Skip to main content
Top
Published in: Journal of Genetic Counseling 2/2010

01-04-2010 | Original Research

Long-term Evaluation of Genetic Counseling Following False-Positive Newborn Screen for Cystic Fibrosis

Authors: Laura Cavanagh, Cecilia J. Compton, Audrey Tluczek, Roger L. Brown, Philip M. Farrell

Published in: Journal of Genetic Counseling | Issue 2/2010

Login to get access

Abstract

This cross-sectional mixed method study was a long-term follow-up evaluation of families who participated in an earlier survey of their understanding of cystic fibrosis (CF) genetics and their infants’ false-positive CF newborn screening (NBS) results. Thirty-seven of the original 138 parents participated in the follow-up telephone survey. Results showed parents who received genetic counseling at the time of their infants’ diagnostic sweat tests had significantly higher long-term retention of genetic knowledge than those without genetic counseling. However, both groups still had misconceptions and lacked accurate information about the actual risk associated with being a CF carrier. Most parents either had already informed (65%) or planned to inform (19%) their children about the child’s carrier status. Mean child age at the time of disclosure was 9.2 years. Situational prompts were the most common reasons for informing their children. Neither parental knowledge, medical literacy, nor parental education predicted whether parents informed their children about their carrier status. False-positive NBS results for CF were not associated with parental perceptions of child vulnerability 11–14 years after the testing. Although the sample from this study was small, these findings underscore the benefits of genetic counseling at the time of the diagnostic sweat test and offer information that can assist parents in talking with their children about the implications of having one CFTR mutation.
Appendix
Available only for authorised users
Literature
go back to reference American Academy of Pediatrics Committee on Ethics. (2001). Ethical issues with genetic testing in pediatrics. Pediatrics, 107, 1451–1455.CrossRef American Academy of Pediatrics Committee on Ethics. (2001). Ethical issues with genetic testing in pediatrics. Pediatrics, 107, 1451–1455.CrossRef
go back to reference Borry, P., Fryns, J.-P., Schotsmans, P., & Dierickx, K. (2006). Carrier testing in minors: a systematic review of guidelines and position papers. European Journal of Human Genetics, 14, 133–138.CrossRef Borry, P., Fryns, J.-P., Schotsmans, P., & Dierickx, K. (2006). Carrier testing in minors: a systematic review of guidelines and position papers. European Journal of Human Genetics, 14, 133–138.CrossRef
go back to reference Chew, L. D., Bradley, K. A., & Boyko, E. J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8), 588–594.PubMed Chew, L. D., Bradley, K. A., & Boyko, E. J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8), 588–594.PubMed
go back to reference Ciske, D. J., Haavisto, A., Laxova, A., Zeng, L., Rock, M., & Farrell, P. M. (2001). Genetic counseling and neonatal screening for cystic fibrosis: an assessment of the communication process. Pediatrics, 107, 699–705.CrossRef Ciske, D. J., Haavisto, A., Laxova, A., Zeng, L., Rock, M., & Farrell, P. M. (2001). Genetic counseling and neonatal screening for cystic fibrosis: an assessment of the communication process. Pediatrics, 107, 699–705.CrossRef
go back to reference Cobb, E., Holloway, S., Elton, R., & Raeburn, J. A. (1991). What do young people think about screening for cystic fibrosis? Journal of Medical Genetics, 28(5), 322–324.CrossRef Cobb, E., Holloway, S., Elton, R., & Raeburn, J. A. (1991). What do young people think about screening for cystic fibrosis? Journal of Medical Genetics, 28(5), 322–324.CrossRef
