'There's no silver bullet.' Seattle researchers say autism answers lie in early diagnosis, interventions

Marianne Bryan had no idea her three young children were autistic.

But she did see they were struggling. There were meltdowns; one of the children banged their head against the floor.

“Having a child who, as a kindergartener, was suicidal, was probably the most traumatic thing I've ever experienced in my life,” she said.

Bryan went to her children’s school, their doctor, and a psychologist. No one knew how to help.

Her story isn’t unusual. Most autistic kids aren’t getting what they need as early as they need it, said Annette Estes, a psychologist and the director of the University of Washington Autism Center.

“We really do know how to identify autism just as soon as it emerges, and we have a lot of really good approaches for supporting development and helping kids meet their full potential,” Estes said.

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Most autistic kids could be diagnosed by the time they’re 2, she said. But many aren’t — sometimes because no one recognizes the signs, or because the waitlists for insurance-paid evaluations can take years. Private psychologists can evaluate sooner, but can cost thousands of dollars out of pocket.

Estes said increasing reimbursement rates for autism evaluations, especially from public insurance like Medicaid, could make them more accessible for lower-income families.

Once kids have a diagnosis, they need intensive interventions, which Estes said can dramatically change a child’s life trajectory.

“Really what it translates to for the child is being able to be in regular classrooms, doing a variety of activities and learning along with their peers,” she said. “When kids don’t get those skills, that has an opposite kind of snowball effect.”

Autism has become a lightning rod issue at the federal level, with U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announcing what he believes are a cause and cure for autism, telling pregnant women not to take Tylenol because, he said, it increases autism risk, and suggesting leucorovin as a possible treatment.

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Autism researchers in Seattle say there’s not enough evidence to back his claims (and that, in fact, the bigger risk is that pregnant women will not take Tylenol to treat fevers, which are known to increase the risk of birth defects). Autism is mostly caused by genetics, they say. There are no pills to cure the condition. What’s needed are early diagnoses and early interventions, according to researchers.

Estes said autistic kids need occupational therapy, speech therapy, parent coaching, and what’s known as applied behavior analysis, or ABA.

Estes said she and her colleagues published the first study on the effectiveness of early interventions 15 years ago. They found that providing support for toddlers between 1 and 3 years old led to earlier talking, higher problem solving and cognitive skills, and even increased IQs.

Estes and her team followed up with the study participants at 6 years and found they were still doing better than those who hadn’t received interventions early on.

The goal of ABA therapy for autistic children is to help them learn new communication or social skills, but Estes said it should look like play.

During a recent ABA session at the UW Autism Center, a preschool-aged child and his ABA therapists were placing colored rings on a stick.

The child knew all his colors. His therapists were trying to get him to answer a yes or no question: Is this green?

He had the knowledge, but social communication was hard for him.

Every time he did say yes or no, they cheered for him.

ABA therapy is controversial in the autistic community. Many autistic people say this form of therapy traumatized them as children.

Marianne Bryan, the mom with three children diagnosed with autism, said that when her kids were first diagnosed, the psychologist suggested ABA — and that ended up doing more harm than good.

“One of the things we were told to do was when explosive behaviors were happening, we were to close a door between us and the child, which led to severe anxiety about abandonment and separation,” she said.

Bryan said occupational and speech therapy were much more helpful; they helped her kids identify and express their feelings and needs, she said.

These days, all three of her children are doing well. The oldest just graduated from college and is training to be a surveyor. The second is studying psychology and the third is still in middle school.

At the end of the day, researchers and parents in the Seattle area agree it’s not about a cure. It’s about early diagnoses and early interventions to help autistic children cope and reach their full potential.

Estes said that’s what she wants the federal government to focus on: expanding access to these proven interventions.

“It is really hard to scale because it’s long-term teaching that’s really individualized, so it takes a lot of training on the clinician side,” she said.

That’s the sort of thing the government could help with, she added.

Correction 11/12/25: An earlier version of this story said Marianne Bryan's children's psychologist recommended ABA therapy only, when in fact other treatments were also recommended.