So then, how do you find healthcare professionals that are understanding of the complexities of adoption? Many physicians, especially pediatricians, have undergone special training in working with adoptive parents and adopted children. If your child was adopted internationally, they may have health concerns that a standard pediatrician may be unable to address. So, how do you go about finding an adoption-friendly doctor? In most cases, Google will do the heavy lifting for you. When our daughter was born, I knew I wanted to see a pediatrician that had experience working with adoptive families. I had enough to deal with having a newborn; I didn’t need to deal with any ignorance from healthcare professionals on top of that! So, I Googled “adoption doctor” and the city we lived in at the time. I was lucky to find a doctor very close to us who had extensive experience working with adoptive families and children that had been adopted both domestically and internationally. It was a relief to know that I had someone who we could bring our daughter to for baby visits who wouldn’t make me want to pull my hair out by asking inappropriate questions.

Some areas you may not be as lucky to find a pediatrician who has this specialization. We moved to a smaller town when my daughter was still a baby, and there is no “adoption pediatrician” in this area. I had to do a little more hunting and ask friends and family for recommendations. Start by consulting the list of pediatricians in your area that are in the network for your insurance. Visit their websites, look at their new patient forms, call their offices, and ask them how many adoptive families they work with. If time permits, make an appointment to visit them without your child and talk to them to gauge how adoption-friendly they are. If you have friends who are adoptive parents who live in your area, ask them who their child sees. 

A second category of “adoption doctor” are specialists who focus their entire practice on working solely with children that have been adopted. Many of them focus even further to specialize on working with newly arrived internationally adopted children. These children, depending on where they are from, will have specialized health concerns such as malnutrition, parasites, or developmental delays that the average pediatrician will not have enough experience with. These adoption doctors usually work for a hospital system and tend to be found mainly in large metropolitan areas. If you live a few hours from an adoption doctor and have adopted a child who has special health care needs, it may be worth it to periodically make the trek to have your child evaluated by an adoption doctor. Adoption doctors can also review children’s files prior to placement to anticipate any healthcare concerns they may have and can help parents decide if they want to accept a match. It can be overwhelming to be matched with a child who is described as having medical or developmental issues, and having an expert who can explain to you what the treatment for those concerns looks like both short and long-term can help you make the decision that is best for your family. Many families who adopt internationally make an adoption doctor their first stop on the way home. Rather than heading straight home, they will spend several days in the city the adoption doctor practices in to have their child triaged by the adoption doctor and start treatment for any health concerns before heading home. These doctors can also recommend competent specialists in your area who you can work with for any of your child’s medical or developmental needs after he or she comes home.

The post Why Should I Use an Adoption Doctor? appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

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. 

The post What Is An Adoption Doctor? appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

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

The post What To Do When Your Child Is Struggling with FAS appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

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.

The post How Do I Help My Child Through RAD? appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

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.

The post 4 Reasons Why Your Child Needs a Developmental Evaluation appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

Plan before you travel. Choose a pediatrician and interview them as soon as you know when you will be bringing your child home. Make sure the office has some experience with international adoption. Sit down with the doctor and talk about the country you’ve chosen and any issues to look for. We had to call the pediatrician while we were in Ukraine to talk to her about what we could expect with our son’s health issues. They were questions we didn’t know to ask beforehand because we had no information on his health. Talking to the doctor allowed us to gather more information while we were in the country. We would have lost that opportunity if we’d waited until we got home.

Gather Information while you’re in the country. You cannot just sign a records release and have all the child’s health history transferred to the new physician. Gather every bit of information you can while you are in the country. Our boys spoke Ukrainian and Russian – we did not. We used an interpreter to talk to them about health and history while we were in country. We talked to the orphanage staff and administrators. We worked to talk to anyone the boys knew.

You will be visiting the embassy doctor before you leave the country. Make sure you pay attention and write down any information you receive. That being said – don’t take the diagnosis they may give as gospel. Items that the embassy doctor thought might be important turned out to be nothing once we got home.