go back to reference Cole, M., & Cole, S. R. (2001). The development of children (4th ed.). New York: Worth Publishers. Cole, M., & Cole, S. R. (2001). The development of children (4th ed.). New York: Worth Publishers.
go back to reference Collins, M. S., Abbott, M. A., Wakefield, D. B., Lapin, C. D., Drapeau, G., Hopfer, S. M., et al. (2008). Improved pulmonary and growth outcomes in cystic fibrosis by newborn screening. Pediatric Pulmonology, 43, 648–655.CrossRef Collins, M. S., Abbott, M. A., Wakefield, D. B., Lapin, C. D., Drapeau, G., Hopfer, S. M., et al. (2008). Improved pulmonary and growth outcomes in cystic fibrosis by newborn screening. Pediatric Pulmonology, 43, 648–655.CrossRef
go back to reference Farrell, M. H., Certain, L. K., & Farrell, P. M. (2001). Genetic counseling and risk communication services of newborn screening programs. Archives of Pediatric Adolescent Medicine, 155, 120–126.CrossRef Farrell, M. H., Certain, L. K., & Farrell, P. M. (2001). Genetic counseling and risk communication services of newborn screening programs. Archives of Pediatric Adolescent Medicine, 155, 120–126.CrossRef
go back to reference Farrell, P. M., Kosorok, M. R., Rock, M. J., Laxova, A., Zeng, L., Lai, H. C., et al. (2001). Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. Pediatrics, 107(1), 1–13.CrossRef Farrell, P. M., Kosorok, M. R., Rock, M. J., Laxova, A., Zeng, L., Lai, H. C., et al. (2001). Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. Pediatrics, 107(1), 1–13.CrossRef
go back to reference Farrell, P. M., Lai, H. J., Li, Z., Kosorok, M. R., Laxova, A., Green, C. G., et al. (2005). Evidence on improved outcomes with early diagnosis of cystic fibrosis through neonatal screening: Enough is enough! Journal of Pediatrics, 147, S30–36.CrossRef Farrell, P. M., Lai, H. J., Li, Z., Kosorok, M. R., Laxova, A., Green, C. G., et al. (2005). Evidence on improved outcomes with early diagnosis of cystic fibrosis through neonatal screening: Enough is enough! Journal of Pediatrics, 147, S30–36.CrossRef
go back to reference Farrell, P. M., Rosenstein, B. J., White, T. B., Accurso, F. J., Castellani, C., Cutting, G. R., et al. (2008). Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report. Journal of Pediatrics, 153(2), S4–S14.CrossRef Farrell, P. M., Rosenstein, B. J., White, T. B., Accurso, F. J., Castellani, C., Cutting, G. R., et al. (2008). Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report. Journal of Pediatrics, 153(2), S4–S14.CrossRef
go back to reference Fiedman, M. M., Bowden, V. R., & Jones, E. G. (2003). Family nursing: Research, theory, and practice (5th ed.). Upper Saddle River: Prentice Hall. Fiedman, M. M., Bowden, V. R., & Jones, E. G. (2003). Family nursing: Research, theory, and practice (5th ed.). Upper Saddle River: Prentice Hall.
go back to reference Forsyth, B. W. C., & Canny, P. F. (1991). Perceptions of vulnerability 3 ½ years after problems of feeding and crying behavior in early infancy. Pediatrics, 88(4), 757–763.PubMed Forsyth, B. W. C., & Canny, P. F. (1991). Perceptions of vulnerability 3 ½ years after problems of feeding and crying behavior in early infancy. Pediatrics, 88(4), 757–763.PubMed
go back to reference Forsyth, B. W. C., Horwitz, S. M., Leventhal, J. M., Burger, J. (1996). The child vulnerability scale: An instrument to measure parental perceptions of child vulnerability. Journal of Pediatric Psychology, 21(1), 89–101.CrossRef Forsyth, B. W. C., Horwitz, S. M., Leventhal, J. M., Burger, J. (1996). The child vulnerability scale: An instrument to measure parental perceptions of child vulnerability. Journal of Pediatric Psychology, 21(1), 89–101.CrossRef
