Children with autism spectrum disorder who improve with fever: Insights from the Simons Simplex Collection.
One in six kids with autism may look 'better' during fever—those kids tend to have lower NVIQ and language plus more repetitive behaviors.
01Research in Context
What this study did
Grzadzinski et al. (2018) asked parents in the Simons Simplex Collection a simple question: does your child with autism ever look 'better' when they have a fever?
The team then compared the kids who improved with the kids who did not. They looked at IQ scores, language levels, and repetitive behaviors.
What they found
About one in six parents said yes—my child talks more, acts calmer, or stims less during fever.
Those 'fever-improvers' had lower non-verbal IQ and language scores and more repetitive behaviors than the rest of the sample.
How this fits with other research
Han et al. (2023) seems to disagree. In China, fever was flagged as a risk factor for autism with regression. Rebecca’s team, however, saw fever as a moment of brief improvement, not harm. The difference is timing: Lu asked about fever before diagnosis; Rebecca asked about fever after diagnosis.
Chakraborty et al. (2021) found that stomach pain and constipation drive repetitive behaviors. Rebecca’s fever-improvers already showed more repetitive behaviors, so GI pain might be one hidden reason their behaviors spike when they are not feverish.
Jahr et al. (2007) showed that autistic kindergarteners initiate far fewer social bids than peers. If fever briefly lifts social withdrawal in the low-language group, clinicians could use that window to probe social motivation.
Why it matters
If you work with minimally verbal or highly repetitive clients, watch them during the next cold or flu. Note any jump in words, eye contact, or flexibility. Share those observations with the medical team; they may guide future medication or inflammation studies. Also, screen for GI pain—treating constipation might recreate the ‘fever effect’ without the fever.
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02At a glance
03Original abstract
UNLABELLED: Literature indicates that some children with ASD may show behavioral improvements during fever; however, little is known about the behavioral profiles of these children. This study aims to (a) investigate the subset of children who show parent-reported behavioral improvements associated with fever and (b) compare the demographic, behavioral, and genetic characteristics of this subset of children to children whose parents report no change during fever. Parents of 2,152 children from the Simons Simplex Collection provided information about whether and in which areas their child improved during fever. Children were randomly assigned into discovery or replication samples. In discovery analyses, children who reportedly improved with fever (Improve Group) were compared to those who reportedly did not improve (No Improve Group) on demographics, medical history, ASD symptoms, adaptive skills, and presence of de novo ASD-associated mutations. Significant and marginal results from discovery analyses were tested in the replication sample. Parent reports of 17% of children indicated improvements during fever across a range of domains. Discovery and replication analyses revealed that the Improve Group had significantly lower non-verbal cognitive skills (NVIQ) and language levels and more repetitive behaviors. Groups did not differ on demographic variables, parent-report of current ASD symptoms or the presence of de novo mutations. Understanding the profiles of children who improve during episodes of fever may provide insights into innovative treatments for ASD. Autism Res 2018, 11: 175-184. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study explored characteristics of children with ASD who are reported to improve during fever. Parents of 17% of children with ASD report improvements across a range of domains during fever including cognition, communication, repetitive behaviors, social interaction, and behavior. Children who are reported to improve during fever have significantly lower non-verbal cognitive skills and language levels and more repetitive behaviors. Understanding the profiles of children who improve during episodes of fever may provide insights into new treatments for ASD.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1856