Fever May Improve Behavior of Children With AutismDisorders

Fever May Improve Behavior of Children With AutismDisorders
MONDAY, Dec. 3 (HealthDay News) -- Children with autism spectrumdisorders (ASD) may show improvements in behavior when they have a fever,a small study suggests.
This is the first study to investigate a relationship between fever andbehavior change in children with autism spectrum disorders (ASD), theresearchers said.
"I think this study means there is hope, because it means that thebasic networks in the brain in autism appear to be intact," said seniorinvestigator Dr. Andrew Zimmerman, a pediatric neurologist at the KennedyKrieger Institute in Baltimore.
According to the authors, ASD includes autism, autistic disorder,pervasive developmental disorder not otherwise specified (PDD-NOS) andAsperger's syndrome.
The new study adds to a growing body of research that suggests thatthe problems children with ASD have with behavior, language skills andsocial skills result from poor connections between synapses in the brain.The question, Zimmerman said, is which synapses are involved and how tostimulate them to function.
Zimmerman said the heat of a fever might stimulate changes at thecellular level. Fever's impact on the hormonal and immune systems mightalso be responsible for the perceived changes in the children. The changesobserved in the study were not permanent, however, and disappeared withina week of the fever's end, the researchers noted.
Zimmerman also noted that the effect seems limited to viral fevers,such as flu-related fever, rather than other illnesses.
"This is a very interesting study," said Dr. Annette Estes, associatedirector of the University of Washington Autism Center, who interpretedthe study's results in the context of a new line of research that islinking autism to immune system response and inflammation.
"This is a novel use of a child who is ill with fever," she said. "I'dlike to see someone replicate this observation and make sure that thisstudy with a small number of children holds up."
"This is the first step in a really long series of studies that needsto be done," Estes added.
In their work, Zimmerman's team compared data from 30 children with ASDwho had a feverish episode, with 30 similar children with ASD who did nothave a fever. Once a child had a fever, the parents were asked to observetheir child for 24 hours and then complete a questionnaire about behaviorand language ability. They completed a second questionnaire 48 hours afterthe fever and a third questionnaire after seven days without fever.Parents of the non-feverish children filled out the same questionnaire atthe same times about their own child's behavior and language ability.
The study results, published in the December issue ofPediatrics, showed fewer autistic-like behaviors for children withfever, compared to the children without fever, with more than 80 percentof the fever participants showing some behavioral improvement.
Estes, who uses the same behavior checklist in her research that theresearchers used in the study, cautioned that the checklist is notspecific to children with ASD, nor is it used to diagnose ASD. It is usedto assess behavior in children with a variety of developmental disorders,including mental retardation, genetic diseases and Down syndrome, shesaid.
"The checklist is used to understand other behaviors that children withautism have troubles with," Estes explained. Irritability and lethargy areamong those problem areas, she said.
The fatigue associated with illness may seem a natural explanation forthe changes in behavior, but the study authors found lethargy was not afactor.
"We stratified subjects based on their level of lethargy and we did notfind a difference. Children in both groups, whether their lethargy washigh or low, had benefits," said study lead author Laura Curran, researchassistant at the institute.
The study may provide hope for future avenues of ASD research. But italso provides an important piece of information for professionals who mustevaluate children with the disorder, the researchers said.
"This research adds to the literature of understanding the underlyingneurological and behavioral aspects of ASD in that it assists with settinga context for evaluation and treatment. It will be important fordiagnosticians to query parents and guardians as to how recently the childhad a fever because it may diminish behaviors that need to be assessed,"said Michael Morrier, assistant director for research and programevaluation at the Emory Autism Center in Atlanta.
Morrier said he would like to see more in-depth study of theeffect.
Autism may strike one in every 150 American children, according tostatistics released earlier this year by the U.S. Centers for DiseaseControl and Prevention. Males are four times more likely than females tobe diagnosed with the disorder.