Prenatal Genetic Testing for Autism: Abortion Decision-making among Taiwanese Parents of Children with Autism Spectrum Disorders

Background: Taiwan has witnessed increased prevalence of Autism Spectrum Disorders (ASD) in recent decades. Though, prenatal genetic testing (PGT) for autism is not currently available in Taiwan, its implementation is anticipated in the future. Thus, to address the ethical, legal and social issues (ELSI), this first-of-its-kind study examined abortion decision-making regarding PGT for autism among parents of children with ASD in Taiwan.

Methods:  We surveyed 450 parents with at least one child having ASD in Taiwan. The survey included both open-ended and close-ended questions regarding parental attitudes toward PGT for autism. Both qualitative and quantitative data were analyzed. 

Results: Our analysis showed that almost half of the participants (48%) would give birth to affected children with ASD and the reasons were: 1) Possibility that the child doesn’t develop ASD after birth and 2) indications of life in a fetus. Less than 1% of the participants would use this information to prepare for childbirth, and early diagnosis, intervention and treatment. The other half of participants (52%), which intended to terminate the affected pregnancies, reasoned 1) reluctance to have another child with ASD, 2) perception of ASD as a severe disease, and 3) insufficient resources to raise another child with ASD.

Conclusions: From our findings, about half of our sample intended to abort the fetuses that might have ASD. These results can be utilized to develop future guidelines for genetic counseling and education for PGT for autism and help clinicians to communicate the benefits and limitations of PGT for informed decision-making.