Table 6.

Proposed timelines for NBHS that integrates physiologic, genetic and CMV screening, confirmatory testing, and habilitation/intervention

Stage	Time frame	Audiologic evaluation	Genetic evaluation	cCMV evaluation	Clinical evaluation
Screening	Prior to discharge from hospital	Physiologic hearing screening	Heel-stick blood sample collected, processed, screening begun	Saliva or urine sample collected for CMV testing	Clinical exam by newborn provider
Confirmation	<1 month of age	Refer with positive physiologic screen results (did not pass)	Genetic results returned (at 1–2 months)	CMV confirmatory testing	Routine examination by primary care provider
Diagnosis	<3 months of age	Diagnostic audiometric testing and evaluation results	Genetic counseling with further genetic testing if indicated	Consider treatment with antivirals if indicated	Examination by otolaryngologist and evaluation/fitting for assistive devices; referral to clinical geneticists and specialists as indicated by genetic testing
Habilitation/intervention	<6 months of age	Repeat audiometry as indicated		Evaluate outcomes of antiviral treatment	Confirm placement of assistive devices Enroll in early intervention programs

CMV cytomegalovirus, NBHS newborn hearing screening.