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Study Confirms Anecdotes of Fevers Improving Autism Symptoms
> 12/3/2007 1:28:25 PM

Some doctors have long suspected that there is a link between fever and mental illness. Hippcrates, the "father of medicine," noted that his psychotic patients seemed to recover�when their temperatures rose. More recently, parents of autistic children have frequently reported that their kids get better during a bout of fever. Such anecdotes are intriguing, but they cannot prove the existence of a connection by themselves. The December issue of Pediatrics brings us a study lead by Dr. Laura Curran that provides strong scientific evidence that fevers do cause temporary alleviation of autistic symptoms.

A viral respiratory infection hit a ward of autistic children at NYU's Bellevue Psychiatric Hospital. Dr. Curran realized that this was a perfect opportunity to confirm or debunk anecdotal evidence, so she quickly moved to set up a study with two groups of 30 autistic children from the ward, one group with fevers and the other without. Parents were asked to evaluate their children before, during, and after the fever using the Aberrant Behavior Checklist (ABC). The ABC showed that, on average, the children with fever had less irritability, hyperactivity, stereotypy, and inappropriate speech. 25 out of 30 children with fever showed a reduction on at least one symptom sub-scale, and 22 out of 30 showed reduction in two or more.

These are incredibly high improvement percentages, but there are two possible confounding factors that need to be addressed: the possibility that fevers reduced symptoms by merely hampering physical activity, and that parents were biased observers. It is true that illnesses cause a variety of physiological effects that can change behavior without affecting neural function. For example, a sore throat can make it harder for patients to make inappropriate comments, and a fever can cause fatigue that lessens hyperactivity and repetitive movements. Aware of this potential problem, researchers looked carefully for any correlation between autism recovery and lethargy or non-fever symptoms of illness. Fatigued patients were not more likely to show recovery, nor were those with more severe illnesses. This is a solid defense against potential criticism, though future studies must include multiple illnesses to determine whether it really is the fever that is improving autism symptoms.

The second obvious criticism of this study is that parents might not have objectively observed their children. Parents have the greatest familiarity with the behavior of their children, and thus the highest potential for spotting changes, but they are also so emotionally involved that their judgement may be compromised. This potential problem was not adequately dispelled by the researchers, so future scientists should include third-party observers. The researchers did address one major potential source of bias�parents seeing improvement because they are expecting improvement. Parents were surveyed before they evaluated their children, and those who expected improvement (around half) were not significantly more likely to report improvement.

Though further research is required on this subject, the Bellevue study clearly shows that anecdotal reports are part of a real phenomenon. While fevers grant only temporary relief it may be possible that they hold could help us to finally understand the mechanisms behind autism. As artificially heating autistic patients does not produce the same symptom alleviation, the effect is probably caused by an interaction between the immune system and the brain. The fact that autistics can temporarily achieve normal function is surprising, but does fit with a study last week that showed that children with Aspergers Syndrome have more grey matter in areas of the brain that deal with social behavior. More grey matter correlates with higher IQ in the general population but not in autistic children, where these neurons do not function properly. This implies that the neurons for social processing are present, but prevented from functioning. If researchers can figure out how the immune system response in fevers restores functioning, they may be able to develop a treatment.

Comments
Hi,My fifteen year old son has manic-depression.Since he was three, I have been telling his Drs about how much improvement he has during the course of a fever. Behaviors, concentration, depression, everything improves with a fever.

Posted by: Laurie 12/4/2007 9:21:58 AM