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Maltman N, Hilvert E, Friedman L, Sterling A. Comparison of Linguistic Error Production in Conversational Language Among Boys With Fragile X Syndrome + Autism Spectrum Disorder and Autistic Boys. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:296-313. [PMID: 36599155 PMCID: PMC10023176 DOI: 10.1044/2022_jslhr-22-00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/18/2022] [Accepted: 10/07/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Expressive language impairments are common among school-age boys with fragile X syndrome (FXS) and autistic boys. Given the high co-occurrence of autism spectrum disorder (ASD) among individuals with FXS, cross-condition comparisons can elucidate the specificity of such impairments as they relate to ASD. Language samples can provide fruitful information regarding individuals' grammatical skills in less structured formats relative to standardized measures. This study examined grammatical errors produced during a conversational language sample among 20 boys with FXS and co-occurring ASD (FXS + ASD) and 19 autistic boys matched on ASD severity. METHOD Language samples were coded for omissions and errors at the word and utterance levels. Participants' grammatical errors were also compared to separate mental age-matched and mean length of utterance-matched boys from a reference database. RESULTS Boys with FXS + ASD and autistic boys produced similar rates of errors across all categories. Relative to their matched comparison groups, boys with FXS + ASD and autistic boys produced significantly more omissions during conversation. CONCLUSIONS These findings suggest that omissions may be a unique grammatical marker associated with the ASD phenotype. Further examination of omissions across diagnostic groups would aid in clarifying the specificity of omissions in the language phenotype of ASD.
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Affiliation(s)
| | | | - Laura Friedman
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Audra Sterling
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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Brady NC, Fleming K, Bredin-Oja SL, Fielding-Gebhardt H, Warren SF. Language Development From Early Childhood to Adolescence in Youths With Fragile X Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3727-3742. [PMID: 33002370 PMCID: PMC8582761 DOI: 10.1044/2020_jslhr-20-00198] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
Purpose The aim of this study was to investigate language growth in individuals with fragile X syndrome (FXS) from early childhood to adolescence and the influence of maternal responsivity on language growth. Method We conducted a longitudinal analysis of language development in 55 youths (44 males, 11 females) with FXS. Data collection spanned the ages of 11-216 months. We measured expressive and receptive vocabulary with standardized tests. The number of different words and mean length of utterance were obtained from language sample analyses of mother-child interactions. We also measured maternal comments (responsivity indicator) produced during the language samples and child nonverbal IQ. Results Growth models indicated that rates of number of different words and receptive vocabulary were related to maternal commenting. Mean length of utterance did not change significantly over time. Expressive vocabulary measured with a standardized test grew, but the growth was not related to maternal commenting. Nonverbal IQ was related to all language outcomes at age of 10 years and to changes over time in vocabulary. Visual analysis indicated that the highest scores on standardized tests were produced by girls; however, measures derived from language sample analyses appeared similar for boys and girls. Language models for boys only were similar to the total sample models with lower scores at age of 10 years for some outcomes. Conclusion Results of persistent language impairments for most youths with FXS suggest the need for continued, focused interventions aimed at improved language productions in addition to a responsive environment. Supplemental Material https://doi.org/10.23641/asha.13022825.
