Profile of Behavioral Comorbidities in Children With Fragile X Syndrome

Anna De Sonia
Anna De Sonia

02 mins read

We are excited to share journal publications like this that resulted from FORWARD data. Many more papers are currently under development, and the future of Fragile X syndrome research is bright as more data are gathered. FORWARD-MARCH is the next step, and we will collect more detailed information.

Authors: Walter Kaufmann, MD; Paul Horn, PhD; and the FORWARD Consortium

Read “Profile of Behavioral Comorbidities in Children With Fragile X Syndrome” published in the Journal of Autism and Developmental Disorders[1]

Summary

Children living with Fragile X syndrome (FXS) often experience behavioral challenges, including anxiety, attention difficulties, hyperactivity, sensory sensitivities, and autism-related behaviors. Many children experience several of these challenges at the same time, which can affect their daily activities and everyday well-being.

In this study, researchers examined information from 1,410 children with FXS (1,072 males and 338 females) who participated in the FORWARD study, a large research project involving Fragile X syndrome specialty clinics across the United States.

Researchers examined eight of the most common behavioral challenges, how often they co-occurred, and how they affected children’s daily lives.

Results show that attention problems and anxiety were the most common behavioral challenges among children with FXS, but they were generally less severe than other challenges. Nearly 7 in 10 children (69%) experienced multiple behavioral challenges, and 39% had more than two. Children with more behavioral challenges tended to have greater difficulties overall.

Researchers also found that certain challenges often occurred together, especially attention problems and hyperactivity, as well as anxiety and mood changes. Surprisingly, sensory problems, such as sensitivity to sounds, lights, or touch, were strongly linked to every type of behavioral challenge studied. This suggests that sensory difficulties may play an important role in understanding the behavioral challenges children with FXS experience.

Why This Matters

These findings highlight how complex behavioral challenges can be for children living with FXS. Rather than focusing on one behavior at a time, healthcare providers may need to consider how multiple challenges interact and affect a child’s daily life.

For families, this research reinforces the importance of discussing all behavioral concerns with their child’s care team, including anxiety, attention, sensory sensitivities, and changes in mood or behavior.

Better understanding these patterns could help clinicians identify challenges earlier, develop more personalized care plans, and improve quality of life for individuals with FXS and their families.

Next Steps

These findings can improve how clinicians identify and manage behavioral challenges in children living with FXS. By understanding which challenges often occur together, healthcare providers can better recognize concerns that might otherwise be missed and develop more personalized care plans that meet each child’s unique needs.

The study also highlights ways to improve how researchers measure behavioral challenges, especially anxiety, attention difficulties, and repetitive behaviors. Better tools could help healthcare providers understand each child’s unique needs and help researchers more accurately measure whether treatments targeting these behaviors are working in clinical trials.

About the FORWARD-MARCH Registry & Database

Since 2012, the CDC has funded FORWARD Fragile X studies to expand understanding of Fragile X syndrome. The NFXF has been coordinating study efforts since the beginning and has been vital in ensuring its success.

FORWARD-MARCH is the next step and will collect more detailed information from participants to better understand FXS and improve the lives of children and adolescents with FXS and the lives of their families.

Learn more about FORWARD-MARCH and how to participate.

About the Author

Anna De Sonia

Anna joined the NFXF team in 2024. She has many years of research experience, starting out as a clinical research coordinator at Rush University Medical Center in Chicago, IL back in 2010. There she worked on a variety of clinical trials in the pediatric neurology division, specializing in Fragile X research. 

More About the Author

References

1. Kaufmann, W.E., Horn, P.S. & FORWARD Consortium. Profile of Behavioral Comorbidities in Children With Fragile X Syndrome. J Autism Dev Disord (2026). https://doi.org/10.1007/s10803-026-07525-8