Many families have questions following recent federal announcements and media reports about vaccine schedules, Tylenol use during pregnancy, and possible new treatments for autism. We know these headlines can create uncertainty, questions and concern.
As a pediatric health care organization, Rady Children’s Health is committed to delivering evidence-based care rooted in science and delivered with compassion. Our recommendations remain aligned with leading medical organizations, which currently provide the following guidance:
- Vaccines: The American Academy of Pediatrics (AAP) and the California Department of Public Health (CDPH) continue to recommend the current childhood vaccine schedule as the best way to protect children against serious illness. Consistent with our commitment to science-based evidence, we know that no current study has found any link between vaccines and autism.
- Tylenol (Acetaminophen): Some recent reports have suggested a connection between acetaminophen use in pregnancy and autism. Current evidence does not establish a causal link. Moreover, studies that control for family genetics and maternal health show that earlier associations disappear. Decades of research show that autism has complex causes involving both genetics and environmental influences working together. Importantly, autism is not caused by anything parents did or did not do. The American College of Obstetricians and Gynecologists has not changed its guidance and continue to consider acetaminophen an appropriate option for managing pain or fever during pregnancy when used as directed.
- Leucovorin Research: Leucovorin is an FDA-approved drug used to treat certain cancers and types of anemia. Research on its use in autism comes from a limited number of studies, and the evidence remains limited. At this time, Leucovorin is not part of standard care for autism. Larger, well-controlled clinical trials are still needed to confirm its efficacy and safety as a therapeutic treatment before any recommendations can be made. Please see FAQs below.
Scientific guidance is essential, and so too is the way we support people with autism, which is a lifelong neurodevelopmental condition that is part of the broader spectrum of neurodiversity. Children and adults on the autism spectrum are valued members of our community, bringing unique strengths, perspectives and potential. Recognizing and embracing neurodiversity means respecting different ways of thinking, processing, and experiencing the world. People with autism and their families deserve care, respect, and support free from stigma. Our role is not to speculate about unproven claims but to walk alongside individuals and families with empathy, accurate information, and high-quality, evidence-based care.
FAQs about Folinic Acid (Leucovorin) and Autism
What is leucovorin?
Leucovorin, also known as folinic acid, is the active form of folate (vitamin B9). It is used in cancers that require specific types of chemotherapies and in certain genetic disorders that cause folate deficiency in the brain.
Is leucovorin an effective treatment for autism?
The use of leucovorin in persons with autism is an ongoing area of investigation. To date, there have only been small research studies with conflicting data. There is currently no strong evidence that leucovorin can treat symptoms of autism. At this time, we do not recommend leucovorin as a universal treatment for autism. More rigorous studies are needed to determine proper dosing, the patients who would benefit, and long-term benefits and/or side effects.
What is folinic acid? Is it the same as folic acid?
Folinic acid is a special form of folate (a type of vitamin B). It is different from folic acid (the common vitamin in foods and supplements) and from L-methylfolate. Folinic acid can reach the brain even when usual folate pathways are blocked.
Is testing for folate deficiency a good idea?
We do not recommend folate receptor autoantibody testing; this test has not been validated and is unreliable. Additionally, we do not recommend testing for cerebral folate deficiency, unless a child displays the symptoms typical for this disorder. This requires a careful discussion with your doctor. Testing for cerebral folate deficiency is invasive, consisting of a lumbar puncture (spinal tap).
What is the recommended treatment for autism?
We continue to strongly recommend standard of care interventions, including evidence-based medical care, behavioral and developmental therapies, and school- and community-based services.
What if I have more questions?
Any further questions regarding medical decision making should be directed to your child’s health care team. We are here to help you weigh possible benefits, uncertainties, and safer choices for your family.
References:
Understanding Autism: Information for Families – HealthyChildren.org
INSAR Public Statement – International Society for Autism Research
Autism Speaks statement on Tylenol and leucovorin | Autism Speaks
interdisciplinary leadership for developmental-behavioral health
CNS-Statement-on-Autism.pdf