Abstract
Many males with FXS meet criteria for ASD. This study was designed to (1) describe ASD symptoms in adolescent and young adult males with FXS (n = 44) and (2) evaluate the contributions to ASD severity of cognitive, language, and psychiatric factors, as well as FMRP (the protein deficient in FXS). A few ASD symptoms on the ADOS-2 were universal in the sample. There was less impairment in restricted and repetitive behaviors (RRB) than in the social affective (SA) domain. The best predictor of overall ASD severity and SA severity was expressive syntactic ability. RRB severity was best predicted by the psychiatric factors. Implications for clinical practice and for understanding the ASD comorbidity in FXS are discussed.
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Abbeduto, L., Brady, N., & Kover, S. T. (2007). Language development and fragile X syndrome: Profiles, syndrome-specificity, and within-syndrome differences. Mental Retardation and Developmental Disabilities Research Reviews, 13, 36–46.
Abbeduto, L., McDuffie, A., & Thurman, A. J. (2014). The fragile X syndrome-autism comorbidity: What do we really know? Frontiers in Genetics, 5, 355.
Abbeduto, L., Murphy, M., Cawthon, S., Richmond, E., Weissman, M., Karadottir, S., et al. (2003). Receptive language skills of adolescents and young adults with mental retardation: A comparison of DS and fragile X syndrome. American Journal on Mental Retardation, 108, 149–160.
Abbeduto, L., Short-Meyerson, K., Benson, G., & Dolish, J. (2004). Relation between theory of mind and language ability in children and adolescents with mental retardation. Journal of Intellectual Disability Research, 48, 150–159.
Adayev, T., LaFauci, G., Dobkin, C., Caggana, M., Wiley, V., Field, M., et al. (2014). Fragile X 8 protein in newborn dried blood spots. BMC Medical Genetics, 15(1), 119.
Bailey, D. B., Hatton, D. D., Mesibov, G. B., Ament, N., & Skinner, M. (2000). Early development, temperament, and functional impairment in autism and fragile X syndrome. Journal of Autism and Developmental Disorders, 30, 557–567.
Bailey, D. B., Jr., Hatton, D. D., Skinner, M., & Mesibov, G. (2001). Autistic behavior, FMR1 protein, and developmental trajectories in young males with fragile X syndrome. Journal of Autism and Developmental Disorders, 31(2), 165–174.
Bailey, D. B., Jr., Raspa, M., Olmsted, M., & Holiday, D. B. (2008). Co-occurring conditions associated with FMR1 gene variations: Findings from a national parent survey. American Journal of Medication Genetics A, 146(16), 2060–2069.
Bassell, G. J., & Warren, S. T. (2008). Fragile X syndrome: Loss of local mRNA regulation alters synaptic development and function. Neuron, 60, 201–214.
Belser, R., & Sudhalter, V. (1995). Arousal difficulties in males with fragile X syndrome: A preliminary report. Developmental Brain Dysfunction, 8, 270–279.
Belser, R., & Sudhalter, V. (2001). Conversational characteristics of children with fragile X syndrome: Repetitive speech. American Journal on Mental Retardation, 106, 28–38.
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society, Series B (Methodological), 57(1), 289–300.
Benson, G., Abbeduto, L., Short, K., Nuccio, J. B., & Maas, F. (1993). Development of a theory of mind in persons with mental retardation. American Journal on Mental Retardation, 98, 427–433.
Boucher, J. (2003). Language development in autism. International Journal of Pediatric Otorhinolaryngology, 67(Suppl 1), S159–S163.
Budimirovic, D. B., & Kaufmann, W. E. (2011). What can we learn about autism from studying fragile X syndrome? Developmental Neuroscience, 33, 379–394.
Bullard, L., McDuffie, A., & Abbeduto, L. (2017). Distance delivery of a parent-implemented language intervention for young boys with fragile X syndrome. Autism & Developmental Language Impairments, 2, 1–22.
Caravella, K. E., & Roberts, J. E. (2017). Adaptive skill trajectories in infants with fragile X syndrome contrasted to typical controls and infants at high risk for autism. Research in Autism Spectrum Disorders, 40, 1–12.
