Policies, Programs, and Decision-Support Tools for DBS and Hearing Screening

The following policies, programs, and decision-support tools outline the responsibilities of PCPs for newborn DBS and hearing screening. They provide clear and efficient pathways for working within state NBS and Early Hearing Detection and Intervention (EHDI) systems.

For DBS screening:

ü      Review the AAP 2008 NBS clinical report, Newborn Screening Expands: Recommendations for Pediatricians and Medical Homes – Implications for the System. The report recommends that PCPs become familiar with the state NBS program and resources, including state-specific decision-support tools. If unaware of who to contact for state-specific program information, consult the NNSGRC state map and then contact the appropriate state NBS program.

ü   Consult optional ACMG ACTion sheets and confirmatory algorithms

For hearing screening:

ü      Review the JCIH 2007 position statement on infant hearing, Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention. The statement recommends that PCPs become familiar with the state EHDI program and resources. As needed, consult the NCHAM state map and then contact the appropriate state EHDI program.

ü      Consult the following updated EHDI algorithms for infant hearing to guide decision making:

-          EHDI algorithm, page 1 (flowchart)

-          EHDI algorithm, page 2 (customizable referral resource)

ü      Consult this supplemental guideline for focused information on the JCIH guidelines for medical homes:

-    The 2009 clinical report from the Committee on Practice and Ambulatory Medicine the Section on Otolaryngology–Head and Neck Surgery: Hearing Assessment in Infants and Children: Recommendations Beyond Neonatal Screening The JCIH position statement covers guidelines for all stakeholders (eg, medical homes, audiologists, early interventionists, and state EHDI programs) whereas this clinical report focuses on the JCIH guidelines for medical homes.

For medical home care coordination:

ü      The AAP Medical Home Policy Statement