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What are the Characteristics of ADHD and ADD in Persons with Fragile X Syndrome?
Attention deficit hyperactivity disorder (ADHD) is a neurologically based condition that causes difficulties
in the abilities to: focus and maintain attention, control impulsivity, remain focused and not distracted, and control the urge to move about and be physically active. Children may have a combination of difficulties in
attention, impulse control, distractibility, and hyperactivity. If the element of hyperactivity is not present, the child or adult may have attention deficit disorder (ADD).
A very high percentage of boys with fragile X syndrome (80-90%) are thought to meet the diagnostic criteria for ADHD. For girls with fragile X, the percentage is lower (35-47%), but still significant.
ADHD and ADD are not diagnosed by direct neurological tests, but by checklists and observations, or sometimes by computerized measures of impulse control. Pediatricians or pediatric neurologists may ask
parents and teachers to fill out checklists or rating scales, which are designed to evaluate the levels of difficulty the child is having in each of four areas (attention, distractibility, hyperactivity, impulsivity).
Boys with fragile X syndrome are often reported to be very active as young children. Indeed, along with
language disorders, hyperactivity is an early, strong indicator when fragile X is suspected. Some boys and girls, however, are not hyperactive, as much as inattentive, failing to focus for long on any difficult tasks.
While girls overall are somewhat more likely to have ADD rather than ADHD, there is a high percentage of girls with fragile X syndrome who have hyperactivity, along with inattention.
Disruptiveness and hyperactivity tend to decrease with age in persons with fragile X syndrome, but attention and concentration problems may persist. Low frustration tolerance often accompanies the symptoms of ADHD.
Medication and behavioral intervention, including management of the learning environment, are essential for many persons with fragile X and ADHD (see Therapy for Behavior Disorders).
Gail Harris-Schmidt, Ph.D., CCC-SLP Saint Xavier University Chicago, Illinois
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