Carrow-Woolfolk, E. (1999). Comprehensive assessment of spoken language. Circle Pines: American Guidance Service.
Clifford, S., Dissanyake, C., Bui, Q. M., Huggins, R., Taylor, A. K., & Loesch, D. Z. (2007). Autism spectrum phenotype in males and females with fragile X full mutation and permutation. Journal of Autism and Developmental Disorders, 37, 738–747.
Cordeiro, L., Ballinger, E., Hagerman, R., & Hessl, D. (2011). Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: Prevalence and characterization. Journal of Neurodevelopmental Disorders, 3, 57–67.
Cornish, K., Sudhalter, V., & Turk, J. (2004). Attention and language in fragile X. Mental Retardation and Developmental Disabilities Research Reviews, 10(1), 11–16.
Crawford, D. C., Acuña, J. M., & Sherman, S. L. (2001). FMR1 and the fragile X syndrome: Human genome epidemiology review. Genetics in Medicine, 3, 359–371.
Demark, J. L., Feldman, M. A., & Holden, J. J. (2003). Behavioral relationship between autism and fragile X syndrome. American Journal on Mental Retardation, 108, 314–326.
Ellis Weismer, S., Lord, C., & Esler, A. (2010). Early language patterns of toddlers on the autism spectrum compared to toddlers with developmental delay. Journal of Autism and Developmental Disorders, 40(10), 1259–1273.
Esbensen, A. J., Rojahn, J., Aman, M. G., & Ruedrich, S. (2003). Reliability and validity of an assessment instrument for anxiety, depression, and mood among individuals with mental retardation. Journal of Autism and Developmental Disorders, 33, 617–629.
Estigarribia, B., Roberts, J. E., Sideris, J., & Price, J. (2011). Expressive morphosyntax in boys with fragile X syndrome with and without autism spectrum disorder. International Journal of Language & Communication Disorders, 46, 216–230.
Ezell, J., et al. (in press). Prevalence and predictors of anxiety disorders in adolescent and adult males with autism spectrum disorder and fragile X syndrome. Journal of Autism and Developmental Disorders.
Finestack, L. H., & Abbeduto, L. (2010). Expressive language profiles of verbally expressive adolescents and young adults with Down syndrome or fragile X syndrome. Journal of Speech, Language, and Hearing Research, 53, 1334–1348.
Fisch, G. S., Carpenter, N., Howard-Peebles, P. N., Holden, J. J., Tarleton, J., & Simensen, R. (2010). The course of cognitive-behavioral development in children with the FMR1 mutation, Williams-Beuren syndrome, and neurofibromatosis type 1: The effect of gender. American Journal of Medical Genetics, 152(6), 1498–1509.
Gabriels, R. L., Cuccaro, M. L., Hill, D. E., Ivers, B. J., & Goldson, E. (2005). Repetitive behaviors in autism: Relationships with associated clinical features. Research in Developmental Disabilities, 26, 169–181.
Hagerman, R. (1999). Neurodevelopmental disorders. Oxford: Oxford University Press.
Hagerman, R. J., Berry-Kravis, E., Hazlett, H. C., Bailey, D. B. Jr., Moine, H., Kooy, R. F., et al. (2017). Fragile X syndrome. Nature Reviews Disease Primers, 3, 17065.
Harris, S. W., Goodlin-Jones, B., Nowicki, S., Bacalman, S., Tassone, F., & Hagerman, R. J. (2005). Autism profiles of young males with fragile X syndrome. Journal of Developmental and Behavioral Pediatrics, 26(6), 464.
Harris, S. W., Hessl, D., Goodlin-Jones, B., Ferranti, J., Bacalman, S., Barbato, I., et al. (2008). Autism profiles of males with fragile X syndrome. American Journal on Mental Retardation, 113, 427–438.
Hatton, D. D., Sideris, J., Skinner, M., Mankowski, J., Bailey, D. B., Roberts, J., et al. (2006). Autistic behavior in children with fragile X syndrome: Prevalence, stability, and the impact of FMRP. American Journal of Medical Genetics, 140(17), 1804–1813.
