Language Development From Early Childhood to Adolescence in Youths With Fragile X Syndrome

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

Early communication development in infants and toddlers with Fragile X syndrome

“…Beyond this, it is not clear when children with FXS begin to combine words and use phrases. Nonetheless, expressive language skills do increase over time Brady et al, 2020 ) with many individuals with FXS using spoken language. In a study of boys with FXS between 21 and 77 months ( Roberts et al, 2007 ), performance on verbal and vocal communication domains (e.g., use of vocalizations, different words, and word combinations) were higher than performance on gestural communication, reciprocity (responding to communicative acts, repair strategies), and symbolic communication (e.g., language comprehension, constructive play) during the direct administration of the CSBS-Behavior Sample ( Wetherby & Prizant, 2003 ).…”

“…Broadly, research on comprehension indicates that while overall receptive language skills are delayed for children with FXS ( Finestack et al, 2013 ; Roberts, et al, 2007 ), they do show increases in receptive language abilities over time ( Brady et al, 2020 ). Like expressive language abilities, studies of children and adolescents have not found significant differences between those with FXS + autism and those with FXS only ( McDuffie et al, 2010 ).…”

Language in young females with fragile X syndrome: Influence on the neurocognitive profile and adaptive behavior

“…Some individuals with FXS meet diagnostics criteria for ASD, and those with ASD have been reported to have poorer language outcomes (Haebig et al, 2020), and tend to have more impaired cognition (Haebig et al, 2020). Sometimes it can be difficult to determine if language outcomes are more affected by IQ or autism status (Brady et al, 2020). One aim of the present investigations is to assess the influence of language on social perception and executive functions in girls with FXS.…”

“…In an ongoing longitudinal study of 55 children with FXS (11 girls) and their mothers, the findings indicated that, while language proficiency continues to be very delayed for most participants, positive slopes were detected for vocabulary measured by standardized test. Rates of number of different words grew steadily for most participants until age of 10 years and then decreased somewhat (Brady et al, 2020).…”

How Knowledge Mapping Can Bridge the Communication Gap Between Caregivers and Health Professionals Supporting Individuals With Complex Medical Needs: A Study in Fragile X Syndrome

“…More importantly, FXS illustrates the complexity of symptoms and the challenges in communication between caregivers and healthcare professionals seen in most NDDs. Indeed, individuals with FXS present clinically with a wide spectrum of symptoms and comorbid conditions, including core cognitive and adaptive function challenges (25), speech delay (26,27), autism spectrum traits (28)(29)(30)(31), sleep issues (32)(33)(34), challenging behavior (35), anxiety (36), and mental health issues (37). FXS is also an excellent model for understanding changing needs over a lifespan as, like most NDDs, it is a lifelong condition where the health, educational, and social needs of individuals evolve over time, making care even more complex and challenging for parents and health professionals (38).…”