1) Acetaminophen-in-pregnancy

The administration is expected to advise limiting acetaminophen in early pregnancy (except for high fevers), citing observational studies that report associations with later ASD/ADHD. But a very large Swedish sibling-comparison study (≈2.5M births) found no causal link, and major medical groups still consider acetaminophen appropriate in pregnancy when used as directed—so this will be controversial. JAMA Network+2PubMed+2

For context: news coverage previews the guidance as a sharp departure; expert reactions emphasize that correlation ≠ causation and warn against scaring patients away from the safest available analgesic in pregnancy. Reuters+2Reuters+2

2) Leucovorin (folinic acid) for a subgroup

Small randomized trials suggest improved verbal communication and clinical scores in some autistic children treated with folinic acid, particularly those with folate-receptor-alpha autoantibodies (FRAA)—a biomarker tied to cerebral folate deficiency (CFD). Encouraging, but not a cure; larger confirmatory trials are still needed. PubMed+2PubMed+2

3) A bigger federal initiative

Reporting points to an NIH/HHS multi-team effort to probe causes and treatments and to coordinate data—details to come with the formal rollout. The Washington Post

Quick primer: what folinic acid is (and isn’t)

Folinic acid = leucovorin (5-formyl-THF), a reduced folate widely used for methotrexate rescue and with 5-FU in oncology. It is not the same as folic acid or L-methylfolate. NCBI+1

Why folinic acid is being discussed for autism

A subset of autistic children show cerebral folate deficiency (CFD), often linked to FRAA that impede folate transport into the brain. In that subgroup, oral folinic acid can bypass the blocked pathway and has shown clinical benefit in trials. (Some clinicians order a commercial FRAT® blood test to detect FRAA and identify likely responders.) PMC+1

Key evidence (human trials)

• Randomized, double-blind, placebo-controlled trial (Frye et al., Molecular Psychiatry): folinic acid improved verbal communication, with larger gains in FRAA-positive kids. Dose ≈ 2 mg/kg/day (max 50 mg/day) divided. Nature
• Randomized, double-blind RCT (Panda et al., 2024, Eur J Pediatr): add-on folinic acid (same dosing) improved CARS/CBCL scores; benefits strongest in high-titer FRAA; no significant safety signals. PubMed
• Systematic reviews: FRAA/CFD are associated with ASD, and d,l-leucovorin shows signal of benefit in this subgroup; larger trials are warranted. PMC

How clinicians have used it (off-label)

• Typical study dose: 2 mg/kg/day (max ~50 mg/day), split BID, often titrated from a lower start. Consider FRAA testing (e.g., FRAT®) to enrich for likely responders. Nature+1

Safety notes: Most effects reported are mild (GI upset; occasional sleep/behavioral activation). Folinic acid interacts with antifolate drugs (e.g., methotrexate, trimethoprim combinations) and modulates 5-FU—review meds first. Use in ASD is off-label; work with a clinician. NCBI

Bottom line

• The White House is set to warn on early-pregnancy acetaminophen (except for high fevers), promote folinic acid as a candidate therapy for a biomarker-defined subgroup, and expand federal autism research/data work. It’s not a cure announcement. The Washington Post
• On acetaminophen, evidence is mixed: a massive sibling-analysis found no causal link, and professional bodies still regard acetaminophen as appropriate when used as directed. Expect pushback. JAMA Network+1
• On folinic acid, two RCTs show clinically meaningful benefits in some children—especially FRAA-positive—but larger trials are needed before any broad claims. PubMed+1

As always, discuss medications and testing with your own clinician; pair any trial of folinic acid with standard behavioral/educational supports.