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Study Finds Fever May Lead to Improved Behavior in Children with Autism Spectrum Disorders

Can fever lessen symptoms of autism? A new study published in Pediatrics aimed to find out, inspired by anecdotes from parents and clinicians of behavioral improvements during fever in people with autism.

Reported improvements include increases in alertness, decreases in self-stimulatory behavior, and for some, more coherent language. The new study, funded by Cure Autism Now (CAN), marks the first attempt to systematically document such a "fever effect" in children with autism.

Primarily the work of Laura Curran, Ph.D., at the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, the study obtained parent responses to the "Aberrant Behavior Checklist" for 30 children with autism during a fever (100.4°F or higher), just after a fever, and when the child had been fever-free for seven days. Most children (83%) showed fewer aberrant behaviors during a fever. This was indicated by lower scores in at least one of the subcategories of the checklist, which includes irritability, hyperactivity, stereotypy, and inappropriate speech. Strikingly, a majority of the children (53%) showed more dramatic improvements, with lower scores in at least three subcategories. Unfortunately, all improvements were transient. The behavior scores during and after the fever also differed from scores obtained over a similar time course from age-, gender- and language skill-matched children with autism who did not have a fever; this suggests that the changes observed in the fever group were not due to day-to-day fluctuations in behavior sometimes seen in autism.

Because the reported improvements involved decreases in aberrant behaviors, the "fever effect" could be due to the lethargy that comes whenever one feels sick. Alternatively, fever might have a more specific effect on the nervous system, perhaps somehow changing the connections, or synapses, between neurons. This new study provided evidence for both possibilities. "It gives hope that we might find causes and treatments for autism by studying synapses and how fever affects them," said senior author of the study, Andrew Zimmerman, M.D., from the Kennedy Krieger Institute in Baltimore, MD.

To understand just how fever influences autistic behavior, future research will have to examine the behavior of sick children who do not develop a fever. If they do not show any improvements, then this would suggest a specific effect of fever beyond sickness-induced lethargy. In the meantime, the new study is significant because it advances the "fever effect" from anecdote to the realm of research, and it shows again how cooperation between parents, clinicians and scientists can yield important insights into the nature of autism.

Click here to read a press release from the Kennedy Krieger Institute.