Dr. Marcia Braden

Why would hearing happy birthday provoke such anxiety? The answer is quite simple. The attention that goes with the singing as well as the expectation to blow out candles and make a wish is a behavioral nightmare to someone with FXS. The problem is that every time the song is sung, the memory of being overwhelmed by all the attention becomes reenacted. As is often the case, the gestalt or wholeness of the experience becomes so solidified that it is very hard to convince the person with FXS that it will not make him anxious the next time it happens. As a matter of fact, it is difficult to convince the person with FXS that even when the song is sung to someone else, it does not need to affect him. Parents mention that the anticipation of a birthday party for another family member can also be intense and the family learns to excludes the song during subsequent celebrations.

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Small or big transitions can often halt progress and create excessive behavioral outbursts. Parents and teachers report difficulty moving their student or child from one activity to the next. The behavior that follows takes time to regulate and get refocused. There are several tips to help with this process.

  1. Always use a visual schedule to advise the child about the day.

  2. Use a first-then board to help the child know that he will do X first followed by Y.

  3. Use a token to take to the next location or transition and have the child put it in a cup or bank at that location.

  4. Give the child a job to take the fear away from changing locations to the job itself. For example, have the child carry an object needed at the next location (a ball to PE, a scooter to recess, a roll of paper to art).

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Marcia L. Braden, PhD. is a licensed psychologist with a clinical practice specializing in children and adolescents. She is a former teacher with experience teaching general and special education.
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