Hazlett, H. C., Poe, M. D., Lightbody, A. A., Gerig, G., Macfall, J. R., & Ross, A. K. (2009). Teasing apart the heterogeneity of autism: Same behavior, different brains in toddlers with fragile X syndrome and autism. Journal of Neurodevelopmental Disorders, 1, 81–90.
Hernandez, R. N., Feinberg, R. L., Vaurio, R., Passanante, N. M., Thompson, R. E., & Kaufmann, W. E. (2009). Autism spectrum disorder in fragile X syndrome: A longitudinal evaluation. American Journal of Medical Genetics, 149(6), 1125–1137.
Hessl, D., Nguyen, D., Green, C., Chavez, A., Tassone, F., Hagerman, R., et al. (2009). A solution to limitations of cognitive testing in children with intellectual disabilities: The case of fragile X syndrome. Journal of Neurodevelopmental Disorders, 1, 33–45.
Hus, V., Gotham, K., & Lord, C. (2014). Standardizing ADOS domain scores: Separating severity of social affect and restricted and repetitive behaviors. Journal of Autism and Developmental Disorders, 44(10), 2400–2412.
Kau, A., Tierney, E., Bukelis, I., Stump, M., Kates, W., Trescher, W., et al. (2004). Social behavior profile in young males with fragile X syndrome: Characteristics and specificity. American Journal of Medical Genetics, 126, 9–17.
Kaufmann, W., Cortell, R., Kau, A., Bukelis, I., Tierney, E., Gray, R., et al. (2004). Autism spectrum disorder in fragile X syndrome. American Journal of Medical Genetics, 129, 225–234.
Kaufmann, W. E., Capone, G., Clarke, M., & Budimirovic, D. B. (2008). Autism in genetic intellectual disability: Insights into idiopathic autism. In A. W. Zimmerman (Ed.), Current theories and evidence (pp. 81–108). Totowa: The Humana Press Inc.
Kaufmann, W. E., Kidd, S. A., Andrews, H. F., Budimirovic, D. B., Esler, A., Haas-Givler, B., et al. (2017). Autism spectrum disorder in fragile X syndrome: Cooccurring conditions and current treatment. Pediatrics, 139(Suppl 3), S194–S206.
Kjelgaard, M., & Tager-Flusberg, H. (2001). An investigation of language impairment in autism: Implications for genetic subgroups. Language and Cognitive Processes, 16(2–3), 287–308.
Klusek, J., Martin, G. E., & Losh, M. (2014a). Consistency between research and clinical diagnoses of autism among boys and girls with fragile X syndrome. Journal of Intellectual Disabilities Research, 58, 940–952.
Klusek, J., Martin, G. E., & Losh, M. (2014b). A comparison of pragmatic language in boys with autism and fragile X syndrome. Journal of Speech, Language and Hearing Research, 57, 1692–1707.
Kover, S. T., & Abbeduto, L. (2010). Expressive language in male adolescents with fragile X syndrome with and without comorbid autism. Journal of Intellectual Disability Research, 54, 246–265.
Kover, S. T., McDuffie, A., Abbeduto, L., & Brown, W. T. (2012). Effects of sampling context on spontaneous expressive language in males with fragile X syndrome or down syndrome. Journal of Speech, Language, and Hearing Research, 55(4), 1022–1038.
Kover, S. T., Pierpont, E., Kim, J.-S., Brown, W. E., & Abbeduto, L. (2013). A neurodevelopmental perspective on the acquisition of nonverbal cognitive skills in adolescents with fragile X syndrome. Developmental Neuropsychology, 38, 445–460.
LaFauci, G., Adayev, T., Kascsak, R., Kascsak, R., Nolin, S., Mehta, P., et al (2013). Fragile X screening by quantification of FMRP in dried blood spots by a Luminex immunoassay. Journal of Molecular Diagnostics, 15(4), 508–517.
