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    Genetic Screening: Who Should Be Tested?

    by Julie Hopp

    North Cobb High School

    Kennesaw, Georgia

Primary Learning Outcomes

    ; The students will define genetic screening.

    ; The students will identify the different types of genetic screening

    ; The students will identify risks and benefits to support a decision of whether or not to

    seek genetic screening.

Additional Learning Outcomes

    The students will be able to identify common genetic disorders.

Materials

    1. LCD projector

    2. PowerPoint or similar presentation program

    3. Computers with Internet access

Technology Connection

    A PowerPoint presentation played on an LCD projector is running as students enter the classroom. Notes and lecture are delivered through a PowerPoint presentation with an LCD projector.

Total Duration

    2 hours

    Procedures

Step 1 Duration: Varies

    Background Information

    This lesson would be appropriate to use to wrap up one or several units on genetics. The students should have previous knowledge from other lessons of mitosis, cancer, and specific genetic disorders and diseases that are in this lesson. The Web sites below provide reference material for the teacher on mitosis, cancer, and genetic disorders and diseases.

    Web Resources

    Title: Genetic Testing of Breast Cancer

    URL: http://cis.nci.nih.gov/fact/3_62.htm

    Description: This web site from the National Cancer Institute gives information about

    genetic testing of BRCA1 and BRCA2 which are genes linked to breast cancer.

    Title: Genetic Testing of Newborns

    URL: http://gslc.genetics.utah.edu/units/newborn/ngt.pdf

    Description: This PDF file from the Genetic Science Learning Center is an educational

    unit on genetic testing of newborns.

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    Title: Cell Cycle and Mitosis Tutorial

    URL: http://www.biology.arizona.edu/cell_bio/tutorials/cell_cycle/main.html

    Description: This Web site includes a tutorial about the cell cycle and mitosis. This

    tutorial would be appropriate for students to do during a cell cycle lesson or for a teacher

    to complete for background information.

    Title: Genetic Testing and the Human Genome

    URL: http://www.genetests.org/img/teachtool/NABTpreview.pdf

    Description: Aimed at biology teachers, this PDF file includes information about genetic

    testing.

    Title: Genetic Testing for Breast Cancer Risk National Cancer Institute

    URL: http://www.nci.nih.gov/cancertopics/genetic-testing-breast

    Description: This Web site from the National Cancer Institute includes information about

    breast cancer and genetic testing.

Step 2 Duration: 5 minutes

    To remind students about different genetic diseases/disorders and to introduce the idea of genetic screening, play the “Genetic Disorders” PowerPoint presentation as students are

    walking into class. On this PowerPoint presentation, there are pictures of different genetic disorders/diseases and a question slide.

    Supplemental Document

    Title: Genetic Disorders

    File Name: Genetic Disorders.ppt

    Description: This PowerPoint presentation is to be used by the teacher to remind

    students about genetic disorders and diseases and to introduce the idea of genetic

    screening. The PowerPoint loops continuously and can be played while the students

    walk into the classroom.

Step 3 Duration: 25 minutes

    Students will be given information about genetic screening and genetic testing through a lecture using the “Genetic Screening and Genetic Testing” PowerPoint presentation. The information

    about genetic screening and testing will include examples using birth defects and screening for cancer. Web resources have been provided as a reference for the teacher.

    Web Resources

    Title: Genetic Testing of Breast Cancer

    URL: http://cis.nci.nih.gov/fact/3_62.htm

    Description: This Web site from the National Cancer Institute provides information about

    the genes associated with breast cancer.

    Title: Newborn Screening

    URL: http://gslc.genetics.utah.edu/units/newborn/ngt.pdf

    Description: This PDF file is an educational unit from the Genetic Science Learning

    Center on the topic of newborn screening.

    Title: Gene Testing Tutorial

    URL: http://press2.nci.nih.gov/sciencebehind/genetesting/genetesting00.htm

    Description: This Web site from the National Cancer Institute gives information about

    gene testing in a tutorial format.

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    Title: Genetic Screening Fact Sheet

    URL: http://www.asrm.org/Patients/FactSheets/Genetic_screening-Fact.pdf

    Description: This Web site provides a fact sheet from the American Society for

    Reproductive Medicine for a teacher's reference.

    Title: Amniocentesis Web site

    URL: http://www.modimes.org/professionals/681_1164.asp

    Description: This Web site provides information about amniocentesis, a common

    prenatal test, from the March of Dimes.

    Title: Chorionic Villi Sampling Information

    URL: http://www.modimes.org/professionals/681_1165.asp

    Description: This Web site from the March of Dimes gives information about another

    prenatal test, Chorionic Villi Sampling.

    Title: Newborn Screening

    URL: http://www.modimes.org/professionals/681_1200.asp

    Description: This Web site from the March of Dimes gives information about newborn

    screening, including different types of screening, how some tests are conducted, what

    these tests can mean, and a link to information on specific tests required in each state.

