Behavioral responses to fevers and other medical events in children with and without ASD.
Level 3 - non-randomized controlled study
Prospective controlled cohort study comparing children with ASD and typically developing controls
PubMed 36164255 · doi:10.1002/aur.2810
What was done
Prospective study evaluating behavioral responses to fever and illness in 141 children with autism spectrum disorder (ASD) and 103 typically developing (TD) controls. Caregivers completed an 11-item survey assessing behaviors at baseline (no illness), during a fever, during the week following a fever, and during non-febrile illnesses. Profiles of individual cases showing consistent behavioral improvements during fever were also evaluated.
What was found
Caregiver ratings indicated worsening social, emotional/behavioral, and somatic symptoms during fever across both groups, with children with ASD showing greater behavioral worsening during fever than TD children. Only 3 out of 141 children with ASD demonstrated consistent behavioral improvements during a fever; these three children presented with varied cognitive and adaptive skill levels. Specific point estimates and statistical test values were not reported in the abstract.
Why it matters
This study challenges the common retrospective narrative that fever broadly alleviates autistic symptoms, suggesting that behavioral improvement during fever is an uncommon phenomenon while behavioral deterioration is more typical.
Limits
Outcomes rely solely on parent-reported behavioral survey responses rather than blinded or direct clinical evaluations. Specific numerical values, effect sizes, illness definitions, and fever temperature thresholds are omitted from the abstract.
Cited by
- contradicts Hot baths improve autistic symptoms in children.