Other Screening Evaluations

• Hearing
 ○ Validate newborn screening when available
 ○ Screen all children if possible, particularly those with risk factors for hearing loss as well as developmental (speech) delays
• Vision
 ○ Eye examination as appropriate for age
 ○ Screening for refraction error as of age 3
 ○ Funduscopic examination for children with birth wt <1500 g
• Dental
 ○ Referral to dentist for all children 12 mo or older
 ○ Earlier referral if evidence of dental caries or abuse via the mouth
• Developmental screening/assessment/interventions
 ○ Timely identification of developmental delays is strongly recommended
 ○ Risk factors include prematurity, illegal drug and/or alcohol exposure, poor prenatal care, institutionalization
  • Formal referral for all children adopted in the newborn period or beyond with risk factors as listed or other concerns
  • Referral for all children adopted beyond the newborn period with risk factors or concerns about development when appropriate.
  • For children adopted internationally, a speech evaluation within a few weeks of arrival home by a speech therapist fluent in the child’s native language is optimal to help reveal gaps in articulation and language processing skills
 ○ Referrals may be made to the early intervention program for children birth through 35 mo of age
 ○ Referrals through the school system for children 36 mo and older with establishment of an Individualized Educational Plan (IEP) when appropriate
 ○ Referral for speech/language, occupational, and physical therapy when indicated
 ○ Children adopted internationally should be placed in an educational setting with flexible placement based on the child’s developmental profile