    Title: Genetic Testing of Breast Cancer

    URL: http://www.nci.nih.gov/cancertopics/genetic-testing-breast

    Description: This Web site from the National Cancer Institute provides information about

    genetic testing for the risk of breast cancer, including a background on breast cancer, a

    discussion of genetics and breast cancer, and information on who should be tested.

    Supplemental Document

    Title: Genetic Screening and Genetic Testing

    File Name: Genetic Screening and Genetic Testing.ppt

    Description: This is the PowerPoint presentation to use for the lecture. Notes have been

    added at the bottom for a teacher script or as teacher reference.

Step 4 Duration: 45 minutes

    Use the following activity to introduce that genetic screening and testing can be hard on families and many decisions have to be made based on personal ethics. All of the scenarios included in this activity were provided by Lawrence Berkeley National Laboratory's ELSI in Science program on the Web site. Classroom scenarios can be accessed by clicking on “What would YOU do?” link under the “Where do we go from here?” heading. In addition to scenarios,

    discussion questions and answers are included.

Split the class into three groups. Hand out the “Scenario #1” to one of the student groups,

    “Scenario #2” to the second group of students, and “Scenario #3” to the third group of students.

    Have students read their assigned scenario. After reading the scenario, students should read the questions and discuss their answers. There are brief answers provided to these questions, however student should go deeper and thoroughly explore all aspects of the situation and questions. One person in each group should be assigned to record the group's final and complete answer. In addition, each group should choose one person to summarize their scenario, and another person to report the group's answers. Once all the groups are completed, the teacher should prompt each group's representative to share the scenario and share the

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    group's answers to the questions. The “Breast Cancer Scenario Teacher Notes” is provided to

    be used by the teacher to clarify answers provided in the scenarios.

    Web Resources

    Title: Breast Cancer Screening Scenarios

    URL: http://www.lbl.gov/Education/ELSI/screening-main.html

    Description: This Web site has a link to scenarios, questions, and answers from

    Lawrence Berkeley National Laboratory's ELSI in Science program. To access these

    scenarios, scroll down and click on “What would YOU do?” under the “Where do we go

    from here?” heading. A screen with the three scenarios will come up. Click on the

    scenario you want to use to view the scenario, question, and possible answers.

    Title: National Cancer Institute

    URL: http://www.nci.nih.gov/cancertopics/genetic-testing-breast

    Description: This Web site from the National Cancer Institute should be used to provide

    up-to-date information about breast cancer.

    Supplemental Document

    Title: Breast Cancer Scenario Teacher Notes

    File Name: Breast Cancer Scenario Teacher Notes.doc

    Description: This document allows a teacher to supply students with more information in

    addition to the answers provided with the breast cancer scenarios.

Step 5 Duration: 40 minutes

    Using the writing prompt provided in the “Genetic Screening Writing Assignment”, have each

    student independently read the scenario about genetic screening of birth defects. Once each student has read the scenario, instruct the students to write a position paper in response to the scenario. The students must decide if the people should seek genetic screening or not and support their decision. Students should also include the pros and cons of their decision. Tell students their paper should be 3-5 paragraphs. This assignment could be completed in class, assigned as homework, or started in class and finished at home. The “Writing Assignment Rubric” can be used to grade the writing assignment or teachers could create their own rubric

    using Teachnology’s “Online Rubric Generator”.

    Web Resource

    Title: Online Rubric Generator

    URL: http://teachers.teach-nology.com/web_tools/rubrics/

    Description: This Web site by Teachnology allows teachers to make their own rubrics.

    The rubric for the genetic screening assignment was made at this Web site.

    Supplemental Documents

    Title: Genetic Screening Writing Assignment

    File Name: Genetic Screening Writing Assignment.doc

    Description: The document contains the writing prompt for students to use to write their

    essay. The essay should include a decision about whether or not to pursue genetic

    screening and a 3-5 paragraph discussion of the pros and cons of their decision.

    Title: Writing Assignment Rubric

    File Name: Writing Assignment Rubric.doc

    Description: This document is a rubric for evaluating the “Genetic Screening Writing

    Assignment.

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    Assessment

    The students’ position paper in Step 5 will be graded using the “Writing Assignment Rubric” or the “Online Rubric Generator” at the Teachnology Web site.

    Modifications

Extension

    1. Students could research specific genetic diseases and the genetic screening available

    for these diseases.

    2. Students could make brochures or pamphlets for placement in doctor offices.

Remediation

    If students could not remember previously covered genetic diseases/disorders, review common genetic birth defects included in the opening Power Point presentation. The Web resources provided in Step 1 could aid in this review.