Lee, M., Bush, L., Martin, G., Barstein, J., Heckel, N., Klusek, J., et al. (2017). A multi-method investigation of pragmatic development in Down syndrome. American Journal of Intellectual and Developmental Disabilities, 122, 289–309.
Lee, M., Martin, G. E., Berry-Kravis, E., & Losh, M. (2016). A developmental, longitudinal investigation of autism phenotypic profiles in fragile X syndrome. Journal of Neurodevelopmental Disorders, 8, 47.
Lewis, P., Abbeduto, L., Murphy, M., Richmond, E., Giles, N., Bruno, L., et al. (2006). Cognitive language and social-cognitive skills of individuals with fragile X syndrome with and without autism. Journal of Intellectual Disability Research, 50, 532–545.
Ligsay, A., & Hagerman, R. J. (2016). Review of targeted treatments in fragile X syndrome. Intractable & Rare Diseases Research, 5(3), 158–167.
Loesch, D. Z., Bui, Q. M., Dissanayake, C., Clifford, S., Gould, E., Bulhak-Paterson, D., et al. (2007). Molecular and cognitive predictors of the continuum of autistic behaviours in fragile X. Neuroscience & Biobehavioral Reviews, 31, 315–326.
Loesch, D. Z., Huggins, R. M., & Hagerman, R. J. (2004). Phenotypic variation and FMRP levels in fragile X. Mental Retardation and Developmental Disabilities Research Reviews, 10, 31–41.
Lord, C., Rutter, M., DeLavore, P., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism diagnostic observation schedule, second edition (ADOS-2) manual (part I): Modules 1–4. Torrance: Western Psychological Services.
Luyster, R. J., Kadlec, M. B., Carter, A., & Tager-Flusberg, H. (2008). Language assessment and development in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(8), 1426–1438.
Martin, G. E., Barstein, J., Hornickel, J., Matherly, S., Durante, G., & Losh, M. (2017). Signaling of noncomprehension in communication breakdowns in fragile X syndrome, Down syndrome, and autism spectrum disorder. Journal of Communication Disorders, 65, 22–34.
Martin, G. E., Losh, M., Estigarribia, B., Sideris, J., & Roberts, J. (2013). Longitudinal profiles of expressive vocabulary, syntax and pragmatic language in boys with fragile X syndrome or Down syndrome. International Journal of Language & Communicative Disorders, 48, 432–443.
Martin, G. E., Roberts, J. E., Helm-Estabrooks, N., Sideris, J., Vanderbilt, J., & Moskowitz, L. (2012). Perseveration in the connected speech of boys with fragile X syndrome with and without autism spectrum disorder. American Journal on Intellectual and Developmental Disabilities, 117(5), 384–399.
McDuffie, A., Abbeduto, L., Lewis, P., Kover, S., Kim, J., Weber, A., et al. (2010). Autism spectrum disorder in children and adolescents with fragile X syndrome: Within-syndrome differences and age-related changes. American Journal on Intellectual and Developmental Disabilities, 115(4), 307–326.
McDuffie, A., Banasik, A., Bullard, L., Nelson, S., Feigles, R. T., Hagerman, R. et al. (2018). Distance delivery of a spoken language intervention for school-aged and adolescent boys with fragile X syndrome. Developmental Neurorehabilitation, 21, 48–63.
McDuffie, A., Kover, S. T., Abbeduto, L., Lewis, P., & Brown, W. T. (2012). Profiles of receptive and expressive language in males with comorbid fragile X syndrome and autism. American Journal on Intellectual and Developmental Disabilities, 117, 18–32.
McDuffie, A., Machalicek, W., Bullard, L., Nelson, S., Tempero-Feigles, R., Castignetti, N., et al. (2016). A spoken language intervention for school-aged boys with fragile X syndrome. American Journal on Intellectual and Developmental Disabilities, 121, 236–265.
McDuffie, A., Oakes, A., Machalicek, W., Ma, M., Bullard, L., Nelson, S., et al. (2016). Early language intervention using distance video-teleconferencing: A pilot study of young males with fragile X syndrome and their mothers. American Journal of Speech-Language Pathology, 25, 46–66.
