DNA Sequencing: A Promising Development in Diagnosing Inherited Diseases

Genome sequencing has become cheaper and more widely available


Published:

Photo courtesy of iStock

Nic Volker spent much of his first four years in a hospital bed. Every time he ate, his immune system attacked his digestive tract, creating holes in his intestines that led to infection and extreme malnutrition. After dozens of tests and operations, his doctors remained mystified as to the cause of the illness, and many gave up hope.

The Washington Post covered this case in its April 20, 2016 issue and reported that, at the time Nic was experiencing these problems (2004-2010), DNA sequencing was costly (around $100,000), untested and unchartered technology. But with little to lose, a bold team of doctors, scientists and the boy’s parents pushed to have portions of his genome sequenced. With lots of theoretical knowledge (the key DNA researcher had worked only with rats) and a little luck, the team identified the mutation that caused the disease and were able to target it with treatment.

Dubbed by Forbes in January 2011 as “The first child saved by DNA sequencing,” Nic Volker’s story made national news and served as an inspiration to both researchers and families looking for answers — including those who parent special needs children. Since then, DNA sequencing has become cheaper and more widely available.

One private company, Illumina, claims it will soon be able to provide customers with whole genome sequencing for $100, though the National Institutes of Health has reported that the quality of genome sequencing varies greatly, and producing a high-quality sequence remains labor-intensive and expensive. Still, universities and private companies operate research and sequencing labs throughout the country, and the Triangle boasts major research labs at Duke University and the University of North Carolina, as well as numerous biotech companies with a focus on DNA sequencing.

Doctors and scientists are still trying to determine how this sudden wealth of information translates and should be used in a case-by-case basis. “There’s still a lot we don’t know,” says Dr. Laurie Smith, Ph.D., M.D., a member of the Department of Pediatric’s Division of Genetics and Metabolism Department at the UNC School of Medicine, adding that DNA sequencing technology is not “ready for prime time.”


The Science

The Human Genome Project took 11 years and required $2.7 billion dollars. It was completed in 2003 and produced the first map of all the hereditary information encoded in human DNA. This map is known as a “genome.” By reading or “sequencing” the DNA of any individual (using a blood sample or saliva), then comparing it to the map, scientists can identify differences or “mutations” that may or may not cause diseases or developmental delays.

Whole genome sequencing (WGS), which was used during the project, reveals the most complete picture of an individual’s DNA. There are about three billion nucleotides (DNA building blocks) in a complete genome, and scientists are still working to determine the significance of much of this information.

By contrast, whole exome sequencing (WES) looks only at the “exons” or protein-coding regions of genes. The exome, about 1.5 percent of the total genome, represents portions of the genome. Since much less DNA is sequenced, WES is cheaper than WGS and easier to interpret. However, WES provides less information to researchers than potentially available through WGS. Most scientists anticipate that as technology improves and more is learned about the whole genome, WES will give way to WGS.


The Research

Niko Katsanis runs what he calls an “intellectual hotel” — the Duke University Department of Cell Biology Center for Human Disease Modeling, which brings together a dream team of experts in various fields to solve genomic puzzles. As an extension of his research, he also leads the Duke Task Force on Neonatal Genomics, which is focused on faster diagnosis and improving the care and treatment of neonates (newborns less than a month old) and infants with genetic conditions.

The core challenge for Katsanis and his lab is trying to define success. “It’s different for everybody,” he says.

For the parents of an afflicted child, he hopes to offer a molecular diagnosis. While there is often no clear treatment, he says a diagnosis offers “a modicum of help” and relief from uncertainty. Determining a diagnosis allows a family to end the “diagnostic odyssey” (or search for a diagnosis) of repeated testing and searching for answers, and gain access to social services that may not otherwise be available. The whole family can benefit from the medical and emotional support of connecting with other families affected by the same condition. And there’s always the slight chance a diagnosis will lead to treatment of or, more likely, better management of symptoms. 


For Katsanis and his peers, a diagnosis is not enough.

