NFXF Webinar Series

Females with Fragile X Syndrome

00 h 55 m

The multidisciplinary panel discussed the unique experiences and support needs of females living with Fragile X syndrome. While females may sometimes exhibit fewer overt support needs, they can be as significantly affected as males. This complexity highlights the necessity for individualized approaches to support and intervention.

About the Webinar

With Barb Haas-Givler, Cora Taylor, Nicole Tartaglia, Tracy Jordan, and Vicki Wilkins
Learn more about the presenters

The discussion explored several key topics:

  • Educational strategies.
  • Complementary therapeutic interventions.
  • Medication options.

The panel also tackled the often-asked question of why females are underrepresented in research opportunities, including clinical trials.

Throughout the hour, the panelists consistently highlighted the importance of understanding the unique variability in how Fragile X syndrome impacts females. Emphasizing support strategies and interventions is most effective when they are meaningful to the individual. We can better support their success by tailoring these approaches to each person’s strengths and interests.

The panelist emphasized a few crucial points throughout the webinar, such as focusing on individual interests and understanding the diagnosis as a starting point for identifying risks rather than a definitive outcome. The panelists shared the following tips:

  • Individual-Centered Approach: The importance of tailoring interventions to the needs of the individual, which should be determined based on their unique interests, strengths, and challenges, has consistently been discussed. This personalized approach ensures that the interventions are more effective and engaging for the individual.
  • Understanding Diagnosis as a Risk Identifier: One of the core messages was that a diagnosis of Fragile X syndrome should be viewed as a tool to understand what the individual may be at risk for, not as a definitive outcome. This perspective helps to shift focus toward proactive strategies and interventions.
  • Prioritizing Appropriate Supports: The panel emphasized the importance of identifying specific risks and needs in order to prioritize the most relevant supports and interventions. These interventions could include educational, behavioral, employment, medical, and social supports.
  • Effective Use of Medications and Therapeutic Interventions: When medications are recommended to help address symptoms or specific behaviors, the panelists discussed that they are most effective when combined with therapeutic interventions, such as behavioral, cognitive, developmental, vocational, and educational therapies.
  • Recommended Programs and Interventions: No universal or therapeutic intervention works for everyone. The What Works Clearinghouse website was mentioned as a resource to help identify evidence-based programs and interventions. Approaches such as applied behavior analysis (ABA) and cognitive behavioral therapy (CBT) were discussed, briefly describing their specific considerations.
    • ABA is often more effective for younger individuals or those at earlier developmental stages. It focuses on behavior modification and skill-building through structured learning.
    • CBT is typically more suitable for older individuals who have reached a certain level of cognitive and emotional development, as it helps address issues like anxiety and social challenges through self-reflection and coping strategies.
  • Puberty and Reproductive Resources: Puberty and reproductive resources are complex topics that require careful consideration of each person’s unique needs to determine what supports and interventions are most appropriate. A collection of resources is available under Puberty & Sexuality and Reproductive Resources on our website. These are available to help provide general guidance, but personalized support should be discussed with the individual and their healthcare team.
  • Research: We commonly hear feedback of frustrations that females with FXS are underrepresented in research projects. Historically, clinical trials have focused on males with Fragile X syndrome, who often exhibit more classic and consistent features, allowing for a greater likelihood of achieving measurable outcomes. This male-centered focus has been necessary to drive meaningful progress, as it enables researchers to make faster advancements and determine effective treatments that can be made available for all individuals living with FXS.
      • Dr. Tracy Jordan shared information about a multi-year research project at Stanford University focused entirely on females called Girl BAND Study.
      • See Research Opportunities for current studies, surveys, and clinical trials.
  • Fragile X Clinics: Find a Fragile X clinic near you

We are grateful to the professionals who shared their knowledge and expertise during the webinar, emphasizing the importance of personalized interventions based on each person’s unique needs. Key takeaways included using the diagnosis to identify risks, rather than outcomes, and prioritizing supports that are meaningful and tailored to the individual for the most effective results.

