What you need to know
Behavioral and psychological assessments are important for individuals with fragile X. They can help determine the presence of concentration/attention problems, anxiety, obsessive-compulsive disorder, aggression, or depression.
Females with fragile X syndrome full mutation may have:
- Social anxiety
- Shyness
- Gaze avoidance
Males with fragile X syndrome full mutation may have:
- Autism (15-25%)
- An additional 50-90% of individuals with fragile X syndrome have symptoms of autism including poor eye contact, hand flapping, hand biting, perseveration in speech and tactile defensiveness.
- Autism spectrum disorder and/or attention deficit hyperactivity disorder may be seen in permutation carriers
- Management of behavior using drugs
- No particular treatment has been found to be uniquely beneficial. Therapy must be individual and closely monitored.
- Medication may be necessary for ADHD and/or anxiety or depression.
- Often tactile defensiveness
- Poor eye contact
- Perseverative speech
- Problems in impulse control
- Easily distracted
- Often fidgety or overactive
- Postural control challenges
- Difficulty with self control
- Sensory defensiveness
- Task avoidance
- Poor understanding of expectations
- Individuals with fragile X have difficulty with self-regulatory function. This causes difficulty with
- Attention
- Anxiety
- Modulation of activity level
- Easily aroused in situations with excessive auditory, visual and tactile stimuli.
- This may lead to tantrums or increased hyperactivity
- Situations like the cafeteria, theater, and/or gym may be challenging
- Arousal states
- Impulsivity
What you can do
Helpful hints that may work for children with Fragile X
- Quiet spaces when needed
- Small group instruction
- Calming activities
- Clear concrete plans and visual cues (i.e. visual sign for quiet)
- Proactive behavioral plans that include goals, rewards, and consequences for appropriate behavior
- Seating in back section of room and/or allow seating near exit.
- Structure and predictability
- Reduced level of environmental noise/sound, natural lightening, and avoidance of crowded areas.
- Predictable transitions and signal with visual cues
- Non verbal cues and feed back
- Role play behavioral consequences
- Physical activities
- Alternative to stressful events
- Breaks and downtime if needed
- Work on conversational skills and friendships