Tangle - Preview - SPECIAL EDITION: Interview with Jill Escher, head of the Escher Fund for Autism.

Episode Date: September 24, 2025

Ari Weitzman catches up with Jill Escher, head of the Escher Fund for Autism, about the recent press releases which claim that Acetaminophen use by pregnant woman may be associated to an increased risk of neurological conditions such as autism and ADHD in children. For more information on this topic and Jill Escher visit her website at:https://www.jillescher.com/Ad-free podcasts are here! To unlock the rest of this episode and more follow the link below:To listen to this podcast ad-free, and to enjoy our subscriber only premium content, go to ReadTangle.com to sign up!You can subscribe to Tangle by clicking here or drop something in our tip jar by clicking here. Our Executive Editor and Founder is Isaac Saul. Our Executive Producer is Jon Lall.This podcast was hosted by Will Kaback and edited and engineered by Dewey Thomas. Music for the podcast was produced by Diet 75 and Jon Lall. Our newsletter is edited by Managing Editor Ari Weitzman, Senior Editor Will Kaback, Lindsey Knuth, Kendall White, Bailey Saul, and Audrey Moorehead.  Hosted on Acast. See acast.com/privacy for more information.

Hey, Tango Pod listeners, it's managing editor Ari Whiteman here dropping in to share this conversation that I recently had with autism philanthropist and researcher Joe Escher. Joe was kind enough earlier this year to sit with me for a longer conversation about autism and since it's in the news, again, I thought it would be a good opportunity to reach back and have another conversation. conversation with her about the recent developments at the Department of Health and Human Services. Joe took 15 minutes every time to talk to me. I thought what she had to say was characteristically thoughtful, nuanced, and illuminating. I got a lot out of the conversation, and I thought a lot of you would too. So here's that talk I had with Joe Escher. Hope you enjoyed. Okay, I'm joined today by Joe Asher, who is,

is the head of the Escher Fund for Autism, somebody who is, I find to be a great thinker and communicator about science research in this area of autism in general. And Joe has finally offered to join us today just to give a little bit of background and her opinion and her perspective on the recent finding from the Department of Health

and Human Services. So thank you, Joe, and welcome to, welcome back to the time of podcast. Thanks for having me, Ari. Our pleasure. So I want to just start by giving you the headline response that I received, which was this press release that came to my inbox yesterday from the Department of Health and Human Services, the Office of Public Affairs, which said the first, the subject line was FDA responds to evidence of possible association between autism and acetaminopin or Tylenol use during pregnancy. They said the U.S. Food and Drug Administration today initiated a process for a label change for acetaminophen, Tylenol, and similar products to reflect evidence suggesting that the use of acetaminopin by pregnant women may be associated with an increased risk of neurological conditions such as autism and ADHD and children. Just in general, what do you make of that? What do you make of this finding and this press release? I think it was not founded in science. And I think that it was.

was irresponsible, frankly, of the administration to hold a press conference, really at the highest echelons of government, yet the president and the DHS secretary there, you know, to make this sort of pronouncement, which was based only on, I think, cherry picking some research and not on fully vetted science that incorporated more thorough research on the matter. So, no. Well, I think we should definitely not be cavalier about the use of medicines during pregnancy. And we're right to be cautious. We're right to exercise questions about, you know, what are the effects on the fetus and the embryo of various medications?

These are important questions. We shouldn't be dismissive of that at all. But on the other hand, Tylenol and the Cedomidamidophon, they've been fairly well studied in epidemiology. and when they do find an association, it's really quite small, and the bigger and better studies find no association. So of all the things to worry about, this is probably not one to worry about. And there are other reasons to think that acetaminopin is not having an effect on autism rates. Clearly, there's no temporal associations that one would expect that would maybe be concordial. current with the upward curve of autism prevalence. So acetaminopin has been around since the 50s,

