Important pediatric news

November 1, 2007

SCHIP update * Infant hearing screening * Tinea capitis * TB regimen * ... and more

Wrangling over SCHIP continues

The House of Representatives failed to override President Bush's veto of the legislation to renew and expand the State Children's Health Insurance Program (SCHIP). Since then, there has been a great deal of partisan activity to come up with an acceptable compromise.

A modified version of the bill was introduced in the House (HR 3963) on October 24 that maintains funding for the program at $60 billion, an increase of $35 billion over five years, and keeps the tobacco tax in crease, including a 61-cent tax hike on cigarettes to pay for the program.

The House passed HR 3963 on October 25 by a vote of 265 to 142. However, this version did not appease the bill's detractors. It did not garner enough Republican support to override another threatened presidential veto-only 42 Republicans voted in favor this time around.

Senator Charles E. Grassley (R-Iowa) is trying to gain support for the bill by contacting GOP colleagues in the House to learn what changes could be made to come up with a veto-proof measure. Grassley was instrumental in writing the legislation that was vetoed by President Bush earlier in the month. The Senate passed the measure by a vote of 64-30, on November 1.

In his opening remarks at the recent American Academy of Pediatrics' National Conference and Exhibition, in San Francisco, President Jay Berkelhamer, MD, emphasized the importance of the Academy's role in establishing a national agenda for children, with a top priority being access to health care for all of the nation's 9 million uninsured children. Commenting on the president's veto, Berkelhamer said, "Clearly, partisan politics and political ideology should never trump the needs of children."

Infant hearing screening by 1 month

The Joint Committee on Infant Hearing (JCIH) has issued an updated policy statement for early hearing detection and intervention programs, recommending that pediatric offices (usually the first medical home) screen all infants at no later than 1 month of age (Pediatrics 2007;120:898). Infants who do not pass this screening should have a comprehensive audiological evaluation no later than 3 months of age, and those diagnosed with hearing loss should receive intervention by 6 months of age.

While the number of newborns screened for hearing loss has increased from 38% in 2000, to 95% in 2007, almost half of those who failed the screening did not receive timely follow-up treatment.

The guidelines also call for enhanced speech and language surveillance at each visit, with objective standardized screening of an infant's global development at 9 months, 18 months, between 24 and 30 months, or any time a health care practitioner or parent has concerns about speech/language development. Neonates who are rehospitalized within the first month of life due to conditions associated with hearing loss should receive a repeat screening. The committee also expanded the definition of hearing loss to include neural hearing loss (auditory neuropathy/dyssynchrony).

Members of the JCIH include the American Academy of Audiology, American Academy of Pediatrics, American Speech-Language-Hearing Association, and Directors of Speech and Hearing Programs in State Health and Welfare Agencies. To view the policy statement, visit http:// http://pediatrics.aappublications.org/cgi/content/full/120/4/898/

FDA News

Menactra: Now serving ages 2 to 10

The Food and Drug Administration (FDA) has expanded the approved age range for the bacterial meningitis vaccine, Menactra, to include children 2 to 10 years of age. Produced by sanofi pasteur, Menactra was first sanctioned in 2005 for patients, ages 11 to 55 years, and offers protection against four groups of Neisseria meningitidis.