Autism Study Lends Credence to 'Fever Effect'
For the first three years of his life, Rene Craft's son, Jackson, communicated primarily through screaming tantrums. He never spoke. He didn't point to things. He didn't make eye contact. He had the classic signs of severe autism.
Then a couple of years ago, Jackson got sick. His mother, Rene Craft, says he was running a high fever.
"He was lying in our bed, and he was recovering," Craft says. "And he said out of the blue, 'I like the sheets, Daddy. They're really comfortable.' And then later that day he looked out the window and he said, 'Oh, it's raining, and squirrels eat nuts."
Craft says that she and her husband got a brief glimpse of a son who had been locked in his own world of autism. Then the fever went away, and so did Jackson's improvement.
Craft isn't the first parent to notice the so-called "fever effect." Autism researchers have been hearing reports about it for decades.
Now a team from the Kennedy Krieger Institute in Baltimore has done a study that suggests the fever effect is real.
Laura Curran, Ph.D., is the lead author of the study, which appears in the current issue of the journal Pediatrics.
"We did find fewer autistic-like behaviors when kids had fevers," she says. "And as the fever disappeared, their autistic behaviors returned."
That wasn't true for every child. And the study included just 30 children, and relied on parents to fill out detailed checklists about each child's behavior.
Even so, Curran says it looks like parents have been right all along. She says she's not surprised.
"As a mother myself, I know no one knows their children better than the parents," she says. "And we've been hearing about these anecdotes for many, many years."
Now the question for researchers is how fever affects autism.
Dr. Andy Zimmerman of Kennedy Krieger says the answer probably involves the connections between brain cells — which many researcher believe is one place things go wrong in autism.
Zimmerman says that it's not the rise in a child's temperature that makes the difference. But it may be that brain connections work better in the presence of small proteins called cytokines that are produced by the immune system.
"We'd like to know what those cytokines are in children with autism when they get fevers, to see if one or more of these cytokines might be unusually increased," he says.
That might lead to a treatment that could mimic the beneficial effects of fever without actually making a child sick.
Craft believes researchers will find an answer, and it will help her son.
She says she has noticed that every time Jackson gets a high fever, he undergoes a dramatic change. He may ask to play a game, or make eye contact, or stop biting his hands until they bleed.
"Jackson runs into furniture with his head when he's upset or I question him," Craft says. "When he has a fever, those behaviors disappear."
Craft says she plans to enroll her son in a new study at Kennedy Krieger that will try to explain the fever effect.
. "There is something occurring in his brain that he needs, that he gets when he has a fever," Craft says. "I don't know what it is. That's for the doctors to figure out. But he's in there. He's waiting to come out."
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RENEE MONTAGNE, host:
And parents of children with autism sometimes say they know things about the disorder that doctors don't. For decades some parents have been saying that symptoms of autism diminish when their child has a high fever, but researchers had never checked out that possibility until now.
NPR's Jon Hamilton has the story.
JON HAMILTON: For the first three years of his life, Rene Craft's son Jackson communicated primarily through screaming tantrums. He never spoke. He didn't point to things. He didn't make eye contact. Then a couple of years ago, Jackson got sick. Craft says he was running a high fever.
Ms. RENE CRAFT: He was lying in our bed and he was recovering, and he said out of the blue, I like the sheets, daddy. They're really comfortable. And then later that day, he looked out the window and he said, oh, it's raining, and squirrels eat nuts.
HAMILTON: Craft says she and her husband got a brief glimpse of a son who'd been locked in his own world. Then the fever went away, and so did Jackson's improvement. Craft watched her son closely the next time he got sick, and the time after that. She says every time Jackson got a high fever, he underwent a dramatic change. He would ask to play a game or make eye contact or stop biting his hands until they bled.
Ms. CRAFT: Jackson runs into furniture with his head when he's upset or I question him. When he has a fever, those behaviors disappear.
HAMILTON: Her son's doctor was baffled, so Craft turned to the Internet. That led her to a group of autism researchers at the Kennedy Krieger Institute in Baltimore. It turned out they were about to publish a study on what they called the fever effect. That study appears in the current issue of the journal, Pediatrics.
Laura Curran is the lead author. She says the results suggest that parents like Craft have been right all along.
Ms. LAURA CURRAN (Autism Researcher, Kennedy Krieger Institute): We did find fewer autistic-like behaviors when kids had fevers, and as the fever disappeared, their autistic behaviors returned.
HAMILTON: That wasn't true for every child. Also, the study included just 30 children and relied on parents to fill out detailed checklists about each child's behavior. Even so, Curran says it looks like the fever effect is real. She's not surprised.
Ms. CURRAN: As a mother myself, I know no one knows their children better than the parents, and we've been hearing about these anecdotes for many, many years.
HAMILTON: Now the question is how fever affects autism.
Dr. Andy Zimmerman of Kennedy Krieger says the answer probably involves the connections between brain cells, which many researchers believe is one place things go wrong in autism.
Zimmerman says it's not the rise in a child's temperature that makes the difference, but it may be that brain connections work better in the presence of small proteins called cytokines that are produced by the immune system.
Dr. ANDY ZIMMERMAN (Pediatric Neurologist, Kennedy Krieger Institute): And we'd like to know what those cytokines are in children with autism when they get fevers to see if one or more of these cytokines might be unusually increased or affective.
HAMILTON: That might lead to a treatment that could mimic the beneficial effects of fever without actually making a child sick. Craft believes researchers will find an answer, and it will help her son.
Ms. CRAFT: I know he's in there, and there is a medical treatment that needs to occur for this child. There is something occurring in his brain that he needs that he gets when he has a fever. I don't know what it is. That's up to the doctors to figure out. But he's in there. He's waiting to come out.
HAMILTON: Craft plans to enroll her son in a new study at Kennedy Krieger that will try to explain the fever effect.
Jon Hamilton, NPR News. Transcript provided by NPR, Copyright National Public Radio.