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Affiliation(s)
- Nancy C. Brady
- Department of Speech-Language-Hearing: Sciences & Disorders, The University of Kansas, Lawrence
| | | | - Shelley L. Bredin-Oja
- Department of Speech-Language-Hearing: Sciences & Disorders, The University of Kansas, Lawrence
| | | | - Steven F. Warren
- Department of Speech-Language-Hearing: Sciences & Disorders, The University of Kansas, Lawrence
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Hoffmann A, Krause SE, Wuu J, Leurgans S, Guter SJ, Block SS, Salt J, Cook E, Maino DM, Berry-Kravis E. Vocabulary comprehension in adults with fragile X syndrome (FXS). J Neurodev Disord 2019; 11:25. [PMID: 31619160 PMCID: PMC6796341 DOI: 10.1186/s11689-019-9285-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Receptive and expressive vocabulary in adult and adolescent males with fragile X syndrome (FXS) have been shown as significantly lower than their chronological age; however, receptive vocabulary has been considered a strength relative to mental age. This has not been formally examined, however, and data are needed to compare receptive vocabulary with other language skills and with mental age in individuals with FXS. This is especially important as vocabulary measures are sometimes used as a proxy to estimate language ability. METHODS This preliminary study examined receptive vocabulary, global language, and cognitive skills in 42 adults (33 males and 9 females) with FXS as a portion of the baseline evaluation prior to randomization in a clinical trial of ampakine CX516. The battery of standardized tests addressed receptive vocabulary with the Peabody Picture Vocabulary Test, Third Edition (PPVT-III), receptive and expressive language (termed henceforth as global language) via the Preschool Language Scale, Fourth Edition or the Clinical Evaluation of Language Fundamentals, Third Edition, and non-verbal cognition via the Stanford-Binet Intelligence Scales, Fourth Edition (SB-IV). RESULTS Results showed (1) significantly higher receptive vocabulary than global language, (2) significantly better receptive vocabulary than non-verbal cognition, (3) equivalent non-verbal cognition and global language, and (4) severity of autism symptomatology was not correlated to receptive vocabulary or global language once non-verbal cognition was removed as factor. The scores from the PPVT-III did not represent the global language skills in our sample of adults with FXS. CONCLUSIONS Findings from this investigation strongly suggest that the PPVT-III should not be used as a screening tool for language levels or cognitive function in clinical studies since the scores from the PPVT-III were not representative of global language or non-verbal cognitive skills in adults with intellectual disabilities. This finding is critical in order to understand how to evaluate, as well as to treat, language in individuals with FXS. Development of efficient and appropriate tools to measure language, cognition, and behavior in individuals with FXS is essential.
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Affiliation(s)
- Anne Hoffmann
- Departments of Pediatrics and Communication Disorders and Sciences, Rush University, 600 N. Paulina, 1016A AAC, Chicago, IL, 60612, USA.
| | - Sue Ellen Krause
- Krause Speech and Language Services, 233 E. Erie Street, Suite 815, Chicago, IL, 60611, USA
| | - Joanne Wuu
- Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Rm 1345, Miami, FL, 33136, USA
| | - Sue Leurgans
- Departments of Neurological Sciences, Rush University, 1750 West Harrison, Chicago, IL, 60612, USA
| | - Stephen J Guter
- University of Illinois at Chicago, Institute for Juvenile Research, 1747 W. Roosevelt Road, Room 155, Chicago, IL, 60608, USA
| | - Sandra S Block
- Illinois College of Optometry, 3241 S. Michigan Avenue, Chicago, IL, 60616, USA
| | - Jeff Salt
- Have Dreams, 515 Busse Highway, Suite 150, Park Ridge, IL, 60068, USA
| | - Edwin Cook
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Road, Room 155, Chicago, IL, 60608, USA
| | - Dominick M Maino
- Illinois College of Optometry, 3241 S. Michigan Avenue, Chicago, IL, 60616, USA
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences and Biochemistry, Rush University, 1725 W. Harrison Street, Suite 710, Chicago, IL, 60612, USA
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Thurman AJ, McDuffie A, Hagerman RJ, Josol CK, Abbeduto L. Language Skills of Males with Fragile X Syndrome or Nonsyndromic Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:728-743. [PMID: 28074353 DOI: 10.1007/s10803-016-3003-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Despite the similarities observed between the fragile X syndrome (FXS) and autism spectrum disorder (ASD) phenotypes, few studies have compared their behavioral profiles outside of ASD symptomatology. In the present study, we sought to compare lexical and grammatical abilities in these two conditions. Comparisons of language abilities in both of these conditions are particularly interesting because both conditions are characterized by difficulties navigating social interactions. Results suggest that although both FXS and ASD are associated with language difficulties, there are important differences between the two conditions in terms of the language profiles observed and the factors influencing language when considering children of similar developmental levels. Theoretical implications are discussed.
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Affiliation(s)
- Angela John Thurman
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA.
