Parent blame, cure and the "autism wars"

Leo Kanner, who in 1943 had described eleven children with "autistic aloneness" and held that the picture was inborn, later turned to the children's emotional life and looked for the cause in a cold home.¹ In a 1949 paper he wrote of children "kept neatly in refrigerators which did not defrost", and of a "maternal lack of genuine warmth" that was "often conspicuous in the first visit to the clinic".^2,3 Others took his phrase and called the mothers "refrigerator mothers".⁴

Bruno Bettelheim made the idea popular. In The Empty Fortress (1967) he argued that a cold, rejecting mother caused the child's autism, and that the remedy was "parentectomy": removing the child from the parents and placing him in an institution such as his own Orthogenic School, in Chicago.⁴ The book rested on three children, and the claim that the treatment worked was his own.⁴

For two decades the account shaped what families were told. It made autism a source of shame, and, as Eric Garcia writes, drawing on the historian Alice Pitney, it "helped keep autism off the agenda" of disability rights.^c2 Histories of psychiatry date its loss of authority to the early 1960s, when epidemiological research in Britain reshaped the concept of autism and parent organizations campaigned for recognition and backed research into other causes.⁵ Bettelheim's account remained popular into the 1970s and later fell into disrepute.^c3,4

Bernard Rimland, a psychologist whose son was autistic, published Infantile Autism in 1964. The book argued that autism was an inborn, neurological condition rather than the result of parenting, and it reached other parents who had been told to blame themselves.⁶ In 1965 Rimland and Ruth C. Sullivan founded the organization now called the Autism Society of America, then the National Society for Autistic Children; Sullivan became its first elected president.⁷ The society published its own definition of the syndrome in 1978.⁸ In 1975 Congress passed the Developmentally Disabled Assistance and Bill of Rights Act, which tied federal money to services and to rights.⁹

The movement then divided over its aim. Steven Kapp writes that the parents who had led the shift to a medical model wanted professional treatment, while autistic self-advocates turned to the neurodiversity movement to seek support on their own terms.¹⁰ When Ruth Sullivan asked the parents at a meeting whether they wanted services or a cure, Steve Silberman records that "nearly all parents' hands went up" for services; Rimland, by contrast, took the movement "into an endless quest for a cure".^c1

One arm of the parent movement pursued a cure. Eric Garcia quotes the mission of Autism Speaks at its founding, to fund research into "causes, prevention, treatments and a possible cure", and Mitzi Waltz describes an autism industry that sold treatments to parents, many of them under pressure to do something for their child.^c2,c4 Around the cure effort grew a market in special diets, supplements and other unproven treatments. A 2008 Cochrane review of gluten- and casein-free diets found the evidence for their benefit poor, from two small trials with 35 children in all; Cochrane later withdrew the review as out of date.¹¹

In February 1998 Andrew Wakefield and colleagues published a paper in The Lancet describing 12 children, 11 of them boys, and reporting that the children's parents associated the onset of behavioral symptoms with the measles, mumps and rubella (MMR) vaccine in 8 of the 12.¹² At the press conference that followed, Wakefield recommended separating the combined vaccine. Vaccination rates fell, and measles outbreaks returned where they had been controlled.¹³

The paper was retracted. The Lancet's notice, published on 6 February 2010, records that after the judgment of the UK General Medical Council's disciplinary panel on 28 January 2010 it had become clear that "several elements" of the 1998 paper were incorrect, and that the journal fully retracted the paper from the published record.¹⁴ A 2011 editorial in The BMJ concluded that the paper was fraudulent;¹⁵ Wakefield was struck off the UK medical register in May 2010.¹⁶ Large cohorts and pooled analyses have since found no link between vaccination and autism; those studies are collected in Contested causes.

The episode cost the parent movement. Silberman records that the vaccine campaign "hijack[ed]" parent advocacy away from services, and Garcia that it split Autism Speaks, which had been founded in 2005 with a mission that included finding a cure; Bianca Toeps argues that the organization "claims to speak for autistics but mostly speaks for the bystanders".^c1,c2,c9 By 2017 the organization's stated mission had dropped the words "cure" and "prevention" for "understanding and acceptance".¹⁷ The clash between some autistic self-advocates, who argued for acceptance, and some parents and professionals, who sought access to interventions for autistic people with high support needs, became known, in the scholarly literature, as the "autism wars".¹⁸ Histories of the campaign trace how it damaged trust in vaccination.¹⁹

What is not in dispute, in the survey that measured these views, is that recognition of autism's difficulties and support for help that eases without trying to eliminate autism did not depend on whether a respondent was autistic.²⁰ The argument is over identity and cure, and it is a disagreement about values as much as about facts.

