Understanding Autism Spectrum Disorder in Fragile X Syndrome

Receiving a diagnosis of FXS and ASD can be appropriate, but the relationship between FXS and ASD and the characteristics of ASD seen in FXS are still an evolving science and the diagnosis of ASD in FXS continues to be studied by clinicians and researchers working with people with FXS. [...] Individuals with FXS who meet criteria for the current definition of ASD represent an area in the ASD “cloud” where an individual may meet for ASD criteria due to reduced social interactions with others, reduced interest in social interaction, and increased repetitive behaviors in addition to the common characteristics associated with FXS, such as social anxiety, intellectual disability, and senso. [...] The crucial point for teachers, therapists and others involved in the support of individuals with FXS, irrespective of whether or not they meet criteria for ASD, is to utilize existing knowledge about behavior and learning styles to better customize teaching and therapy strategies to the needs of the individual. [...] Studies have shown that the use of antipsychotics is more prevalent in those with FXS and ASD likely due to the common clinical experience of better effectiveness of antipsychotics for symptom combinations of anxiety and aggression/irritability often seen in those with FXS and ASD (Kaufmann et al., 2017; Eckert et al., 2019). [...] Because of the prominence of ADHD symptoms, in general, children with FXS may be more likely to respond to treatment with stimulant medication than those with ASD; however, caution should be taken as individuals with FXS in general and those with FXS who meet criteria for ASD in particular, may experience worsening symptoms of perseverative, anxious, or irritable behaviors, as is often seen in tho.