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA.
| | - Andrea McDuffie
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA
| | - Randi J Hagerman
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Pediatrics, University of California Davis, Davis, USA
| | - Cynde K Josol
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA
| | - Leonard Abbeduto
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA
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Thurman AJ, Kover ST, Ted Brown W, Harvey DJ, Abbeduto L. Noncomprehension Signaling in Males and Females With Fragile X Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1606-1621. [PMID: 28586922 PMCID: PMC5544413 DOI: 10.1044/2016_jslhr-l-15-0358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 06/10/2016] [Accepted: 12/05/2016] [Indexed: 05/25/2023]
Abstract
Purpose This study used a prospective longitudinal design to evaluate the trajectory and predictors of noncomprehension signaling in male and female youth with fragile X syndrome (FXS). Method A direction-following task in which some of the directions were inadequate was administered. Participants were 52 youth (36 boys, 16 girls) with FXS. Upon study entry, participants ranged from 10 to 16 years. The average number of annual assessments per participant was 3.65 (range = 1-4), providing 198 data points for analysis. Results Participants with FXS were less likely to signal noncomprehension than younger, typically developing, cognitively matched children. The average rate of change in noncomprehension signaling was not significantly different from 0 for either boys or girls, suggesting a plateau. Both FMRP and nonverbal IQ were significant independent predictors of noncomprehension signaling for boys. Variability in noncomprehension signaling among girls was not explained by any of the predictors, but trends similar to those observed for boys were observed. Conclusions Noncomprehension signaling appears to be an area of weakness for individuals with FXS. Because the failure to signal noncomprehension can have negative, cumulative effects on comprehension, the results suggest a need for interventions targeting the requisite cognitive skills.
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Affiliation(s)
- Angela John Thurman
- MIND Institute, University of California Davis, Sacramento
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento
| | - Sara T. Kover
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - W. Ted Brown
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island
| | | | - Leonard Abbeduto
- MIND Institute, University of California Davis, Sacramento
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento
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Komesidou R, Brady NC, Fleming K, Esplund A, Warren SF. Growth of Expressive Syntax in Children With Fragile X Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:422-434. [PMID: 28219082 PMCID: PMC5533553 DOI: 10.1044/2016_jslhr-l-15-0360] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/28/2016] [Accepted: 08/06/2016] [Indexed: 05/31/2023]
Abstract
PURPOSE This research explored syntactic growth in children with fragile X syndrome (FXS) over a 5-year period, and variability in growth in relation to autism symptoms, nonverbal cognition, maternal responsivity, and gender. METHOD Language samples at 4 time points from 39 children with FXS, 31 boys and 8 girls, were analyzed using the Index of Productive Syntax (Scarborough, 1990) and mean length of utterance (Brown, 1973). The degree of autism symptoms was evaluated using the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988) at the first time point. Maternal responsivity estimates were averaged across time points. RESULTS Children with FXS showed significant syntactic growth over time and a significant plateau (quadratic trend) in the later observations. Children who exhibited more autism symptoms at Time 1 had significantly lower syntactic abilities over time than children who exhibited fewer autism symptoms. Nonverbal cognition significantly predicted mean length of utterance scores but not Index of Productive Syntax scores. Maternal responsivity was not a significant predictor of syntactic outcomes. Girls with FXS generally demonstrated better expressive syntax than boys with FXS with notable individual differences. CONCLUSION Despite significant growth over time, expressive syntax is a vulnerable domain for children with FXS, especially for those with severe autism symptoms. Clinical implications arising from the current findings are discussed.
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Booth R, Happé F. "Hunting with a knife and ... fork": examining central coherence in autism, attention deficit/hyperactivity disorder, and typical development with a linguistic task. J Exp Child Psychol 2010; 107:377-93. [PMID: 20655060 PMCID: PMC2941847 DOI: 10.1016/j.jecp.2010.06.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 06/15/2010] [Accepted: 06/16/2010] [Indexed: 11/17/2022]
Abstract
A local processing bias, referred to as "weak central coherence," has been postulated to underlie key aspects of autism spectrum disorder (ASD). Little research has examined whether individual differences in this cognitive style can be found in typical development, independent of intelligence, and how local processing relates to executive control. We present a brief and easy-to-administer test of coherence requiring global sentence completions. We report results from three studies assessing (a) 176 typically developing (TD) 8- to 25-year-olds, (b) individuals with ASD and matched controls, and (c) matched groups with ASD or attention deficit/hyperactivity disorder (ADHD). The results suggest that the Sentence Completion Task can reveal individual differences in cognitive style unrelated to IQ in typical development, that most (but not all) people with ASD show weak coherence on this task, and that performance is not related to inhibitory control. The Sentence Completion Task was found to be a useful test instrument, capable of tapping local processing bias in a range of populations.
