Looked after children are recognised as generally having greater health needs than their peers. There are numerous potential causes, environmental and genetic, and the aetiology is often multifactorial. Assessments, especially clinical genetic ones, may be limited if the information available is incomplete or not shared. There have been some exciting recent advances in diagnostic genetic testing and more are on the horizon. However, we are currently only able to make a genetic diagnosis in less than half of patients, even when both parents are available for comparative testing. There may, therefore, remain an inevitable degree of residual uncertainty about the genetic contribution to a particular child's problems. There are increasing societal pressures for genetic information to be made available to individuals in general. However, there are significant considerations in carrier/predictive testing in children and we would maintain that looked after children should not be treated differently to other children in this regard, unless there is a compelling 'best interest' justification for so doing. Diagnostic criteria exist for fetal alcohol syndrome and other embryopathies and should be applied. Such should be considered as diagnoses of exclusion, so a child should not be prematurely labelled with these conditions, without fully assessing for the contribution of other factors, genetic or otherwise.

Original publication

DOI

10.1136/archdischild-2014-307215

Type

Journal article

Journal

Arch Dis Child

Publication Date

06/2016

Volume

101

Pages

581 - 584

Keywords

Adoption, Fetal Alcohol Syndrome, Genetic Testing in Children, Genetics, Looked After Children, Child, Child Protective Services, Child Welfare, Fetal Alcohol Spectrum Disorders, Fetal Diseases, Foster Home Care, Genetic Carrier Screening, Genetic Diseases, Inborn, Genetic Testing, Humans, Needs Assessment, Referral and Consultation, United Kingdom