About the Panelists

Barbara Haas-Givler

Barbara Haas-Givler, MEd, BCBA, is a board-certified behavior analyst in Lewisburg, Pennsylvania. Ms. Haas-Givler has extensive experience in special education. She has served in many different capacities over the course of her career, including classroom teacher, administrator, educational consultant, behavior analyst, and research associate for clinical pharmaceutical trials.

Ms. Haas-Givler has been a long-time member of the Fragile X community. Her dedication to providing families living with Fragile X strategies for success has greatly impacted over the years. She is also a member of the NFXF Clinical Trials Committee.

Nicole Tartaglia

Nicole Tartaglia, MD, attended university and medical school at the University of Colorado. She completed her training in general pediatrics at Children’s Hospital Los Angeles, and fellowship training in developmental-behavioral pediatrics at the University of California Davis MIND Institute, where her research focused on children and adults with developmental disabilities, chromosomal abnormalities, Fragile X syndrome, and autism spectrum disorder. She also obtained her master’s in clinical investigation from the University of Colorado Graduate School.

Since 2007, Dr. Tartaglia has worked as faculty for the Colorado School of Medicine at Children’s Hospital Colorado in the Department of Pediatrics Section of Developmental Pediatrics, where she founded and directs the eXtraordinarY Kids Clinic for children and adolescents with sex chromosome disorders, and is also the director of the Denver Fragile X Clinic. In these clinics, she leads multidisciplinary teams that include medical providers, genetic counseling, psychology, speech-language therapy, occupational therapy, nursing, and social work, and collaborates extensively with community providers, therapists, and schools to provide optimal care for these special populations.  She also evaluates and treats children with general developmental delays, autism spectrum disorder, ADHD, and other neurogenetic disorders.

Dr. Tartaglia has federally funded research projects evaluating natural history and outcome measures in sex chromosome disorders and Fragile X and collaborates with national networks of clinics to develop best practices for treatments of these conditions. She is also very active in clinical trials of targeted treatment medications for neurobehavioral features and developmental disabilities. Dr. Tartaglia is also a member of the NFXF’s Clinical Trials Committee.

Vicki Wilkins

Vicki Wilkins, MD, is a pediatric hospitalist at the University of Utah who specializes in provider-family communication, experience of care, and care for children with complex healthcare conditions. She has a son with Fragile X syndrome and has therefore developed a Fragile X practice and research portfolio. She trains and coaches physicians, nurses, and other healthcare providers in engaging in difficult conversations, conflict resolution, disclosure and resolution of adverse events, and shared decision-making. She is the medical director of experience of care at Primary Children’s Hospital in Salt Lake City, Utah. Dr. Wilkins is an NFXF board member and advisor.

Cora Taylor, PhD

Dr. Taylor has expertise in the diagnostic evaluation of children with a range of developmental concerns. At Geisinger, Dr. Taylor conducts research and leads the phenotypic battery selection and administration on a variety of current research protocols at Geisinger, with a focus on the phenotypic characterization of individuals with rare genetic conditions. Dr. Taylor has experience in engaging families and family-based organizations for rare genetic conditions in research through online participation that is offered internationally to interested patients and families. Prior to joining Geisinger, Dr. Taylor completed her graduate training at the University of Tennessee, and a research and clinical postdoctoral fellowship at Vanderbilt University.

Tracy Jordan, PhD

Tracy Jordan, PhD is a licensed clinical psychologist and clinical researcher at the Stanford University Center for Interdisciplinary Brain Sciences Research. Her research interests include the intersection of genetic conditions and medical illness with cognitive, affective, and social functioning in children and adolescents. Currently, she is involved with a with a major longitudinal NIH-funded study of brain development, cognition, mood, and behavior in school-aged girls diagnosed with Fragile X syndrome. She has also been involved with projects examining neurocognitive development in school-aged boys with Klinefelter syndrome and girls with Turner syndrome.