Allergies, Asthma and Autism

Allergies, asthma and autism are distinctly different medical conditions. Asthma is a chronic respiratory disease and an allergy is an immune system overreaction. Autism spectrum disorder (ASD) is a neurodevelopmental disorder. It affects communication skills, social interactions and behavior.

Is it possible there is a connection between the two respiratory diseases and autism? Multiple studies, including a National Institutes of Health study of asthma and autism, say there is no association at all.

However, other research has found children with asthma may have a slightly higher risk of developing autism. Another study suggests autism can sometimes occur alongside immune-related conditions such as asthma.

Research has also looked at common risk factors that may play a role in autism and allergic diseases. These factors include:

• parental asthma and allergies
• gut microbiome imbalance
• diet
• prenatal exposures to air pollution
• certain medications
• diabetes during pregnancy
• sleep disturbances

When taken together, the research does NOT prove a definite link between these conditions. The studies do NOT show that asthma and allergies cause autism, or that autism causes asthma and allergies. More research is needed to understand whether there is a relationship.

If your child with asthma and/or allergies is also diagnosed with autism, talk with a healthcare provider for advice and guidance. When advocating for your child, remember that people with ASD may have a hard time understanding and managing respiratory diseases.

Can autism cause breathing problems?

First, let’s define autism spectrum disorders and asthma. ASD affects a person’s communication, social interaction and behavior. It is called a “spectrum” disorder because the symptoms and their severity can vary. Some with ASD may have mild developmental disabilities. They can function well in everyday life. Others may have more severe symptoms that impact their daily functioning.

Asthma affects a person’s ability to breathe properly. It causes the airways in the lungs to become narrow and inflamed, making it difficult to breathe. Asthma can be triggered by various factors. These include:

• allergens such as pollen, mold, dust mites or pet dander
• irritants such as smoking or air pollution
• respiratory viruses including a cold or the flu
• exercise
• stress

Asthma and autism do NOT have a cause-and-effect relationship. However, researchers have identified common risk factors for both. These include genetics, immune system dysfunction and environmental factors.

Some studies have suggested exposure to allergens and air pollution could increase the risk of having both autism and asthma.

It is also possible the relationship between asthma and ASD is indirect. Some people with autism may have difficulty explaining their symptoms caused by asthma. This could make it harder for them to get the right diagnosis or find treatment. In addition, some people with ASD may have sensory processing issues. This can make it hard for them to avoid asthma triggers or tolerate medications. This could worsen asthma.

Can asthma medication use during pregnancy cause autism in early childhood?

There is currently no clear evidence that asthma medications taken during pregnancy can cause autism in children.

A 2016 study from the Drexel Autism Institute examined whether beta2-agonists – common asthma medications used in short-acting and long-acting inhalers – might be linked to fetal brain development and autism in children. The study found slightly more children with autism were born to mothers who used beta2-agonists during pregnancy (compared to those who did not).

Researchers emphasized the elevated risk was very small. Less than 1% of autism cases could be linked to prenatal use of asthma inhalers. The study did have key limitations. It relied on prescription records rather than actual medication use. The research also did not take into account environmental risk factors for childhood asthma.

A 2019 National Institutes of Health study further examined this issue. Researchers found no evidence linking asthma medications use during pregnancy to autism. The study noted a slightly higher risk of autism when either parent had asthma.

What is the key takeaway from these studies? Women with asthma should NOT stop taking prescribed medications during pregnancy. Untreated asthma can lower oxygen levels for both mother and baby. This increases the risk of premature birth or low birth weight. These medications are considered life-saving and essential for maternal health.

Pregnant people with asthma should work together with their healthcare team. It is normal to have questions or concerns about the use of medication during pregnancy. Talk with your doctor about the impact of medications on your child’s development.

Are people with autism spectrum disorder more likely to have allergies?

Researchers have found an association between autism and common allergic conditions. However, there is no cause-and-effect relationship between ASD and allergies.

The study used data from the U.S. National Health Interview Survey (1997 to 2016) to examine autism and allergies. Another study on autism and allergies found the following:

• 11.25% of children with ASD had a food allergy, compared to 4.25% of children without ASD who had a food allergy.
• 18.7% of children with ASD had respiratory allergies, compared to 12% of children without ASD.
• 16.8% of autistic children had skin allergies, versus 9.8% of children without ASD.

Autism and allergies are complex conditions. They are caused by a variety of factors. One risk factor is genetics. Environmental factors and immune dysfunction are also at play. More research is needed to further establish the connection between ASD, allergies and immune function.

Practical tips for managing asthma and allergies if you or your child has autism

Living with asthma and allergies can be a challenge for people with autism spectrum disorder. This is often due to sensory processing differences and communication difficulties. (It can also impact other developmental conditions, such as attention deficit hyperactivity disorder.)

With the right tools, people with autism and their families can successfully manage asthma and allergies. Here are some practical tips:

Create a visual schedule for medication and check-ups

Using a visual schedule can provide a sense of structure and predictability. It can also make it easier to remember when to take daily asthma controller medication or attend doctor appointments.

Visual aids, such as a calendar, chart or planner, can help you keep track of medication and check-ups. A color-coded Asthma Action Plan may be especially helpful for people with autism. Pictures or symbols may help people with autism understand foods they need to avoid.

Use social stories to explain asthma and allergies

Social stories are short stories that teach people with autism about situations or behaviors. Create a social story that explains:

• asthma and allergy symptoms;
• what triggers asthma flares;
• what triggers a severe allergic reaction; and/or
• how to use an inhaler, epinephrine auto-injector, or other medication.

This can help reduce anxiety and confusion around managing asthma and allergies.

Use technology to track asthma

Many smartphone apps and wearable devices are available. These can help people with autism and asthma track their symptoms and medication use. Some apps provide reminders when it’s time to take medication or go to a doctor appointment. These tools can also be particularly helpful for people with autism who struggle with discussing their symptoms.

Develop a routine

People with autism often thrive on routines and predictability. Create a routine that includes taking a daily controller medication at the same time each day. Schedule doctor appointments at the same time of the month. Developing a routine can help reduce stress and anxiety. It can also increase follow-through on treatment plans and dietary restrictions.

Educate yourself and your loved ones

Get a better understanding of asthma and allergies. Knowing the symptoms and treatment can help people with autism feel more in control. It can also help loved ones better support and advocate for people with autism.

Identify and avoid triggers

Asthma triggers can vary from person to person. Triggers can include pollen, mold, dust mites, pet dander, cold air, exercise and stress. Work with your doctor to identify and avoid triggers that may worsen asthma symptoms.

Carry medications

Make sure to always keep quick-relief asthma inhalers or emergency epinephrine on hand. Keep a spare set in the car, at work or at school, if necessary. Find out whether your child’s school has emergency albuterol inhalers or epinephrine. Whether a child with autism is developmentally ready to self-carry their medication is a decision to discuss with a doctor.

It can also be helpful for people with autism to have a medical ID bracelet that indicates the asthma or allergy diagnosis.