“The intellectual goal is to move from prescription to prediction. ‘Take two and call me in the morning’ is a fantasy in these cases,” Katsanis says. “Therapeutic access for these patients is very low and will take a long time to develop for each disease. Compared with finding cures, sequencing the human genome was a walk in the park, and that took 10 to 15 years. It will take the same amount of time for each therapeutic drug.”

Despite these challenges, Katsanis finds his work, which includes extensive testing of human DNA on zebrafish, thrilling. (According to the National Institutes of Health, 70 percent of human genes are found in zebrafish.)

“Every day we learn something,” he says. “Genomics is like a huge fire hose spewing out stuff, and right now we just have a little bucket.”


The Doctor’s Office

Most clinics and labs claim between a 20-30 percent rate of “positive results” with WES and WGS cases, which means they find a direct connection between a gene mutation and a child’s disease. UNC’s Smith says her positive results are closer to 70 percent.

“We are very picky with the patients we take for WES,” she says.

All of her patients are referred to her through pediatricians or genetic counselors, and she is selective about which referrals she accepts.

“By the time we’ve screened for clinical features and reviewed the child’s medical history and performed some testing, we are relatively confident that the child has a genetic disorder that might be found with sequencing. And we don’t want to just look at the patient’s DNA,” she says. “We won’t perform sequencing unless we can get both parents sequenced as well.”

Smith is quick to point out the drawbacks of genomic sequencing: A high price tag often not covered by insurance, and the likelihood that the best-case scenario is just a diagnosis. “Families need to understand the limitations,” she says.

In addition, Smith takes the ethical treatment of her patients very seriously. WGS and WES involve several unresolved moral issues, such as a patient finding out something he or she may not want to know about. While sequencing a child’s genome, for example, a doctor may find genetic mutations that are unrelated to the disorder in question. Smith says this happens in 3-5 percent of cases. These “incidental findings” include adult-onset disorders and an increased risk for certain cancers that may or may not affect the individual’s health, and may or may not have health ramifications for family members or future children.

“There is the possibility of receiving information you might not want to hear,” Smith cautions. “You have to figure out how comfortable you are with the knowledge you will gain.”

She notes that parents are asked beforehand whether they want to hear incidental findings, though the American College of Medical Genetics and Genomics recommends that doctors disclose any “actionable” incidental findings that might be alleviated or prevented with lifestyle changes or preventive medicine. (Currently, there are about 60 findings listed, which you can learn more about at ncbi.nlm.nih.gov/clinvar/docs/acmg.).


The Clinical Trial

One way for a family to avoid the high cost of WES and WGS is to participate in a clinical trial. One such trial is run by the Undiagnosed Diseases Network, which is funded by the NIH and available through seven clinic locations around the country. Dr. Vandana Shashi, M.D., is a professor of pediatrics and the principal investigator for the Undiagnosed Disease Network at Duke University.

Like Smith, Shashi and the Undiagnosed Diseases Network only see children who have been thoroughly evaluated and recommended by a pediatrician or geneticist.

“Patients (adults and children) from all over the country apply,” Shashi says. “We’ve come to recognize that we can’t help some patients with a diagnosis, so we review very carefully the workup by a patient’s physician or geneticist, and we look for signs of an undiagnosed disorder that we can help resolve.”

The Duke University location ends up taking about half of the patients who apply and, like Smith’s office, the Undiagnosed Diseases Network lab has a diagnosis rate that is higher than average — around 35 percent.

Shashi says working with the Undiagnosed Disease Network gives her access to researchers there and at research cores across the country. In addition, modern technology facilitates the comparison of DNA modification cases so that physicians and researchers around the world can determine if they can work together to diagnose previously unknown diseases.

One of Shashi’s favorite resources is GeneMatcher, a freely accessible online database of genes and associated disease characteristics. “It’s the ‘match.com’ for genes,” she says. “It allows me to compare notes on specific genes with any clinician or researcher in the world. It’s fantastic.”


