“You have certain groups — the Amish, for example — that have essentially no autism,” declared President Donald Trump with trademark certainty yesterday. Stood next to his Health Secretary Robert F. Kennedy Jr., he suggested that Amish people have low levels of autism because Amish women don’t take paracetamol (sold as Tylenol in the US) during pregnancy. Famously, they also don’t spend their days glued to screens; they’re too busy churning butter, raising barns and producing dozens of children. But Trump chose to point the finger at painkillers.
Clinicians across the world scrambled to rebut him. In Britain, Health Secretary Wes Streeting replied, “I trust doctors over President Trump.” It’s easy to be smug, but whatever the driver, Trump is right about one thing: autism figures are rocketing. A generation ago, the condition was rare. By 2000, one in 150 eight-year-olds in the US had a diagnosis; by 2022, it was one in 31. The UK is following the same pattern. Diagnoses rose 787% between 1998 and 2018, and the BMA now estimates one in 100 British children has an ASD label.
Once a narrow category, “autism spectrum disorder” has metastasised into a fashionable identity. The label now stretches from children who will never speak or live independently to tech titans like Elon Musk. Now that the stigma has ebbed away, pushy middle-class parents angle for diagnoses to give their offspring an educational edge, while students at elite universities self-identify as autistic for both extra exam time and the warm glow of victimhood. Meanwhile, those with the most profound needs — whose families are exhausted by round-the-clock care — are increasingly drowned out.
Academics have begun to notice. Professor Ginny Russell of Exeter University warns that ever-wider criteria, often based on self-description rather than clinical observation, risk a situation where “maybe everyone is categorised as neurodiverse”. “As awareness and diagnoses increase, those with less severe symptoms come forward with their own stories of how autism affects them,” Russell says. “The diagnostic criteria is widened to take these accounts on board, which loops back again to another increase in diagnoses.”
This is not simply a medical question but a cultural one: a disorder once marked by silence and incapacity has become a lazy shorthand for genius. Yet diagnostic creep can only explain part of the phenomenon. Something else is happening to children. As evolutionary biologist Heather Heying writes in A Hunter-Gatherer’s Guide to the 21st Century, the “uptick in diagnoses on the autism spectrum” may be “related to the number of children who were raised staring into screens.” “Do not let inanimate objects babysit your children,” Heying commands, “Those seemingly alive creatures, which cannot and therefore will not respond to a child’s looks or gestures or questions, send the message to the developing brain that the world is not an emotionally responsive place.”
In other words, toddlers pacified by Peppa Pig on repeat learn that the world does not answer back. Reduced eye contact, poor reciprocity, repetitive behaviours: the classic signifiers of autism can also be the hallmarks of children’s behaviour when raised on screens. If we wanted to manufacture a generation displaying autistic-like traits, we could hardly have done better than to outsource parenting to iPads.
Author and psychotherapist Joe Burgo, who works with teenagers who identify as trans, sees the same detachment. Patients who “spend countless hours online in virtual interactions, playing video games, and social media scrolling,” he tells me, become unmoored. “This leads to a dissociated experience of being in your head rather than down in your body where you might notice your feeling states. This dissociation is what we’re seeing rather than true ASD.”
The surge in diagnoses, then, is likely twofold: ever-expanding criteria and an environment that fosters autistic mimicry. Tackling it will require more than scolding expectant mothers for taking paracetamol. It means resisting the pathologisation of every quirk, and it means putting down our phones — parents as well as children.
Yet Trump may have been half-right. For all their butter-churning and barn-raising, the Amish really might be on to something.
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