At the end of September 2025, big words were heard once again from American politics and media about ‘finding an answer’ to the autism spectrum, and even warnings about paracetamol (acetaminophen) during pregnancy. Statements like these cause unrest, while the core is really very simple: the autism spectrum is a way of being within the broad neurodiversity spectrum, and not an illness that you ‘cure’. People do not need a ‘solution’. They need recognition, respect, a context they can understand and suitable support. That is kinder, and it is also scientifically more accurate.

The paracetamol discussion

Take that paracetamol discussion. For years, observations have appeared that suggest a minuscule link between frequent use of paracetamol in pregnancy and developmental outcomes. But such links are shaky, not causal, and often disappear when you correct better for confounding factors. In the Netherlands, where PsychosisNet comes from, the advice remains: use paracetamol sensibly, only when needed, at the lowest possible dose, and consult a professional about long-lasting complaints. Check the advice in your own country. It is important to keep in mind that fever and severe pain can themselves carry risks.

Bluntly claiming that paracetamol ’causes autism’ helps nobody and, on top of that, once again wrongly puts the blame on mothers. It is a classic trap: compressing a complex reality into a quick, moralising message.

It is not a broad ‘medicine against autism’

Then the other news: in September 2025 the American FDA announced the approval of a medicine that soon appears in headlines as a ‘treatment for autism’: leucovorin (folinic acid). Take a breath and look carefully. What it is about is a rare metabolic route, cerebral folate deficiency, in which folate does not get into the brain properly. In a small subgroup, in which folate receptor antibodies often play a part, some autism-related characteristics can overlap. For that specific subgroup there are signs that leucovorin can improve certain functions, such as language and social communication. That is truly good news for families and clinicians who screen for this carefully. But it is not a broad ‘medicine against autism’, any more than a pair of glasses ‘cures the person’. It targets a narrow biological route that is not representative of the whole of the variation on the autism spectrum. The autism spectrum is diversity, not a defect.

Anyone who lives with the autism spectrum knows that the real difference is often made by the environment. If you constantly have to mask in order to meet a norm, you become exhausted and less sure of yourself, not the other way round. Recognition, predictability, clear communication, regulation of stimuli, and room for your own interests and pace: that is the basis. On that footing you can look together at which aids fit, from practical adjustments at school or work to targeted forms of therapy and, in exceptional cases and after proper investigation, a biological intervention such as leucovorin for proven folate transport problems. The order matters: first the person, then the mechanics.

Let us use science for what it is meant for

Scientifically speaking, modesty is a good adviser. You simply cannot derive hard causality from observational studies. You do not solve this ‘just like that’ with a spreadsheet or a one-off analysis; there are methodological and ethical limits to that. Let us use science for what it is meant for: carefully accumulating evidence, small steps forward, and returning again and again to the question of what it means in someone’s daily life.

How do we keep it helpful? By holding on to two things at once. One: the autism spectrum is a valuable form of neurodiversity, not a mistake of nature. Two: within that diversity there is a rare subgroup with specific biological profiles for which targeted support can also be meaningful. Leucovorin fits into that rare category: possibly helpful for a small group with demonstrable folate problems, not a universal ‘cure’ for the autism spectrum.

Update March 2026: the FDA has now approved leucovorin for cerebral folate transport deficiency. That approval applies to that rare condition, not to autism.

Respect, room and realistic support

To parents, partners, colleagues and professionals: trust in ordinary good work. Keep talking with the person concerned, build a living environment that fits, and use evidence where it applies without turning it into an article of faith. Less flashy than the next ‘breakthrough’, but a good deal more effective in practice, and exactly what people on the autism spectrum have been asking for for years: respect, room and realistic support.

Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare. 

Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.

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Blogs by Jim van Os can be read here

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