go back to reference Gallo, A. M., Angst, D., Knafl, K. A., Hadley, E., & Smith, C. (2005). Parents sharing information with their children about genetic conditions. Journal of Pediatric Health Care, 19(5), 267–275.CrossRef Gallo, A. M., Angst, D., Knafl, K. A., Hadley, E., & Smith, C. (2005). Parents sharing information with their children about genetic conditions. Journal of Pediatric Health Care, 19(5), 267–275.CrossRef
go back to reference Green, M., & Solnit, A. J. (1964). Reactions to the threatened loss of a child: a vulnerable child syndrome: pediatric management of the dying child, part III. Pediatrics, 34, 58–66.PubMed Green, M., & Solnit, A. J. (1964). Reactions to the threatened loss of a child: a vulnerable child syndrome: pediatric management of the dying child, part III. Pediatrics, 34, 58–66.PubMed
go back to reference Gurian, E. A., Kinnamon, D. D., Henry, J. J., & Waisbren, S. E. (2006). Expanded newborn screening for biomedical disorders: the effects of false-positive result. Pediatrics, 117(6), 1915–1921.CrossRef Gurian, E. A., Kinnamon, D. D., Henry, J. J., & Waisbren, S. E. (2006). Expanded newborn screening for biomedical disorders: the effects of false-positive result. Pediatrics, 117(6), 1915–1921.CrossRef
go back to reference Kerruish, N. J., Campbell-Stokes, P. L., Gray, A., Merriman, T. R., Robertson S. P., et al. (2007). Maternal psychological reaction to newborn genetic screening for type 1 diabetes. Pediatrics, 120(2), e324–335.CrossRef Kerruish, N. J., Campbell-Stokes, P. L., Gray, A., Merriman, T. R., Robertson S. P., et al. (2007). Maternal psychological reaction to newborn genetic screening for type 1 diabetes. Pediatrics, 120(2), e324–335.CrossRef
go back to reference Kloosterboer, M., Hoffman, G., Rock, M. J., Gershan, W., Laxova, A., Li, Z., et al. (2009). Clarification of laboratory variables influencing CF newborn screening with initial analysis of immunoreactive trypsinogen. Pediatrics, 123, 338–346.CrossRef Kloosterboer, M., Hoffman, G., Rock, M. J., Gershan, W., Laxova, A., Li, Z., et al. (2009). Clarification of laboratory variables influencing CF newborn screening with initial analysis of immunoreactive trypsinogen. Pediatrics, 123, 338–346.CrossRef
go back to reference Krippendorff, K. (2004). Content analysis: An introduction to its methodology (2nd ed.). Thousand Oaks: Sage Publications. Krippendorff, K. (2004). Content analysis: An introduction to its methodology (2nd ed.). Thousand Oaks: Sage Publications.
go back to reference Lewis, S., Curnow, L., Ross, M., & Massie, J. (2006). Parental attitudes to the identification of their infants as carriers of cystic fibrosis by NBS. Journal of Paediatrics and Child Health, 42, 533–537.CrossRef Lewis, S., Curnow, L., Ross, M., & Massie, J. (2006). Parental attitudes to the identification of their infants as carriers of cystic fibrosis by NBS. Journal of Paediatrics and Child Health, 42, 533–537.CrossRef
go back to reference Metcalfe, A., Coad, J., Plumridge, G. M., Gill, P., & Farndon, P. (2008). Family communication between children and their parents about inherited genetic conditions: a meta-synthesis of the research. European Journal of Human Genetics, 16(10), 1193–1200.CrossRef Metcalfe, A., Coad, J., Plumridge, G. M., Gill, P., & Farndon, P. (2008). Family communication between children and their parents about inherited genetic conditions: a meta-synthesis of the research. European Journal of Human Genetics, 16(10), 1193–1200.CrossRef
go back to reference Morris, N. S., MacLean, C. D., Chew, L. D., & Littenberg, B. (2006). The single item literacy screener: evaluation of a brief instrument to identify limited reading ability. BMC Family Practice, 24, 7–21.CrossRef Morris, N. S., MacLean, C. D., Chew, L. D., & Littenberg, B. (2006). The single item literacy screener: evaluation of a brief instrument to identify limited reading ability. BMC Family Practice, 24, 7–21.CrossRef
