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What You Need to Know About a Child You Might Adopt

Children in Foster Care

If you adopt a foster child in the United States, the medical information you receive will only be as good as the case records.

Since foster children may receive inadequate health care prior to their placement for adoption, children who have lived in foster homes need a thorough physical exam.

It's also a good idea before the adoption is complete to ask a medical expert to review whatever medical records you can obtain, to ensure that any known medical problems can be handled by your family and your doctor.

Children who have lived in foster care are at risk for developmental delays and mental health issues. Don't be afraid to request psychological evaluations of the child even if the health-care provider doesn't mention them. For information on how older foster children should be evaluated by a psychologist, read “Evaluating Older Pre-Adoptive Children,” available online at: www.apa.org/journals/ pro/pro295428.html.

Health Issues Overseas

Obtaining background medical information can be an especially difficult problem in international adoptions, because the orphanage may know nothing about the child prior to his or her arrival. Also, sometimes children from other countries have illnesses that are not seen often in the United States. In addition, children who have lived in institutions for more than a few months can be severely impacted by the orphanage experience.

Children living in foster care (as opposed to an orphanage) in another country are also at risk for medical problems. For all children adopted internationally, there are increased risks of infectious diseases, exposures to toxins (such as lead) in the environment, and growth and developmental delays. The longer the child lives in an orphanage, the higher the probability that the child will have health or psychological problems later.

If the agency doesn't provide you with enough information, ask the agency to ask their facilitator or the orphanage director for more.

Adoption Alert

If you adopt a child from another country, all medical testing that was done prior to your child's adoption should be repeated by your pediatrician after your child is with your family.

Listen Up!

Unfortunately, some eager adopters seem deaf to the medical information that they're given. Social workers report that sometimes even when adopters are told of a child's possible health problems, they don't necessarily “hear” the information. They are too anxious to adopt to really consider the ramifications of what they're being told.

For this reason, some agencies list possible risks in writing and require adopters to sign these forms in front of a notary.


A genetic predisposition refers to a probability that a child will inherit some feature that occurred in the biological family, from something as simple as blue eyes to far more complicated issues such as alcoholism and mental illness.

Good Genes, Bad Genes

Most of us don't think about any of the “bad” genes that might run in our families. Yet, we all have positive and negative genetic predispositions. Some people inherit a predisposition for high blood pressure, for example. Many experts believe there are inherited predispositions for certain psychiatric problems as well.

Familybuilding Tips

All too often, adopted adults have inadequate medical or genetic background information. You can head off this problem by seeking this data for your child now. Not only will you be able to use the information, but you also can pass it on to your child when he or she grows up.

When people have biological children, they can't selectively choose the good genes that they want and de-select the ones they don't. (Not yet, anyway!) It's pretty much a roll of the genetic dice. Yet adopters frequently want as much genetic information as they can obtain, because they want to control what they will and will not deal with in a child. Keep in mind that although a family history for a particular problem may exist, the birthparents may never actually develop the problem, and the adopted child may not develop it, either. However, if you would have difficulty dealing with a particular condition or illness, for whatever reason, be sure to make this clear to the adoption arranger.

More on: Adoption

Excerpted from The Complete Idiot's Guide to Adoption © 2004 by Christine Adamec. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

To order this book visit the Idiot's Guide web site or call 1-800-253-6476.


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