Genetic Testing in Neurodevelopmental Disorders

Neurodevelopmental disorders are the most prevalent chronic medical conditions encountered in pediatric primary care. In addition to identifying appropriate descriptive diagnoses and guiding families to evidence-based treatments and supports, comprehensive care for individuals with neurodevelopmenta...

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Vydáno v:Frontiers in pediatrics Ročník 9; s. 526779
Hlavní autoři: Savatt, Juliann M., Myers, Scott M.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland Frontiers Media S.A 19.02.2021
Témata:
autism
exome sequencing
genetic testing
global developmental delay
intellectual disability
neurodevelopment
Pediatrics
chromosomal microarray
exome sequencing
neurodevelopment
global developmental delay
genetic testing
fragile x
autism
intellectual disability
ISSN:2296-2360, 2296-2360
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Shrnutí:Neurodevelopmental disorders are the most prevalent chronic medical conditions encountered in pediatric primary care. In addition to identifying appropriate descriptive diagnoses and guiding families to evidence-based treatments and supports, comprehensive care for individuals with neurodevelopmental disorders includes a search for an underlying etiologic diagnosis, primarily through a genetic evaluation. Identification of an underlying genetic etiology can inform prognosis, clarify recurrence risk, shape clinical management, and direct patients and families to condition-specific resources and supports. Here we review the utility of genetic testing in patients with neurodevelopmental disorders and describe the three major testing modalities and their yields – chromosomal microarray, exome sequencing (with/without copy number variant calling), and FMR1 CGG repeat analysis for fragile X syndrome. Given the diagnostic yield of genetic testing and the potential for clinical and personal utility, there is consensus that genetic testing should be offered to all patients with global developmental delay, intellectual disability, and/or autism spectrum disorder. Despite this recommendation, data suggest that a minority of children with autism spectrum disorder and intellectual disability have undergone genetic testing. To address this gap in care, we describe a structured but flexible approach to facilitate integration of genetic testing into clinical practice across pediatric specialties and discuss future considerations for genetic testing in neurodevelopmental disorders to prepare pediatric providers to care for patients with such diagnoses today and tomorrow.
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ObjectType-Review-3
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Reviewed by: Flora Tassone, University of California, Davis, United States; Tommaso Pippucci, Sant'Orsola-Malpighi Polyclinic, Italy
Edited by: Merlin G. Butler, University of Kansas Medical Center, United States
This article was submitted to Genetics of Common and Rare Diseases, a section of the journal Frontiers in Pediatrics
ISSN:2296-2360
2296-2360
DOI:10.3389/fped.2021.526779