title: The genetic assessment of looked after children: common reasons for referral and recent advances.
abstract: 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.
authors: Sheffield Clinical Genetics Service, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, South Yorkshire, UK.
authors: Michael J
authors: MJ
authors: Parker
authors: Looked After and Adoptive Children's Health Team, Sheffield, South Yorkshire, UK.
authors: Katherine
authors: K
authors: Teasdale
authors: The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors: Michael J
authors: MJ
authors: Parker
mesh_terms: D002648:Child; D000068216:Child Protective Services / Q000706:statistics & numerical data; D002669:Child Welfare / Q000706:statistics & numerical data* / Q000639:trends; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis; D005315:Fetal Diseases / Q000175:diagnosis; D005581:Foster Home Care / Q000706:statistics & numerical data / Q000639:trends; D006580:Genetic Carrier Screening / Q000379:methods; D030342:Genetic Diseases, Inborn / Q000175:diagnosis*; D005820:Genetic Testing / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D020380:Needs Assessment; D012017:Referral and Consultation; D006113:United Kingdom
keywords: Adoption; Fetal Alcohol Syndrome; Genetic Testing in Children; Genetics; Looked After Children