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Affiliation(s)
| | - Francesca Happé
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, London SE5 8AF, UK
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Schneider A, Hagerman RJ, Hessl D. Fragile X syndrome -- from genes to cognition. ACTA ACUST UNITED AC 2010; 15:333-42. [PMID: 20014363 DOI: 10.1002/ddrr.80] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Fragile X syndrome (FXS), a single gene disorder with an expanded CGG allele on the X chromosome, is the most common form of inherited cognitive impairment. The cognitive deficit ranges from mild learning disabilities to severe intellectual disability. The phenotype includes hyperactivity, short attention span, emotional problems including anxiety, social avoidance, poor eye contact, and hyperarousal to sensory stimuli. Imaging studies in FXS have clarified the impact of the FMR1 mutation on brain development and function by documenting structural abnormalities, predominantly in the caudate nucleus and cerebellum, and functional deficits in the caudate, frontal-striatal circuits, and the limbic system. On the basis of current research results, a targeted treatment for FXS will be available in the near future. Currently, a number of psychopharmacological agents are helpful in treating many of the problems in FXS including hyperactivity, attention deficits, anxiety, episodic aggression, and hyperarousal. Although the targeted treatments aim at strengthening synaptic connections, it is essential that these treatments are combined with learning programs that address the cognitive deficits in FXS.
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Affiliation(s)
- A Schneider
- M.I.N.D. Institute, University of California at Davis Medical Center, 2825 50th Street, Sacramento, CA 95817, USA.
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Kover ST, Abbeduto L. Expressive language in male adolescents with fragile X syndrome with and without comorbid autism. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54:246-65. [PMID: 20146742 PMCID: PMC2852463 DOI: 10.1111/j.1365-2788.2010.01255.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND Approximately one-quarter of individuals with fragile X syndrome (FXS) meet diagnostic criteria for autism; however, it is unclear whether individuals with comorbid FXS and autism are simply more severely affected than their peers with only FXS or whether they have qualitatively different profiles of behavioural impairments. To address this issue, variation in the FXS linguistic phenotype was examined in males with FXS with and without autism. The syndrome-specificity of the expressive language impairment of both groups of those with FXS was assessed in relation to Down syndrome. The extent to which different language sampling contexts affected expressive language in each diagnostic group was also examined. METHOD Spontaneous language samples were collected from male adolescents with FXS without autism (n = 20), comorbid FXS and autism (n = 8), and Down syndrome (n = 16). Syntactic complexity (indexed by mean length of utterance), expressive vocabulary (indexed by lexical diversity), talkativeness, fluency and intelligibility were assessed in two contexts: conversation and narration. Groups were matched on non-verbal IQ, non-verbal mental age and chronological age to allow the assessment of relative strengths and weaknesses across language variables. RESULTS Males with comorbid FXS and autism were less intelligible than males with only FXS; no other differences between these two groups were found. Participants' performance differed across contexts for syntactic complexity, lexical diversity, talkativeness and fluency. CONCLUSIONS These findings contribute to existing research on the behavioural profiles of individuals with FXS or FXS with autism who have low cognitive abilities. Although individuals with comorbid FXS and autism may be, as a group, more impaired than those with only FXS, data from this small sample of males with comorbid FXS and autism with low IQs suggest that their relative strengths and weaknesses in spontaneous expressive language are largely comparable and not differentially affected by the context in which their talk occurs.