The Direct-to-Consumer Option

As DNA sequencing technology becomes faster and less expensive, companies are starting to provide direct-to-consumer testing, like 23andMe, which has a strong brand name and some staying power (it won the Time Magazine “Product of the Year” award in 2008). 23andMe offers DNA reports on various topics, from ancestry to health to family planning, but it does not provide WGS or WES — rather, it is a “genotyping” service that looks only at specific points in the genome known to vary among individuals.

The company is very forthcoming about its products’ limitations.

“The 23andMe Health + Ancestry Service is not diagnostic, and should not be used to address concerns regarding a suspected genetic disorder,” says Stacey Detweiler, a licensed and certified genetics counselor for 23andMe. “It is important for families with an ill child to work with their health care providers, such as a geneticist or a genetic counselor, to determine appropriate testing options.”

The 23andMe services are designed for people who are curious about their ancestry, or who want to know whether they have genetic traits that could lead to a greater risk of developing certain diseases in the future. Currently, 23andMe tests for 10 diseases, including late-onset Alzheimer’s and Parkinson’s. Detweiler says the company’s DNA test could also be helpful for family planning purposes.

“Individuals planning for a pregnancy can benefit from knowing and sharing their carrier status with their health care providers,” she says.

Detweiler adds that there are factors, including “family history, lifestyle and environment, as well as a number of genetic variants, that are not covered by the test that can also play a role in one’s health.” She says clients should only use the 23andMe results as supplemental information to discuss with a genetic counselor or health care provider.

LabCorp, Inc., a private company headquartered in Burlington with an office in Research Triangle Park, provides genetic testing for doctors in hospitals and private practices across the country. LabCorp also has a long-standing relationship with 23andMe. Geraldine McDowell, senior technical director for LabCorp’s Center for Molecular Biology and Pathology, calls direct-to-consumer genetic testing “a very exciting area for LabCorp and for consumers as they look for more information about their health.”

However, like Detweiler and Smith, McDowell is thinking carefully about what constitutes too much information.

“Is it good for a child or their parent to know that he is at greater risk for developing a cancer that may not affect him until well into adulthood, or which may never develop?” she asks. “Does that create an obligation to notify potential spouses or partners, or employers, or insurers? How much to know and when to know it is a big question that we’re in the early stages of grappling with.”


The Future

Despite the ethical qualms, most scientists agree that universal WGS for newborns will be standard in the near future. Other countries are already pursuing it. Smith recently gave a talk in Estonia, a country poised to implement DNA sequencing for all newborns.

The U.S. is trying to approach DNA sequencing carefully. The NIH has sponsored Genomic Sequencing for Childhood Risk and Newborn Illness (“The BabySeq Project”) to study the effect of knowing the makeup of a child’s genome on the child’s health and health care costs.

Scientists, who can’t move forward without data, tend to be more willing to sacrifice privacy issues in order to gain access to a variety of genomes. Katsanis struggles with this at Duke University.

“There is a disagreement about who owns the data — the families or the researchers,” he says. “We try to engage families and patients as collaborators, and sometimes it’s wonderful, sometimes it’s trying. We hope the families will be forthcoming, and that they’ll understand it’s the best way for all of us to move forward.”


Caitlin Wheeler is a freelance writer living in Durham.

Edit ModuleShow Tags
Edit ModuleShow Tags

Related Content

Wake County Public Libraries Adds Sunday Hours at Select Branches

Beginning Sept. 1, four libraries will be open from 1-5 p.m. on Sundays.

Aug. 17-19 Chess 101, Milling Flour, Making Fabric Art and Observing Honey Bees

This weekend in the Triangle, play chess, learn how flour is milled, make fabric art and observe honey bees.

Mastering Time Management: The Hardest Part of High School

Figuring out how to use time wisely can be the bane of a teen's existence. Here are some tips that might help.
Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

August 2018

Run Club meets every Sunday at 8 a.m. in Midtown Raleigh or Wake Forest. Stroller friendly; children invited. 