McDuffie, A., Thurman, A. J., Hagerman, R. J., & Abbeduto, L. (2015). Symptoms of autism in males with fragile X syndrome: A comparison to nonsyndromic ASD using current ADI-R scores. Journal of Autism and Developmental Disorders, 45, 1925–1937.
Merenstein, S. A., Sobesky, W. E., Taylor, A. K., Riddle, J. E., Tran, H. X., & Hagerman, R. J. (1996). Molecular-clinical correlations in males with an expanded FMR1 mutation. American Journal of Medical Genetics Part A, 64(2), 388–394.
Miguel, E. C., Baer, L., Coffey, B. J., Rauch, S. L., Savage, C. R., O’Sullivan, R. L., et al. (1997). Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette’s syndrome. The British Journal of Psychiatry, 170(2), 140–145.
Miller, M., Iosif, A. M., Young, G. S., Hill, M. M., & Ozonoff, S. (2018). Early detection of ADHD: Insights from infant siblings of children with autism. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2016.1220314
Mitchell, S., Brian, J., Zwaigenbaum, L., Roberts, W., Szatmari, P., Smith, I., et al. (2006). Early language and communication development of infants later diagnosed with autism spectrum disorder. Journal of Developmental and Behavioral Pediatrics, 27(2 Suppl), S69–S78.
Müller, R. A., & Amaral, D. G. (2017). Editorial: Time to give up on autism spectrum disorder? Autism Research, 10(1), 10–14.
Murphy, M. M., & Abbeduto, L. (2007). Gender differences in repetitive language in fragile X syndrome. Journal of Intellectual Disability Research, 51, 387–390.
Niu, M., Han, Y., Dy, A. B. C., Du, J., Jin, H., Qin, J., et al. (2017). Autism symptoms in fragile X syndrome. Journal of Child Neurology, 32(10), 903–909.
Oakes, A., Kover, S. T., & Abbeduto, L. (2013). Language comprehension profiles of young adolescents with fragile X syndrome. American Journal of Speech Language Pathology, 22, 615–626.
Oakes, A., McDuffie, A., Thurman, A. J., Bullard, L., & Abbeduto, L. (2016). Characterising repetitive behaviours in young males with fragile X syndrome. Journal of Intellectual Disability Research, 60, 54–67.
Oostra, B. A., & Willemson, R. (2003). A fragile X balance: FMR1 expression levels. Human Molecular Genetics, 12, 249–457.
Park, C. J., Yelland, G. W., Taffe, J. R., & Gray, K. M. (2012). Morphological and syntactic skills in language samples of preschool aged children with autism: Atypical development? International Journal of Speech Language Pathology, 14, 95–108.
Philofsky, A., Hepburn, S., Hayes, A., Rogers, S., & Hagerman, R. (2004). Linguistic and cognitive functioning and autism symptoms in young children with fragile X syndrome. American Journal on Mental Retardation, 109(3), 208–218.
Price, J. R., Roberts, J. E., Hennon, E. A., Berni, M. C., Anderson, K. L., & Sideris, J. (2008). Syntactic complexity during conversation of boys with fragile X syndrome and down syndrome. Journal of Speech Language and Hearing Research, 51(1), 3–15.
Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., et al. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45(9), 1094–1103.
Roberts, J. E., Clarke, M. A., Alcorn, K., Carter, J. C., Long, A. C., & Kaufmann, W. E. (2009). Autistic behavior in boys with fragile X syndrome: Social approach and HPA-axis dysfunction. Journal of Neurodevelopmental Disorders, 1, 283–291.
Roberts, J. E., Ezell, J. E., Fairchild, A. J., Klusek, J., Thurman, A. J., McDuffie, A., et al. (2018). Biobehavioral composite of social aspects of anxiety in young adults with fragile X contrasted to autism spectrum disorder. American Journal of Medical Genetics Part B. https://doi.org/10.1002/ajmg.b.32674
Roberts, J. E., Martin, G., Moskowitz, L., Harris, A. A., Foreman, J., Nelson, L. (2007). Discourse skills of boys with fragile X syndrome in comparison to boys with Down syndrome. Journal of Speech, Language, and Hearing Research, 50, 475–492.
