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Genetic Disorders

  • Overview

    Genetic disorders include congenital malformations, chromosomal disorders and metabolic diseases, also known as inborn errors of metabolism.

    • Some of the symptoms can be the same as those for conditions that are not inherited
    • Features can appear at birth (congenital heart disease or cleft lip or palate) or during the course of childhood (developmental delays or learning problems)
    • Diagnosis may involve a physical exam or targeted genetic testing

    Genetic services at Boston Children's Hospital

    • The General Genetics Program works closely with the Genetics Division's research laboratories to develop scientific findings into new treatments and cures for your child.
    • Home to world's only center studying rare "orphan" diseases that affect fewer than 200,000 people in the country.
    • The Gene Partnership Program is poised to become the richest database of genetic and clinical pediatric data in the world.
    • Researchers the Autism Care and Research Program are investigating genetic causes of autistic spectrum disorders (ASDs) in the hopes of developing better medical treatments and earlier diagnostic tests.
    • Researchers are studying genes involved in dyslexia; specifically, genes involved in directing how the brain develops.
      
    Boston Children's Hospital
    300 Longwood Avenue
    Pavilion 2
    Boston MA 02115

     617-355-3896
     fax: 617-730-0302

  • In-Depth

    Isaac Kohane, MD, PhD, director of the Children's Hospital Informatics Program (CHIP)

    What are genetic disorders?

    Genetic disorders is a category of diseases that includes certain types of birth defects, chronic diseases, developmental problems and sensory deficits that are inherited from one or both parents.

    Birth defects

    Chronic diseases

    Developmental Problems

    Sensory Deficits

    What are the physical signs of genetic disorders?

    The following list includes features that might suggest that your child has a genetic disorder. However, some of these characteristics are commonly found in people without a disorder. You'll want to check with you doctor if your child has at least two of the following features:

    • Ear abnormalities
    • Unusually shaped eyes
    • Different colored eyes
    • Facial features that are unusual or different from other family members
    • Brittle or sparse hair
    • Excessive body hair
    • White patches of hair
    • Large or small tongue
    • Misshapen teeth
    • Missing or extra teeth
    • Loose or stiff joints
    • Unusually tall or short stature
    • Webbed fingers or toes
    • Excessive skin
    • Unusual birthmarks
    • Increased or decreased sweating
    • Unusual body odor

    What is genetic counseling and how do I know if I need it?

    Genetic counseling can tell you whether you're at risk of developing a genetic disorder or having a child with a genetic disorder. Genetic counseling can also help you to make sense of the information and put it into context for your child. It may be conducted by a geneticist, a doctor with special training or a genetic counselor, who will explain the cause of a disorder, availability of testing, prognosis, medical management and treatment. Genetic counseling sessions typically last an hour or longer, depending on the complexity of your child's case is. There are many reasons to seek genetic counseling, including the following:

    1. Family history or previous child with:

    2. A parent with an autosomal dominant disorder, or any disorder seen in several generations

    3. Pregnancy factors (mother older than 35 years)

    4. Mother with any of the following:

    • schizophrenia
    • depression
    • seizures
    • alcoholism
    • diabetes
    • thyroid disorder
    • fetal or parental exposure to certain drugs, chemicals, radiation or infections
    • advanced paternal age at the time of conception
    • infertility cases where either parent is suspected of having a chromosome abnormality
    • couples requiring assisted reproductive techniques to achieve a pregnancy, or individuals donating eggs or sperm for those purposes
    • Ethnic groups or geographic areas with a higher incidence of certain disorders, such as Tay Sachs disease, sickle cell disease or thalassemias
       
  • Tests

    Mother of child treated at Children's for profound dyslexia. Children's researchers aim to identify genes that cause dyslexia.

    Children's provides genetic testing for pregnant women, newborns and children of all ages. In some cases, a diagnosis can be made after a physical exam. Most of the time, genetic disorders are diagnosed through a specific test, which can include examining chromosomes or DNA (the tiny proteins that make up genes), or testing the blood for certain enzymes that may be abnormal. Studying enzymes is called biochemical genetic testing.

    At your initial appointment, a member of the genetics team (a genetic counselor, a clinical genetics fellow, and/or a geneticist) will review your medical, family and pregnancy history and perform tests. Tests may include X-rays, an MRI or genetic tests (usually blood or urine tests). Your child may also be referred to a specialty clinic within the hospital.

    The different categories of genetic tests are:

    • Predictive genetic testing: can tell you the chances that a healthy person with our without a family history of a certain disease might develop that disease. These diseases can include some types of cancer and heart disease.
    • Presymptomatic genetic testing: can tell if a person with a family history for a genetic disease but does not have symptoms, has a genetic alteration associated with the disease.
    • Carrier testing: can determine if a person carries one copy of a gene linked to a certain disease. An "autosomal recessive" disease means that the disease will appear only if two copies of the altered gene are inherited. Couples who both carry the same autosomal recessive gene have a one in four, or 25 percent, chance with each pregnancy to have a child with that disease.
    • Prenatal diagnosis: used to diagnose a genetic disease or condition in the developing fetus. Prenatal tests include screening blood, ultrasound (sonograms), amniocentesis, chorionic villus sampling (CVS), and percutaneous umbilical blood sampling (PUBS)
    • Preimplantation studies: are used only in in vitro fertilization to diagnose a genetic disease in an embryo before it is implanted into the mother's uterus.
    • Newborn screening: is used to check for certain genetic disorders that can be diagnosed and treated early in life.
  • Tying genetics to dyslexia allows us to identify a potential problem at birth, so that gives us the earliest possible chance to intervene. Doctors might make diagnoses using brain imaging, before reading even starts.

    Christopher Walsh, MD, PhD, Children's Chief of Genetics

    Treatment of genetic disorders varies depending on the specific disease. In some cases, such as autism, the symptoms are treated with medication, behavioral and educational interventions. Other disorders, such as PKU (phenylketonuria) can be managed through diet while some of the physical symptoms of certain genetic diseases can be corrected with surgery. In many cases, your child will need ancillary services that may include speech therapy and occupational therapy, among others.

    Whatever your child's diagnosis, a member of your child's genetic team will discuss treatment options with you and your family and make the appropriate referrals when necessary. We understand the kinds of challenges children and families with genetic disorders face and can connect you with outside resources for additional support.

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