Hoang Ny, Cytrynbaum Cheryl, Scherer Stephen W
Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada.
Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada.
Patient Educ Couns. 2018 Feb;101(2):352-361. doi: 10.1016/j.pec.2017.07.029. Epub 2017 Jul 29.
Individuals with Autism Spectrum Disorder (ASD) share characteristics (impairments in socialization and communication, and repetitive interests and behaviour), but differ in their developmental course, pattern of symptoms, and cognitive and language abilities. The development of standardized phenotyping has revealed ASD to clinically be vastly heterogeneous, ranging from milder presentations to more severe forms associated with profound intellectual disability. Some 100 genes have now been implicated in the etiology of ASD, and advances in genome-wide testing continue to yield new data at an unprecedented rate. As the translation of this data is incorporated into clinical care, genetic professionals/counsellors, as well as other health care providers, will benefit from guidelines and tools to effectively communicate such genomic information. Here, we present a model to facilitate communication regarding the complexities of ASD, where clinical and genetic heterogeneity, as well as overlapping neurological conditions are inherent. We outline an approach for counselling families about their genomic results grounded in our direct experience from counselling families participating in an ASD research study, and supported by rationale from the literature.
患有自闭症谱系障碍(ASD)的个体具有一些共同特征(社交和沟通障碍、重复的兴趣和行为),但在其发育过程、症状模式以及认知和语言能力方面存在差异。标准化表型分析的发展表明,ASD在临床上具有极大的异质性,从较轻微的表现到与严重智力残疾相关的更严重形式不等。目前约有100个基因与ASD的病因有关,全基因组检测的进展继续以前所未有的速度产生新数据。随着这些数据转化为临床护理,遗传专业人员/顾问以及其他医疗保健提供者将受益于有效传达此类基因组信息的指南和工具。在此,我们提出一个模型,以促进关于ASD复杂性的沟通,其中临床和遗传异质性以及重叠的神经疾病是内在的。我们概述了一种基于我们为参与ASD研究的家庭提供咨询的直接经验,并得到文献依据支持的为家庭提供基因组结果咨询的方法。