I know what you are thinking. You are asking yourself “What is an adoption doctor and what does he or she do?” If you are like me, you may not have heard this term before. An adoption doctor is a physician who specializes in adoption. An adoption doctor will help you before, during, and after the adoption. Before you adopt, an adoption doctor can help you interpret the medical records of the child to determine any medical issues the child has had and help you determine if the child is the best fit for your family. During the adoption, an adoption doctor will help you prepare for the child and give you some helpful advice. After the adoption, the adoption doctor will complete a comprehensive physical exam and refer the child to any specialists if needed. 

If you choose to adopt internationally, an adoption doctor will also complete some laboratory screenings, evaluation of growth status, immunization counseling, and developmental screening. It is recommended that you postpone the physical exam for at least 1-2 weeks to allow the child some time to adjust to his/her new family and surroundings. If needed, you can schedule follow-ups to review the development and behavior problems addressed at the initial visit. This follow-up may include monitoring development over time and neurodevelopmental testing as needed.

Now that you know what an adoption doctor does, you probably want to know where you can find one. The best thing to do is talk to your doctor to receive a referral to an adoption doctor. You may also visit this hopkinsallchildrens.org or kidshealth.org to get more information about services. 

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Signs of FAS include (but are not limited to):

• physical abnormalities and deformities including wide-set eyes, small eyes, lowered ears
• vision and hearing problems
• heart defects
• kidney and bone issues
• small head circumference
• slow growth
• brain and central nervous system issues

Children with FAS have poor memory and may have social and behavioral abnormalities. This may manifest with poor performance in school and trouble forming bonds and friendships with peers. These children may have tantrums due to difficulties with changes and routine disruptions. Children with FAS are more prone to angry outbursts and mental illness such as depression, ADHD, and anxiety. Children who do not have obvious FAS symptoms may have difficulty getting a prior diagnosis and may therefore not get the proper treatment needed.

When raising a child with FAS, the first most important step is ensuring a proper diagnosis. Children with FAS can be diagnosed based on the prominent facial features, and/or a known past history of alcohol use during pregnancy. Biological mothers may not disclosure alcohol use to prospective adoptive parents or adoption agencies due to fear of being reported to authorities or losing benefits.

If you suspect alcohol use in pregnancy, or that your child or a child close to you could have FAS, talk to your doctor about your concerns. Children will need to have an evaluation by a pediatrician that will include getting a history and list of symptoms. A child with FAS may not have all of the symptoms, but visiting with various specialists may be necessary to rule out possible secondary disorders. Meeting with a behavioral specialist may help with behavioral issues and meeting with a counselor or psychiatrist may help with mental health illnesses.

If your child has been diagnosed with FAS, it is important to have a good relationship with teachers and your child’s principal to ensure that your child is getting the help and support needed at school. A child with FAS may need special resources to help him or her excel in school. For example, teachers may give additional time to complete assignments in school. 

It is important to find treatment when your child is struggling with FAS. As with many other types of medical disorders, FAS will require a team effort between parents, caregivers, doctors, and teachers. If you believe your child may have FAS and you are not getting the necessary resources and support from teachers and doctors, then keep searching until you find someone who will be an advocate for your child.

The following websites are helpful for parents of children with FAS:

National Organization for Fetal Alcohol Syndrome

Substance Abuse and Mental Health Services Administration

Families Moving Forward Program

Families Affected by Fetal Alcohol Spectrum Disorder

The FASD Trust

Centers for Disease Control

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Take A Break

Don’t feel guilty for taking a break. Everyone needs to recharge their batteries, after all, we are not Energizer Bunnies. Respite is a time when another person cares for your child for a few hours or a few days. You take time off from work and time away from your partner, why not take time off from your child? Find one (or two) consistent, trustworthy, reliable people that understand the complexity of trauma and set up regular times to assist you with your child. If your child is enrolled in a behavioral health clinic in your state, they may be eligible for behavioral health respite. These respite providers are specially trained in the needs of your child. Agencies like CASA or Big Brothers/Big Sisters also have mentorship programs that can really assist your child. Respite also provides a change of pace for your child; sometimes they need a break from you. When your child returns from respite, spend quality and quantity time with your child and let them know you missed them and they are loved.