It’s not all true. So – you’ve gathered all the medical history you could while you were in country. Don’t be upset if you find some of it is incorrect. We tittered all the immunizations we were told our boys were given. Some were correct – some were not.

The first visit is a long one – but it’s only the first one. Take all the information you’ve gathered with you for that first visit. Also, bring something for your children to do while you talk. You will have a lot to go over and the children are likely to be worried and bored at the same time. The doctor will do a series of developmental tests, draw blood, do a full examination and schedule follow up visits. For the first six months our boys were home, we were at the doctor often.

As with everything, your attitude will be important for your child’s peace of mind. Our boys did not speak English when they came home. They took cues from my mood. If I was having an adventure they were too.

As with all things surrounding your adoption the doctor’s visit takes a little bit of thought and preparation and provides a wealth of joy afterwards.

What other advice do you have about the doctor after international adoption? What do you with you had known? Share with us in the comments!

The post Visiting The Doctor After International Adoption appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

1. Do your research. Some doctors are very familiar working with adoptees and willing to go the extra mile. They may have to dig a little further and be good at picking up clues. Take your time, and ask to speak with the doctor beforehand. It’s important to find the right fit for you.

2. Ask your family for any information that they might have on your biological family’s health. They may not have much information, but every little bit is a piece of your health puzzle that can help your doctor look for clues. If you are lucky enough to have your health history, bring it in to share with the doctor.

3. Pay attention to patterns. When I started to get sick after I ate I started taking notes. Every single food that made me ill I wrote down. Even though I didn’t have a full biological family history, my doctor was able to use my notes and diagnose me with Celiac’s disease.

4. Don’t let the doctor dismiss you. Let’s face it; some doctors have the bedside manner of an electric chair. Not knowing your medical history can make it harder to get the right diagnosis and treatment. You can get more stressed when you feel that you are being brushed off or ignored. Don’t let yourself be pushed around. Stand firm and either ask for more testing or seek a doctor who will listen to you.

The bottom line is we all want good medical care and caring professionals to help us. Doctor’s visits can be challenging and stressful but they can also be helpful and can get you the treatment you need to be healthy. Don’t be afraid to advocate for yourself to get the compassion and care that you need.

The post How To Handle Adoptee Doctor Visits appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.

When my daughter was about a year old, she developed a pretty nasty cold. It was the first time she’d really been sick, and I was worried about her breathing and the potential of asthma so, I called for an appointment with our family physician. Unfortunately, our regular doctor was not available on short notice, and I accepted their earliest opening with a doctor who was new to the practice. We’ll just call him “Dr. Theraflu” for the sake of anonymity.

I explained to him that my daughter been placed with us as a newborn but that our knowledge of her medical history was somewhat limited, thus my concern that we rule out asthma. From that moment forward, Dr. Theraflu prefaced every single note he entered into her chart with the (audible) phrase, “per adoptive mom.”

“Per adoptive mom, no known allergies.”

“Per adoptive mom, no noticeable change in appetite.”

And so on and so on for the next twenty minutes. It was no longer her breathing that was of greatest concern. It was mine. I was fuming and I can tell you he was one “per adoptive mom” away from death by stethoscope. I was mentally prepared to answer the investigator’s questions.

“How did the stethoscope become tightened around the doctor’s’ neck?”

“Well, officer, per adoptive mom…”

I’m not currently serving a life sentence for murder so, clearly I made it through but I tell you, it was touch-n-go there for a minute.

It’s important to have a physician who is familiar with adoption and not only for the sake of your own feelings (such as in my story). The understanding of limited medical histories, complicated medical histories, as well as a working knowledge of the psychological issues and/or mental health concerns that are most likely to affect adopted children, will make your physician a better advocate for you and your child as they grow. I have found over the years that most doctors (save Dr. Theraflu) are open to learning adoption positive language and willing to put the extra effort into giving your child the individualized care they need and deserve. You just have to ask. Offer to share articles and websites that address your concerns. If they are not willing to meet you halfway, start looking for a doctor who is.

The post Why You Need An Adoption Doctor appeared first on Adoption Doctor | Special Needs Child Adoption, Attachment.