AbstractBoys with fragile X syndrome with (n = 49) and without (n = 33) characteristics of autism spectrum disorder, boys with Down syndrome (39), and typically developing boys (n = 41) were compared on standardized measures of receptive vocabulary, expressive vocabulary, and speech administered annually over 4 years. Three major findings emerged. Boys with fragile X without autism spectrum disorder did not differ from the younger typically developing boys in receptive and expressive vocabulary and speech production when compared at similar levels of nonverbal cognitive skills. Boys with fragile X without autism spectrum disorder and typically developing boys had higher receptive vocabulary and speech production than did boys with Down syndrome. There were mixed patterns of results for the boys with fragile X and characteristics of autism spectrum disorder.