If you start using a medication in a person with autism, you should see an obvious improvement in behavior in a short period of time. If you do not see an obvious improvement, they probably should not be taking the stuff. It is that simple.

Grandin is arguing for a pragmatic, outcomes-based approach to psychopharmacology in autism: medication should be justified by clear, observable functional gains (reduced distress, improved self-regulation, better sleep/attention) within a reasonable trial period, rather than by vague hopes or pressure to “do something.” Implicit is a warning about overmedication and the tendency to treat autism itself rather than specific, impairing co-occurring symptoms (e.g., anxiety, aggression, ADHD). The quote also reflects a broader ethical stance: because side effects and long-term burdens can be significant, continuing a drug without demonstrable benefit is hard to defend. It promotes careful monitoring, measurable goals, and willingness to discontinue ineffective treatment.