The Preschool Period: Sensorimotor Integration Therapy

Sensorimotor integration therapy by an OT can improve motor planning, motor coordination, joint stability, and coordination of visual, auditory, and tactile information into a motor output. The OT can be particularly helpful in teaching calming techniques to the parents, which may control tantrums (chap. 10). Continued language therapy to improve pragmatics, attention, and problem-solving skills in addition to other language deficits is beneficial for boys and girls affected by FXS. Regular preschool experience with normal children is helpful in providing normal role models for the child with FXS.

The Preschool Period: Seizures

The physician must be vigilant about taking a history for possible seizures, which occur in approximately 15-20% of children with FXS. The type of seizure may include absence episodes, partial motor, generalized (grand mal), or partial complex seizures, as described in chapter 1. If such a history is obtained, an electroencephalogram (EEG) that includes both waking and sleeping states should be done. Pharmacotherapy for seizures is described below.

"Epilepsy in Fragile X Syndrome"

The Preschool Period: Ophthalmology

An ophthalmologic examination is recommended by four years of age or earlier because strabismus or other difficulties including ptosis, nystagmus, myopia, or hyperopia may occur in children with FXS (chap. 1). An obvious visual defect requires referral to an ophthalmologist as soon as it is noticeable.

The Preschool Period: Toilet Training

Delays in toilet training are common in young children with FXS. The attention deficits and the sensorimotor integration problems add to toileting difficulties. An approach to toilet training is presented in appendix 4, and Luxem and Christophersen (1994) provide an excellent review of behavioral approaches to toilet training. Consistent use of positive behavior reinforcement and the use of a music video like the one developed by Duke University (1-800-23POTTY) are usually helpful. The average age for successful toilet training in males with FXS is between five and six years and for females it is by four years (Fragile X Society 1995).

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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References: A, B, C, D, EF, G, H, IJ, K, L, M, NOP, QR, S, T, UVWXYZ
 

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