| Sumario: | A genomic diagnosis for a young child could guide access to developmental care, school services, and social supports; yet these contexts remain understudied. Here we describe (at least) two ways a genomic diagnosis could promote such utility: as a ticket, where the diagnosis qualifies a child for services they weren't previously able to access, or as a roadmap, where the diagnosis guides which services might be helpful. We explore the implications of a diagnosis that functions as either a ticket or a roadmap, including how either might create additional disparities in the US developmental services system. We argue that fewer inequities would exist in a world where a genomic diagnosis functions more as a roadmap than a ticket. We recommend policy changes (increase early intervention funding, improve family navigation, and incentivize developmental services research) that can avoid the inequities associated with the "ticket" and move us towards a "roadmap" future.
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