National medical organizations recommend that during prenatal counseling sessions, healthcare providers discuss how having a child with Down syndrome (DS) might impact the family unit. Few studies, to date, have surveyed families about their life experiences. For this investigation, we examined 41 family attitudes, which were obtained from mailed questionnaires completed by 1,961 parents/guardians, 761 brothers/sisters, and 283 people with DS who were members of six DS non-profit organizations, chosen for their size, ethnic/racial diversities, and geographic distribution throughout the United States. About 83% of families reported to all being proud of the family member with DS, and 87% reported to all feeling love for the member with DS. Younger siblings (ages 9-11) were more likely to feel embarrassed by their sibling with DS if their parents/guardians also did. If one or more parents/guardians felt that their children without DS did have a good relationship with their child with DS, siblings were more likely to report that they loved and liked their brother/sister with DS. Overall, our data demonstrate that positive themes tend to dominate within modern-day families who have members with DS, although challenges were not insignificant for some. Ó 2015 Wiley Periodicals, Inc.Key words: trisomy 21; prenatal tests; noninvasive prenatal screens; abortion; family attitudes; quality of life
INTRODUCTIONAs the popularity and availability of noninvasive prenatal screening (NIPS) expands, more expectant couples will contemplate pregnancy options after receiving a "positive" result for Down syndrome (DS). The American College of Medical Genetics and Genomics (ACMG) endorses "accurate, up-to-date, and balanced information about DS" as crucial to informed decision-making [Gregg et al., 2013]. The National Society of Genetic Counselors (NSGC) recommends that healthcare providers "specifically discuss how having a child with Down syndrome might affect the family as a unit, the parents' relationship as a couple, and other present or future children" [Sheets et al., 2011]
930While decades of studies have catalogued medical conditions that often accompany DS, few have surveyed families about their life experiences. Previously, we reported analyses of 3,056 parents, siblings (ages 9 and older), and people with DS (ages 12 and older) from across the United States [Skotko et al., 2011a,b,c]. From these questionnaires, a family portrait emerged. Nearly, all parents reported loving (99%) and being proud (97%) of their child with DS. About 79% said that their outlook on life was more positive because of their son/daughter with DS. Brothers and sisters also had a favorable perspective, with nearly all reporting love (97%) and pride (94%). Older siblings reported being a better person (88%) because of their brother/sister with DS. Yet, approximately 5% of parents reported general embarrassment, 4% regretted having their son or daughter with DS, and nearly 11% reported marital strain attributable to the child. Among siblings, 7% were ...