Ronald L. Lindsay, MD

Ronald L. Lindsay is a developmental-behavioral pediatrician.

Autism prevalence surveillance: a reckoning, not a crisis

Conditions

November 26, 2025

A recent Wall Street Journal graphic traces the rise in autism prevalence among eight-year-olds from 2000 to 2020. The slope is unmistakable, upward, steady, and steep. But it’s not a crisis. It’s a reckoning.

Each inflection point on that chart marks a milestone in institutional clarity:

2000: The CDC begins formal autism surveillance.
2007: The American Academy of Pediatrics urges universal screening at …
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Autism prevalence surveillance: a reckoning, not a crisis

Pediatric leadership silence on FDA ADHD recall

Ronald L. Lindsay, MD

Conditions

November 24, 2025

“The FDA has issued a nationwide recall of lisdexamfetamine capsules.”

That sentence in Newsweek magazine should have triggered alerts, guidance, and coordinated response. Instead, the silence from pediatric leadership has been deafening. Newsweek turned to the FDA and the American Academy of Family Physicians. Where are the leadership of the American Academy of Pediatrics (AAP) and the Society for Developmental and Behavioral Pediatrics? Silent. Why?

The recall that should have sparked action

In …

Did the CDC just dismantle vaccine safety clarity?

Ronald L. Lindsay, MD

Policy

November 22, 2025

“Vaccines do not cause autism.” That statement once anchored public health. The CDC just dismantled it, quietly, strategically, and dangerously.

Presumption reversed, justice subverted

Attorney Lindsey Halligan didn’t misspeak when she claimed James Comey must prove his innocence beyond a reasonable doubt to a Virginia grand jury. She exposed the new doctrine: guilt by accusation, innocence by loyalty. Then she staged a procedural ambush. She bypassed the full grand jury entirely. She …

Why we fund unproven autism therapies

Ronald L. Lindsay, MD

Physician

November 21, 2025

The average KevinMD reader may wonder why I’m so prolific in my commentary on pediatric medicine and the systemic reforms it demands. The answer is simple: I go to the source. Always.

That habit was forged nearly 30 years ago when the American Academy of Pediatrics invited me to serve as contributing section editor for Developmental-Behavioral Pediatrics in AAP Grand Rounds. My role: select key studies, critique methodology, and distill bottom-line …

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Why we fund unproven autism therapies

Interdisciplinary medicine: lessons from the cockpit

Ronald L. Lindsay, MD

Physician

November 19, 2025

In aviation, the right seat is typically reserved for the instructor. In medicine, it’s the role of the diagnostician, the mentor, the gatekeeper. I once piloted a T-37B “Tweet” trainer from the right seat, not as a student, but as someone trusted to guide. That experience shaped how I approach clinical decision-making, interdisciplinary fluency, and the choreography of care.

During a military training program, our squad faced a simulated obstacle: an …

Funding autism treatments that actually work

Ronald L. Lindsay, MD

Conditions

November 18, 2025

Applied Behavior Analysis (ABA) has become the default therapy for autism in the U.S., not because it’s the most effective, but because it’s the most entrenched. Mandated by insurers, funded by Medicaid, and marketed as “medically necessary,” ABA now consumes hundreds of millions of dollars annually. But here’s the truth: ABA is unproven, ethically fraught, and fiscally unsustainable.

As a developmental-behavioral pediatrician and lead investigator for the NIH-funded RUPP trials, I …

Why the media ignores healing and science

Ronald L. Lindsay, MD

Physician

November 17, 2025

I recently published a reflection on KevinMD, “A doctor’s duty on 9/11 in a small town,” a piece about clinical duty, quiet advocacy, and legacy. Boston University included it in my nomination for their Advocacy, Equity & Social Justice Alumni Award. I sent it to every major news outlet in my region. No one responded. One station asked if I’d go on camera. I agreed. Then, silence. This is …

A new autism care model in Idaho

Ronald L. Lindsay, MD

Conditions

November 15, 2025

Idaho has become the first state to end Medicaid funding for Applied Behavior Analysis (ABA) therapy. This marks a shift away from concerns about inflated billing and variable outcome metrics toward a model focused on measurable and inclusive care. As a pediatrician who participated in NIMH-RUPP trials and has observed the clinical evolution of ABA, I recognize the significance of Idaho’s decision. The state acted proactively rather than awaiting federal …

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A new autism care model in Idaho

A pediatrician’s reckoning with behavior therapy

Ronald L. Lindsay, MD

Physician

November 7, 2025

For decades, I practiced developmental-behavioral pediatrics with a focus on coordinated care, measurable goals, and clinical accountability. I believed that if we could define a child’s needs clearly and track progress with integrity, we could build systems that honored both science and dignity.

But I now realize I missed something critical.