I believe, and it went off. It was over the counter, I think in 1961. And it's been in use for a long time. There hasn't been this rapid increase in the use of prenatal acetaminopin in the recent decades where we see the upswing of autism. So there's no real temporal association at all. There's also no real biological plausibility. The underlying mechanisms of autism don't map to what we might see with acidaminopin use. So there's really no reason for them to have chosen this one. I just think that they were very eager to get something on the map. They just, I feel the administration just wanted to throw some spaghetti at the wall at this point. And let's actually talk a bit about the rising incidents of autism rates. That's something that, as you said, there's a difference in the usage

of acetaminophen and prenatal acetaminopin and how that would map to the increase in autism. But I've also seen a lot of narratives in the media that are saying we can attribute most of, if not all of the rise in autism diagnoses to the way that we diagnose autism or ADHD or other psychological diagnoses that we have. But in this case, just to focus on autism, I refer to a recent episode of Derek Thompson's wonderful podcast, this plain English podcast, where he brought on Suzanne O'Sullivan, who's a neurologist who's written about how diagnosis can be attributed to the rise

of incidence and autism. I'm just wondering how you would rebut that argument. Is it actually the case that autism, as we would have defined in the 80s has gone up, and not that autism, as we define it now, has gone up, but that would then correspond to the entire incidence increase that we see in the diagnosis. Yeah, I mean, I strongly disagree with those who attribute the rapidly and very markedly, dramatically increasing rates of autism to awareness and diagnostic practices. There actually is next to no hard evidence for that at all. This is purely based on speculation.

There are a couple kind of cherry pick studies here and there that people might refer to to support that argument. But when you look at the breadth of the data over decades, it's really clear that there is overwhelming evidence for an increase in autism. Autism as defined by a serious neurodevelopmental disorder. Not autism is defined by, you know, things that we might consider kind of awkward or quirky or kind of poor social development. And we can see that in many, many places. I mean, I could go on for half an hour about them, which you don't want to do.

But I'll give you just an example from California. California has the best autism statistics of any state. We keep great data here because of our robust developmental services system that has been around really since the 60s and 70s. And this system has been counting autism cases in the state. Now, autism in the scope of developmental services in California, is defined as a serious developmental disorder that involves three or more areas of basic lack of function, like whether that's communication or self-help

skills. So these people are very impaired who enter the system. There were about 3,000 such cases in the 1980s, and today there are more than 220,000 such cases, right? This is, again, we're comparing apples to apples here. We're not opening up, we're not blowing up the spectrum, right, to include everybody in this particular administrative area. So, yeah, 3,000 to 220,000, it's not even close. There's never been any showing that that is attributable to diagnostic shifts. In fact, when it has been studied, for example, by the UC Davis Mind Institute, they concluded that the growth is not, cannot be explained by diagnostic factors. Now, there are lots of examples like that. I can go rattle off many from not just from the U.S., also from other countries as well, including the U.K., including

Australia, Japan, et cetera. Israel is another good example. But we frankly just don't understand what's causing the increase. And I think that it's the discomfort with the lack of understanding it that leads us to kind of be in denial about it and kind of has us looking for justifications for it that aren't really there. So as a person who's been involved with the research in this area for a long time, and you're talking about the findings that you know of that are convincing about the rise in this apples to apples, severe or profound autism diagnoses and cases going up. And as a parent of two autistic children, I think that's something that you've been invested

in personally, just trying to understand what's causing this increase. just to reiterate, what you're saying is that this increase is real. At the same time, there's a real increase in the number of cases that fit the autism diagnosis umbrella as that's expanded. But is it fair also to say that the administration is actually looking at something that is a real trend that has been generally not given a lot of focus by the scientific media or the scientific literature or just, the scientific apparatus in general, and is it fair for them to be looking into questions about

what could be causing this increase? Yeah, well, this is one area where I fully agree with the administration, both President Trump and Secretary. Hey, everybody. This is John, executive producer for Tangle. We hope you enjoyed this preview of our latest interview. If you are not currently a newsletter subscriber or a premium podcast subscriber and you are enjoying this content and would like to finish it, you can go to retangle.com and sign up for a newsletter subscription, or you can sign up for a podcast subscription or a bundled subscription, which gets you both the podcast and the newsletter, and unlocks the rest of this episode, as well as ad-free daily podcasts, more Friday editions, Sunday

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