Clinic for Special Children

Clinic for Special Children

The Clinic for Special Children is a gene research clinic located in Strasburg, Pennsylvania. The facility, established by Dr. D. Holmes Morton, specializes in genetic problems of the plain sects such as the Amish and Old Order Mennonites.

The clinic treats about 600 children for 80 different genetic disorders or syndromes such as glutaric aciduria (GA1), maple syrup urine disease (MSUD), Crigler-Najjar syndrome (CNS), and medium-chain acyl-CoA dehydrogenase deficiency (MCADD). Not all the children are Amish or Old Order Mennonites; about 15% of the children come from elsewhere, including Africa and Asia. About 75% of the children are treatable—and a third of those are highly treatable, many through techniques developed at the center. The center is responsible for nearly two dozen scientific papers.

The Amish and genetics

The vast majority of the nearly 200,000 Amish in America derive from about 200 families who moved from the lower Rhine valley, the German Palatinate and Alsace in the 18th century, though there have been some converts from the outside "English" world. The Amish do not allow marriage outside of the faith, therefore their gene pool is more shallow than that of the average person. Some Amish are afflicted by heritable genetic disorders, including dwarfism (Ellis-van Creveld syndrome), and are also distinguished by the highest incidence of twins in a known human population, various metabolic disorders, and unusual distribution of blood-types. Since almost all of the current Amish descend primarily from about 200 founders in the 18th century, some genetic disorders from a degree of inbreeding do exist in more isolated districts. However, Amish do not represent a single closed community, but rather a collection of different demes or genetically-closed communities. Some of these disorders are quite rare, or even unique, and they are serious enough that they increase the mortality rate among Amish children. The majority of the Amish accept these as "Gottes Wille" (God's will); they reject any use of genetic tests prior to marriage to prevent these disorders as well as genetic testing of unborn children that would discover any genetic disorder.

There is an increasing consciousness among the Amish of the advantages of exogamy. A common bloodline in one community will often be absent in another, and genetic disorders can be avoided by choosing spouses from unrelated communities. For example, the founding families of the Lancaster County Amish are unrelated to the founders of the Perth County Amish community in Canada.

Treating genetic problems is the mission of the Clinic which has developed effective treatments for such problems as maple syrup urine disease, a disease which previously was fatal. The clinic has been enthusiastically embraced by most Amish, and has largely ended a situation in which some parents felt it necessary to leave the community to care properly for their children, an action which normally might result in being shunned.

History of the Clinic

In the 1980s, Morton took a special interest in Amish children with rare metabolic diseases. Morton was a pediatrician at the Children's Hospital of Philadelphia when he first became aware of their special problems. In 1989, Morton bought untillable land from an Amish farmer and held a barn-raising. The result was a community hospital providing care, counseling, and genetic testing for disorders unique to the Amish and Old Order Mennonite populations.

He initially did most of his own genetic testing and lab work, but now outsources DNA testing for over 30 genetic disorders in addition to the 25 extremely rare disorders he and his team screen for.

Amish and Mennonites near Middlefield, Ohio, have raised US$700,000 towards the US$1.8 million needed to open the nonprofit Deutsch Center for Special Needs Children in Middlefield, to be headed by Dr. Heng Wang, who studied and worked with Morton.

The Lancaster County community holds several benefit auctions for the clinic each year, raising sufficient funds to cover about a third of the clinic's operating costs. Amish and Mennonite families donate quilts, furniture, baked goods, and other items to the sale. The clinic is a registered 501(c)(3) nonprofit charity.

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