a new Centers for Disease Control and Prevention report that found the prevalence of autism rising to 1 in 31 among 8-year-olds, the latest in a series of increases in recent decades.

Kennedy said “autism destroys families” and is an “individual tragedy as well.”

Kennedy said many autistic children were “fully functional” and had “regressed” into autism “when they were 2 years old. And these are kids who will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go out on a date. Many of them will never use a toilet unassisted.”

He also said: “Most cases now are severe. Twenty-five percent of the kids who are diagnosed with autism are nonverbal, non-toilet-trained, and have other stereotypical features.”

Medical experts, along with people on the autism spectrum, told PolitiFact that Kennedy’s portrayal was skewed. A 2023 study written by CDC officials and university researchers found that one-quarter of people on the autism spectrum have severe limitations. But this is on the high end of studies, and many people in that one-quarter of the autism population do not have the limitations Kennedy mentioned.

The vast majority of people on the spectrum do not have those severe challenges.

“I wish he would spend some time with parents of other autistic children, and well-regarded scientists who have studied this condition for decades,” said David Mandell, a University of Pennsylvania psychiatry professor and director of the Penn Center for Mental Health. “He has a fixed, myopic view.”

The Department of Health and Human Services did not provide data on what share of people with autism diagnoses are unable to do the things Kennedy described.

“Secretary Kennedy remains committed to working toward a society where people with autism have access to meaningful opportunities, appropriate supports, and the full respect and recognition they deserve,” department press secretary Vianca N. Rodriguez Feliciano told PolitiFact. “His statements emphasized the need for increased research into environmental factors contributing to the rise in autism diagnoses, not to stigmatize individuals with autism or their families.”

The Washington Post reported that an HHS spokesperson said Kennedy “was referring to those that are severely affected by this chronic condition” and that “this was in no way a general characterization.”

We took a closer look at the available data and research.

What Is Autism Spectrum Disorder?

At root, “autism is a difference in how your child’s brain works that shapes how they interact with the world around them,” according to the Cleveland Clinic. People with autism diagnoses, the clinic says, “may excel more in certain areas and need more support in other areas compared to their neurotypical peers.”

Over the years, autism’s definition and diagnosis has changed.

In the 1950s and 1960s, “it is very likely that many people with profound autism were misdiagnosed with ‘mental retardation,’ a term in use at the time, or schizophrenia, while other autistic people probably got no diagnosis at all,” said John J. Pitney Jr., a Claremont McKenna College politics professor, author of the book “The Politics of Autism: Navigating the Contested Spectrum,” and a father of an autistic son who’s about to graduate from college.

In more recent decades, the diagnostic criteria for autism have broadened, producing a spectrum ranging from severe impacts to more modest ones. Today’s definition encompasses “individuals with milder symptoms, stronger language skills, and higher IQs,” said Christopher Banks, president and CEO of the Autism Society of America.

How Common are the More Limiting Forms of Autism?

Autism’s expanded definition means a minority of people on the spectrum have the kinds of severe limitations Kennedy cited, though it’s hard to say how many.

The highest total we found comes from a 2023 federal report, written by CDC officials and university researchers. It found that 26.7% of 8-year-olds with autism had “profound” autism, a newly framed (and not universally accepted) definition that included children who were nonverbal, were minimally verbal, or had an IQ below 50. (“Average” IQ is considered 90 to 109.)

People with profound autism “will require lifetime, round-the-clock care,” said Judith Ursitti, co-founder and president of the Profound Autism Alliance, a nonprofit. Ursitti said her 21-year-old son “is not headed towards employment or a career in poetry or baseball. Acknowledging this fact is important, as this population is often excluded from media portrayals and research.”

Other estimates are lower.

A study published in 2024, by researchers at the University of Utah and Children’s Hospital of Philadelphia, looked at 1,368 U.S. children with autism. When parents were asked whether they would characterize their child’s autism as “severe,” 10.1% said yes. Among this group of children with “severe” autism, a minority — 38% — were classified as having a “severe” intellectual disability.

“Even among those with an intellectual disability, there’s huge variability,” Mandell said. “People with Down syndrome have an intellectual disability but often are quite capable and can do all the things RFK points to.”

The CDC published data in 2020 showing that 42% of people with autism had an IQ in the average or higher range, and another study has found that this figure could be as high as 60%.

Zoe Gross, the director of advocacy at the Autistic Self Advocacy Network, said limited available data suggests that Kennedy’s characterization is exaggerated.

Gross, who is on the spectrum herself, said a 2017 study found that 61% of people on the spectrum who were studied were employed. As for baseball, the Special Olympics, which was founded by Kennedy’s family and includes competitors who are on the spectrum, includes softball. At least two people who played major league baseball, Tarik El-Abour and Jim Eisenreich, were public about their autism diagnoses.

Gross said there is no official data on autistic poets, but she was aware of the poet DJ Savarese, a nonspeaking but highly literate advocate. Gross was also unable to find data on dating, but she said she’s married, and she pointed to the Netflix reality show “ Love on the Spectrum,” which follows autistic people’s dating lives. It is now in its third season.

As for not using a toilet unassisted, the 2024 study that analyzed 1,368 U.S. children with autism and found that 10.1% were considered “severe” found that 67% of those in the “severe” category had trouble bathing or dressing, which, if generalizable to the entire autistic population, would be less than 7%. Another study found urinary incontinence reported by 12.5% of the autistic people studied and fecal incontinence by 7.9%.

Eric M. Garcia, who is on the spectrum and who has written the book “We’re Not Broken: Changing the Autism Conversation,” was covering Kennedy’s remarks as Washington bureau chief of The Independent. Hearing his words “felt so demoralizing,” Garcia told PolitiFact. “A lot of people will respond by saying, ‘He didn’t mean autistic people like you.’ But that doesn’t make it any better.”

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