Hale and collaborators [14] summarize the challenges of 5q-SMA NBS in the USA as follows: (1) deciding whether determining the number of copies of SMN2 should be a state decision, (2) a retrospective systematic analysis will help to better understand the clinical progression in 5q-SMA cases with 4 copies of SMN2, and (3) acknowledging that insurance authorization for treatment can be lengthy, potentially delaying the start of recommended treatment. Here, SMN2 is linked to proximal spinal muscular atrophy.