Cost: $10/run or $100/annual pass

Where:
Optimist Park Community Center/Greenways
5900 Whittier Drive
Raleigh, NC  27609
View map »


Sponsor: FIT4MOM
Telephone: 919-348-0472
Contact Name: Missy Currin
Website »

More information

June 30-August 12; 8:30 a.m.– 5:00 p.m. Come to Historic Yates Mill to see a new temporary exhibit, Rich in the Rare, on loan from the N.C. Department of Natural and Cultural Resources. This...

Cost: Free

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Road
Raleigh, NC  27603
View map »


Sponsor: Historic Yates Mill County Park
Telephone: 919-856-6675
Website »

More information

Join Mindful Families of Durham, a Buddhist-inspired spiritual community that supports area parents, caregivers, and their children in the practice of mindfulness and the understanding of the...

Cost: Free

Where:
Erwin Road
Durham, NC  27705
View map »


Sponsor: Mindful Families of Durham
Contact Name: Adam, Laura, Josh, Sumi
Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

Shop antiques, crafts and art, and enjoy food trucks at this artisan and vintage market in downtown Cary.

Cost: Free

Where:
Fidelity Bank Parking Lot
100 W. Chatham St.
Cary, NC  27511
View map »


Contact Name: Leslie & Jessica
Website »

More information

Children make treasured memories while increasing their knowledge of plants and animals. Ages 7-10. Register online.

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Join staff and volunteers from the Morehead Planetarium and Science Center, Chapel Hill Astronomical and Observational Society (CHAOS) and Raleigh Astronomy Club (RAC) for a free skywatching...

Cost: Free

Where:
Dorothea Dix Park
2105 Umstead Dr.
Raleigh, NC  27603
View map »


Website »

More information

Show More...
Show Less...

Examine “Shinrin-yoku," a Japanese healing technique that "takes in the forest atmosphere." Visit a natural area in the park and walk in a relaxed way to receive calming,...

Cost: Free

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, NC  27603
View map »


Sponsor: Historic Yates Mill County Park
Telephone: 919-856-6675
Contact Name: Rebecca Cope
Website »

More information

Squish, touch and feel your way through center-based activities to explore the senses.  Make a smelly painting and splash in a sink/float bucket. Ages 18 months-3 years with an...

Cost: $2/child

Where:
Crowder County Park
4709 Ten-Ten Rd.
Apex, NC  27539
View map »


Sponsor: Crowder County Park
Telephone: 919-662-2850
Website »

More information

Enjoy a family-friendly movie. See the website for the movie title. Showings at 11 a.m. and 2 p.m. 

Cost: Free

Where:
Crabtree Valley Mall
4325 Glenwood Ave.
Raleigh, NC  27612
View map »


Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

Observe the 41st anniversary of Elvis' passing by seeing two tribute bands, Scot Bruce and The Fab Four, face off in an adrenaline-pumping musical showdown. Purchase tickets online.

Cost: $35-$65

Where:
Fletcher Opera Theater
2 E South St.
Raleigh, NC  27601
View map »


Website »

More information

Show More...
Show Less...

Enjoy live entertainment, hands-on projects and gallery hunts.

Cost: Free

Where:
Nasher Museum of Art
2001 Campus Dr.
Durham, NC  27705
View map »


Website »

More information

Meet a favorite princess or superhero from 11 a.m.-noon and 1-2 p.m.

Cost: Free

Where:
Crabtree Valley Mall
4325 Glenwood Ave.
Raleigh, NC  27612
View map »


Website »

More information

Learn froggy fun facts through trivia games and activities. Discover the differences and similarities between frogs and toads. All ages with adult. Registration required online. Meet...

Cost: $1/person

Where:
Crowder County Park
4709 Ten-Ten Rd.
Apex, NC  27539
View map »


Sponsor: Crowder County Park
Telephone: 919-662-2850
Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

Weekly basic skills cooking class for children aged 5-10 at Whole Foods North Raleigh.  This free class meets each Tuesday at 4 p.m. and is offered by registering in advance...

