STAGE 2

It begins between ages 1 to 4 and last for few weeks to months.

• a short neck
• Loss of purposeful hand skills and spoken language
• Characteristic hand movements such as wringing, tapping, clapping, repetitive taking of hand to mouth occurs
• The child may hold the hands clasped behind the back or held at the sides, with random touching, grasping, and releasing
• The movements continue while the child is awake but disappear during sleep
• Breathing irregularities such as episodes of apnea and hyperventilation may occur, although breathing usually improves during sleep
• Some girls also display autistic-like symptoms such as loss of social interaction and communication. Walking may be unsteady and initiating motor movements can be difficult
• Slowed head growth is usually noticed during this stage

STAGE 3

It usually begins between ages 2 and 10 and can last for years.

• Apraxia, motor problems, and seizures are prominent during this stage
• there may be improvement in behavior, with less irritability, crying, and autistic-like features
• In stage III there may be more interest in the surroundings and alertness, attention span, and communication skills may improve
• Many girls remain in this stage for most of their live

STAGE 4

It can last for years or decades .

• Prominent features include reduced mobility, curvature of the spine, and muscle weakness, rigidity, spasticity, and increased muscle tone with abnormal posturing of an arm, leg
• Girls who were previously able to walk may stop walking
• Cognition, communication, or hand skills generally do not decline in stage IV
• Repetitive hand movements may decrease and eye gaze usually improves