Report: Fever Improves Autism Symptoms

Reason for Improvement Not Understood

From the WebMD Archives

Dec. 3, 2007 -- Children with autism appear to improve when they have a fever, according to intriguing new research that could lead to a better understanding of the disorder.

Fever was associated with less hyperactivity, improved communication, and less irritability in the study involving children with autism and related disorders.

Anecdotal reports of improvements in autism symptoms related to fever have circulated for years, but the research represents the first scientific investigation into the observed association.

While kids with autism might be expected to be calmer and less hyperactive when they have fevers, the improvement in communication and socialization seen in the study suggests that fever directly affects brain function, pediatric neurologist Andrew Zimmerman, MD, of Baltimore's Kennedy Krieger Institute, tells WebMD.

"The improvement in symptoms may mean the underlying wiring of the brain (of an autistic child) develops more normally than we have thought," he says, adding that the problem may lie with the connections within the brain responsible for sending information.

"Somehow fever appears to be changing the ability to make these connections," he says.

4 out of 5 Kids With Fever Improved

The study involved 30 children with autism spectrum disorders, including autism, who were observed by parents during and immediately after experiencing a fever of 100.4 degrees or greater, and seven days after being without fever.

The parents were asked to complete standardized behavior questionnaires during the three time points designed to assess behavior. Parents of children with autism spectrum disorders who did not experience fever were also surveyed at related time points.

More than 80% of the children with fever in the study showed some improvement in behavior during temperature elevations, the researchers reported in the December issue of the journal Pediatrics.

Further analysis showed that behavior improvement was not dependent on the degree of fever.

Zimmerman and lead researcher Laura K. Curran, PhD, tell WebMD that more study is needed to confirm the findings.

"We'd like to interview more families to better understand this," Zimmerman says. "And at the chemical level, we'd like to have blood samples from children while they have fever to analyze what is going on."


Autism, Fever, and Cytokines

One theory is that fever may affect brain function at the cellular level by influencing the production of immune-system signaling proteins known as cytokines.

If this proves to be the case, the finding could result in treatments for autism spectrum disorders that target cytokine expression.

"That would be a long way off, but it is certainly within the realm of possibility," Zimmerman says.

Marguerite Kirst Colston says the new research is significant because it is one of the first to examine the symptoms parents deal with in biological terms.

Colston is a spokeswoman for the American Society of Autism (ASA) and the mother of a 7-year-old son with autism.

"We are hearing more and more about this from parents," she tells WebMD. "Children seem calmer when they are sick and they seem to tolerate closeness and touch better. We have all sort of marveled at this."

Colston hopes the research will lead to more studies that look beyond the genetics of autism.

"The more we study what happens biologically, as well as genetically, the more insight we may have into how to treat children to improve their symptoms," she says. "I would like to see us focus on questions like, 'What helps these kids learn?' and 'What makes them feel better?' 'What do people with autism need to live well?' I'm a parent who has tried a lot of things, and I have no idea."

WebMD Health News Reviewed by Louise Chang, MD on December 03, 2007


SOURCES: Curran, L.K., Pediatrics, December 2007; vol 120: pp 1386-1392. Laura K. Curran, PhD, department of epidemiology, Johns Hopkins Bloomberg School of Public Health and department of neurology and developmental health, Kennedy Krieger Institute, Baltimore. Andrew W. Zimmerman, MD, pediatric neurologist, Kennedy Krieger Institute, Baltimore. Marguerite Kirst Colston, director of communications, Autism Society of America, Bethesda, Md.

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