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.

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Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

When is a stick not a stick? (When it is a caterpillar that looks like a twig.) Many plants and animals play tricks on each other – they look or act like something other than what they really...

Cost: FREE. Registration is required.

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


Telephone: 919-856-6675
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

Great Blue Herons can be seen every day at Lake Crabtree. Learn all about these amazing birds, including how they catch fish, where they nest, and more! We'll practice catching fish, make a...

Cost: FREE

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


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

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Holly Springs native Jasmine Brown is on a mission to help improve the staggeringly low financial literacy proficiency rates among North Carolina high school graduates and has written a book - The...

Cost: Free to attend; book retails for $17.95

Where:
Our Moments In Time
205 South Main Street
Holly Springs, NC  27540
View map »


Contact Name: FACTS for Youth
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

Join park staff for a fun, informal fishing experience. Bring your own poles or borrow one of ours through the Tackle Loaner Program. Bait and basic instruction are provided. Fishing is catch and...

Cost: FREE

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


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

More information

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The Engage Art Contest is a juried competition for original Visual Art, Music Video, Film and Performing Arts. The topic is the Spiritual Battle described in Ephesians 6:10-20 and related...

Cost: Free

Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

I am a mom and retired CPA who is passionate about teaching teens about the high cost of their choices. I teach a fun, interactive "Game of Life meets Dave Ramsey" class that has teens experience...

Cost: $225

Where:
Hope Community Church- Apex
2080 E Williams Street
Apex, NC  27539
View map »


Sponsor: Beyond Personal Finance
Contact Name: Charla McKinley
Website »

More information

Short class advertising for local class   I am a mom and retired CPA who is passionate about teaching teens about the high cost of their choices. I teach a fun, interactive "Game of Life meets...

Cost: $225

Where:
Hope Community Church- Apex
2080 E Williams Street
Apex, NC  27539
View map »


Sponsor: Beyond Personal Finance
Contact Name: Charla McKinley
Website »

More information

Short class advertising for local class   I am a mom and retired CPA who is passionate about teaching teens about the high cost of their choices. I teach a fun, interactive "Game of Life meets...

Cost: $225

Where:
Hope Community Church- Apex
2080 E Williams Street
Apex, NC  27539
View map »


Sponsor: Beyond Personal Finance
Contact Name: Charla McKinley
Website »

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

Show More...
Show Less...

The Engage Art Contest is a juried competition for original Visual Art, Music Video, Film and Performing Arts. The topic is the Spiritual Battle described in Ephesians 6:10-20 and related...

Cost: Free

Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Forget tourist-filled museums, make your own memories with a photo scavenger hunt tour in Raleigh! On a Let’s Roam scavenger hunt, you and your team will work together to wander throughout...

Cost: $11

Where:
500 S Salisbury St
raleigh, NC  27601
View map »


Sponsor: Let's Roam
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

The Community Farm at Chestnut Ridge + Growga are excited to offer outdoor yoga classes this spring!   The Little Sprouts Growga program is for ages 2-5. They learn basic mindfulness elements...

Cost: $150

Where:
The Community Farm at Chestnut Ridge
2902 Mt. Willing Road
Efland, NC  27243
View map »


Sponsor: The Community Farm at Chestnut Ridge
Telephone: 919-304-2178
Contact Name: Erica Romkema
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

The park comes alive after dark! Let the moon guide your way as we stroll around the pond in search of these night-time critters. Play fun games and try to catch some nocturnal bugs! Don't forget a...

Cost: FREE. Registration required for everyone; children must have adult accompaniment

Where:
Crowder County Park
4709 Ten-Ten Rd
Apex, NC  27529
View map »


Telephone: 919-662-2850
Website »

More information

Show More...
Show Less...

The Engage Art Contest is a juried competition for original Visual Art, Music Video, Film and Performing Arts. The topic is the Spiritual Battle described in Ephesians 6:10-20 and related...