    Education Standards

National Science Education Standards

    LIFE SCIENCE, CONTENT STANDARD C:

    As a result of their activities in grades 9-12, all students should develop understanding of

    ; The cell

    ; Molecular basis of heredity

    ; Biological evolution

    ; Interdependence of organisms

    ; Matter, energy, and organization in living systems

    ; Behavior of organisms

SCIENCE IN PERSONAL AND SOCIAL PERSPECTIVES, CONTENT STANDARD F:

    As a result of activities in grades 9-12, all students should develop understanding of

    ; Personal and community health

    ; Population growth

    ; Natural resources

    ; Environmental quality

    ; Natural and human-induced hazards

    ; Science and technology in local, national, and global challenges

Georgia State Science Standards

    Grade: 9-12, Science, Biology 11

    Topic: Genetics (Patterns of Inheritance)

    Standard: Describes patterns of inheritance and genetic engineering.

Grade: 9-12, Science, Applied Biology/Chemistry II 7

    Topic: Continuity of Life

    Standard: Predicts the special needs of the expectant mother and the developing fetus during different states of pregnancy and birth.

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Grade: 9-12, Science, Applied Biology/Chemistry II 10

    Topic: Continuity of Life

    Standard: Outlines methods for altering the genetic makeup of an organism.

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    Breast Cancer Scenario Teacher Notes

    Genetic Screening: Who Should Be Tested

    Julie Hopp, CDC’s 2004 Science Ambassador Program

    Some of the answers supplied for the scenario questions are simple and can be misleading. Here are some points for students to consider in addition to the answers provided in the scenarios.

    ; Positive test results (BRCA-2) might motivate a person to pursue preventive measures such

    as appropriate lifestyle changes (diet, exercise).

    ; Positive test results might motivate a person to pursue medical screening with consequent

    detection of disease and treatment at an earlier stage.

    ; Positive test results could result in a better survival rate because of localized disease not

    because of treatment efficacy per se.

    ; Some people may not want to know years in advance that they have a predisposition for a

    life-threatening condition which cannot be cured and which they can pass on to future

    offspring.

    ; Negative test results do not necessarily mean that a person is not at risk for disease

    because a lab error could have occurred or a limited test panel focusing only on a few

    mutations or the most common ones would miss rare disease-causing mutations.

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    Genetic Screening Writing Assignment

    Genetic Screening: Who Should Be Tested

    Julie Hopp, CDC’s 2004 Science Ambassador Program

    Based on your knowledge of genetics, genetic disorders, and the risks and benefits of genetic screening, you should write a 3-5 paragraph persuasive paper in response to the scenario listed below. Make sure to state if genetic screening should be arranged and why/why not. Also, include the pros and the cons of your decision.

    Jack and Diane have been trying to have children for the past five years. Diane has been pregnant four times in the last five years and has miscarried each one of the pregnancies. At least two of the miscarriages have been determined to be due to chromosomal abnormalities of the fetus. Diane is now 35 years old and concerned about a future pregnancy. Diane knows that there have been chromosomal abnormalities in prior fetuses. At age 35, Diane also knows the risk of chromosomal problems and miscarriages increases, and a child could be born with Down’s syndrome. Jack desperately wants to have a child with Diane and is willing to take the risks. Diane believes it would be in their best interest to seek advice and possibly genetic screening before another pregnancy. Should Jack and Diane seek advice and genetic screening before another pregnancy or should they try again without any professional intervention?

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    Writing Assignment Rubric

    Genetic Screening: Who Should Be Tested

     Julie Hopp, CDC’s 2004 Science Ambassador Program

    Name:____________________________ Teacher: ______________________________

     Criteria Pts.

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     4 3 2 1

    Position is clearly Position is clearly Position Statement of stated and stated and Position is stated, Statement position cannot but is not consistently consistently (Is the student be determined. maintained maintained. Clear maintained. for or against consistently references to the References to the ____ the genetic issue(s) are issue(s) at hand are throughout work. screening?) missing. stated.

    Evidence clearly Supporting Evidence clearly supports the Argument is Evidence is Information supports the ____ unrelated to position; but there is supported by position; evidence not enough limited evidence. argument. is sufficient. see below* evidence.

    Some attempt to

    structure the There is a total Structure of work Structure developed argument has been ____ Organization is clearly lack of reasonably well, but made, but the lacks clarity. developed. structure. structure is poorly

    developed.

    Tone is Tone enhances Tones does not Tone is consistent and persuasiveness, but ____ Tone inappropriate contribute to enhances there are persuasiveness. to purpose. inconsistencies. persuasiveness.

    Sentence structure Work contains Work pays little is generally correct. structural Sentence attention to Sentence structure Some awkward weaknesses and Structure is correct. proper sentence sentences do grammatical structure. errors. appear.

    There are four There are two or There is one error or more errors Punctuation and Punctuation & three errors in capitalization are in punctuation in punctuation Capitalization punctuation and/or correct. and/or capitalization. and/or capitalization. capitalization.

     Total----> ____ Teacher Comments:

Teach-nology, Inc. Rubric Makers [online]. 2003 [date cited 27 July 2004] Available at URL:

    http://teach-nology.com/web_tools/rubrics/.

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