A wadded up piece of red paper sits next to a wastebasket filled with similar pieces of crumped red paper.
Case closed: An autism journal has retracted a paper two years after researchers raised concerns about its conclusions.
Photograph by Richard Drury

Controversial ‘cost of autism’ paper retracted

The journal’s decision comes two years after Spectrum covered backlash from researchers over the study.

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Citing methodological issues and undeclared conflicts of interest, an autism journal has retracted a paper that forecast the prevalence and cost of autism.

The retraction note, posted last week, comes two years after Spectrum reported on backlash surrounding the paper, which was published in the Journal of Autism and Developmental Disorders in July 2021. A month after publication, the journal added an editor’s note that the study was under investigation because of criticisms of its conclusions.

“I am glad to see that it was retracted, although at a pace that maybe is a bit frustrating in terms of how long it took. But it was the right choice,” says Brittany Hand, associate professor of health and rehabilitation sciences at Ohio State University in Columbus.

Outside experts who reviewed the paper on the journal’s behalf found that it misrepresented the rise in autism diagnoses and gave “insufficient attention” to some potential causes of the increase, such as improved surveillance and changes to the diagnostic criteria. The authors also used “higher estimates and assumptions that inflated costs,” according to the retraction note.

The authors — Mark Blaxill, Toby Rogers and Cynthia Nevison — all disagree with the journal’s decision, the note also says. None responded to Spectrum’s request for comment.

“As a publisher, our priority is to protect the validity of the scientific record, and, as with all our post-publication investigations, this determined our actions in this case,” Chris Graf, research integrity director at Springer Nature, told Spectrum in an email.


he study predicted that 3 to 10 percent of children in the United States will have autism by 2060, and that the increased prevalence will cost the nation $5.5 trillion a year. The authors then modeled how preventing autism would lower the forecasted figures. They argued that their calculations “demand an urgent focus on prevention strategies.”

“I wish that the retraction notice was a bit more condemning of the eugenics undertones in the article,” Hand says. “It is advocating for the prevention of the existence of a marginalized group of people.”

In addition to describing the methodological issues, the retraction note also points out that the authors did not declare their “non-financial” conflicts of interest. All three authors have ties to organizations that promote a false link between vaccines and autism, Spectrum reported in 2021.

“It’s just an awful paper,” says David Mandell, professor of psychiatry at the University of Pennsylvania in Philadelphia. “It is methodologically incorrect. It is so transparently ideologically biased.”

Most studies on the cost of autism are intended to identify areas in which the health-care system, autistic people and their families might need extra support, Mandell says. But, he adds, the authors misused calculations from other studies — including several of his own — on topics such as the proportion of people with autism who are institutionalized or unable to work. “So I know that they are — I think intentionally, but it could be unintentionally — twisting those numbers to inflate them as much as possible.”

The paper was cited 18 times before its retraction, according to the data analytics firm Dimensions. One of those citations appeared in a call for autism research submissions from Translational Psychiatry, a journal in the Nature portfolio.