| Mar 20, 2005 |
| http://www.autisme-montreal.com/english/Marvin_Boris.html
This study has demonstrated that many children with ASD and ADHD exhibit marked neurobehavioral regression during the spring and fall pollen seasons. This shows an association between pollen exposure and central nervous system dysfunction, not related to typical IgE mediated allergies. Pollen exposure may have multifaceted impact on multiple organ systems. Neurobehavioral Disorders Increased by Pollen Exposure in Children with Autism and Attention Deficit Hyperactivity Disorder (ADHD) Marvin Boris, MD FAAA, FACAAI, Associate Clinical Professor of Pediatrics, New York University School of Medicine PAPER The first phase of this study investigated whether exposure during the normal pollen seasons had any neurobehavioral regressive effect on children with ASD or ADHD. The second phase was a double blind crossover pollen challenge during the winter. 50 children with ASD and 50 children with ADHD were randomly selected from among 1500 children with ASD and 300 children with ADHD in the clinical allergy and immunology practice of the authors. Letters were sent to the parents outlining the study. Twenty-nine of the ASD and 18 of the ADHD parents agreed to have their children participate in the study. The ASD group consisted of 23 males and 6 females. The ADHD group consisted of 15 males and 3 females. The age ranged from 3 to 14 years with the median of 7 years. All participants lived at home throughout the study. Informed consent was obtained from parents and when applicable children capable of granting such consent. Forty-three of the 47 children were diagnosed by a pediatric neurologist, developmental pediatrician or psychologist prior to referral. The other 4 were identified by the primary author on consultation as part of the clinical evaluation process prior to the conception of this study. All subjects were reviewed by one neuropsychologist to confirm the diagnosis and use a consistent criteria. The ASD subjects met the DSM IV criteria for Autism and are understood to be within the autistic spectrum. The ADHD subjects meet the DSM IV criteria for Attention Deficit Hyperactive Disorder. ADHD subtype is not relevant to the aims of this study. Allergy Evaluation: All members of both groups had blood drawn for an IgE level and RAST test to oak tree, timothy grass and ragweed. Prick skin tests were done to the latter pollens. If the prick tests were negative, the child was tested interdermally with .05 cc. of a 100 pnu solution. Histamine was used as the positive control and the phenol saline diluting fluid as the negative control. A child was considered allergic if the child had an elevated IgE and was RAST positive to the pollens and/or was positive to the skin tests. During the study the participants were advised not to take any allergy medications. No restrictions were placed on their educational or behavioral therapeutic regimens. Pollen Counts: Pollen counts were obtained from Surveillance Data Inc. for our local area. Study Design: During the late winter, as a baseline, the parents of the ASD children completed the Aberrant Behavior Checklist and The Allergic Symptom Screen for each week for two weeks. Parents of the ADHD children completed the Conners' Revised Parent Short Form and The Allergic Symptom Screen for the same period. The Aberrant Behavior Checklist is a standard instrument for assessing neurobehavioral function in children with ASD (Marshburn & Aman, 1992). Parents of the ADHD children completed the Conners' Revised Parent Short Form and The Allergic Symptom Screen for the same periods. Likewise the Conners' Revised Parent Short Form assays the degree of neurobehavioral symptoms in children with ADHD (Conners, 1970). During the pollen seasons, parents completed the above forms weekly starting March 1 and continuing through November1. Pollen counts were acquired daily from a regional reporting source and then correlated with neurobehavioral scores and allergy symptoms. During the winter, parents of the autistic spectrum children completed the Aberrant Behavior Checklist and The Allergic Symptom Screen for each week for two weeks prior to the crossover challenge and one week subsequent to each challenge. This will be a total of completion of the forms four times .The Aberrant Behavior Checklist is a standard instrument for assessing neurobehavioral function in children with ASD. Parents of the ADHD children completed the Conners' Revised Parent Short Form and The Allergic Symptom Screen for the same periods. Likewise the Conners' Revised Parent Short Form assays the degree of neurobehavioral symptoms in children with ADHD. Results: Among the 47 total children, 25 (53%) showed neurobehavioral regression during the natural pollen season. The percent regression was measured from their winter baseline scoring form values. The regression in this combined group reached 44% above the average baseline winter values. In the ASD group of 29 children, 15 (52%), regressed during pollen exposure. This approached 30% over the baseline values. In the ADHD group,10 of 18 (56%) regressed during this period. The level of regression was in the 40% range with one period at 60%. No statistical differences were evident in neurobehavioral regression whether the child was allergic or non allergic. Allergy symptoms, as scored on the Allergy Symptom Screen reported by the parents, occurred only in 8 of the 47 children. Five of 8 (63%) of these children regressed and 3 did not regress. This was not statistically significant. A total of 47 children participated in the double blind crossover pollen challenge study. Twenty-seven children met the criteria for ASD and 18 for ADHD. In the ASD group, 16 children (55%) regressed from their individual baseline on nasal pollen challenge while 13 children (45%) had no neurobehavioral changes. Among the ADHD group 12 of 18 (67%) children regressed. After the pollen nasal challenge the significance of neurobehavioral regression in both groups was p<0.01. No placebo effect was observed in these groups. This study has demonstrated that many children with ASD and ADHD exhibit marked neurobehavioral regression during the spring and fall pollen seasons. This shows an association between pollen exposure and central nervous system dysfunction, not related to typical IgE mediated allergies. Pollen exposure may have multifaceted impact on multiple organ systems. |
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