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Updated: Jun 6, 2025

A Strategy to Identify de Novo Mutations in Common Disorders such as Autism and Schizophrenia
Published on: June 15, 2011
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.
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.
Abstract:
This manuscript provides a review of the potential role of newborn genetic testing for autism, and whether the state has an inherent responsibility to facilitate and subsidise this. This is situated within the broader construct of benefits and limitations of genetic testing currently. Potential benefits of such presymptomatic genetic testing include facilitating earlier diagnosis and access to appropriate intervention which can improve the treatment outcome for the child and indirectly benefit caregivers and society by reducing the care needs of the child and adult in future. However, there are several limitations to newborn genetic testing including the variable penetrance of 'autism-risk' genes, marked phenotypic heterogeneity of autism, real-world limitations in access to treatment, potential psychological harm to caregivers and financial considerations. We hence argue for facilitation of diagnostic genetic testing instead, especially for parents who seek to have greater understanding of recurrence likelihoods, related to reproductive decision-making. Facilitation of such testing can be in the form of both financial subsidies and infrastructural elements including availability of testing facilities and trained healthcare personnel for individualised pregenetic and postgenetic test counselling.
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