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MNAAP Newsletter

Screening Instruments: Caring for the Whole Child

AndyBarnesBy Andrew Barnes, MD , MPH, FAAP, Assistant Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota

If you’ve ever wondered whether you’re seeing more children with disabilities in your clinic over the past 15 years, you are – from 2000-2010, this population of children grew the fastest since it started to be recorded in the U.S. This increasing prevalence was mostly due to neurodevelopmental differences and mental health conditions – up 20% in the past decade (while physical health disabilities were down 10%), rising fastest among families with higher socioeconomic status. We may be identifying some of these children better in our clinics because of improved standardized developmental screening, as recommended by the American Academy of Pediatrics in their 2006 policy statement. This policy (and other related policies relating to autism, social-emotional, and mental health screenings) recognize that early intervention is critical for children with developmental and behavioral needs, and that these conditions are best managed within a medical home that cares for the whole child.

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Word from the President: Sue Berry, MD, FAAP

SueBerryNo matter how you look at it or what your political beliefs are, this has been a momentous season for the health of children.

The Supreme Court’s affirmation of the rights of families and children to be supported by loving, married parents irrespective of their sexual orientation is a larger reflection of the process we supported as a chapter in Minnesota to affirm those rights for our own citizens. I know not all of our members agreed with that decision, but we as a chapter spoke out to acknowledge that children are better off with committed parents who have legal protections supporting their families.
I don’t think any of us thinks that the Affordable Care Act is perfect, but its implementation allowed millions of Americans, including American children, to have health insurance. While Minnesota was less impacted by the decision to maintain access to health care exchanges (because we had long ago taken steps to improve access to insurance for Minnesotans) the overall effect has been to improve access to health care. I think all of us know that for the children we serve, this is an essential aspect for their well-being.

Our chapter is continuing to actively support and pursue projects to seek reduction in health disparities, reduce the impacts of poverty, and reduce risks to children through non-accidental injury. I hope as you can, you will work with us, your colleagues, to advance these endeavors.

On a personal note, many of you know that I am relatively recently a grandparent. So, an update: My granddaughter Caroline is now nearly 10 months old. She reminds me at every opportunity of why what we do is so important. Every time I think of the work we do, I think of her sweet little face and remember why I became a pediatrician (and mom) in the first place.

I look forward to  continuing to work with such an amazing group of committed professionals!

Collaborative Grant to Study Integrated Newborn Screening Hearing and CMV Screening in MN

MarkSchleissBy Mark R. Schleiss, MD, Division Director, Pediatric Infectious Diseases and Immunology, U of M Medical School

A new grant has enabled establishment of a research partnership between Children’s Hospitals and Clinics of Minnesota and the University of Minnesota Medical Center (UMMC), aimed at evaluation of newborn infants who fail newborn hearing screening for possible congenital infection with cytomegalovirus (CMV).

CMV is the most common cause of congenital infection in pediatric practice, and is responsible for up to 30 percent of all cases of hearing loss in childhood. Although CMV can cause severe, clinically evident injury in newborns, consisting of features such as hepatosplenomegaly, microcephaly, and rash, most infants with congenital infection are in fact asymptomatic. Approximately 10-15 percent of asymptomatic congenitally infected infants will have hearing loss due to CMV infection.

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Open Your Eyes: MDH Releases New Vision Screening Guidelines

MikeSeversonBy Michael Severson, MD, FAAP; Susan Schloff, MD, FAAP; Faith Kidder, APRN, CPNP, MS, PHN, Minnesota Department of Health

The Minnesota Department of Health (MDH) recently updated its vision screening guidelines and best practices in a succinct, easy-to-access document for providers who do not have the time nor the need to scan a procedure manual.

Developed by a cross section of screening entities and professional organizations, including Dr. Mike Severson representing the Minnesota Chapter of the American Academy of Pediatrics, the document provides at-a-glance information about recommended vision screening procedures for children post newborn through age 20.

In Minnesota, the number of kids who receive vision screening is above the national average. Still, many kids pass when they need further testing. The new guidelines direct practices, schools and early childhood programs to use correct methods to ensure accurate, reliable results.

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Telemed for Newborn Resuscitations: Finding the Right Technology

By Jennifer L. Fang, MD, FAAP1; Beth L. Kreofsky, MBA2; Matt Bushman, BS1; Lisa A. Stubert, PMP2; Hussain Mohammed3; Kathleen D. Stuart3; Joan K. Broers, MS, RN2; Robert V. Johnson, MD, FAAP1; Christopher E. Colby, MD, FAAP1

JenniferFangMinnesota’s current regionalized perinatal care system is designed to ensure that high-risk deliveries occur in tertiary care centers in order to optimize neonatal outcomes. However, an expectant mother’s access to these advanced-level services may be limited due to various factors including geography, transportation, or unanticipated need. When high-risk deliveries occur in community hospitals, the local providers may have limited expertise and resources to optimally respond to these newborn emergencies.

To address this issue, Mayo Clinic’s Division of Neonatal Medicine and Center for Connected Care have implemented telemedicine for high-risk neonatal resuscitations in six community-based health system sites over the last 24 months. This includes hospitals located in Blue Earth, Freeborn, Goodhue, Martin, Mower and Olmsted counties. To date, this video telemedicine service has been activated 70 times for a variety of cases, such as resuscitation of the extremely preterm infant, management of meconium aspiration syndrome, and identification of congenital anomalies.

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