Cost: Free

Where:
Online
PO Box 78951
Charlotte, NC  28271
View map »


Sponsor: Engage Art Contest
Telephone: 980-999-1447
Contact Name: Ranika Chaney
Website »

More information

Forget tourist-filled museums, make your own memories with a photo scavenger hunt tour in Raleigh! On a Let’s Roam scavenger hunt, you and your team will work together to wander throughout...

Cost: $11

Where:
500 S Salisbury St
raleigh, NC  27601
View map »


Sponsor: Let's Roam
Website »

More information

  Meet at the Waterwise Garden (first parking lot on right) Join our bird enthusiast, Vernon, for an easy walk while looking and listening for our feathered friends. Discover...

Cost: FREE

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


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

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on week of camp

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

Summer Garden Camps at the JCRA invite your child to investigate nature during half or full day camps.  Campers tend to the garden, harvest vegetables, catch insects, and create crafts from the...

Cost: Varies depending on camp week

Where:
JC Raulston Arboretum
4415 Beryl Rd
Raleigh, NC  27606
View map »


Sponsor: JC Raulston Arboretum
Telephone: (919) 513-7011
Contact Name: Elizabeth Overcash
Website »

More information

PARENTS JOIN OUR DHHS APPROVEDCPR/AED & First Aid Certification ClassesFoster parents are required to be CPR & First Aid certified. Parents, bring your child to class with you. Children 10 years...

Cost: 50-80

Where:
Holly Springs, NC
1001 Silverstone Way
Holly Springs, NC  27540
View map »


Sponsor: Save A Life Now Training Center LLC
Telephone: 919-215-6942
Contact Name: Valentina Cordoba
Website »

More information

Amongst the ancient oak trees is the heart of Raleigh. We'll help you see the forest for the trees and all its magic splendor. Tourist, local, or new to town, this is a lively small group activity...

Cost: $11

Where:
Downtown
500 S Salisbury St
Raleigh, NC  27601
View map »


Sponsor: Let's Roam
Telephone: 833-202-7626
Contact Name: Kelly
Website »

More information

PARENTS JOIN OUR DHHS APPROVEDCPR/AED & First Aid Certification ClassesFoster parents are required to be CPR & First Aid certified. Must register in advance. Space is limited. Parents, bring your...

Cost: 50-80

Where:
Holly Springs, NC
1001 Silverstone Way
Holly Springs, NC  27540
View map »


Sponsor: Save A Life Now Training Center LLC
Telephone: 919-215-6942
Contact Name: Valentina Cordoba
Website »

More information

Enjoy a wonderful springtime Brunch with the Bunny and photo op on Saturday, April 4, 2020 at Patterson Farm Market & Tours. Our Brunch with the Bunny is always a popular event! Tickets must be...

Cost: Ages 2 – 6: $10.00 includes tax Ages 6 – 12: $12.00 includes tax Ages: 13 – 54

Where:
Patterson Farm Inc. Market and Tours
10390 Caldwell Road
Mount Ulla, NC  28125
View map »


Sponsor: Patterson Farm Inc. Market and Tours
Telephone: 704-636-4005
Contact Name: Megan Hedrick
Website »

More information

Opportunities to explore all 4 levels of the mill don’t happen often! Learn the history of milling in North Carolina, test your mill trivia, and discover what interesting machinery is preserved...

Cost: $10/Adult; $8/Senior (ages 60+); $6/Child (ages 10-16);Registration is required

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


Telephone: 919-856-6675
Website »

More information

Beavers are such busy creatures and have many unique features that allow them to survive in their aquatic world. Learn about their special adaptations through our "Build a Beaver" program then walk...

Cost: Free

Where:
Harris Lake County Park
2112 County Park Dr.
New Hill, NC  27562
View map »


Sponsor: Harris Lake County Park
Telephone: 919-387-4342
Contact Name: Joanne St. Clair
Website »

More information

Join us for an egg-cellent time on the farm Saturday, April 4 & 11,  2020 from 10 a.m. – 5 p.m. Explore the farm while you hunt for eggs and enjoy spring farm fun activities. Search for 12...

