In 1986, a population study of school children in the city of Coventry
gave an overall prevalence in males and females for fragile X syndrom
e of 1/952. The 29 children diagnosed as having fragile X syndrome in
this study have been re-evaluated with molecular diagnostic techniques
. Eighteen of the original 29 children have been found not to have the
expansion of the FMR1 gene associated with fragile X syndrome. Revise
d prevalence figures have been calculated giving rise to an overall pr
evalence figure of 1/2720 (range 1/2198-1/3089). If the four children
lost to follow up are also assumed not to have the fragile X syndrome,
the revised prevalence figure was 1/5714 (range 1/4762-1/6349). Clini
cal review of boys with severe mental retardation from this and a subs
idiary study show that the clinical features of head circumference gre
ater than the 50th centile, testicular volume greater than the 50th ce
ntile, and IQ between 35 and 70 remain helpful in distinguishing boys
with fragile X syndrome from those who have nonspecific mental retarda
tion.