go back to reference Moskowitz, S. M., Chmiel, J. F., Sternen, D. L., Cheng, E., Gibson, R. L., Marshall, S. G., et al. (2008). Clinical practice and genetic counseling for cystic fibrosis and CFTR-related disorders. Genetics in Medicine, 10(12), 851–868.CrossRef Moskowitz, S. M., Chmiel, J. F., Sternen, D. L., Cheng, E., Gibson, R. L., Marshall, S. G., et al. (2008). Clinical practice and genetic counseling for cystic fibrosis and CFTR-related disorders. Genetics in Medicine, 10(12), 851–868.CrossRef
go back to reference Parsons, E. P., Clarke, A. J., & Bradley, D. M. (2003). Implications of carrier identification in newborn screening for cystic fibrosis. Archives of Disease in Childhood, 88, 467–471.CrossRef Parsons, E. P., Clarke, A. J., & Bradley, D. M. (2003). Implications of carrier identification in newborn screening for cystic fibrosis. Archives of Disease in Childhood, 88, 467–471.CrossRef
go back to reference Poulakis, Z., Barker, M., & Wake, M. (2003). Six month impact of false positives in an Australian infant hearing screening programme. Archives of Diseases in Children, 88, 20–24.CrossRef Poulakis, Z., Barker, M., & Wake, M. (2003). Six month impact of false positives in an Australian infant hearing screening programme. Archives of Diseases in Children, 88, 20–24.CrossRef
go back to reference Rock, M. J., Hoffman, G., Laessig, R. H., Kopish, G. J., Litsheim, T. J., & Farrell, P. M. (2005). Newborn screening for cystic fibrosis in Wisconsin: Nine-year experience with routine trypsinogen/DNA testing. Journal of Pediatrics, 147, S73–77.CrossRef Rock, M. J., Hoffman, G., Laessig, R. H., Kopish, G. J., Litsheim, T. J., & Farrell, P. M. (2005). Newborn screening for cystic fibrosis in Wisconsin: Nine-year experience with routine trypsinogen/DNA testing. Journal of Pediatrics, 147, S73–77.CrossRef
go back to reference Tluczek, A., Mischler, E. H., Farrell, P. M., Fost, N., Peterson, N. M., Carey, P., et al. (1992). Parents’ knowledge of neonatal screening and response to false-positive cystic fibrosis testing. Journal of Developmental and Behavioral Pediatrics, 13(3), 181–186.CrossRef Tluczek, A., Mischler, E. H., Farrell, P. M., Fost, N., Peterson, N. M., Carey, P., et al. (1992). Parents’ knowledge of neonatal screening and response to false-positive cystic fibrosis testing. Journal of Developmental and Behavioral Pediatrics, 13(3), 181–186.CrossRef
go back to reference Waisbren, S. E., Albers, S., Amato, S., Ampola, M., Brewster, T. G., Demmer, L., et al. (2003). Effects of expanded newborn screening for biomedical genetic disorders on child outcomes and parental stress. JAMA, 290(19), 2564–2572.CrossRef Waisbren, S. E., Albers, S., Amato, S., Ampola, M., Brewster, T. G., Demmer, L., et al. (2003). Effects of expanded newborn screening for biomedical genetic disorders on child outcomes and parental stress. JAMA, 290(19), 2564–2572.CrossRef
go back to reference Wheeler, P. G., Smith, R., Dorkin, H., Parad, R. B., Comeau, A. M., & Bianchi, D. W. (2001). Genetic counseling after implementation of statewide cystic fibrosis newborn screening: two years’ experience in one medical center. Genetics in Medicine, 3(6), 411–415.CrossRef Wheeler, P. G., Smith, R., Dorkin, H., Parad, R. B., Comeau, A. M., & Bianchi, D. W. (2001). Genetic counseling after implementation of statewide cystic fibrosis newborn screening: two years’ experience in one medical center. Genetics in Medicine, 3(6), 411–415.CrossRef
Metadata
Title
Long-term Evaluation of Genetic Counseling Following False-Positive Newborn Screen for Cystic Fibrosis
Authors
Laura Cavanagh
Cecilia J. Compton
Audrey Tluczek
Roger L. Brown
Philip M. Farrell
Publication date
01-04-2010
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 2/2010
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-009-9274-4

Other articles of this Issue 2/2010

Journal of Genetic Counseling 2/2010 Go to the issue