Controversy over the Trump administration's proposal of leucovorin as a treatment for autism

The suggestion of using leucovorin to 'treat' autism is worrying. Firstly, because the research in this area is poor quality and not at the level that we would expect when making recommendations for approvals. It is also worrying because such statements impact how people understand and perceive autism.

Autism is not something that needs treating or to be cured, it’s a neurodevelopmental difference. When we frame it as a condition that needs 'fixing', we risk adding to the stigma autistic people already face.

What really makes a difference for autistic people is the right supports: inclusive classrooms, workplaces that adapt to needs, communities that understand communication and sensory differences, and policies shaped by good-quality research. These are the things that help autistic people thrive and the things that governments have the opportunity to create.

Autistic people don’t need treatments or cures. They need a world that accepts and values them for who they are.

Leucovorin (folinic acid) has been promoted as a 'treatment' for autism, but the evidence is weak. A few small trials suggest possible small improvements in behavioural outcomes, yet these studies are limited by small numbers, inconsistent findings, and a lack of independent replication. 

Right now, the science does not come close to the standard needed to recommend leucovorin in the clinical management of autism. The field lacks large, multisite, rigorously controlled trials that could confirm whether benefits are real, reproducible, and meaningful in everyday life. 

In short, leucovorin remains experimental. Current research is too narrow and preliminary to draw strong conclusions, and the enthusiasm far outstrips the scientific evidence. Families and clinicians should be cautious, and also know that there are already many support programs with strong scientific backing that reliably support development in autistic children. Compared to these proven approaches, leucovorin is still very much unproven.

The evidence about the use of leucovorin as a treatment for autism, either provided in pregnancy or to children with autism, is preliminary and requires stronger scientific studies to ensure safety and effectiveness. There are some promising studies suggesting possible benefits, but these studies have many limitations that suggest that further research is needed. They are not at the quality that is needed for widespread use. 

There are also some studies suggesting negative side effects. More work is needed to be certain about the correct dose and timing, particularly when given in pregnancy and early childhood, before being taken up as a treatment for the community. 

At a time when scientific research has been severely underfunded and challenged internationally, this work further highlights the importance and need for high quality scientific studies that can provide data to governments, policy makers, health practitioners and families about evidence-based practice.