Fragile X Syndrome

Students with fragile X syndrome can often be like the proverbial girl with the curl in the middle of her forehead – when they’re good, they’re very, very good, and when they are bad they are horrid.

Knowing these 10 things will help bring out the good and minimize the horrid!

The number 1 thing teachers should know about students with FXS is that they are prone to hyperarousal and anxiety.

It is how their nervous systems are wired. Most recommendations that follow are geared to maximizing focus and cooperation by minimizing hyperarousal and anxiety:

Don’t force eye contact.

Eye contact will come naturally as the student becomes more comfortable with you.

Expect inconsistency.

Engagement and performance is likely to vary greatly; it can be difficult to discern why. Try to accept this to avoid frustration; your student will pick up on frustrated energy and that will exacerbate anxiety.

Students are “simultaneous” vs “sequential” learners

Students with FXS are good sight word learners, but have a terrible time with phonetics. They are motivated by the end result, and impatient with the process. Use backward rather than forward chaining; use checklists to show progress toward an end result.

Allow and/or encourage frequent breaks.

Accommodate attention deficits by keeping tasks brief. Keep up a good pace – power breaks are short breaks.

Verbal expression is cognitively taxing.

Provide some non-verbal alternatives for students to show what they know, such as following directions and pointing to visual representations.


There are times when students with FXS enjoy attention, but most often they are adverse to the limelight. Give compliments in the 3rd person about the student to others within earshot; use incidental learning; include the student in a small group while directing instruction to a peer; avoid direct, open-ended questioning: prompt “The President of the United States is…..” vs. “Who is the President of the United States?”

Prepare for transitions.

Give 10 and 5 minute prompts. Allow to be at the head or back of the line. Use social stories about routine transitions. Provide a purposeful errand so the focus is on the outcome (e.g. delivering an envelope) rather than moving from one place to another.


Work with an OT knowledgeable about sensory integration and embed S-I strategies into the school day.

Students with FXS are prone to hyperarousal and anxiety which undermines focusing ability- learn what S-I techniques are calming for your student – heavy work like re-arranging desks, cleaning windows, moving stacks of books? Vestibular input, like going for a walk, doing wall push-ups, swinging, using a skateboard? Integrate these activities throughout the day to sustain a calm, regulated nervous system.

Notice environmental triggers.

Students with FXS often have sensory sensitivities to sound, light, textures, taste, and smell that provoke hyperarousal. Make adjustments to the environment (dim lighting, allow use of muting headphones) as much as possible.

Know FXS strengths.

Common strengths associated with FXS are a good visual memory, sense of humour, desire to be helpful, empathic nature, and gift for mimicry. Use visual cues, make learning fun, provide opportunities to be of assistance, encourage providing emotional support to peers, use modelling as a primary teaching technique – embed academics into useful and practical tasks, such as taking attendance (counting) or ordering from a menu (reading)