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    Newborn Hearing Screening: A Road
    Map for Families

    English: 5:37 spot

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    Newborn Screening Unit
    PO Box 149347, MC-1918
    Austin, Texas 78714-9347

    Phone: 512-776-3957
    Fax: 512-776-7450
    Toll-free: 800-252-8023, ext. 3957


Newsletter - Winter 2017

View or print this newsletter. (PDF)

Texas Newborn Screening Tests Babies for 55 Serious Medical Conditions

In May 2015, the Texas Department of State Health Services (DSHS) Newborn Screening Laboratory expanded newborn screening to include 24 secondary metabolic conditions. Previously, the blood spot samples were screened for 29 core conditions. Newborn screening also includes two point-of-care tests performed at the birthing facility to check a baby’s hearing and to screen for critical congenital heart disease.

Finding and treating these health conditions early can prevent serious complications including growth and developmental delays, deafness, blindness, intellectual disabilities, and sudden or early death. Learn more about each of these conditions. 

Critical Congenital Heart Disease: Reporting Diagnosed Babies

Reporting of confirmed critical congenital heart disease (CCHD) cases became mandatory on Sept. 1, 2014. Implemented as a point-of-care test, Texas law requires that all newborns receive CCHD screening. According to information from the Centers for Disease Control and Prevention, CCHD occurs in about 9 out of 4000 births in the United States. That means that an estimated 900 babies are born with CCHD annually in Texas.

CCHD is one of the leading causes of death in infants who are less than one year old. Screening helps to identify some of those babies with a critical heart defect that is time sensitive. Typically done between 24-48 hours after birth, newborns receive the screen at their birthing facility. Confirmed CCHD cases should be reported to the Texas Department of State Health Services. Download the CCHD Reporting Form.

CCHD Toolkit: A toolkit for CCHD provides educational and technical information as well as recommended protocol for CCHD screening.

Online CCHD Training & CEUs: Texas Health Steps offers a free online provider education training module for CCHD screening. Go to the website and select “Courses” at top of the page. Then select the topic “Genetic Screening” in the Course Finder and click Find. Earn free continuing education credit after course completion.

Free Newborn Screening Educational Publications for Parents and Providers

Free newborn screening brochures and other publications are available in English and Spanish for healthcare providers, parents, and medical staff. Download these educational materials as PDF files or order them at no cost.

View or Order Online

Timing Is Everything: Newborn Screening Transit Times

A delay in the transit (shipping) of newborn screening (NBS) specimens can cause a delay in testing and can lead to late or delayed diagnosis of a child. In February 2015, the United States Department of Health and Human Services Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC) formalized a series of recommendations regarding timeliness in newborn screening.

These recommendations included:

  1. Initial NBS specimens should be collected in the appropriate time frame for the newborn’s condition but no later than 48 hours after birth, and
  2. NBS specimens should be received at the laboratory as soon as possible; ideally within 24 hours of collection.

Despite huge improvements in timely delivery of NBS specimens, the Texas Department of State Health Services (DSHS) laboratory receives approximately only 25% of initial newborn screening specimens within 24 hours of collection. DSHS remains committed to assisting providers in minimizing the time from specimen collection to receipt in the NBS laboratory.

How Is Your Facility Doing?

Review your facility’s transit times on the monthly Newborn Screening Report Card. For more information, go to Lab Healthcare Provider Resources and select “Facility Report Cards.”

Model Workflow to Minimize Transit Time

Develop specimen collection processes where collections are completed:

  • When the patient is between 24 and 48 hours of age.
  • At least 4-5 hours before scheduled courier pick up to allow time for drying and shipment preparation. Many successful hospitals schedule NBS collections during the overnight shift to ensure the specimens are dried and ready for shipment on time.

Use the monthly facility report cards to frequently assess and monitor facility performance, including specimen transit times.

Investigate internal processes that may delay shipment and implement improvements.

Raise staff awareness of online DSHS educational materials and facility report cards.

Assign specific staff members 7 days a week to:

  • Gather specimens from all areas 1 hour before scheduled courier pickup.
  • Check specimen quality and accuracy/legibility of demographic information.
  • Follow up on any specimens that have pending orders.
  • Account for all newborn screening orders.
  • Ensure all specimens collected in the facility are included in the next possible courier shipment.
  • Ensure courier documentation is completed correctly 7 days a week.

Contact the Texas DSHS Newborn Screening Laboratory for any needed assistance at 1-888-963-7111 ext. 7585 or NewbornScreeningLab@dshs.texas.gov.

Medical Director’s Corner -Dr. Debra Freedenberg, Newborn Screening Medical Director

Three Conditions Added to the Recommended Uniform Screening Panel (RUSP)

Three conditions have been added to the RUSP since 2015: Pompe disease, mucopolysaccharidosis type I (MPS I, Hurler syndrome) and X-linked adrenoleukodystrophy (X-ALD). Read the article “Panel recommends screening newborns for 3 additional conditions” in the American Academy of Pediatrics’ AAP News to learn about these conditions.

Although added to the RUSP, each state decides which conditions it will screen. Texas currently does not screen for the above conditions. See what conditions Texas screens.

Video: Families Share How Newborn Screening Impacted The Lives of Their Children

A 5-minute video, “More Than Drops On a Card,” features two Texas families whose children were diagnosed with life-threatening conditions. They share their stories about how newborn screening saved their children from lifelong disabilities and possible death.

Texas Department of State Health Services laboratory and clinical care staff as well as a medical consultant discuss how critical it is to collect timely, good quality blood spot specimens. Babies with a rare condition can become very ill if not diagnosed within a few days after birth.

“Newborn screening is really a race against time. For some of these disorders, that’s a very fast moving clock and every minute counts,” said Clinical Biochemical Geneticist James Gibson, MD, PhD, who appears in the video. 

Proper Packaging Essential to Maintaining Blood Spot Specimen Quality

According to the Clinical and Laboratory Standards Institute, It is not recommended that Dried Blood Spot (DBS) specimens be packaged in airtight, leak proof, sealed containers because the lack of air exchange in the inner environment of a sealed container causes heat buildup and moisture accumulation. Heat, direct sunlight, humidity, and moisture are detrimental to the stability of DBS specimens and analyte recovery.” (Approved Standard NBS01-A6)

DO NOT use the FedEx Clinical Pak to ship newborn screening specimens. The Clinical Pak bag hermetically seals (does not allow any airflow) which makes them unsuitable for shipping newborn screening blood spot specimens. FedEx Clinical Pak bags are easily identified by their orange border. In order to maintain specimen quality, please DO NOT pack newborn screening specimens in these type of bags or containers.

Acceptable packaging for shipping blood spot specimens includes available FedEx boxes or bags that do not provide a totally air-tight seal. The Large Pak bag is one acceptable option.

Distinguished Newborn Hearing Screening Programs - July 2017 Cycle

The Texas Early Hearing Detection and Intervention (TEHDI) program recognizes more than 170 facilities that earned distinguished status as of the July 2017 cycle. Twice per year in January and July, TEHDI reviews newborn hearing screening programs that require recertification.

There are more than 240 facilities in Texas with newborn hearing screening programs. TEHDI certifies these facilities in accordance with Texas Department of State Health Services and Texas Health and Safety Code certification criteria as well as best practices protocols.

Certification consists of four levels: Preliminary (a new program), Provisional, Standard  and Distinguished. View the list of facilities with distinguished status.

For more information about the facility certification process, email tehdi@dshs.texas.gov or call 1-800-252-8023, ext. 7726. (Use relay option of your choice to call if needed.)

Last updated March 8, 2021