Tylenol, Autism and the Perils of Basic-Level Literacy

Pondiscio: When most Americans lack the reading skills to judge competing claims in critical debates, they are at the mercy of others.

By Robert Pondiscio

This story first appeared at The 74, a nonprofit news site covering education. Sign up for free newsletters from The 74 to get more like this in your inbox.

“Don’t take Tylenol,” President Donald Trump urged pregnant women in a packed White House press briefing Sept. 22, claiming a link between acetaminophen use and autism. Within hours, experts pushed back. One Reuters headline put it bluntly: “Trump links autism to Tylenol and vaccines, claims not backed by science.”

Who should we believe?

A friend of mine, a young mother, vented her frustration on Facebook. “In today’s day and age it’s not hard to spend a bit of time looking at the sources,” she wrote. That sounds plausible — until you actually try it. Evaluating competing scientific claims is hard work. It requires the ability to parse complex studies, distinguish correlation from causation, weigh evidence and spot bias.

And here’s the uncomfortable truth: As the latest round of 12th-grade NAEP results makes clear, this kind of independent evaluation is simply beyond the reading comprehension ability of most Americans.

To make sense of the Tylenol–autism debate — or any competing claims purporting to be scientifically sound, you need to do far more than skim headlines. You must:

• Comprehend dense scientific language — including technical terms, qualifiers and statistical nuances.
• Distinguish types of evidence — a correlational study versus a randomized controlled trial, or anecdotal accounts versus peer-reviewed findings.
• Compare conflicting results — noting sample size, methodology and limitations.
• Evaluate credibility and motives — is the claim coming from trial lawyers, pharmaceutical companies, advocacy groups or independent researchers?
• Synthesize across sources to form a tentative, reasoned judgment.

These are advanced literacy skills. They align closely with reading levels that the National Assessment of Educational Progress labels as Proficient and Advanced. At those levels, readers can not only understand text, but critique it, integrate ideas across multiple sources and evaluate rhetorical effectiveness.

By contrast, readers at the Basic level can generally summarize explicit information in a single text. Those Below Basic struggle to do even that. But neither Basic or Below Basic readers have what it takes to effectively weigh competing claims — and that’s two-thirds of Americans. They can’t reconcile conflicts, judge evidence or detect bias. They may read the words, but they can’t test the arguments.

Some critics urge caution before declaring a reading emergency. Paul Thomas, for example, has argued flatly that “there is no reading crisis,” pointing to the way NAEP defines its benchmarks. Diane Ravitch often warns that “schools in crisis” narratives are exaggerated. In doing so, she has cited Tom Loveless, a former Brookings scholar who has been careful and consistent in reminding readers that scoring as Proficient on NAEP is not the same thing as reading at grade level. Loveless has done valuable service in clarifying that the NAEP benchmark represents mastery of challenging subject matter, not minimum competence.

That distinction is real, and it deserves to be respected. Basic does not mean illiterate. A student scoring at NAEP Basic can generally follow directions, read newspapers and function in daily life.

The Tylenol controversy neatly illustrates what’s at stake. It may not be accurate to say two-thirds of Americans can’t read. But it is accurate to say that two-thirds of Americans don’t read well enough to independently evaluate the kinds of competing claims undergirding the autism debate and myriad other contemporary issues and controversies: the reality and causes of climate change, the long-term risks and benefits of artificial intelligence, the trade-offs in energy policy between fossil fuels and renewables, the economic and public-safety arguments surrounding immigration and trade, or Is crime so out of control that we should call in the National Guard?

That’s a real cost. Reading at only a Basic level leaves you unable to parse complex evidence, weigh competing arguments or judge credibility. You live instead in a state of intellectual second-class citizenship — with no option other than to defer to authority or rely on third parties, forever vulnerable to those whose political or financial interests may or may not align with your own.

To be clear, even advanced readers rely heavily on intermediaries — journalists, trusted experts, institutions — to help navigate scientific and policy debates. That’s normal. None of us can be experts in everything.

But the difference is choice. A strong reader can lean on intermediaries but also push back, double-check or seek alternative explanations. Basic readers have no such option. Their skepticism leads to cynicism or blind faith. They must either trust or reject the messenger wholesale.

That condition is what we might think of as literacy dependence. It means millions of citizens live in an intellectual state where their capacity to evaluate evidence is outsourced entirely to others. They are, in effect, governed not just politically, but epistemically.

Literacy dependence does more than limit independence: It actively aids and abets cynicism and partisanship. When you lack the ability to evaluate evidence for yourself, you are almost axiomatically dependent on the views of others — political figures, interest groups, media outlets — whose motivations may not mirror your own.

This dependence has consequences:

• Partisanship fills the gap. When people can’t evaluate claims, they default to tribal cues: which side said it, which identity group it affirms.
• Misinformation thrives. Simplistic, emotive narratives spread more easily than nuanced explanations, and those unable to interrogate them are more vulnerable.
• Legitimacy erodes. When people don’t understand the reasoning behind policies — whether vaccines, climate action or economic trade-offs — they may dismiss them as elite impositions.
• Inequality deepens. Those with higher literacy become a narrow class of people capable of evaluating evidence. Everyone else lives in dependence.

So let’s be clear: Yes, NAEP Proficient is a high bar. It’s wrong to equate it with grade level. But that doesn’t mean there’s no crisis. Because in a society where evaluating arguments is the lifeblood of citizenship, Basic is not enough. Functional literacy is not civic literacy. The problem is not whether you can read. It’s whether you can reason.