Volume 34 • Number 3 • March 2013
AAP updates guidance on diagnosing, managing acute otitis media
A revised clinical practice guideline from the Academy emphasizes
the need for accurate diagnosis of acute otitis media (AOM) in children
6 months to 12 years of age. Experts agree that the bulging of the
tympanic membrane correlates with an AOM diagnosis. Page 4
AAP News photo by Jeff Knox
Reports address ethics of genetic testing
by Patrick M. O’Connell • Digital Content Editor
In the first statement on genetic
testing by a U.S. professional organization in more than a decade, the
Academy, in collaboration with the
American College of Medical Genetics and Genomics (ACMG), has
tackled the ever-changing ethical,
social and medical issues attached to
The statement, and accompanying technical report, include
detailed recommendations to help
pediatricians shepherd parents and
teens through the complex and
often emotional path associated
with genetic testing.
“This is a really big step forward,” said co-author Lainie F.
Ross, M.D., Ph.D., FAAP, a member of the AAP
Committee on Bioethics.
The policy statement is published in the March
issue of Pediatrics (2013;131:620-622; http://pedi
2-3680), and the technical report is published in
ACMG’s journal, Genetics in Medicine ( www.nature.
tml). Both are titled Ethical and Policy Issues in Genetic
Testing and Screening of Children.
Perils of predictive genetic testing
At every turn, decisions about genetic testing and
screening should be driven by the best interest of the
child, according to the statement. Pediatricians should
make great effort to determine if testing is necessary,
and when it is, clearly explain the ramifications to
the child and parents.
The development of new technologies in the field
of genetic testing has added new wrinkles to the
already thorny issues related to screening, especially
among older children. With these advanced technologies come some potentially perilous situations,
especially if the ethical and emotional issues surrounding decisions on whether to take a genetic test
are not fully considered, the reports state.
Since the Academy’s last statement on genetic testing was reaffirmed in 2004, the stance on predictive
genetic testing is now divided into deciding appropriateness of screening based on whether the testing
is for childhood or adult-onset conditions. The policy
statement recommends against genetic screening in
Chapters Views and News
AAP voices opposition
to loosening state
from the AAP Department of Community,
Chapter and State Affairs
The December tragedy at Sandy Hook Elementary School has reignited the national debate over
gun-safety measures. Though encouraged by the
Obama administration’s pledge to enact stronger
gun laws, AAP chapters and other child safety
advocates realize that state-level action may be necessary to augment any new federal legislation or
policy change addressing firearms.
Pediatricians have long been advocates for gun-safety legislation. The AAP policy statement
Firearm-Related Injuries in the Pediatric Population
/2012/10/15/peds.2012-2481.full.pdf ) recommends that states pass the strongest possible gun
regulations to protect children from deaths and
injuries due to firearms. These measures can include
child access prevention laws that require firearms
to be stored locked and unloaded; bans on assault
weapons and high-capacity magazines; universal
background checks that include screening for mental health conditions and domestic violence complaints; and taxes on firearms and ammunition.
Anne R. Edwards, M.D., FAAP, chair of the
AAP Committee on State Government Affairs,
notes a dichotomy in the approaches states are taking on the gun safety issue, some of which are in
line with AAP policy recommendations and others
that are not.
“While some states have started considering bans
on assault weapons and high-capacity magazines,
other states have taken a different approach, loosening conceal and carry restrictions and allowing
teachers and other school personnel to carry guns
See Guns, page 9
In this issue
Vaccines: What’s new or changed?
In its first update in nearly two years, the Vaccine Status Table
reflects new recommendations or changes. Pages 12-13
Hidden defense costs
Approximately 61% of the total losses incurred by medical professional liability insurers was spent on defense costs and cost
containment expenses. Page 22