Social and emotional
Most children with Fragile X—especially boys—feel a great deal of social anxiety; that is, they aren’t completely comfortable in new situations, meeting new people, or doing new things. Their level of anxiety can be so high that they may avoid social situations. When these children do seek contact with others, they are often extremely nervous or uncomfortable. Their anxiety may show up as a lack of eye contact and/or fast, choppy speech. Although all children feel some degree of social anxiety, this discomfort usually doesn’t keep them from being social, as it may for children with Fragile X.
In addition to being anxious, males with Fragile X tend to be easily upset. They are easily overwhelmed with sights and sounds (see the What are the signs and symptoms of Fragile X?—Sensory section of this booklet for more information), and can become very distressed in a busy store or restaurant. Unexpected changes in routine, like entering a new class or classroom, can also upset them. Some children respond by becoming extremely rigid or tense, while others whine or cry. At times, their reactions can spill over into tantrums or repetitive actions, such as rocking back and forth and biting themselves. In adolescence, changes, such as rising hormone levels, may make these outbursts more extreme. In one study of teenage males with Fragile X, about one-third showed angry, aggressive behavior. 8 Such behavior can get them into trouble at school. Providing medication and a calm environment can help keep such behaviors from getting worse. (See the Are there treatments for Fragile X? section for more information.)
In addition, males with Fragile X tend to experience much longer periods of anxiety than their peers. Like other males, their heart rate and other signs of nervousness increase when they do challenging tasks, but many males with Fragile X stay highly anxious for much longer time frame. So, in addition to having a level of anxiety that is often higher than their peers, males with Fragile X also take longer to calm down than other males do.
Females with Fragile X may have social problems, too, but theirs tend to be milder. A female with Fragile X may feel uneasy around strangers or have trouble making friends, but these females don’t tend to be aggressive as adolescents.
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