Hope, but never expect? Comparing parents' pre- and post-disclosure attitudes toward return of results from diagnostic exome sequencing for their child

BackgroundCounseling for whole-exome sequencing (WES) could benefit from aligning parents' pre- and post-disclosure attitudes. A few studies have qualitatively compared parents' pre- and post-disclosure attitudes toward receiving WES results for their child in a diagnostic setting. This study explored these attitudes in the context of children with a developmental delay.MethodsSemi-structured interviews were conducted with parents (n = 27) of 16 children undergoing diagnostic WES in trio-analysis, both before and after receiving results.ResultsThree key insights emerged. First, the distinction between hoping and expecting was relevant for shaping parents' experiences with receiving results related to the primary indication. Second, parents of young children whose development of autonomous capacities was uncertain sometimes found themselves in a situation resembling a Catch-22 when confronted with decisions about unsolicited findings (UFs): an important reason for consenting to WES was to gain a better picture of how the child might develop, but in order to make responsible choices about UFs, some ideas of their child's development is needed. Third, default opt-ins and opt-outs helped parents fathom new kinds of considerations for accepting or declining UFs in different categories, thereby aiding decision-making.ConclusionResults from this study are relevant for counseling and policy development. A few studies have qualitatively compared parents' pre- and post-disclosure attitudes toward receiving results from whole-exome sequencing (WES) for their child in a diagnostic setting. This study explored parental attitudes in the context of children with a developmental delay and/or multiple congenital abnormalities via semi-structured interviews with parents (n = 27) of 16 children undergoing diagnostic WES in trio-analysis, both before and after receiving results. The findings from this study are relevant for counseling and policy development.image