Cost: Free

Where:
Whole Foods Market (North Raleigh)
8710 Six Forks Road
Raleigh, NC  27615
View map »


Website »

More information

Take the family for Kids Night at Chick-Fil-A in Garner. Enjoy a free indoor playspace, face painting and balloon twisting with Mimi the Clown. 

Cost: Free

Where:
Chick-Fil-A
2720 Timber Dr.
Garner, NC  27529
View map »


Sponsor: The MelodyMaker Entertainment
Telephone: (919)639-9328
Contact Name: Melody Scruggs
Website »

More information

Show More...
Show Less...

Enjoy live entertainment, hands-on projects and gallery hunts.

Cost: Free

Where:
Nasher Museum of Art
2001 Campus Dr.
Durham, NC  27705
View map »


Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

Read "Froggie Babies" by Suzanne Farrior and make a froggy craft. Practice jumping skills, learn to "ribbitt," and examine the differences between the frogs and toads. Ages...

Cost: $4/child

Where:
Crowder County Park
4709 Ten-Ten Rd.
Apex, NC  27539
View map »


Sponsor: Crowder County Park
Telephone: 919-662-2850
Website »

More information

See Happy Dan perform magic, comedy and more.

Cost: $5/person

Where:
Renaissance Centre
405 Brooks St.
Wake Forest, NC  27587
View map »


Website »

More information

Enjoy a Build-A-Bear activity, storytime, games and painting from 11 a.m.-noon and 1-2 p.m.

Cost: Free

Where:
Crabtree Valley Mall
4325 Glenwood Ave.
Raleigh, NC  27612
View map »


Website »

More information

Expand your knowledge of our local flora and fauna by exploring a different area of the park each month. Join park staff as they "nerd out" over amphibians, birds, insects, spiders, and...

Cost: Free

Where:
Lake Crabtree County Park
1400 Aviation Pkwy.
Morrisville, NC  27560
View map »


Sponsor: Lake Crabtree County Park
Telephone: 191-946-03355
Contact Name: Carol Cunningham
Website »

More information

Join park staff for an informal fishing experience for the whole family. Take your own poles or borrow one from the park through the Tackle Loaner Program. Bait and basic instruction are...

Cost: Free

Where:
Lake Crabtree County Park
1400 Aviation Parkway
Morrisville, NC  27560
View map »


Sponsor: Lake Crabtree County Park
Telephone: 919-460-3355
Contact Name: Carol Cunningham
Website »

More information

Join park staff for an informal fishing experience for the whole family. Take your own poles or borrow one from the park through the Tackle Loaner Program. Bait and basic...

Cost: Free

Where:
Lake Crabtree County Park
1400 Aviation Pkwy.
Morrisville, NC  27560
View map »


Sponsor: Lake Crabtree County Park
Telephone: 191-946-03355
Contact Name: Carol Cunningham
Website »

More information

Show More...
Show Less...

Celebrate National Tell a Joke Day by sharing some jokes with the park community. Meet in the Exhibit Hall. Drop-in program. All ages. Registration not required.

Cost: Free

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, NC  27603
View map »


Sponsor: Historic Yates Mill County Park
Telephone: 919-856-6675
Contact Name: Rebecca Cope
Website »

More information

Enjoy live entertainment, hands-on projects and gallery hunts.

Cost: Free

Where:
Nasher Museum of Art
2001 Campus Dr.
Durham, NC  27705
View map »


Website »

More information

Enjoy an easy-paced and stroller-friendly walk along the greenway. Suggested for ages 3 and younger with parent. Register online. Choose course #219872.

Cost: Free

Where:
Walnut Creek Wetland Park
950 Peterson St.
Raleigh, NC  27610
View map »


Sponsor: City of Raleigh Parks, Recreation and Cultural Resources
Telephone: 919-996-2761
Contact Name: Stacie Hagwood
Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

Ages 7-12 enjoy fashion and design activities from 11 a.m.-noon.; ages 13-18 enjoy the same activities from 1-2 p.m.