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Price JR, Roberts JE, Hennon EA, Berni MC, Anderson KL, Sideris J. Syntactic complexity during conversation of boys with fragile X syndrome and Down syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2008; 51:3-15. [PMID: 18230852 DOI: 10.1044/1092-4388(2008/001)] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE This study compared the syntax of boys who have fragile X syndrome (FXS) with and without autism spectrum disorder (ASD) with that of (a) boys who have Down syndrome (DS) and (b) typically developing (TD) boys. METHOD Thirty-five boys with FXS only, 36 boys with FXS with ASD, 31 boys with DS, and 46 TD boys participated. Conversational language samples were evaluated for utterance length and syntactic complexity (i.e., Index of Productive Syntax; H. S. Scarborough, 1990). RESULTS After controlling for nonverbal mental age and maternal education levels, the 2 FXS groups did not differ in utterance length or syntactic complexity. The FXS groups and the DS group produced shorter, less complex utterances overall and less complex noun phrases, verb phrases, and sentence structures than did the TD boys. The FXS with ASD group and the DS group, but not the FXS-only group, produced less complex questions/negations than did the TD group. Compared with the DS group, both FXS groups produced longer, more complex utterances overall, but on the specific complexity measures, they scored higher only on questions/negations. CONCLUSION Boys with FXS and DS have distinctive language profiles. Although both groups demonstrated syntactic delays, boys with DS showed greater delays.
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Affiliation(s)
- Johanna R Price
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, USA.
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Murphy MM, Abbeduto L. Gender differences in repetitive language in fragile X syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2007; 51:387-400. [PMID: 17391255 DOI: 10.1111/j.1365-2788.2006.00888.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Verbal perseveration (i.e. excessive self-repetition) is a characteristic of male individuals with fragile X syndrome; however, little is known about its occurrence among females or its underlying causes. This project examined the relationship between perseveration and (1) gender, (2) cognitive and linguistic ability, and (3) language sampling context, among youth with fragile X syndrome. METHOD Language transcripts were obtained from adolescent male (n = 16) and female participants (n = 8) with fragile X syndrome in two language contexts (i.e. narration and conversation) designed to elicit spontaneous language samples. Transcripts were coded for utterance-level repetition (i.e. repetition of words, phrases, dependent clauses or whole utterances), topic repetition and conversational device repetition (i.e. repetition of rote phrases or expressions). RESULTS Male participants produced more conversational device repetition than did female participants. Gender differences in conversational device repetition were not explained by differences in non-verbal cognitive or expressive language ability. Context influenced the type of repetition observed; for example, more topic repetition occurred in conversation than in narration regardless of gender. CONCLUSIONS The observed gender differences in conversational device repetition among adolescents with fragile X syndrome suggest that, relative to females, male participants may rely more heavily on rote phrases or expressions in their expressive language. Further, results suggest that this gender difference is not simply the result of the correlation between gender and cognitive or linguistic ability in fragile X syndrome; rather, gender may make an independent contribution to conversational device repetition. Repetition type also varied as a function of expressive language context, suggesting the importance of assessing language characteristics in multiple contexts.
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Affiliation(s)
- M M Murphy
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
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Abbeduto L, Brady N, Kover ST. Language development and fragile X syndrome: profiles, syndrome-specificity, and within-syndrome differences. MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES RESEARCH REVIEWS 2007; 13:36-46. [PMID: 17326110 PMCID: PMC7416600 DOI: 10.1002/mrdd.20142] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Fragile X syndrome (FXS) is the leading inherited cause of mental retardation. In this article, we review what is known about the language and related problems of individuals with FXS. In doing so, we focus on the syndrome-specific features of the language phenotype and on the organismic (i.e., genetic and individual neurocognitive and behavioral) and environmental factors associated with within-syndrome variation in the phenotype. We also briefly review those aspects of the behavioral phenotype of FXS that are relevant for understanding syndrome-specific features of, and within-syndrome variability in, language. The review includes summaries of research on the prelinguistic foundations for language development and on each of the major components of language (i.e., vocabulary, morphosyntax, and pragmatics). Throughout the review, we point out implications of existing research for intervention as well as directions for future research.
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Affiliation(s)
- Leonard Abbeduto
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin 53705, USA.
