AUTISM AND THE FRAGILE X-SYNDROME

Many epidemiological studies have demonstrated the exceptionally high incidence of autism in children with the fragile X syndrome, and autis m is often considered a << behavioral phenotype >> of this syndrome. H owever, the discrepancies between the results of these studies disclos ed strong effects of methodological flaws and demonstrated the need fo r gathering clinical data. Atypical << autistic-like >> behaviors were then found to be common, early symptoms of the syndrome occurring aga inst the background of early manifestations of mental retardation. The se behaviors reflect these children's exquisite reactivity to change a nd contact with others. Avoidance of eye contact is the most significa nt feature. The appropriate diagnosis is not autism but phobia of soci al relationships. This highly specific vulnerability, which may be inh erited, probably leads some of these patients to experience the fate o f autistic children. It highlights the influence of environment on the clinical course and indirectly supports the role of early specialized care.