Take A Vacation

“Are we there yet?”, “I gotta go potty!”, are some of the awesome phrases we all have heard or said on a family vacation. The opposite side of taking a vacation from your child is to take a vacation with your child. Family time outdoors promotes strong bonding. Kids who have attachment issues need this. Even if you think it may be torture, your child needs it. He of she needs to trust you as a caregiver and needs to explore new environments with you, The bottom line is that your child needs time alone with you without the distraction from TV, video games, or computers. 

Take A Class

Wouldn’t it be nice to have a professional therapist on call, whenever you need? About 20-30 years ago, there wasn’t much literature out there on Attachment Disorders. Now there is a proliferation of information on Attachment that you can find through books, websites, magazines, podcasts, radio programs, or webinars.

The following are four experts on attachment who are at the top of their field:

Bruce Perry

Dr. Perry is the Senior Fellow of the Child Trauma Academy and is a nationally known psychotherapist who approaches attachment disorders from the perspective of childhood trauma on the brain.

http://childtrauma.org/

Nancy Thomas

Dr. Thomas is a Therapeutic Parenting Specialist whose books, “When Love is Not Enough” and “99 Ways to Drive Your Child Sane” are essentials in any adoptive parent’s home.

https://www.attachment.org/

Karyn Purvis

Dr. Purvis was the Rees-Jones Director and co-founder of the Institute of Child Development at Texas Christian University in Fort Worth, TX. He is also the creator of Trust-Based Relational Intervention.

www.empoweredtoconnect.org/

The key to helping a kid with RAD is to have a healthy, well-rounded, well-rested, and well-educated caregiver. There is no pill. There is no instant fix. You need plenty of understanding of where the children came from and a positive outlook on his or her future. Don’t give up. Find help today.

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A developmental evaluation is an assessment of a child’s overall development. It measures their performance and how it relates to other children of the same age. Testing includes the measuring of physical capabilities, language, intelligence, and social and emotional skills. Typically a team of professionals will administer tests to ensure accurate outcomes. These evaluations will also come with recommendations to help the child continue to make positive strides toward normal development.

Adopted children often come into their new homes with unknown information related to their pre-adoptive life. The following four reasons explain why a developmental evaluation is necessary to help understand a child’s current level of functioning and future development.

1. Trauma

Losing a parent is traumatic; however, for many adoptive children, it doesn’t stop there. Poor living conditions, abuse, and neglect are just some of the traumatic experiences a child can face in their birth homes. Trauma can come in many different forms and can manifest in children in many different ways. It is extremely important to know as much about the child’s history as possible at adoption. Presenting this information at the developmental evaluation can provide the assessment team with valuable knowledge for future development.

2. Drug and Alcohol Exposure

Children exposed to drugs or alcohol prenatally have a higher probability of experiencing developmental delays. Gaining an initial baseline at adoption is invaluable to indicate normal growth and development patterns. Drugs and alcohol can cause issues such as Fetal Alcohol Syndrome and other physical, mental, and emotional issues.

3. Genetics

Our genes play a huge role in who we are and what we will become. Genetics are not only about how your adopted child looks, but also how he or she grows and develops. If you are lucky enough to know the birth parents, gather as much information as possible about their medical and mental health histories. This information plays a crucial role in your child’s life. In cases where birth family information is not known, the developmental evaluation will create a baseline of information to compare to later on if your child begins to have difficulty.

4. Troubled pregnancy 

Having a child whose birth mother experienced difficulties during her pregnancy could fit under the umbrella of trauma. However, the issue is so important that it requires its own heading. Many do not realize how in utero trauma can be detrimental to a child’s healthy development. Women who place their babies for adoption are typically under a lot of stress during their pregnancies. These stressors can include teen pregnancy, homelessness, lack of proper nourishment, domestic violence, and more. Stress alone can cause a baby’s body to be flooded with cortisol. Cortisol, simply defined, is the stress chemical that creates the fight, flight, or freeze reaction in a stressful situation. Additionally, cortisol regulates a person’s blood pressure, energy levels, sleep/wake cycles, and how your body controls weight. Studies are showing that high levels of cortisol produce reduced fetal growth. A fetus exposed to an extreme amount of cortisol can develop mood disorders such as anxiety or depression later in life.

Now imagine a birth mother who is not receiving proper nutrition or prenatal care, is homeless or has other medical conditions. All of these factors play a role in fetal development which can leave a lasting effect on the child you are adopting.

Often, children who have been adopted struggle with adjustment issues, sometimes other issues can arise. In these cases, developmental evaluations can also be helpful if child behavioral issues that might occur. If you have concerns that your child may not be on track with other children their age, contact your pediatrician and express your concerns.

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