Top 10 Things a Teacher Should Know About Fragile X Syndrome

top-10-list[1]These 10 things will help bring out the strengths of each child and minimize or improve some of their struggles they may encounter.

The #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:

  1. Don’t force eye contact.
    Eye contact will come naturally as the student becomes more comfortable with you.
  2. 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.
  3. 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.
  4. Allow and/or encourage frequent breaks.
    Accommodate attention deficits by keeping tasks brief. Keep up a good pace – power breaks are short breaks.
  5. 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.
  6. Think “INDIRECT.”
    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?”
  7. Jacob and Sophia from Palmyra, PA

    Jacob and Sophia from Palmyra, PA

    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.

  8. 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.
  9. 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.
  10. Know FXS strengths.
    Common strengths associated with FXS are a good visual memory, sense of humor, 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 modeling as a primary teaching technique – embed academics into useful and practical tasks, such as taking attendance (counting) or ordering from a menu (reading)  –  and ENJOY YOUR STUDENT WITH FXS!

For more information, check out the Lesson Planning Guide. The introduction is especially recommended.

Jayne Dixon WeberLaurie Yankowitz, Ed.D.
The Vice President of Individual and Family Support Services at HeartShare Human Services of New York. She has more than 30 years experience working with families of individuals with developmental disabilities.

Dr. Yankowitz can be contacted at for in-service trainings and consultations.


  • This is fantastic advice! Is there more about curriculum modification? Thanks!

    • Hi, Gila – I don’t think it’s possible to give much useful advice about modifying curriculum in a general way – it would need to be customized to the individual student AND the particular learning environment and situation. I’m glad you found the advice helpful – thanks so much for the feedback! – Laurie

  • Sharing this with all my “teachers” out there.

  • my daughter was tested for fragile x but does not have the condition but she seems to display lots of the issues as described for fragile x , can anyone shed any light on conditions similar to fragile x?

  • Thank you for this info. I will print it and give it to my grandson’s teachers. Can someone help me with advice about what to do when he hits me and pinches me. He is such a loving child, but suddenly he will start doing this and I am at a loss as to how to handle it. He is 11 years old and getting strong. I am 73. When this passes, he apologizes and is loving again. Thanks.

    • Consistency, consistency, consistency! i have 3 sons each exibiting different symptoms, and behaviours. What I have learned to be the most valuable is to anticipate the behaviour and short circuit it before it occurs. Sometimes thats feasible, sometimes not.

  • Jacob pictured above participates with my son in Special Olympics, and is an absolutely incredible human being!!

  • sudip kumar mukherjee

    April 13, 2015 at 11:00 AM (Reply)

    My son 3yrs 6 month is a fragile x. We do not have any family history about this. He is under different therapy, what is the best school, or how we will train him about his education?

  • I own a Karate school. One of my students had Fxs. I was very intimidated at first. He loves routine. He recently tested and achieved the rank of Purple belt. This kid is like a sponge, he learned all of his purple material and is preparing for his next rank. I look forward to working with him each day. I highly recommend martial arts as an outlet. Jyst make sure you research the teachers in your areas.

  • Excellent advice. I have 3 boys, 2 of which are diagnosed Fragile X. They are grown up now 30 and 44. Both are in supported living. They are very different in their behaviour, but the learning ability is the same.
    I wish this advice had been available for schools, when they were young.

  • AWESOME TIPS!! I just got a new student with Fragile X and these are great tips!!

  • Glad to hear it!!!

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