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Moore CJ, Daly EM, Schmitz N, Tassone F, Tysoe C, Hagerman RJ, Hagerman PJ, Morris RG, Murphy KC, Murphy DGM. A neuropsychological investigation of male premutation carriers of fragile X syndrome. Neuropsychologia 2004; 42:1934-47. [PMID: 15381024 DOI: 10.1016/j.neuropsychologia.2004.05.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2003] [Revised: 05/10/2004] [Accepted: 05/11/2004] [Indexed: 11/18/2022]
Abstract
It is currently thought that fragile X syndrome (FraX; the most common inherited form of learning disability) results from having more than 200 cytosine-guanine-guanine (CGG) trinucleotide repeats, with consequent methylation of the fragile X mental retardation (FMR1) gene and loss of FMR1 protein (FMRP). It was also considered that premutation carriers (with 55-200 CGG repeats) are unaffected, although a tremor/ataxia syndrome has recently been described in older adult male carriers. We reported that premutation expansion of CGG trinucleotide repeats affects brain anatomy, which, together with other studies, indicates that the molecular model for FraX needs modification. However, there are few studies on the cognitive ability of adult male premutation carriers. Thus, we selected 20 male premutation carriers on the basis of their genetic phenotype, and compared them to 20 male controls matched on age, IQ and handedness. We investigated intellectual functioning, executive function, memory, attention, visual and spatial perception, and language and pragmatics. The premutation carriers had significant impairments on tests of executive function (Verbal Fluency, Trail Making Test and Tower of London) and memory (Names sub-test of the Doors and People, Verbal Paired Associates Immediate Recall and Visual Paired Associates Delayed Recall sub-tests of the WMS-R, and Category Fluency Test for natural kinds). We therefore suggest that CGG trinucleotide repeats in the premutation range affect specific neuronal circuits that are concordant with specific neuropsychological deficits; and that these deficits reflect an emerging neuropsychological phenotype of premutation FraX.
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Affiliation(s)
- Caroline J Moore
- Division of Psychological Medicine, Section of Brain Maturation, Institute of Psychiatry, King's College London, DeCrespigny Park, London, UK.
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Abstract
Data on the relationships between cognitive and physical phenotypes, and a deficit of fragile X mental retardation 1 (FMR1) gene-specific protein product, FMRP, are presented and discussed in context with earlier findings. The previously unpublished results obtained, using standard procedures of regression and correlations, showed highly significant associations in males between FMRP levels and the Wechsler summary and subtest scores and in females between these levels and the full-scale intelligence quotient (FSIQ), verbal and performance IQ, and some Wechsler subtest scores. The published results based on data from 144 extended families with fragile X, recruited from Australia and the United States within a collaborative NIH-supported project, were obtained using robust modification of maximum likelihood in pedigrees. The results indicated that processing speed, short-term memory, and the ability to control attention, especially in the context of regulating goal-directed behavior, may be primarily affected by the FMRP depletion. The effect of this depletion on physical phenotype was also demonstrated, especially on body and head height and extensibility of finger joints. It is recommended that further studies should rely on more accurate measures of FMRP levels, and use of larger samples, to overcome extensive variability in the data.
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Affiliation(s)
- Danuta Z Loesch
- School of Psychological Science, La Trobe University, Melbourne, Australia.
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Abstract
Fragile X syndrome (FXS) is a well-recognized cause of mental retardation and developmental delay in males. Alongside the well-documented clinical characteristics of the condition, recent advances in technology and methodology have begun to define FXS at a number of different levels: genetic, brain structure and function, cognition, and behavior. This article suggests that the FXS phenotype is not merely a juxtaposition of spared and impaired functions but rather may be characterized by an inhibitory control deficit that interferes with the individual's ability to modulate output causing perseverative responding across various skill areas. It is further suggested that an inability to modulate arousal may be at least one cause for the inhibitory control deficit that typifies the FXS phenotype. The approach to understanding atypical development outlined here holds exciting promise for future research in FXS and other developmental disorders.
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Affiliation(s)
- Kim Cornish
- Department of Educational Psychology, McGill University, Montreal, Canada.
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Loesch DZ, Bui QM, Grigsby J, Butler E, Epstein J, Huggins RM, Taylor AK, Hagerman RJ. Effect of the Fragile X Status Categories and the Fragile X Mental Retardation Protein Levels on Executive Functioning in Males and Females With Fragile X. Neuropsychology 2003; 17:646-657. [PMID: 14599277 DOI: 10.1037/0894-4105.17.4.646] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The effects of a fragile X disorder on executive function impairment were assessed in 144 extended families, which included individuals with fragile X premutation and full mutation and their relatives without fragile X. A modification of the maximum-likelihood estimators for pedigree data, as well as ordinal logistic regression, were used in data analysis. The most outstanding deficit, occurring especially in males, involved impaired capacity to use an intention to regulate purposeful behavior. This deficit occurred independently of general cognitive impairment but was related to depletion of fragile X mental retardation 1 gene protein product. The other executive function deficits were accounted for by the general cognitive impairment. Possible mechanisms of the effect of fragile X premutation on impairments of executive functioning are considered.
