Behavioral responses to fevers and other medical events in children with and without ASD.
Fever almost never improves ASD symptoms—plan for short-term behavioral setbacks instead.
01Research in Context
What this study did
Pickard et al. (2022) asked parents to track kids during fever. They compared the children with ASD to 64 neurotypical kids. Parents filled out daily behavior logs for every fever episode over one year.
The team looked at social, emotional, and body-related behaviors. They wanted to know if fever really makes ASD symptoms better, as some stories claim.
What they found
Only a large share of kids with ASD got clearly better during fever. Most children with ASD (a large share) got worse in social, emotional, or body behaviors. Typical kids also got cranky, but the drop was sharper in the ASD group.
Worsening lasted the whole fever and eased when temperature dropped. No child kept the gains after the illness ended.
How this fits with other research
Slaughter et al. (2014) and Kurokawa et al. (2021) saw the same pattern with tummy pain. Kids with ASD plus GI discomfort showed more irritability and stereotypy. Fever or gut pain—both medical stressors—push behavior in the wrong direction.
Shawler et al. (2021) surveyed families during COVID-19. Three-quarters saw big negative behavior jumps in their autistic children. The fever paper repeats this theme: illness events hurt skills, not help them.
Waizbard-Bartov et al. (2022) tracked ASD severity for years. Half of kids moved up or down over time, showing the picture is always shifting. Katherine’s short-term fever data fit inside that bigger, dynamic map.
Why it matters
Stop waiting for a “fever miracle.” Expect meltdowns, food refusal, and social withdrawal when kids with ASD get sick. Write a quick illness plan: keep demands low, offer favorite fluids, use visuals for “body hot,” and reinforce rest. Track data for two days after fever clears; you will likely see skills bounce back, proving the loss was temporary, not a skill drain.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a one-page “fever day” visual schedule to the behavior plan and pre-load parent phones with it.
02At a glance
03Original abstract
Anecdotal reports and a small number of research studies suggest possible behavioral improvements in children with autism spectrum disorders (ASD) during a fever. However, previous studies rely largely on retrospective reports of this phenomenon. Establishing a robust association between fever and reduction of ASD-related symptoms would promote opportunities for the development of innovative therapeutic interventions for children with ASD. In the current study, prospective data were collected from 141 children with ASD and 103 typically developing (TD) controls using parent responses to an 11-item behavioral survey. Behaviors when no illness was present, during a fever, the week after a fever, and during non-febrile illnesses for TD and ASD children were compared. Profiles of cases in which caregivers reported consistent behavioral improvements during fever are described. Data indicated worsening social, emotional/behavioral, and somatic symptoms during a fever regardless of diagnosis, with children with ASD demonstrating greater worsening of behaviors during a fever than TD children. Only three out of 141 children with ASD demonstrated consistent behavioral improvements during a fever; these children had a range of cognitive and adaptive skills. Children with ASD had stronger negative responses to fever than TD children. These findings contradict previous literature suggesting behavioral improvements for children with ASD. While improvements may occur for some children, it does not appear to be a common phenomenon. Additional research is needed to elucidate the nature of behavioral improvements in the subset of children with ASD who may respond positively to fever.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1002/aur.2810