Autism, fever and the study of short-term behavior change.

다국어 초록 (Multilingual Abstract)

Systematic study of short-term behavior fluctuations may provide critical insights for understanding the pathophysiology of autistic disorder and other autism spectrum disorders (ASDs). A recent observation of interest involves the potential role of fever in altering behaviors. One limitation in current ASD research is that reliable and valid research tools to assess short-term behavior change are needed.
A prospective study was conducted between September 2002 and November 2003 of 109 children with ASD, ages 2-18 years, seen at a clinical facility between 1992 and 2002, or affiliated with one of two select ASD groups. Two related research projects were undertaken using this dataset. The aim of the first project was to investigate recent reports of behavior changes associated with fever. Because the tool selected to study behavior change, the Aberrant Behavior Checklist (ABC), has not been validated in persons with ASD, the second research aim was to modify the ABC to make it more suitable to study short-term behavior change in persons with ASDs.
Of the 109 enrolled subjects, 40 acquired fevers during the study period. Behaviors of febrile participants and control subjects with ASD matched by age, gender and language skills were evaluated by their parents using the ABC. ABC data collected at baseline for 100 participants were used for the second aim. From this data, behaviors that were rated by the parents to be both frequent and "bothersome" were selected. An index consisting of the subset of ABC items meeting this criterion were assembled.
In the fever study, mean ABC scores compared the two groups across three select time points: fever onset, recovery from fever, and once the fever was gone for at least seven days. Repeated-measures analysis of variance (RM-ANOVA) modeling revealed behavior improvements during fevers on the ABC subscales of Irritability (p=0.016), Stereotypy (p=0.006), Hyperactivity (p=0.001), and Inappropriate Speech (p=0.003). Our major findings in the second research aim were that the reduced set of ABC items successfully discriminated between autistic disorder and all other ASD diagnoses and was also sensitive to behavior change. The findings from both studies should be validated in other, larger samples.