Topic: Screening Test Results Copy
The doctor joins both Mr. and Mrs. Abbott, and provides them with a careful description of the screening test results. He emphasizes the probability that the baby will not have Down syndrome, and at the same time responds to the Abbotts’ concerns about the life possibilities for a child with Down syndrome.
Video Transcript
Dr. Thomas:
(Pleasantly.) Good morning, Mrs. Abbott. It is so good to see you today.
Mrs. Abbott:
Hi, Dr. Thomas. This is my husband, Nick.
Dr. Thomas:
Nice to meet you, Mr. Abbott (Shakes hands and takes a seat.)
Mrs. Abbott:
(With some intensity.) I am particularly glad to see you, Dr. Thomas. I have been so torn about getting the results of the tests. You know, my husband and I have tried to have a baby for the last three years, and I’m not sure how I would feel about positive results on the screening test.
Mr. Abbott:
(Affirmingly) Yes, this pregnancy means a lot to both of us. We are really looking forward to being parents.
Dr. Thomas:
Before I describe the results to both of you, remember our discussion that these results only describe the likelihood or odds of your having a child with Down syndrome.
Mrs. Abbott:
Yes, I remember.
Dr. Thomas:
Having said that, Mrs. Abbott, your test results indicate that the chances of you having a child with Down syndrome are approximately 1 in 20. As we discussed, given your age, our standard of care is to offer you either chorionic villus sampling, or CVS for short, or an amniocentesis. Either of these tests will confirm whether or not your baby has Down syndrome.
Mr. Abbott:
(Hopefully) But doesn’t this mean that the odds are 95% in our favor that our baby won’t have Down syndrome?
Dr. Thomas:
That’s right, Mr. Abbott, statistically it is considerably more likely that the baby will not have Down syndrome, even with your wife’s increased risk level. The screening test does show that Mrs. Abbott has a significantly higher chance of having a child with Down syndrome than most women. What do you two know about Down syndrome?
Mr. Abbott:
(With some dismay.) Aren’t these children mentally retarded? I think I’ve also read they don’t live very long.
?Decision Point: What would you say next?
Important issues to include: Emphasize
- The use of the term intellectual disability, and not “retardation.”
- The wide variability exists in children with Down syndrome, as in all children.
- What is now possible for individuals with Down syndrome, given supports and early intervention.
- Note improved life expectancy.
Reflect for a minute on what you would say next, then check your answer against the suggestion below.
Suggested Response
Actually, there is a great deal of variation in the intellectual abilities of children with Down syndrome, just as there are in all children. Many children with Down syndrome do experience some degree of intellectual disability, but we are learning all the time about the things they can do, especially with early intervention. And with improved health care, their life expectancies are improving and coming closer to those of the general population.