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17
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Loesch DZ, Huggins RM, Bui QM, Taylor AK, Pratt C, Epstein J, Hagerman RJ. Effect of fragile X status categories and FMRP deficits on cognitive profiles estimated by robust pedigree analysis. Am J Med Genet A 2003; 122A:13-23. [PMID: 12949966 DOI: 10.1002/ajmg.a.20214] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The effect of the fragile X pre-mutation and full mutation categories, and FMRP deficits in these categories, on neurocognitive status, have been assessed in fragile X individuals from 144 extended families, which included fragile X individuals, as well as their non-fragile X relatives. Neuropsychological status was assessed by the Wechsler summary and subtest test scores. A modification of the maximum likelihood estimators for pedigree data that is resistant to outliers was used to analyze the data. The results have demonstrated the effect of large expansions of CGG repeat in the FMR1 (fragile X mental retardation 1) gene (full mutation) in decreasing full scale IQ (FSIQ), as well as several FSIQ-adjusted subtest scores in the performance domain. Moreover, the results have demonstrated significant cognitive deficits in male individuals with pre-mutation. FMRP depletion correlates strongly with neurocognitive status in the full mutation subjects. Evidence for the effect of FMRP in smaller expansions (pre-mutation) in reducing FSIQ, Performance and Verbal scores, as well as subtest scores in males, has also been obtained. The results are also suggestive of factors other than FMRP deficit which may determine some specific cognitive deficits in fragile X pre-mutation carriers. Genetic variance estimated from the models accounts for less than half of the total variance in FSIQ, and it varies widely between individual Wechsler subtests.
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Affiliation(s)
- D Z Loesch
- School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia.
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Language and Communication in Fragile X Syndrome. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s0074-7750(03)27003-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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19
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Loesch DZ, Huggins RM, Bui QM, Epstein JL, Taylor AK, Hagerman RJ. Effect of the deficits of fragile X mental retardation protein on cognitive status of fragile x males and females assessed by robust pedigree analysis. J Dev Behav Pediatr 2002; 23:416-23. [PMID: 12476071 DOI: 10.1097/00004703-200212000-00004] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The effect of the fragile X mental retardation 1 (FMR1) gene product (fragile X mental retardation protein [FMRP]) deficits on Full-Scale IQ (FSIQ) and FSIQ-adjusted Wechsler subtests and index scores in fragile X disorder were assessed using a robust modification of the maximum likelihood estimators for pedigree data. The results from 144 extended families have demonstrated a linear effect of progressively reduced levels of FMRP on the FSIQ and all subtest and summary scores in either gender. The effect of FMRP in decreasing FSIQ-adjusted subtest scores was highly significant for Digit Span, Symbol Search, Object Assembly, and Picture Arrangement, with a consistent trend in both genders. Heritability for FSIQ and unadjusted subtest scores estimated from the covariance model did not exceed 50% and varied widely from the highest for Verbal score to the lowest for Picture Completion score. Possible mechanisms by which FMRP deficit impacts on specific weaknesses in fragile X are considered on the basis of present data.
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Affiliation(s)
- Danuta Z Loesch
- School of Psychological Science, La Trobe University, Melbourne. d.
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20
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Yonamine SM, da Silva AA. [Characteristics of the communication in individuals with fragile X syndrome]. ARQUIVOS DE NEURO-PSIQUIATRIA 2002; 60:981-5. [PMID: 12563393 DOI: 10.1590/s0004-282x2002000600018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of this study was to make a characterization of the communication in a group with fragile X syndrome (FXS), based on normal development scale. The sample has 10 boys, between 6 and 13 years and with FXS. All of them were submitted to language evaluation. The most part of them had the communication in linguistic form (80%), until 3 years old. It was considered that the data confirmed the significant delay in the acquisition and development of the communication, being necessary an early and specialized intervention.
