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Lisa Belkin

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Does Illness Define A Child?

Posted: 10/25/2011 6:07 pm

A new prenatal test, called MaterniT21 was made available to the public yesterday (in 20 cities across the U.S.), one that can detect Down syndrome early in a pregnancy with far less risk.

Odds are good that it will decrease the number of women who have amniocentesis or chronic villus sampling, the existing tests, both of which are more invasive. Odds are also good that there will be fewer babies born with Down syndrome, as women get earlier information more easily and decide to terminate their pregnancies.

This particular test is controversial for many reasons (you can read about that here and here) but what I want to talk about today is the philosophical underpinning of the tests.

Are children their illnesses? That is an ongoing question of parents whose children are diagnosed as having Down syndrome and autism spectrum disorders, and a host of other conditions that often define them to others. Decades of insistence by parents who know the power of language have made it clear to those who are paying attention, for instance, that there are no "autistic children" just "children with autism."

And yet, if you could somehow erase the condition, would you be left with the same child? And if you could avoid having a child with that condition, would you? Should everyone? Would there be something lost to the world if -- many would use the word "when" -- we can screen many in advance and reverse others after birth?

Temple Grandin, among the best known adults with autism in the country, has said that she would not accept a "cure" were one available. It comes up often when she is interviewed, most recently on the Brian Lehrer Show on NPR yesterday morning:

Amy Julia Becker's daughter Penny is a little girl with Down syndrome. Her mother writes about her often, on her blog, Thin Places, and most recently in her new book, A Good and Perfect Gift: Faith, Expectations, and a Little Girl Named Penny http://www.amazon.com/Good-Perfect-Gift-Expectations-Little/dp/0764209175/ref=pd_sim_b_1. A year ago, when she was pregnant with her third child, she wrote about her decision not to have any existing tests for Down syndrome, in spite -- or more accurately, because -- of the fact her daughter lived with the condition. Today she is here to write about the new tests, and her realization of how an extra chromosome does, and does not, define child.

So go on off to read what she has to say (as always, she says it beautifully.) Then use the comments to discuss a world in which some lifelong conditions are optional.

READ: Explaining Down Syndrome, To My Daughter, And Myself

 
 
 
A new prenatal test, called MaterniT21 was made available to the public yesterday (in 20 cities across the U.S.), one that can detect Down syndrome early in a pregnancy with far less risk. Odds ...
A new prenatal test, called MaterniT21 was made available to the public yesterday (in 20 cities across the U.S.), one that can detect Down syndrome early in a pregnancy with far less risk. Odds ...
 
 
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08:04 AM on 10/27/2011
I support parental rights to use whatever tests are at their disposal and whatever legal means they have with respect to a woman's right to her reproductive health. To ask questions that deliberately force taking sides is disingenuous, at best. The author's unfortunate choices to play hypothetical games only muddy the waters. What is the point in dividing people on such sensitive, personal issues?
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MissAstrid
My thoughts spilled out of my fingertips
03:34 AM on 10/27/2011
I don't understand some of these comments. What's wrong with not wanting to have a child with Down Syndrome?
11:49 PM on 10/26/2011
A rhetorical question. Illness defines a child in the same way that athletic prowess defines a child. The question misses the mark- a child is ill (or brilliant) in the context of something greater, most commonly, a family. The way in which the family deals with the illness defines the child, and siblings.
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Vicki Larson
Journalist, mother, thinker
05:22 PM on 10/26/2011
You ask "And if you could avoid having a child with that condition, would you? " That is why most women past a certain age get genetic testing — to see "if." But as most parents know, genetic testing only goes so far — there are a lot of conditions and illnesses that can't be tested for. They can make life more challenging, but we love and care for our kids just the same.
05:22 PM on 10/26/2011
As a parent of a Cerebral Palsy son that walks with crutches and craves to play sports, I'd love to see a "cure". Hearing him dream of playing professional sports, breaks my heart but makes me proud to be his Dad.

He was a 29 weeker that was in many respects lucky to survive. He has an above average intelligent, reads and absorbs more information than most. But his dam legs don't work so well

He has a great personality, stubborn, and very independent. How would he differ sans CP. If there were a "fix" he, me and his Mom would opt in.

Its not the same as Down or autism. But I've had a lot of contact with such children through my son's sports activities. I understand why some would say NO, to a fix for many of these. They are often smart (if not intelligent), functional if not social...but they have all had a positive impact on me and my family.

I saw some "judgement" replies criticizing those that might consider opting out. And as was stated, these people make an important contribution to families where they are loved, encouraged, and allowed to grow.

I wouldn't want to encourage parents to pursue having a handicapped child, but neither would I encourage selectively aborting them categorically.

It isn't the weakest link that determines the strength of a chain, its how you adapt surrounding it with stronger members.

