Should newborn genetic testing for autism be introduced?

Ramkumar Aishworiya1,2, Hui-Lin Chin2,3, Julian Savulescu4,5

  • 1Division of Developmental and Behavioural Paediatrics, Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore.

Journal of Medical Ethics
|December 3, 2024
PubMed

Insights

Newborn genetic testing for autism offers early diagnosis benefits but faces limitations. The study advocates for facilitating diagnostic genetic testing instead, aiding reproductive choices and parental understanding.

Area of Science:

  • Genetics
  • Developmental Pediatrics
  • Public Health Policy

Background:

  • Genetic testing is advancing, raising questions about its application in early childhood conditions like autism.
  • Current genetic testing for autism has benefits and limitations, including variable gene penetrance and phenotypic heterogeneity.
  • The state's role in facilitating and subsidizing genetic testing, particularly for newborns, is under consideration.

Purpose of the Study:

  • To review the potential role of newborn genetic testing for autism.
  • To examine the state's responsibility in facilitating and subsidizing such testing.
  • To compare newborn genetic testing with diagnostic genetic testing for parental decision-making.

Main Methods:

  • Literature review of current genetic testing benefits and limitations.
  • Analysis of potential benefits of presymptomatic autism genetic testing.
  • Evaluation of limitations including penetrance, heterogeneity, access to treatment, psychological harm, and cost.

Main Results:

  • Presymptomatic newborn genetic testing could enable earlier diagnosis and intervention, improving outcomes.
  • Limitations include variable gene penetrance, autism's phenotypic diversity, treatment access issues, caregiver psychological impact, and financial concerns.
  • Diagnostic genetic testing is proposed as a more beneficial alternative for understanding recurrence risks and informing reproductive choices.

Conclusions:

  • Facilitating diagnostic genetic testing, with financial and infrastructural support, is recommended over widespread newborn genetic testing for autism.
  • Support should include subsidies, testing facilities, and trained personnel for pre- and post-genetic test counseling.
  • This approach better addresses parental needs for reproductive decision-making and understanding genetic conditions.

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