After School Programs
Many children receive most of their recreational experiences through these programs. Coaches can be wonderful mentors and for some families after school programs eliminate some daycare needs.
Audiologist
An audiologist provides intervention strategies and services for individuals with deafness or hearing impairments.
Classroom Teacher
Your child’s classroom teacher is the person who will spend the most time with your child and will know her best. A classroom teacher is a valuable resource for helping identify any educational, emotional or social issues the child may be having in school.
Early Intervention Services
Every state offers an early intervention program to help identify infants and toddlers (up to age three) who may have developmental delays or disabilities. An evaluation is completed to determine the child’s cognitive, physical/motor, speech, language, social, emotional and adaptive development. A physician or the local school district can direct families to those services.
Educational Advocate
An Educational Advisor or Advocate helps parents work with the child’s school. As an additional member of an Individual Education Plan (IEP) team, an Educational Advocate provides additional experience and expertise to get the best outcome for the child.
Occupational Therapist
An occupational therapist is a licensed health professional who provides strategies and services to assist individuals with motor or sensorimotor functions, including fine motor manipulation, self-help, adaptive work skills, and play or leisure skills.
Physical Therapist
A physical therapist is a licensed health professional who works with individuals with motor or sensorimotor functioning in such areas as mobility and positioning.
School Counselor
A school counselor may assist in the identification of a child’s needs and may help to determine appropriate responses.
School Nurse
A school nurse provides medical care during the school day, monitors allergic reactions and may administer medication needed during school hours.
School Psychologist
A school psychologist assists in the identification of a child’s behavioral, social, emotional, educational and vocational needs and helps to determine appropriate responses.
School Social Worker
A school social worker is trained to assess a child’s educational needs including social, emotional, behavioral and adaptive needs. She provides intervention services including individual, group, parent and family counseling and serves as liaison between home, school and community.
Special Education Instructional Specialist
The special education instructional specialist provides ongoing support to special and general education instructional personnel. The specialist helps to identify and plan for the least restrictive environment appropriate for the child.
Speech-Language Pathologist
A speech-language pathologist provides intervention strategies and services related to speech and language development as well as disorders of language, voice, articulation and fluency.
Transportation Specialist
A transportation specialist works with the school district to provide special transportation and equipment for students with disabilities.
Tutoring Services
Many children can benefit from short or long-term use of a tutor. Families receiving federal (and some state) subsidies should look to the schools for help rather than Children and Family Services.
Your agency has an obligation to provide medical information about a child they are referring to you. Any information that is available should be provided to you in English. Do not be surprised though if there isn’t much information.
Some information may not be available depending on the situation: an abandoned child may have no previous history recorded; some orphanages are short-staffed, do not have access to adequate medical services or have failed to document everything. Learn what is reasonable to expect in your situation.
Consult with your medical advisor and make specific requests for more information. If you are traveling to the country, it may be possible to obtain more information while you are there, including photographs and videos. You may even be able to send them back to your medical professional while you are in country.
Talk to your agency about what information has been provided and if additional information can be obtained.
All the information provided about a child should be taken seriously, but it should be reviewed critically. Medical information may be confusing, obscure or simply wrong. Medical diagnoses and terms may be used differently in different countries.
Sometimes specific diagnoses are applied to children to make them available for international adoption or to attract support for the orphanage where they live.
On the other hand, diagnoses made in the country of origin should never be discounted or ignored. Your agency or a medical professional familiar with current trends in international adoption should be able to help with interpreting these records.
- Information is dated; six month or year-old data isn’t very useful
- Unintentionally undiagnosed problems due to insufficient resources available or experience
- Illegibility of hand-written original medical records or photocopies
- Errors in translation or acquisition of data
- Errors in converting from metric system
- Lack of data, including dates, measurements, and description of development
- Misinterpretation of the record by translator who is rarely medically trained
- Lack of standard protocols and terminology
- Inadequate attention to minor congenital abnormalities
- Unclear current status of child
- Failure to demonstrate how a diagnosis was confirmed
- Developmental characteristics considered typical in one culture but atypical in another
TIP: There can be confusion on how dates are listed. For example, is 2/12 February 12th or the 2nd of December? People in the U.S. note them differently than those in most other countries. In some countries, it is not uncommon to find a mix of standards for displaying a date.
The decision you are about to make will affect you for the rest of your life, you don’t want to rush into it. Prior to receiving any referrals, discuss with your agency how much time you’ll have to review them before the country expects an answer. A one day turnaround is not sufficient. You need enough time to contact the international medical expert you chose. It is very helpful to pre-register at an international adoption clinic so that all your preliminary information will be on file when you ask them to consult on a referral.
There may be situations where a rapid decision is necessary; for example, when a country is about to suspend international placements. If this is a possibility, your agency should alert you in advance to the medical issues which you are likely to face. If a rapid decision is necessary, you would then have had time to inform yourself about the health problems that are common in your child’s country of origin.
Choose a physician or clinic which has experience evaluating the medical information of international children. Many of them provide pre-adoption evaluations. They can help alert you to areas of concern, and can help you solicit more information from the birth country.
Your agency should have a list of community and national resources that can assist you in evaluating the medical status of your child.
Consider the circumstances of your child’s birth and upbringing until now, and the conditions in the country she lives in. Children in poorer countries are at increased risk for a variety of infectious diseases, immunizations will be incomplete or non-existent and information may be inaccurate, with little likelihood that additional information will follow.
Even if you have never had a child, you know what a happy, healthy one should look like. If you suspect that a child is not growing and/or developing in a normal fashion, there may be a problem. There are two major exceptions to this general rule—premature infants and children who grow up in orphanages or hospitals. If something seems wrong or you are not comfortable with the information you’ve been given, ask more questions until you know all you need to know.
It is important to choose a child that you are capable of parenting. Before you adopt a child who may have special needs, consider your family’s size, job commitments, income, insurance coverage, general health, and support network. Remember, your whole family as well as your adopted child will enjoy the rewards and suffer the burdens of any adoption decision.
Talk to your agency about the reasons for your decision. They want to place a child with you who is the best possible match for all of you. Any information you provide will help that process.
Turning down a referral is difficult and you may feel guilt or grief over it. Talk to your agency about your feelings. They will help you through it.