Patient case (clinical description): A 15-year-old boy with mild intellectual disability is brought to the office by his parents for a routine physical examination.  The boy is going to a school for students with learning disabilities.  The patient was adopted, and his immunizations are up to date.  Review of the patient's medical records is notable for cytogenetic studies that showed a small gap near the tip of the long arm of the X chromosome, which is consistent with fragile X syndrome, an X-linked disorder. The defect is an unstable expansion of trinucleotide repeats (CGG) in the fragile X mental retardation 1 (FMR1) gene, located on the long arm of the X chromosome. He is not using any medications and vital signs are within normal levels. His blood chemistry analysis as bellow:
Blood Chemistry Value      Normal Range     Patient Value
Glucose                    90-120 mg/dl     95 mg/dl
BUN (Blood Urea Nitrogen)  7-24 mg/dl       10 mg/dl
Creatinine                 0.7-1.4 mg/dl    0.8 mg/dl
Calcium                    8.5-10.5 mg/dl   9 mg/dl
Sodium                     134-143 mEq/L    135 mEq/L
Potassium                  3.5-4.5 mEq/L    3.7 mEq/L
Chloride                   95-108 mEq/L     98 mEq/L
CO2                        20-30 mEq/L      25 mEq/L
Blood pH                   7.38-7.42        7. 39

Patient's own account: My husband and I brought our 15-year-old son to the clinic for his routine exam. My son is going to school for special needs students. We adopted him a few years ago. His vaccinations are up to date. He already passed some chromosome testing and they found that he has a fragile X syndrome. The doctor told us that it comes from repeats in the fragile X chromosome. My son is not using any medication and his blood pressure temperature and breathing were normal during the exam. He also did a blood test. The results came back and showed that his blood sugar urea creatinine calcium sodium potassium chloride CO2 and blood pH were all within the normal range.

Clinical trial: Improving STEM Outcomes for Young Children With Language Learning Disabilities

Eligibility criteria:
Inclusion Criteria:

          -  Age between 4 and 7 years

          -  Not yet begun first grade

          -  Speaks English as their primary language

          -  Has SLI confirmed by 1) a standard score of 94 or lower on the Structured Photographic
             Expressive Language Test, 3rd edition (SPELT-III, Dawson, Stout, & Eyer, 2003) OR
             below a scaled score of 7 on the Diagnostic Evaluation of Language Variance™-Norm
             Referenced (DELV-NR, Seymour, Roeper, & de Villiers, 2005) syntax subtest; AND 2)
             performing below age-relevant cutoffs on the Dollaghan and Campbell (1998) Nonword
             Repetition Task OR enrollment on a clinical caseload.

          -  Nonverbal matrices t score of 35 or higher on the Developmental Abilities Scale

          -  Passes a pure-tone audiometric screening administered according to the standards of
             the American Speech-Language-Hearing Association (ASHA, 1997)

          -  Can produce simple sentences that contain a subject and a verb.

          -  Performs with less than 40% accuracy on expressive probes of complement clauses prior
             to study onset

          -  Performs with less than 40% accuracy on vocabulary definition probes prior to study
             onset

        Exclusion Criteria:

          -  Other diagnosed neurodevelopmental disorders (e.g., autism, Down syndrome) via parent
             report or significant sensory or motor impairments (e.g., severe vision impairment
             uncorrectable by glasses)

          -  Exposure to a language other than English at home or school more than 20% of the time.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 4 Years old.
Subject must be at most 7 Years

Eligibility (NLI label): Contradiction