Roberts, J. E., Tonnsen, B., Robinson, A., & Shinkareva, S. V. (2012). Heart activity and autistic behavior in infants and toddlers with fragile X syndrome. American Journal on Intellectual and Developmental Disabilities, 117(2), 90–102.
Roberts, J. E., Weisenfeld, L. A., Hatton, D. D., Heath, M., & Kaufmann, W. E. (2007). Social approach and autistic behavior in children with fragile X syndrome. Journal of Autism and Developmental Disorders, 37, 1748–1760.
Rogers, S., Wehner, E., & Hagerman, R. (2001). The behavioral phenotype in fragile X: Symptoms of autism in very young children with fragile X syndrome, idiopathic autism, and other developmental disorders. Journal of Developmental and Behavioral Pediatrics, 22, 409–418.
Roid, G., & Miller, L. (1997). Leiter international performance scale-revised. Wood Dale: Stoelting.
Rutter, M., LeCouteur, A., & Lord, C. (2008). Autism diagnostic interview-revised. Los Angeles: Western Psychological Services.
Scherr, J. F., Hahn, L. J., Hooper, S. R., Hatton, D., & Roberts, J. E. (2016). HPA axis function predicts development of working memory in boys with FXS. Brain and Cognition, 102, 80–90.
Shield, A., Pyers, J., Martin, A., & Tager-Flusberg, H. (2016). Relations between language and cognition in native-signing children with autism spectrum disorder. Autism Research, 9(12), 1304–1315.
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of American Academy Child and Adolescent Psychiatry, 47, 921–929.
Skinner, M., Hooper, S., Hatton, D., Roberts, J., Mirrett, P., Schaaf, J., et al. (2005). Mapping nonverbal IQ in young boys with fragile X syndrome. American Journal of Medical Genetics A, 132, 25–32.
Stembalska, A., Łaczmańska, I., Gil, J., & Pesz, K. A. (2016). Fragile X syndrome in females–a familial case report and review of the literature. Developmental Period Medicine, 20(2), 99–104.
Sudhalter, V., & Belser, R. C. (2001). Conversational characteristics of children with fragile X syndrome: Tangential language. American Journal on Mental Retardation, 106, 389–400.
Sudhalter, V., Cohen, I., Silverman, W., & Wolf-Schein, E. (1990). Conversational analysis of males with fragile X, Down syndrome, and autism: Comparison of the emergence of deviant language. American Journal on Mental Retardation, 94, 431–441.
Tager-Flusberg, H., & Sullivan, K. (1994). Predicting and explaining behavior: A comparison of autistic, mentally retarded and normal children. Journal of Child Psychology and Psychiatry, 35(6), 1059–1075.
Tager-Flusberg, H., & Sullivan, K. (2000). A componential view of theory of mind: Evidence from Williams syndrome. Cognition, 76(1), 59–90.
Talisa, V. B., Boyle, L., Crafa, D., & Kaufmann, W. E. (2014). Autism and anxiety in males with fragile X syndrome: An exploratory analysis of neurobehavioral profiles from a parent survey. American Journal of Medical Genetics, 164(5), 1198–1203.
Tassone, F., Hagerman, R. J., Ikle, D. N., Dyer, P. N., Lampe, M., Willemsen, R., et al. (1999). FMRP expression as a potential prognostic indicator in fragile X syndrome. American Journal of Medical Genetics, 84(3), 250–261.
Tek, S., Mesite, L., Fein, D., & Naigles, L. (2014). Longitudinal analyses of expressive language development reveal two distinct language profiles among young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44, 75–89.
Thurman, A. J., McDuffie, A., Hagerman, R. J., & Abbeduto, l (2014). Psychiatric symptoms in boys with fragile X syndrome: A comparison with nonsyndromic autism spectrum disorder. Research in Developmental Disabilities, 35, 1072–1086.
