Down Syndrome, Prenatal Testing, and a Teenage Soap Opera? The Importance of Switched At Birth


Switched At Birth is a teen soap opera that airs Monday nights on ABC Family. It also might just be, to my continuing pleasure and surprise, the best show on television at addressing disability issues. For three and a half seasons, the show has explored Deaf issues mostly admirably. Now, the ex-girlfriend (Lily) of the brother (Toby) of the girls who were “switched at birth” (Bay and Daphne) is pregnant. In the final scene of the first new episode this fall (two weeks ago), revealed she had been through genetic screening and received a positive test for Down syndrome.

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I’m the father of a boy with Down syndrome and a disability-rights journalist. The idea of a soap opera addressing an issue in which I am so personally invested would have, in almost any other context, made me pre-emptively wince. But Switched at Birth has been doing an excellent job engaging with Deaf culture and issues affecting the Deaf community for years.

The premise is that Bay – short, dark-haired, artistic – and Daphne – tall, fair, athletic, and Deaf – were switched at birth. Bay grew up with rich conservative parents, and Daphne grew up with a single Latina mother and grandmother. Katie LeClerc, who plays Daphne, has hearing loss, and while some in the Deaf community have criticized her casting, overall the reception is positive. The key, for me, is to remember that a soap opera will do soap operatic things, and if that means sometimes over-dramatizing life, that’s what we sign up for when we turn on the show.

The show creators knew that Down syndrome, prenatal testing, and abortion were major issues within the disability community and American society overall. What they couldn’t have predicted is that, thanks to a proposed ban on abortion because of a prenatal diagnosis of Down syndrome in Ohio, their new plotline would tie into front page news.

I don’t know what choice Lily will make, but the most recent episode used the pregnancy to dive into questions about life with disability, cross-disability identity (Daphne thinking about connections between her identity as a Deaf woman and Down syndrome), abortion, and the complications of any unplanned pregnancy. Daphne nearly broke up with her boyfriend when he made ableist remarks (he’s trying to make amends). Lily, the expectant mother, spoke about her deep connection to her brother (who has an unspecified genetic condition) and the ways that life with a disability can be different than expected, but still rich and full of joy.

Once I heard about the plot, I wanted to know how the show creators prepared to execute it and whether any people with Down syndrome would be directly involved. I feared that, as too often happens on mainstream TV, the show would be about a disability without someone with that disability. I should have known better.

I corresponded about the plotline with show creator and executive producer Lizzy Weiss. Here’s our conversation:

David Perry: How did the writers decide to have a pregnant character receive a prenatal diagnosis of Down syndrome?

Lizzy Weiss: This is a storyline we’ve been talking about for over a year but we never had the space for it because we focused on campus assault in the last batch of episodes.  Switched at Birth is about difference, and to use a word that some find controversial, disability. And so I knew that this would be a great topic for us to dive into for our characters. I wanted to hear how Daphne – who is deaf – might  see the subject, vs. say, Bay, who is hearing. As a storyteller, I like subjects in which our characters get to be honest about tough conversations that aren’t always clear cut and maybe even make contradictions and have unexpected reactions. How is John, a Republican senator going to feel about this? What about Regina or Kathryn?  This is a subject that I haven’t seen on TV before and I knew we were primed to dive into in a unique and compelling way.  

Perry: What research did you do into prenatal testing in American society?

Weiss: I had everyone in the room read the chapter on Down Syndrome from Far From the Tree by Andrew Solomon. I had read the book when it first came out because of the chapter on deafness and found it to be a phenomenal read. We of course had our writers’ assistants pull tons of research on prenatal genetic testing, on the number of DS [Down syndrome] pregnancies in which the couple chooses to abort (though I know this is a number that is hard to be sure of and thus varies widely), about the lives of individuals with Down Syndrome. I read everything I could get my hands online that was written by parents of kids with DS and I spoke at length to a parent of a child with Down Syndrome who was very open with me about his journey from the moment he discovered it (in the delivery room), to now, when his child is a teenager. As always with research, it was that personal conversation that I found to be the most illuminating and helpful to writing. 

Perry: Will there be any characters with Down syndrome on the show?

Weiss: Without giving anything away, I can say that in the third episode [airing next Monday, 9/7], our characters visit a school for children with Down Syndrome. We of course used only actors with Down Syndrome for those parts and that was one of the most fascinating days in our four-year history. 

Perry: What can you tell me about the themes you want to explore as this story plays out?  

Weiss: This whole experience of writing this show has been a journey for me on the subject of difference. If most hearing people heard that a baby was born deaf, they would express sadness or pity, because it is framed as loss. What was revolutionary for me early on in writing the pilot was the idea that many or most deaf people love being deaf. They are proud of their language, their culture, their uniqueness. They wouldn’t trade it in to be hearing. And I think we’ve done a pretty good job in explaining that to people over the years of the show. In the same way, I read about many parents of kids with Down syndrome who truly – not just to be p.c., but truly – celebrate how their children see the world. The idea that we don’t all have to be the same is pretty revolutionary. I mean, most of us are striving to have the exact same body type (‘as thin as possible.’) We are so achievement-oriented as a country. No one is whitewashing the challenges of what raising a Down Syndrome child have to be, day after day, but what I hope is gotten across is that difference in the world is okay. 

Perry: When you introduced Deaf issues at the opening of the show, really episode 1, you went right for the debate about Cochlear implants and “fixing” Deafness. There are lots of debates right now about Down syndrome too – are these going to come up?

Weiss: Thank you, and yes. Absolutely. Keep watching. 

Switched at Birth airs on ABC Family at 8 EST/7 CST.

David M. Perry is a freelance journalist. Find his work at thismess.net. Follow him on Twitter (@Lollardfish).

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