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Childhood Allergies’ Connection to Developmental-Behavioral Conditions

NightLight · October 8, 2022

By Stephani Monhollon (Pediatrix)

Children who become easily agitated or aggressive, display symptoms of hyperactivity, struggle with self-regulation, appear distracted or exhibit learning difficulties may have developmental or behavioral conditions, such as attention-deficit/hyperactivity disorder (ADHD). However, these symptoms aren’t only signs of a developmental-behavioral health issue.

Research shows a correlation between allergies and children’s emotional, developmental and behavioral health. If any of the symptoms above occur only during certain times of the year, such as spring or fall, your child may be suffering from seasonal allergies that may affect his or her behavior.

Mild allergy symptoms, such as slight itchiness or sneezing, likely won’t be confused with developmental or behavioral issues. However, if a child is suffering from severe allergies, he or she may display unusual emotional, developmental or behavioral symptoms.

According to the Asthma and Allergy Foundation of America, allergies are the 6th leading cause of chronic illness in the United States and affect 7% (5.2 million) of children. Common allergy symptoms include:

  • Persistent itchy, red or watery eyes
  • Frequent sneezing
  • Runny nose
  • Nasal congestion
  • Rash or hives
  • Chronic ear problems

Children who experience several allergy symptoms for extended periods may feel sluggish, sick, exhausted, foggy, temperamental, moody or lethargic. This persistent discomfort may bring about distractions in the classroom or mood changes that are sometimes mistaken for learning disorders or behavioral issues.

In addition, children with nasal congestion may not sleep well, intensifying the situation and potentially causing restlessness, irritability, impulsive behavior or anxiety.

Reaching an Accurate Diagnosis

It’s difficult to distinguish symptoms related to allergies from other health conditions, such as developmental-behavioral disorders, making it critical to get to the root cause of the symptoms as soon as possible.

Parents may struggle to determine which pediatric specialist to see — a pediatric allergist, developmental-behavioral pediatrician or another pediatric specialist. A good starting point is with your child’s pediatrician, who can make a referral after evaluating your child.

“If your child exhibits allergy symptoms along with signs of developmental-behavioral issues, he or she may be referred to a pediatric allergist,” said Aasma Khandekar, M.D., a developmental-behavioral pediatrician and practice medical director for Pediatrix® Developmental Medicine of Dallas. “On the other hand, if allergy symptoms are not present, the clear choice would be a pediatric developmental-behavioral physician or other child specialist, depending on the primary pediatrician’s findings.”

Regardless, the sooner a proper diagnosis is made, the sooner your child can receive appropriate medical care.

Treating Childhood Allergies

Once a diagnosis has been made, the appropriate pediatric specialist will work with your child and your family to develop a care plan tailored to your child’s unique needs. If allergies are the cause, the pediatric allergist may recommend a combination of treatment options, such as:

  • Avoiding the allergens responsible for the symptoms or reaction
  • Immunotherapy (allergy shots)
  • Allergy medication (Zyrtec, Clarinex, Allegra, Xyzal, Claritin, nasal sprays, eye drops)

Before starting a treatment plan, the pediatric allergist may run a series of tests, such as:

  • Scratch testing to identify specific allergens
  • Patch testing to determine the cause of atopic dermatitis (eczema)
  • Fractional exhaled nitric oxide (FeNO) or spirometry testing used to diagnose asthma

If eczema or asthma are diagnosed, additional medications may be included in the treatment regimen.

“Antihistamines may cause drowsiness, dizziness, constipation, upset stomach, blurred vision or mouth/eyes/nose/throat dryness,” said Dr. Khandekar. “And while rare, they may cause some kids to become irritable or hyper. If parents feel their kids are exhibiting side effects from their allergy medications, they will need to work with the pediatrician or pediatric allergist to determine if tweaking their treatment is necessary to minimize the side effects.”

Community Support

Parents can leverage the community’s support by establishing relationships with their child’s teachers, friends’ parents, family members and other adults who spend time with the child. Keeping communication lines open with others helps identify issues that parents may not be aware of or recognize.

Additionally, if your child is in daycare, preschool or school, work with the facility’s management or nurse to establish a care plan in the event your child experiences health issues while in their care. Building awareness with those who spend time with your child can help them more easily identify medical problems and quickly act.

“If you notice changes in your child’s ability to learn or overall mood, consider scheduling an appointment with your child’s pediatrician,” said Dr. Khandekar. “These changes may be related to allergies, developmental-behavioral issues or something completely unrelated to either. Early detection is always in the best interest of your child and your family.”