The complex interplay between autism, Lyme disease, and immune function reveals a landscape where biology, environment, and identity converge, demanding nuanced understanding rather than simplistic blame. Autism represents a spectrum of neurological expression shaped by genetics, immune activity, and environmental influences, while chronic infections and immune dysregulation can amplify stress and behavioral changes without causing neurodiversity. The gut–brain–immune axis, maternal health, and early-life programming further influence development, highlighting the importance of observation, pattern recognition, and individualized care. Effective support balances respect for neurodiverse identity with responsible medical inquiry, integrates families, educators, and health professionals, and prioritizes quality of life, dignity, and self-sufficiency. By embracing systems thinking, cross-disciplinary collaboration, and ethical stewardship, families and communities can reduce suffering, enhance capacity, and foster meaningful participation in life.