Reality Check Common Health and Developmental Issues of Internationally Adopted Children Reality Check Common Health and Developmental Issues of Internationally Adopted Children Written by Jody Temple White and Jill Barnhart A collaborative effort between International Family Services and University of Alabama - International Adoption Clinic Special thanks to Richard Price, Michelle Henley, Rachelle Staley for their help with writing, editing and insight. Published by International Family Services REALITY CHECK Contents Table of Contents Introduction to International Family Services (IFS)...............................................5 Welcome .................................................................................................................5 IFS History .............................................................................................................5 IFS Mission Statement......................................................................................5 IFS Code of Conduct..........................................................................................6 Prospective Adoptive Parent’s Responsibility ......................................6 Goals and Objectives of This Course........................................................7 About This Course.............................................................................................7 General Overview of International Adoptions ......................................8 What is an International Adoption? ..................................................8 What Children are Available for International Adoption? ......8 Who is Involved in an International Adoption?...........................8 What is the Process of an International Adoption?................ 10 Graphic 1. IFS International Adoption Process........................ 11 Part One: Health and Medical Risks and Concerns........................................... 12 Introduction........................................................................................................... 12 IFS is pleased Why Do an International Adoption? ........................................................... 12 to present you Child Issues........................................................................................................... 13 Needs of Children Awaiting Adoption.......................................... 13 this training Graphic 1.1. Maslow’s Hierarchy of Needs................................ 13 course. We Special Needs of Adopted Children............................................... 16 hope you find Orphanages and Foster Care............................................................ 17 Life in an Orphanage............................................................................ 18 it helpful as Affects of Malnutrition on Children .............................................. 19 you prepare to Other Conditions Affecting Waiting Children........................... 20 add a very Data on Institutionalized Children................................................. 22 Immunizations ........................................................................................ 22 special child Environmental Toxins.......................................................................... 23 to your family. Traditional Immunization Schedule .............................................. 23 Catch-up Immunization Schedule.................................................. 25 Risk Factors Associated With Adopted Children..................... 25 Maternal Substance Abuse................................................ 25 Genetic Risks........................................................................... 29 Emotional Risks...................................................................... 29 Attachment and Bonding ................................................... 29 Recommendations for Fostering Attachment........... 30 Culture Shock and Loss ...................................................... 32 Culture Shock Symptoms................................................... 33 Behavioral Risks..................................................................... 34 Other Behavioral Issues ..................................................... 40 Summary.................................................................................... 41 REALITY CHECK Contents Part Two: Developmental Risks and Concerns................................................... 42 Introduction......................................................................................................... 42 General Factors Affecting a Child’s Development ............................. 43 Parent Observations of Infant and Toddlers ....................................... 45 General Development of Gross Motor Skills ........................................ 45 Parent Observations of Pre-Schoolers and Kindergarteners ....... 50 Graphomotor and Scissoring Development.......................................... 52 Parent Observations of School Age Children....................................... 53 Assessment at the Point of Referral ........................................................ 56 Assessing Developmental and Treatment Needs .............................. 56 Conclusion.......................................................................................................................... 57 Summary ............................................................................................................... 57 Key Terms ............................................................................................................ 58 Resources ............................................................................................................. 59 Review Questions ............................................................................................. 63 Statement of Completion............................................................................... 63 Bibliography ........................................................................................................ 64 Copyright © 2005 by International Family Services All rights reserved. No part of this book shall be reproduced, stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying, recording or otherwise without written permission for Interna- tional Family Services (IFS). Although every precaution has been taken in the preparation of this book, IFS as- sumes no responsibility for errors or omissions. This is not a legal document and information contained within this book is subject to change without notice. Neither is any liability assumed for damages resulting from the use of information contained herein. For information, address IFS Corporate Headquarters 700 S. Friendswood Drive, Suite B, Friendswood, Texas 77546 REALITY CHECK Introduction Page 5 Introduction to International Family Services Welcome It is a pleasure to present this book to you. It represents thousands of combined hours of research, personal experience, and training. International Family Services (IFS) wants families to be as prepared as possible as they enter into and complete the adoption process. This material is thorough and realistic. As you read it, we encourage you to write down any questions and concerns and review them with your social worker or program director. International Family Services History International Family Services (IFS) was founded in 1991 by Carol and Bob Mardock with the first adoptions coming out of Romania. By IFS Adoption 1994, IFS had grown to two offices, located in Texas and Pennsylvania, Programs: and had completed over 125 adoptions from three countries, Romania, • China Vietnam and Russia. IFS has continued to grow, adding offices in • Russia Arizona, Oregon, California, Kansas, Missouri, Alabama and Michigan. • Guatemala Now, the international adoption programs include countries such as China, Russia, Kazakhstan, Guatemala, India and others. With over • India 3,000 children placed in permanent homes across the country, IFS • Kazakhstan continues to work hard to help families navigate the international • Ukraine adoption process. IFS Mission Statement International Family Services, Inc. (IFS) is a U.S. 501(c)(3) non-profit humanitarian aid organization who mission is to: • Place orphaned and abandoned children in permanent and loving families; • Assist prospective adoptive families navigating the international adoption process; • Provide financial support and aid to orphanages and child welfare organizations who support and care for those children who may never be placed in permanent homes; • Educate and empower adoptive families to successfully transition the child into the family and community; • Serve with respect and dignity, honoring individual choices and cultural differences. REALITY CHECK Introduction Page 6 IFS Code of Conduct IFS is committed to high ethical standards and has instituted a Code of Conduct Statement which applies to all programs we offer. This State- ment is adhered to by all IFS staff, directors, adoption coordinators and Family Hope coordinators. IFS will: • Provide all information regarding a child’s medical, social and be- havior history to families as we receive it. • Advocate for each child with the goal of finding permanent and loving homes. • Relay any critical information in a timely manner. • Work with families to help complete the adoption as quickly as possible. • Keep all family information confidential unless given written per- mission. NOTES __________________