SUMMARY Through a community study of boys requiring special education for the severely mentally retarded, 12 families were ascertained in which the fragile X was found to be segregating. By assiduous follow up of these families, it was found that in only four of them could male transmission be ruled out from the grandparents' or great grandparents' generation and that the segregation ratios are disturbed.In the course of a population study of X linked mental retardation, 14 boys who were receiving special education at schools for the severely mentally subnormal were found to carry the fragile X(q27 3).'There were two sets of brothers so a total of 12 families in which the fragile X was segregating had been ascertained in a completely unbiased manner. The pedigrees are shown in the figure.In view of the reported unusual segregation pattern of the fragile X syndrome, in that one-third of the heterozygous females can be affected2 and that the disease can be transmitted through a normal male,-5 it was decided to follow up all family members of either sex, both affected and unaffected. In this way it was hoped to determine whether the unusual segregation and inheritance patterns found in the fragile X syndrome could be partially the result of bias in ascertainment of the families studied so far, or of partial follow up of affected and unaffected subjects in fragile X families.
Methods