There were three observations that were critical in ultimately helping my son.
- Symptom improvement during fevers: There was always a significant improvement in my son’s symptoms whenever he had a fever. Ever since he was a small child, when he developed a fever his agitation, anxiety, self-abusive behavior, OCD, behavioral inflexibility, lack of impulse control, low frustration tolerance, and hypersensitivity to external stimuli ("Symptoms") would markedly decrease. In fact, we always looked forward to colds and infections because of the significant behavioral improvement that always accompanied them.
- Symptoms get worse when his allergies are active: My son had bad seasonal allergies and whenever he exhibited bad allergies his Symptoms would get much worse.
- The final clue: Chigger bites: The last and most important clue was an event that occurred while Lawrence was away at sleep-away camp in 2003. He had attended the same camp at the exact same time during the summer for 5 consecutive years. He always had a very tough time at camp, hitting himself, throwing his food, not being able to participate, etc. That year I got a call from camp saying that he had suddenly become calm and that he was fully participating in every event and activity. They had no explanation for this, nor did I. It was one week before the end of camp, so I counted my blessings and waited to see how he would be when I picked him up. When I got him a week later he was calm, focused, behaviorally flexible, and with virtually no symptoms. We were able to go to a restaurant for dinner for the first time in years, where he behaved appropriately and enjoyed his dinner. I was dumbfounded and happy but was also completely at a loss to explain the dramatic improvement. When he got ready for bed that night I saw something shocking: his legs were completely covered with chigger bites, from the mid-thigh down to the ankle. I quickly went to the internet and did some research on chiggers; they are the larval form of a mite common in wet grassy areas of the US, that attaches to the skin and sucks dissolved tissues to obtain nutrition. The residual hardened cone of tissue that is left after the chigger falls off causes an extremely powerful immune response in humans. This immune response causes itching and discomfort and lasts about two weeks, when the bites finally fade. With Lawrence, the complete elimination of Symptoms lasted for another week, then, as the bites faded, the Symptoms returned.
These three clues seemed to suggest that when my son’s immune system had something “legitimate” to do, the symptoms would subside. This, along with the knowledge that there was a well documented but poorly understood relationship between the immune system and autism, led me to formulate my hypothesis.