Phoenix, Arizona — Nathaniel Schumann, a nonverbal autistic boy, began speaking in full sentences at age 8 after taking leucovorin, a drug that has shown promise in children with cerebral folate deficiency. For years, Nathaniel had understood everything but struggled to communicate, leaving his parents frustrated and concerned.
“He had a laundry list of everything that upset him throughout the years,” said Dr. Kathleen Schnier, Nathaniel’s mother. “People weren’t having him be part of the conversation or just assuming he wasn’t understanding it. But it was all there.”
Now 13, Nathaniel is part of a growing group of children benefiting from leucovorin, a generic and inexpensive medication that helps deliver vitamin B9 to the brain more effectively.
Early Challenges and Diagnosis
The second child of Kathleen and Paul Schumann, Nathaniel was a social and babbling toddler, making eye contact and engaging easily with his surroundings. But as he grew, he began missing developmental milestones.
“He didn’t start walking until 14 months, and then he started regressing with his words,” said Kathleen, provost and chief academic officer at Colorado Tech University.
By age 3, Nathaniel was diagnosed with autism, receptive-expressive language disorder, and ADHD. Despite early intervention with speech, developmental, and occupational therapy, he remained mostly nonverbal for several years.
“You could never have a conversation with him,” Kathleen said. “That was the most horrendous thing as a parent: knowing that you can’t have a conversation with your own child, or that somebody could hurt him and he couldn’t tell you.”
Leucovorin and the Road to Speech
In 2021, Kathleen discovered a clinical trial led by Dr. Richard Frye at Phoenix Children’s Hospital, studying leucovorin’s effect on autistic children with cerebral folate deficiency, a condition linked to speech delays and behavioral challenges.
“It was like something clicked. He went from one or two words to full-on sentences within six months,” Kathleen recalled.
Researchers estimate that up to 70% of autistic children have antibodies that block folate transport into the brain, contributing to speech and behavioral difficulties. Leucovorin, a form of folate first approved in 1988 for chemotherapy support, bypasses this block and delivers the nutrient directly to the brain.
“If you’re going to the doctor and looking for an autism pill, it doesn’t exist,” Frye said. “But leucovorin has helped a lot of children.”
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The drug costs around $100 per month without insurance, and as little as $10 with coverage.
Finding Nathaniel’s Voice
Once Nathaniel began taking leucovorin, he rapidly transitioned from limited words to full sentences, allowing him to express years of thoughts and frustrations.
“The TV in my brain, I can say it in my mouth,” Nathaniel told his mother. “It was always there, he just couldn’t say it.”
Kathleen emphasized that the medication was not a cure-all. Nathaniel’s years of speech, developmental, and occupational therapy provided the foundation for his newfound communication skills.
“Suddenly, he had the capability of talking, but he had to learn how,” she said. “When you have a conversation with a person, you have to ask them things and listen to them. It’s not all what you want to talk about the whole time, and he can do that now — but leucovorin didn’t do that for him. Speech therapy did that for him.”
Frye noted that leucovorin accelerates the effectiveness of existing therapies, but does not replace them.
“You have to treat a lot of things to make the body well. What [leucovorin] does, we think, is accelerate the effectiveness of all these therapies,” he said.
Nathaniel’s story underscores how combining medical interventions with consistent therapies can open new communication pathways for children with autism.
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