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From 2010 to 2017, the United States experienced a significant increase in maternal opioid-related diagnoses and neonatal abstinence syndrome (NAS). NAS is increasingly being referred to as neonatal opioid withdrawal syndrome (NOWS), as opioids are becoming the most common cause of neonatal withdrawal, whether alone or in the presence of other substances. A major challenge in the field is the lack of a standardized clinical definition of NAS. To address this challenge, the authors convened two modified-Delphi expert panels consisting of national experts on substance-exposed mother-infant dyads. Through these online panels, the authors solicited expert opinion to inform the development of clinical definitions of NAS and NOWS for use at the bedside as part of the U.S. Department of Health and Human Services initiative on NAS. To convene the panels, the authors used ExpertLensTM, a previously evaluated platform for conducting iterative online modified-Delphi panels. Participants provided initial responses to study questions about key components of the clinical definition of NAS and NOWS; reviewed how their responses compared to those of other participants; and revised their responses based on group feedback and discussion, if needed. Eighteen experts provided numeric ratings and free-text comments to contextualize their responses. Simple descriptive statistics, including frequency distributions, medians, interquartile ranges, as well as the RAND/UCLA Appropriateness Method Manual's approach to determining consensus in expert panels were used to analyze rating data, and the authors thematically analyzed the experts' free-text comments.

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To help schools safely return to in-person instruction and expand coronavirus disease 2019 (COVID-19) testing of teachers, other staff, and students, it will be imperative to successfully scale up and spread promising practices from K–12 schools and districts that were early adopters of COVID-19 testing in the fall semester of 2020. This report describes approaches that early adopters of COVID-19 testing in U.S. K–12 schools were using as of December 2020, highlighting key facilitators that made testing feasible, acceptable, and effective in these schools. In the first half of the report, the authors describe the landscape of testing as of December 2020, summarize the benefits and costs of early adopters' testing programs, and offer recommendations to school leaders, district officials, and policymakers for implementing feasible, acceptable, and effective COVID-19 testing in K–12 schools. They then profile COVID-19 testing programs in selected schools, districts, and states, with a focus on describing the practical details of their testing approaches, challenges they had to overcome, and key factors that facilitated their efforts.