Cost: Free

Where:
Crabtree Valley Mall
4325 Glenwood Ave.
Raleigh, NC  27612
View map »


Website »

More information

Celebrate Raleigh's creativity under the beautiful lights and cobblestone streets of City Market. Find locally-made goods and enjoy a night filled with music and entertainment with over 30...

Cost: Free

Where:
City Market
306 Parham St
Raleigh, NC  27601
View map »


Sponsor: Raleigh Night Market
Contact Name: Sara Buxton
Website »

More information

Show More...
Show Less...

Take part in a class that teaches individualized ways to foster motor development for your child. Learn about tummy time alternatives, best positions for your baby, how to help your child learn to...

Cost: $18

Where:
Open Arts
1222 Copeland Oaks Dr
Morrisville, NC  27560
View map »


Sponsor: Babies On The MOVE
Contact Name: Rebecca Quinones
Website »

More information

Enjoy live entertainment, hands-on projects and gallery hunts.

Cost: Free

Where:
Nasher Museum of Art
2001 Campus Dr.
Durham, NC  27705
View map »


Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

A wonderfully kid-paced hour featuring music, play and dancing with toddler stars singing on the mic at Cotton's gently amplified & participatory music show. Children delight in...

Cost: Free with admission

Where:
Pump It Up Raleigh
10700 World Trade Blvd, #112
Raleigh, NC  27617
View map »


Sponsor: Pump it Up
Telephone: 919-828-3344
Contact Name: Owner/manager Kellie Paterson McHugh
Website »

More information

Take part in a class that teaches individualized ways to foster motor development for your child. Learn about carry positions, best positions for your baby, how to help your child learn to crawl,...

Cost: $18

Where:
Open Arts
1222 Copeland Oaks Dr
Morrisville, NC  27560
View map »


Sponsor: Babies On The MOVE
Contact Name: Rebecca Quinones
Website »

More information

Experience the the excitement of wheelchair basketball in preparations for August Madness. Whether your team is practicing for August Madness or you're looking for a fun Friday activity, all...

Cost: Free

Where:
American Tobacco Campus YMCA 'Cage' Court
304 Blackwell Street
Durham, NC  27701
View map »


Sponsor: Bridge II Sports
Telephone: 18668802742 x12
Contact Name: Katharine Doyle
Website »

More information

Take a walk with a park naturalist to explore the woods and fields at this special time of day.  Register online.

Cost: $3

Where:
Wilkerson Nature Preserve
5229 Awls Haven Dr.
Raleigh, NC  27614
View map »


Sponsor: City of Raleigh Parks, Recreation and Cultural Resources
Telephone: 919-996-6764
Contact Name: Wilkerson Nature Preserve staff
Website »

More information

See the PG-rated movie under the stars at Booth Amphitheatre. After the disappearance of her scientist father, three peculiar beings send Meg, her brother,and her friend to space in order to...

Cost: $5 ages 13 and older. Free for ages 12 and younger.

Where:
Booth Amphitheatre
8003 Regency Pkwy.
Cary, NC  27518
View map »


Website »

More information

Show More...
Show Less...

Kindergarten students entering the traditional school calendar practice a lunch line, get moving at recess, hop on a school bus and more.  

Cost: Free

Where:
Marbles Kids Museum
201 E. Hargett St.
Raleigh, NC  27601
View map »


Website »

More information

Take a walk in the woods and discover the animals and plants that call the park home. Help collect data for our Natural Resource Inventory Database and other citizen science projects. All...

Cost: Free

Where:
Crowder County Park
4709 Ten-Ten Rd.
Apex, NC  27539
View map »


Sponsor: Crowder County Park
Telephone: 919-662-2850
Website »

More information

Young entrepreneurs, ages 6 -14, have an opportunity to sell their products or services to the general public. Participants can keep any profits from sales they make at the fair and will earn cash...

