Examining the Specificity of Forms and Functions of Aggressive Behavior in Boys With Fragile X Syndrome.
Tobias C Britton, Ellen H Wilkinson, Scott S Hall
PMID 32609801WHAT IT FOUND
Caregivers reported aggression in adolescent boys with fragile X syndrome and other developmental disabilities was mostly linked to gaining attention or items, or escaping tasks.
Scratching and biting were more common in fragile X syndrome, but functions were not syndrome-specific.
Key findings
01Boys with FXS were more likely than boys with other IDD to scratch others (odds ratio 3.42, 99% confidence interval 1.05 to 11.14) and bite others (odds ratio 3.94, 99% confidence interval 1.14 to 13.59).
02The most common reported sources of reinforcement were social attention or access to preferred items and social escape from tasks; in boys with FXS these were identified in 63.4% and 61.0% of cases, and in controls in 47.5% and 54.2% of cases, with no group difference.
03Among boys with FXS, those taking psychotropic medications for aggression were older (mean 15.0 years versus 12.6 years), had more forms of aggression (mean 7.0 versus 4.0), and were more likely to kick others (odds ratio 7.5, 99% confidence interval 1.21 to 46.35) or pull hair (odds ratio 9.5, 99% confidence interval 1.02 to 88.76); no such associations were found in controls.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Caregivers reported behavior by online survey, so there was no direct observation or experimental functional analysis to confirm the reported functions. The study was cross-sectional, so it cannot show whether medication use followed aggression severity or whether aggression led to medication. Cognitive level and autism status were not measured, so the groups may not have been well matched beyond age and reported aggression. The study did not record how long participants had taken medications or whether medications reduced aggression. Findings apply to boys aged 11 to 18 years with weekly aggression; it does not say what happens in girls, younger children, or less frequent aggression.
The easy way to misread this
Do not read the medication findings as evidence that psychotropic medications cause specific aggressive forms or that they were effective. The study was cross-sectional, used parent report, and did not measure medication duration or response.