>Made that up, but it makes sense to me;)
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jerry allbright
I'm not willfully ignorant so I must be a liberal
05:15 PM on 10/26/2011
Ask the children if they would be happier not being different to the extent that they are defined by their difference.
03:15 PM on 10/26/2011
Humanity to your fellow beings is enhanced through the understanding of children born with defects.Theirs is a special grace.
12:19 PM on 10/26/2011
People have been practicing eugenics on their own fetuses for a long time. If you don't know the word 'eugenics' it basically means getting rid of unborn fetuses because you judge them as being diseased or inferior. You decide that they are not worth living. Abortion is an option because it is legal. I believe that abortion should be legal but for some reason I don't like the idea of killing fetuses because they have Down Syndrome. It reminds me of Hitler. I don't like the judgement that these babies are not worth living. It also makes me fear that people will look at children like this and wonder why they are alive. Why did a mother choose to bring a child into the world that will very possibly have heart problems and cognitive problems and "why should we spend money on THESE PEOPLE?"
People have their rights though. I just hope that they will be accepting of others who do have the love in their hearts to raise a child with Down Syndrome.
I do not have a child with Down Syndrome but I would have happily (with some fear of course) born this special kind of child. I wanted a child. I was ready to accept my fate with whatever child was coming and no I am not a born-again Christian. I just wanted to be a mother.
12:16 PM on 10/26/2011
Autism and Down Syndrome can both vary greatly in severity of symptoms. There are several companies around the world that exclusively hire autistic people to work at producing hardware and software for high tech equipment. And many people afflicted with milder forms of Down Syndrome have found work, married and had families of their own. Most of my life I've had little direct contact with Down Syndrome people, but a decade ago, I frequented a Burger King restaurant near my home. There was a Down Syndrome youngster who worked at that Burger King, and if I was present in the restaurant when his break time came, he would invariably come and sit at my table to talk. I was surprised to learn how enthusiastic he was to engage in conversation and how receptive he was to learning new things, perhaps even desperately so. Meeting and talking with him was both a humbling and enlightening experience and erased forever whatever prejudicial notions I might have had about people with Down Syndrome.

Leo Toribio
Pittsburgh, PA
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MIMom
Your ad here.
04:53 PM on 10/26/2011
How can an employer exclusively hire based on a condition like that? Isn't it illegal to ask that in an interview?
12:15 PM on 10/26/2011
My son has an autism spectrum disorder. While the disorder doesn't define who he is, it certainly makes his life a great deal more challenging for him. If he could be cured, or even treated to the point where the symptoms of his disorder did not periodically overwhelm him and the things he wants to to do, I am sure we would be takers.
I also want to be clear about the sentiments of many parents with children that have disabilities. The children are ours. We love them very dearly, at least as much as every other parent loves their children. We worry about our children, in ways that parents of children without disabilities can only imagine. While we are blessed with a child who has relatively mild symptoms, we still worry about how to get him the appropriate educational support now, and how he will fare as an adult.
As far as screening during pregnancy is concerned, and resulting decisions or actions, I really am not prepared to make a comment on that, other than that I would not wish that on anyone.
11:51 AM on 10/26/2011
I can maybe see not wanting to cure a kid with mild autism. Often their lack of social skills are made up for by being a savant in other areas. Even this is only true of people that are have mild Aspergers. There is no reason not to cure kids with Down's Syndrome though. The disease doesn't just affect them mentally. It comes with a whole host of physical problems as well. They absolutely are defined by their disease. It's the first thing that anyone will notice about them, and it the one thing that everyone will remember about them. They will need constant care and supervision for the entirety of their short lives. Everything else about the child will dwarf in comparison to their condition.
11:29 AM on 10/26/2011
My son has fragile x syndrome. If all I knew of FXS is what I read or heard from a geneticist I would have said of course you wouldn't chose this for your child. I said during my pregnancy that I could handle anything but autism or intellectual disability.

Hindsight is a funny thing. I now have a beautiful, funny 7 year old son with FXS. I have contact with over 400 families with children with FXS. I know more about daily living with it than any geneticist or website. Now my answer is not only can I handle it, I love this life I would have rejected.

While I would make his life easier in any way possible, this comes down to a different question entirely. Would I not want *him*? If I had terminated my pregnancy, I wouldn't have *him*. I would have some other mix of genes, some other child and I would have missed out on so much for not knowing him.

I'm all for people having the info they need to make an informed decision but so few people seem to realize that you won't have all the *knowledge* you need to make a truly informed decision until it's too late.
10:39 AM on 10/26/2011
I think we're becomming a bit too quick to judge children as being too flawed to be worthy of life. Abortion issue aside, you really have no idea how severely a child will be afflicted with Autism spectrum traits or with Downs Syndrome.

Here's why: my husband has mild Aspergers. We didn't have a diagnosis when we were married, but I did notice some social/communication issues. He's kind, extremely intelligent man. A test would have shown that he has spectrum traits. Should he have never existed?

Our 1 1/2 year old daughter, while very neurotypical in most ways, shows low level spectrum traits. (Toe walking, obcession with patterns, etc.) She's probably a carrier of spectrum traits. Should she be encouraged to discard any future children she might have on the off chance they might end up with Aspergers?

Finally, I was the child of a teen mother. I have emotional issues due to trauma I experienced as an infant. You wouldn't know it if you met me, though. All I'm saying is, by some people's logic, neither my husband nor I should be here. Yet, here we are, productive members of society. Nobody is perfect, but some of us are able to fake it better than others to pass muster.
10:37 AM on 10/26/2011
We have a toddler with autism, who has responded amazingly well to intensive treatment since it was caught very early (@14 months). Of course we would do anything that would allow her to not have to struggle and work so hard to attain each of the little developmental steps that come like breathing for other kids. I've had two previous lost pregnancies (one before my child, one after), both died in utero and were later tested to have trisomies (one DS, one trisomy 15). We have another one on the way, still early but we know we're high risk and so will use all available prenatal testing and will make the best decision for our family based on the identified risks and probabilities, our resources, ability to care for a severely disabled child through adulthood, and future burden on our current child. We're somewhat older parents, and do not have many available close relatives or friends in the area to help. No parent can ever predict with certainty whether or not a child will have a disability or other difficult health condition, there are too many variables. All we can do is maximize our odds, be vigilant, and get intervention as early as possible if it's needed.
06:33 AM on 10/29/2011
Very wise.... maximize the odds, be vigilant, get early intervention. I wish you well, and with your approach, any children you do have will have better odds than they would have with less thoughtful parents.
09:35 AM on 10/26/2011
As Jesus said long ago, "Who among you, if his child asks for bread, would give him a stone instead." If your child is ill you help them if you can. There is no question that I would heal my children if I could.