Cost: Free

Where:
Park West Village
Village Market Place
Morrisville, NC  27560
View map »


Sponsor: Triangle Children's Business Fair
Website »

More information

Enjoy a celebration of products, services and resources for families featuring local organizations focusing on education, health and wellness, safety, special needs, child care and more....

Cost: Free

Where:
JD Lewis Multipurpose Center
2245 Garner Rd.
Raleigh, NC  27610
View map »


Sponsor: Sunshine Family Expos
Telephone: 813-463-2712
Contact Name: Melinda Perez

More information

Enjoy live entertainment, hands-on projects and gallery hunts.

Cost: Free

Where:
Nasher Museum of Art
2001 Campus Dr.
Durham, NC  27705
View map »


Website »

More information

Enjoy an interactive dance story and craft time. Ages 3-7. 

Cost: Free

Where:
Graceful Expressions Dance Education
312 W. Chatham St., #103
Cary, NC  27511
View map »


Sponsor: Graceful Expressions Dance Education
Telephone: 191-975-86003
Website »

More information

Search for snakes, salamanders, turtles and more. Ages 10-13. Register online.

Cost: $12/resident, $16/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Raleigh, NC
View map »


Telephone: 919-387-5980
Website »

More information

Children's booksellers read their favorite picture books. All ages.

Cost: Free

Where:
Quail Ridge Books
4209-100 Lassiter Mill Rd.
Raleigh, NC  27609
View map »


Website »

More information

Little ones enjoy storytime.

Cost: Free

Where:
Barnes & Noble
5959 Triangle Town Blvd.
Cary, NC  27616
View map »


Website »

More information

Learn more about pollinators during this family friendly event. Sample and buy local honey and honey-based products.

Cost: Free

Where:
State Farmers Market
1201 Agriculture St.
Raleigh, NC  27603
View map »


Website »

More information

Take the family for treats, music, art and more. See a special exhibit showcasing the work of Artspace's talented young artists.

Cost: Free

Where:
Artspace
201 E. Davie St.
Raleigh, NC  27601
View map »


Website »

More information

Stop by a discovery table to learn fun about the animals that live in Crowder Pond. All ages. Registration required. The display table is located at the Upper Playground.

Cost: Free

Where:
Crowder County Park
4709 Ten-Ten Rd.
Apex, NC  27539
View map »


Sponsor: Crowder County Park
Telephone: 919-662-2850
Website »

More information

Explore how bees pollinate flowers and help gardens grow. Discover how bee hives work and learn the ways that bee-keepers have historically housed and cared for their hives. All...

Cost: Free

Where:
Historic Yates Mill County Park
4620 Lake Wheeler Rd.
Raleigh, NC  27603
View map »


Sponsor: Historic Yates Mill County Park
Telephone: 919-856-6675
Website »

More information

Explore the historic heart of downtown Raleigh on a walking tour of Fayetteville Street. Tours highlight the people, places, architecture and political movements that have shaped...

Cost: Adults (18+) $10; Youth (7-17) $4; Children (6 & under) Free.

Where:
City of Raleigh Museum
220 Fayetteville St.
Raleigh, NC  27601
View map »


Website »

More information

See the PG-rated movie "Jurassic Park," part of the City of Raleigh's Movies by Moonlight series. Also enjoy food trucks. Register online....

Cost: Free

Where:
Dorothea Dix Park Flowers Field
2105 Umstead Dr.
Raleigh, NC
View map »


Sponsor: City of Raleigh
Telephone: 919-996-6688
Contact Name: Joseph Voska
Website »

More information

Show More...
Show Less...
Edit Module

Magazine

Edit ModuleShow Tags
Edit ModuleShow Tags

Directories

Edit ModuleShow Tags Edit ModuleShow Tags

Annual Guides

Education Guide

The 2017-18 Education Guide offers 660 education resources in the Triangle, including area preschools, private schools, public school systems, charter schools, boarding schools and academic resources.

The Triangle Go-To Guide

Our Triangle Go-To Guide connects you to family fun resources across the Triangle. Plus, find out who our 2018 Readers' Favorites are.