Thurman, A. J., McDuffie, A., Josol, C., Hagerman, R. J., & Abbeduto, L. (2017). Language skills of males with fragile X syndrome or nonsyndromic autism spectrum disorder. Journal of Autism and Developmental Disorders, 47, 728–743.
Thurman, A. J., McDuffie, A., Kover, S. T., Hagerman, R. J., & Abbeduto, L. (2015). Autism symptomatology in boys with fragile X syndrome: A cross-sectional developmental trajectories comparison with nonsyndromic ASD. Journal of Autism and Developmental Disorders, 45, 2816–2832.
van Steensel, F. J., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical, Child, and Family Psychology Review, 14, 302–317.
Waterhouse, L., & Gillberg, C. (2014). Why autism must be taken apart. Journal of Autism and Developmental Disorders, 44(7), 1788–1792.
Waterhouse, L., London, E., & Gillberg, C. (2017). The ASD diagnosis has blocked the discovery of valid biological variation in neurodevelopmental social impairment. Autism Research, 10(7), 1182.
Weller, E. B., Weller, R. A., Fristad, M. A., Rooney, M. T., & Schecter, J. (2000). Children’s interview for psychiatric syndromes (ChIPS). Journal of American Academy of Child and Adolescent Psychiatry, 39, 76–84.
White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Reviews, 29, 216–229.
Wolff, J. J., Bodfish, J. W., Hazlett, H. C., Lightbody, A. A., Reiss, A. L., & Piven, J. (2012). Evidence of a distinct behavioral phenotype in young boys with fragile X syndrome and autism. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1324–1332.
Acknowledgments
The authors gratefully acknowledge the families who participated in the project. The authors also thank the many research staff involved in the project, but especially Alicia Cox, Joan Gunther, Leona Kelly, Debra Reisinger, Emily Schwoerer, and Stephanie Summers.
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This research was supported by grants R01HD024356 and U54HD079125 from the National Institutes of Health awarded to Leonard Abbeduto, grant F32DC013934 to Jessica Klusek, grants R01MH090194 and R01MH107573 to Jane E. Roberts, and by grant UL1TR001860 to University of California, Davis.
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LA conceived of the study, participated in its design and coordination, performed the statistical analysis, drafted the manuscript, and conceptualized and received funding for the larger project from which the data for this study were drawn; AJT participated in the design, data collection, data preparation, and interpretation of the data; AM participated in the design, data collection, and interpretation of the data; JK participated in the design, data collection, and interpretation of the data; RTF participated in data collection and interpretation of the data; WTB participated in the design of the study and interpretation of the data; DJH participated in the conceptualization of the statistical analysis and the interpretation of the data; TA, GL, and CD all helped perform the analysis of the biological measures and interpretation of the data; and JER helped conceive of the larger study from which the data were drawn and participated in the design, coordination, and interpretation of the data for this study. All authors helped to draft the manuscript, and read and approved the final manuscript.
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Leonard Abbeduto has received funding to develop and implement outcome measures for clinical trials from F. Hoffman-LaRoche, Ltd., Roche TCRC, Inc., Neuren Pharmaceuticals Limited, and Fulcrum Therapeutics, Inc. W. Ted Brown and Giuseppe LaFauci hold a patent for a measure used in this study [System and Method for Quantifying Fragile X Mental 1 Protein in tissue and blood samples (United States Patent # 8628934)], with the assignee for the patent being the Research Foundation for Mental Hygiene, Inc. No other authors have conflicts or financial disclosures to declare.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All authors obtained review and approval from the Institutional review boards of their respective universities/institutions. This article does not contain any studies with animals performed by any of the authors.
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Abbeduto, L., Thurman, A.J., McDuffie, A. et al. ASD Comorbidity in Fragile X Syndrome: Symptom Profile and Predictors of Symptom Severity in Adolescent and Young Adult Males. J Autism Dev Disord 49, 960–977 (2019). https://doi.org/10.1007/s10803-018-3796-2
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DOI: https://doi.org/10.1007/s10803-018-3796-2