After reviewing the #BanABA initiative and speaking with Dr. Henny Kupferstein, I’ve come to understand the full scope of harm linked …

The collapse of developmental pediatrics

Ronald L. Lindsay, MD

Physician

November 7, 2025

The terrain I refused to leave

At Madigan Army Medical Center, I built a diagnostic model that delivered autism answers in under 30 minutes. No shortcuts, just smarter care. A Ph.D. pediatric nurse practitioner performed triage. I conducted the Screening Tool for Autism in Toddlers (STAT-MD), a targeted autism screening protocol developed at Vanderbilt, confirmed criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and families left …

What is professional inertia in medicine?

Ronald L. Lindsay, MD

Physician

November 4, 2025

I learned that in a rural exam room where four agencies circled a child with autism; and no one moved. Not the nurse. Not the case manager. Not the system. The child failed the Autism Screening Test. He was nonverbal, avoided eye contact, even with his parents, and flapped his hands while playing with toys in unusual ways. The signs were classic. The diagnosis was clear. I spoke the “A” …

The crisis in modern autism diagnosis

Ronald L. Lindsay, MD

Conditions

November 2, 2025

Autism was never meant to be diagnosed in 15 minutes.

The original vision, born in war-torn Vienna and postwar Baltimore, called for deep observation, multidisciplinary insight, and time. But somewhere between the ideal and the insurance code, we lost the standard.

Today, families navigate a system built for speed, not truth. And children pay the price.

The ideal vs. reality

In theory, pediatricians perform routine developmental surveillance. Screenings like the M-CHAT happen at 18 …

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The crisis in modern autism diagnosis

The dismantling of public health infrastructure

Ronald L. Lindsay, MD

Physician

October 31, 2025

Florida has seen over 1,300 pertussis cases this year, an 81 percent increase from 2024. I didn’t speak as a retired pediatrician. I spoke as a witness: a witness to systems retreat, a witness to the dismantling of public health, and a witness to the consequences of ignoring coordinated care.

The numbers are staggering. Over 1,500 confirmed measles cases in 2025. Three deaths, the first measles-related fatalities in the U.S. in …

The case for coordinated care for children

Ronald L. Lindsay, MD

Physician

October 29, 2025

I entered medicine not just to treat illness, but to confront injustice. I wanted to be a force for good, battling death, yes, but also misinformation, institutional neglect, and the quiet superstition that children with developmental disabilities were somehow less worthy of coordinated care. That conviction led me to align my career with the legacy of Eunice Kennedy Shriver, whose advocacy gave rise to the Special Olympics and helped shape …

How health disparities affect children

Ronald L. Lindsay, MD

Physician

October 27, 2025

In 1995, I stood at the edge of a map most policymakers ignored: Appalachian Ohio. The Surgeon General’s 2002 report, “Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation,” would later cite our work as a model for rural specialty outreach. But long before that recognition, we were ledgering care into counties where children with developmental disabilities had no clear path to diagnosis, let …

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How health disparities affect children

The secret illnesses of U.S. presidents

Ronald L. Lindsay, MD

Physician

October 25, 2025

Presidents are not immortal. But for much of American history, their bodies have been treated as state secrets, curated, concealed, and choreographed for public reassurance. When illness is hidden, the cost is not just clinical. It is geopolitical.

Warren G. Harding: collapse before the scandal

President Warren G. Harding died suddenly on August 2, 1923, at age 57, while touring the country on his “Voyage of Understanding.” He collapsed in San Francisco’s …

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The secret illnesses of U.S. presidents

Traveling with end-stage renal disease

Ronald L. Lindsay, MD

Physician

October 23, 2025

My wife, Kathy, had stage 4 end-stage renal disease. She was slowly dying, but never stopped living. Her resilience in managing peritoneal dialysis made travel possible, even with the logistical complexities involved. Ireland had long been on our bucket list, inspired by Kathy and Stephanie’s earlier visit while we lived in Peoria. With careful planning, we booked our flights using points out of Orlando, knowing the drive would minimize Kathy’s …

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Traveling with end-stage renal disease

My experiences as an Air Force pediatrician

Ronald L. Lindsay, MD

Physician

October 21, 2025

In Minot, I practiced a kind of pediatrics no flowchart could predict: improvised, airborne, and often surgical. Minot didn’t always follow the flowchart. One night, a toddler arrived in the emergency room, inebriated. Her father had given her vodka for teething pain, never imagining she’d swallow it. She did. She stopped breathing. I called a code and began CPR, ordering a blood alcohol level (BAL) and routine labs. Her BAL …

A pediatrician’s role in national research

Ronald L. Lindsay, MD

Physician

October 19, 2025

I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.

From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes …

Treating autism and ADHD as a spectrum, not a contradiction

Ronald L. Lindsay, MD

Physician

October 14, 2025

He was five, wiry, and fast, so fast his mother looped her purse strap around his wrist in the waiting room. She spoke softly, in Spanish, explaining that he could not sit still, could not sleep, could not stop. As she described his meltdowns, he interrupted with nonsense sentences, unrelated to her words, untethered from context. It was not defiance; it was overflow.

I and my team of CNA Spanish interpreters …