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Affiliation(s)
- Sueli Mami Yonamine
- Departamento de Oftalmo-Otorrinolaringologia da Faculdade da Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
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21
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Fisch GS, Holden JJ, Carpenter NJ, Howard-Peebles PN, Maddalena A, Pandya A, Nance W. Age-related language characteristics of children and adolescents with fragile X syndrome. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/(sici)1096-8628(19990402)83:4<253::aid-ajmg4>3.0.co;2-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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22
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Miezejeski CM, Heaney G, Belser R, Brown WT, Jenkins EC, Sersen EA. Longer brainstem auditory evoked response latencies of individuals with fragile X syndrome related to sedation. AMERICAN JOURNAL OF MEDICAL GENETICS 1997; 74:167-71. [PMID: 9129717 DOI: 10.1002/(sici)1096-8628(19970418)74:2<167::aid-ajmg10>3.0.co;2-g] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Brainstem auditory evoked response latencies were studies in 75 males (13 with fragile X syndrome, 18 with mental retardation due to other causes, and 44 with no disability). Latency values were obtained for each ear for the positive deflections of waves I (P1), III (P3), and V (P5). Some individuals with mental retardation required sedation. Contrary to previous report, latencies obtained for individuals with fragile X did not differ from those obtained for persons without mental retardation. Persons receiving sedation, whether or not their retardation was due to fragile X, had longer latencies for wave P5 than persons who did not receive sedation. This effect of sedation may also explain the previously reported increased latencies for persons with fragile X.
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Affiliation(s)
- C M Miezejeski
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island 10314, USA
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23
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Murray J, Cuckle H, Taylor G, Hewison J. Screening for fragile X syndrome: information needs for health planners. J Med Screen 1997; 4:60-94. [PMID: 9275266 DOI: 10.1177/096914139700400204] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- J Murray
- Centre for Reproduction, Growth & Development, Research School of Medicine, University of Leeds, United Kingdom
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25
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Franke P, Barbe B, Leboyer M, Maier W. Fragile X syndrome. II. Cognitive and behavioral correlates of mutations of the FMR-1 gene. Eur Psychiatry 1996; 11:233-43. [DOI: 10.1016/0924-9338(96)82329-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/1995] [Accepted: 05/21/1996] [Indexed: 10/17/2022] Open
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Slaney SF, Wilkie AO, Hirst MC, Charlton R, McKinley M, Pointon J, Christodoulou Z, Huson SM, Davies KE. DNA testing for fragile X syndrome in schools for learning difficulties. Arch Dis Child 1995; 72:33-7. [PMID: 7717734 PMCID: PMC1510971 DOI: 10.1136/adc.72.1.33] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Fragile X syndrome is the most common inherited cause of mental retardation. Early diagnosis is important not only for appropriate management of individuals but also to identify carriers who are unaware of their high risk of having an affected child. The disorder is associated with a cytogenetically visible fragile site (FRAXA) at Xq27.3, caused by amplification of a (CGG)n repeat sequence within the gene at this locus designated FMR1. Clinical and molecular studies have been undertaken to screen for fragile X syndrome in 154 children with moderate and severe learning difficulties of previously unknown origin. Southern blot analysis of peripheral blood showed the characteristic abnormally large (CGG)n repeat sequence associated with fragile X syndrome in four of the 154 children. The findings were confirmed by cytogenetic observation of the fragile site and by further molecular studies. The families of the affected children were offered genetic counselling and DNA tests to determine their carrier status. These findings show that there are still unrecognised cases of fragile X syndrome. Given the difficulty of making a clinical diagnosis and the implications for families when the diagnosis is missed, screening in high risk populations may be justified. The issues involved in screening all children in special schools for fragile X syndrome are discussed.
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Affiliation(s)
- S F Slaney
- Department of Medical Genetics, Churchill Hospital, Oxford
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27
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Cohen IL. A theoretical analysis of the role of hyperarousal in the learning and behavior of fragile X males. ACTA ACUST UNITED AC 1995. [DOI: 10.1002/mrdd.1410010410] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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