Laurie C. Miller, M.D., is an Associate Professor of Pediatrics, Director, International Adoption Clinic, Tufts University School of Medicine, Boston. Her book The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers is an excellent guide the the exciting and often mystifying process of adoption answering important questions about how to keep the new family member healthy. In the excerpt below Miller highlights some important questions to ask upon first meeting your child.
Parents usually have the opportunity to meet their child’s caregivers and the orphanage director (usually a doctor) during the adoption process. The following list includes suggested topics to discuss during these meetings. This may be particularly helpful for parents who make two trips to complete the adoption (Russia and Vietnam) or who adopt from Ukraine (where no information is provided prior to travel).
Questions for Caregivers
1. Maternal history
Obstetric history (previous pregnancies, outcome, where are children now? names available?)
Known history of alcohol use? Drug use? Smoking?
Maternal social history, occupation if known
2. Any paternal information, if available
3. Why is child in orphanage?
Relinquishment at birth?
Foundling? Circumstances when child was found? Condition of child when found?
Termination of parental rights (are legal documents available?)
4. Previous placements (hospitals, other settings)
5. Date child entered orphanage
Weight, height, head circumference
Emotional and physical status
6. Health during time in orphanage
Any hospitalizations? (Parents should be aware that children may be hospitalized for relatively minor illnesses.)
Blood tests? (hepatitis B, HIV, syphilis, hepatitis C)
Growth measurements at different ages and currently.
7. Developmental issues? Behavior problems? Emotional problems?
8. Language skills?
9. Any signs of fetal alcohol syndrome or fetal alcohol exposure?
10. For older children
Does the child have friends?
Special interests, activities, or talents?
Fits well into group?
Wants to be adopted? Prepared?
11. Overall opinions about prognosis, recommendations for treatment
1. Observe the child in a familiar environment with known caregivers, peers, and toys. Record behaviors, preferences, responses to environment and people. (Consider acute health issues, time of day, effect of disruption of routines, presence of strangers, etc.)
2. Listen carefully for vocalizations and speech. Your translator can be very helpful in assessing the child’s language abilities. Look for the child’s ability to understand (receptive language), use gestures, and use nonverbal communication.
3. Caregivers may be able to describe the child’s personality and behaviors, the best techniques to soothe and comfort, and the child’s special likes and dislikes. Do the caregivers seem to like the child?
4. Check out the daily routine schedule.
5. Visits over several days are better than a single visit to determine the child’s abilities and function.
6. Caregivers may have specific information about the child’s family, previous visitors, etc.
7. Observe the child’s energy level and attention span
8. Observe self-stimulatory (rocking, head banging) or other unusual behaviors. See if other children in the group also have these behaviors.
9. Observe eye contact and whether the child has emotional interactions with others, and engages others in play.
Things to Bring (and Leave Behind) for Young Children
Simple cardboard books, ball, stacking cups or rings, cause/effect toy, music or squeak toy, unbreakable mirror, photos of you (wear the same clothes when you return), family members, house, and pets.
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