Early Adolescence: Mood Lability

Females with FXS usually have less severe hyperactivity compared to the males, but other ADHD symptoms including impulsivity and a short attention span are a problem for many (chaps. 1 and 9). Increasing problems with mood lability are noticeable as girls move into puberty. Frequent crying spells for no reason, verbal outbursts, or tantrums may occur around the menstrual period and may be labeled as premenstrual syndrome (PMS). When these problems are severe, use of a serotonin agent that helps to stabilize the mood during hormonal changes is often helpful, as described below (Steiner et al. 1995).

Early Adolescence: Testicular Volume

Testicular volume normally increases during the early stages of puberty, but in boys with FXS this increase is usually quite dramatic, leading to macroorchidism (enlarged testicles). During and after puberty, macroorchidism is represented by a testicular volume of .30 ml bilaterally. These changes are typical for FXS, and they do not require intervention. Lachiewicz and Dawson (1994) reported that the testicular volume begins to increase significantly in boys with FXS by 8 or 9 years of age, which is before pubic hair develops. Fryns (1994) reported 3 cases of massive hydrocele in 3 males with FXS ages 15, 16, and 19 years. The author postulated that males with FXS may be predisposed to hydrocele formation because of the large volume increase of the testicle during puberty. This problem could also be related to a connective tissue dysplasia, as are hernias.

Early Adolescence: IQ

The physician may be consulted by a teacher or psychologist concerning an IQ decrease in the early adolescent boy with FXS. A decrease in IQ is common in the majority of boys and girls with FXS (Wright-Talamante et al. 1996; chap. 6). Since it is commonly seen, a more detailed neurologic workup is usually not indicated. Problems that may interfere with learning, however, such as subtle seizures or absence episodes, significant attentional problems, and emotional or behavioral difficulties, must be identified and treated to optimize the cognitive development of children with FXS.

This article is not intended to give medical advice for individual cases.  Any change in medical treatment should be done in consultation with appropriate medical personnel. This article is written for medical professionals.  Some of the terms will be unfamiliar to those who are not trained in medical fields. *This article is from the chapter on treatment in the 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research edited by Randi Jenssen Hagerman, M.D. and Paul Hagerman, M.D., Ph.D., to be published May 2002.  It is included with permission from The Johns Hopkins University Press. References to other chapters refer to chapters in the book which are not included as part of this website. The complete 3rd edition of Fragile X Syndrome: Diagnosis, Treatment, and Research can be ordered from the National Fragile X Foundation by calling 1-800-688-8765 or from The Johns Hopkins University Press at 1-800-537-5487.

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