The largest survey of views about a cure specifically is an online study by Steven Kapp and colleagues, of 657 people: autistic people, relatives and friends of autistic people, and people with no close connection to autism. It found that people who identified as autistic, and those aware of neurodiversity, were more likely to see autism as a positive identity that "needs no cure". It found no difference between groups in recognizing autism's difficulties.²⁰ The sample was self-selected and online, so it underrepresents autistic people with an intellectual disability and those who communicate without speech, and it cannot say what most autistic people want.

The positions are held by named people. Against a cure, Sol Smith writes that "autism isn't an affliction"; Megan Anna Neff answers the question of a cure pill with "No, I wouldn't take that pill"; and Temple Grandin, quoted by Silberman, said that if she could "snap my fingers and be non-autistic" she would not, "because then I wouldn't be me".^c5,c6,c1 Others would not decide for anyone else: Megan Griffith writes that she would never take a cure herself but "would also never stop someone else from taking it, as long as they were fully informed", and Barnabear, writing in an edited collection, that "if you 'cured' my Asperger's then I'd be someone else".^c10,c11 The wish for a cure is real too: Garcia writes that "if autism is a tragedy, then some parents feel entirely justified in doing whatever it takes to 'cure' their kids", and Price, in a later book, argues that pride is optional: "We don't all have to feel positively about our neurotypes".^c2,c8 Autistic-led organizations and the writers above largely reject cure framing, while some parents and clinicians continue to seek treatments.

What would settle it is partly a matter of study and partly not. A representative sample, rather than a self-selected online one, that deliberately includes autistic people with an intellectual disability and people who communicate without speech, with questions set in advance and run in more than one country, would give a better answer to how many autistic people want a cure. Whether a cure would be desirable is a values question, and no study settles it.

In 2025 and 2026 the US federal government returned to the questions the parent movement had fought over a decade or two earlier. On 22 September 2025 the Department of Health and Human Services announced a group of actions, including leucovorin as a "promising treatment for symptoms of autism", a notice to physicians on acetaminophen in pregnancy, and the first award recipients of its Autism Data Science Initiative.²¹ On 1 August 2025 the health secretary, Robert F. Kennedy Jr., published an article calling on Annals of Internal Medicine to retract a Danish study of aluminum-containing vaccines; the journal declined, as reported in The BMJ on 18 August 2025.^22,23 In November 2025 the Centers for Disease Control and Prevention changed its vaccine-safety page to say that the claim "vaccines do not cause autism" is "not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism", and said the department had begun an assessment of autism's causes.²⁴ On 28 January 2026 the department appointed 21 new members to its Interagency Autism Coordinating Committee.²⁵

The primary studies test those claims. A Danish cohort of 657,461 children found no increase in autism with MMR vaccination (hazard ratio 0.93, 95% confidence interval 0.85 to 1.02).²⁶ A Danish cohort of 1,224,176 children found no association between the amount of vaccine aluminum a child received in the first two years and autism or the other chronic conditions studied, though the authors note that small effects on rarer conditions could not be ruled out.²⁷ Eric Fombonne, in a 2025 commentary, attributes the measured rise in prevalence to changes in definition, criteria, diagnostic practice and case-finding, among other factors, rather than to an epidemic.²⁸ A 2025 editorial by Kathryn Wright and Kellan McNally argues that the "autism crisis" framing of the 2025 Kennedy hearings misrepresented the evidence, and calls for disability justice in social work.²⁹

Writers describe the blame era from the receiving end. Steve Silberman records that the movement was "energized by the rage of parents who had been scapegoated for causing their own children's misery", and Pearson and Rose note that "Bettelheim's theory of parents being responsible for their child 'developing' autism remained popular into the 1970's".^c1,c3 Eric Garcia writes that "from the 1970s until the mid-2000s, much of the political advocacy for autism was done without the input of autistic people", and that parents "must recognize when their own desires come at the expense of autistic people's well-being".^c2

The cure market is described from the inside. A parent writing in I Will Die On This Hill says that "biomedical companies offer parents the hope of curing our children", and "take advantage of our desire to give our kids the best lives possible".^c12 The refusal of a cure is often about identity: Barnabear writes, "if you 'cured' my Asperger's then I'd be someone else, and actually I'm comfortable in my own fur". Devon Price writes that autism "cannot be 'cured,' and most people in the Autism self-advocacy community eventually come to see that fact as a blessing". Griffith, who would not take a cure herself, allows the other view: "some folks want a cure, and that's okay".^c11,c7,c10 Garcia records the parents' side of the same argument: "if autism is a tragedy, then some parents feel entirely justified in doing whatever it takes to 'cure' their kids".^c2 Kayla Rodriguez, writing to parents, puts it plainly: autism "isn't a bad 'disease' that needs to be 'cured' or 'prevented'."^c13