Cost: $10.00 for Hunters $7.00 for Non-Egg Hunters $6.00 for Non-Egg Hunters Senior (A

Where:
Patterson Farm Inc. Market and Tours
10390 Caldwell Road
Mount Ulla, NC  28125
View map »


Sponsor: Patterson Farm Inc. Market and Tours
Telephone: 704-636-4005
Contact Name: Megan Hedrick
Website »

More information

Kindermusik is a research-based early childhood curriculum that includes 45-minute classroom lessons with materials and resources that encourages parental involvement . Research has linked...

Cost: $70/month

Where:
Hope Community Building
2080 E Williams St
Hope Community Building, Fuquay Varina Room
Apex/Holly Springs, NC  27539
View map »


Telephone: 191-990-25432
Contact Name: Leigh Hamm
Website »

More information

The Town of Holly Spring's annual spring event, Spring Fling, is taking on a new location that has a nice ring to it. This year’s Spring Fling at Ting! will take place on Saturday, April 4 from...

Cost: FREE

Where:
Ting Park Baseball Stadium
1151 N. Main St.
Holly Springs, NC  27540
View map »


Sponsor: Town of Holly Springs
Contact Name: Rachel Downey

More information

Many wildflowers bloom in spring.  Join us for a leisurely hike through our fields and woods as we learn to recognize some blooming beauties and appreciate their stories. Age: 5yrs. and up;...

Cost: $2

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


Telephone: 919-996-6764
Contact Name: Bryan England
Website »

More information

Sign up for a Raleigh scavenger hunt and put on your best Nick Cage impression as you seek out the national treasures hidden in Raleigh. Via an app, be guided through the cultural, historical,...

Cost: See website for fees

Where:
Downtown Raleigh
500 S. Salisbury St.
Raleigh, NC  27601
View map »


Sponsor: LetsRoam!
Telephone: 833-202-7626
Contact Name: LetsRoam!
Website »

More information

Want to get inside Historic Yates Mill? Join us for a half-hour tour (starting at 1, 1:30, 2, 2:30 or 3 p.m.) to view the main power drive and milling machinery while exploring the mill's history...

Cost: $5/Adult, $4/Senior (60+ yrs), $3/Child (7-16yrs), Free/Child (6yrs & younger)

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


Telephone: 919-856-6675
Website »

More information

Bring the whole family for this fun interactive Growga family class. Siblings and parents come together for a fun Growga hour, combining elements of our Little Sprouts and Growga Kids programs...

Cost: $150

Where:
The Community Farm at Chestnut Ridge
2902 Mt. Willing Road
Efland, NC  27243
View map »


Sponsor: Chestnut Ridge Camp & Retreat Center
Telephone: 919-304-2178
Contact Name: Erica Romkema
Website »

More information

We invite all Triangle youth between the ages of 8 thru 17 with a sincere interest in the Performance Art of Magic to join Magic Youth Raleigh! This youth program teaches magic history and theory,...

Cost: $35 per Student

Where:
New Horizons Fellowship
820 E. Williams St.
Apex, NC  27502
View map »


Sponsor: The International Brotherhood of Magicians
Contact Name: Roger Way
Website »

More information

Young children and their families are invited to participate in an interactive program with books, songs, movement, and other early literacy-based activities, carefully selected to engage an...

Cost: Free

Where:
Cameron Village Regional Library
1930 Clark Avenue
Raleigh, NC  27605
View map »


Sponsor: Wake County Public Libraries

More information

Garner Sports League Opening Day Ceremony will be held at South Garner Park at 9am on Saturday April 4, 2020.  Come join us as we kick off the Spring season for recreational baseball, fast-pitch...

Cost: 0.00

Where:
South Garner Park
1210 Poole Drive
Garner, NC  27529
View map »

More information

Topper the Bunny can’t wait to see you at the 5th Annual Egg-ceptional Egg Hunt at Hubb’s Farm in Clinton, NC, features age-appropriate egg hunts with a grand finale airplane egg drop at 3pm...

Cost: 10

Where:
Hubb's Farm
10276 US HWY 421 N
Clinton, NC  28328
View map »


Sponsor: Hubb's Farm
Telephone: 910-564-6709
Contact Name: Tammy Peterson
Website »

More information

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