Developmental associations between motor and communication outcomes in Fragile X syndrome: Variation in the context of co-occurring autism

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

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Will, E. A., Hills, K. J., Smith, K., McQuillin, S., & Roberts, J. (2024). Developmental associations between motor and communication outcomes in Fragile X syndrome: Variation in the context of co-occurring autism. Autism, 28(9), 2191-2203. https://doi.org/10.1177/13623613231225498

Publication date: 8 Mar 2024 Added to AutiHub: 26 Sep 2026 Type: Article Article language: English

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Authors

Publication authors
5
Publication authors identified as autistic
1 / 5 (20.0%)

Abstract

Fragile X syndrome (FXS), the leading heritable cause of intellectual disability, has a co-occurrence rate of autism spectrum disorder (ASD) estimated at ~60%. The onset and rates of motor development in FXS are slower relative to neurotypical development, and even more so in the context of co-occurring FXS + ASD. Extant evidence suggests these differences are likely to affect communication, yet this developmental process or how it varies in the context of co-occurring ASD remains unknown in FXS. We aimed to delineate developmental associations between early motor abilities and their rate of development from 9 to 60 months of age on communication outcomes in 51 children with FXS, 28 of whom had co-occurring ASD. We also aimed to identify variation in these developmental associations in the context of co-occurring ASD. Results captured within-syndrome variability in these developmental associations as a function of co-occurring ASD. Fine motor proved to be a robust predictor of receptive communication regardless of co-occurring ASD, but we identified differences between FXS with and without ASD in the association between aspects of motor development and expressive outcomes. Findings provide evidence for differential developmental processes in the context of co-occurring ASD with implications for timely developmental intervention. Lay abstract Fragile X syndrome (FXS), the leading heritable cause of intellectual disability, has a co-occurrence rate of autism spectrum disorder (ASD) estimated at ~60%. Children with FXS experience delayed achievement and slower development of key motor abilities, which happens to an even greater extent for children with both FXS and ASD. A multitude of studies have demonstrated that motor abilities are foundational skills related to later communication outcomes in neurotypical development, as well as in the context of ASD. However, these associations remain unexamined in FXS, or FXS + ASD. In this study, we aimed to determine the associations between early motor skills and their rate of development on communication outcomes in FXS. Furthermore, we investigated whether these associations varied in the context of co-occurring FXS + ASD. Results revealed within-FXS variation in the context of co-occurring ASD between some aspects of motor development and communication outcomes, yet within-FXS consistency between others. Findings provide evidence for variability in developmental processes and outcomes in FXS in the context of co-occurring ASD and offer implications for intervention.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:01.

Cited references
65
With a DOI
60
Without a DOI, from raw bibliography text
5
0 / 65 (0.0%) cited references include at least one author identified as autistic.
References with data to complete
0 / 65 (0.0%)
References with detected author names
65 / 65 (100.0%)
Without detected author names
0
Without a structured title
0
Without a stable identifier
5
References with raw author names still to review
0
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
227
From DOI or external metadata
227
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
53 / 227 (23.3%) names are linked to an author already present in AutiHub. 174 / 227 (76.7%) names are not yet linked.
Names linked to a person identified as autistic
0 / 227 (0.0%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 0 / 53 (0.0%). Distinct people identified as autistic: 0 / 169 (0.0%).
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