PREADOPTION MEDICAL EVALUATION

The essence of preadoption examination is to help parents to make an informed decision on adoption just on the place. Of course, many of adoptive parents send documents and images directly to the home office of specialists in international adoption for a review via email. But in case of any delays with the answer- time difference, technical problems, lack of time etc. significant problems may arise. In opposite, if you, after talk with an expert, decide not to adopt a child because risks are too high, you have time to see another referral while you are in the country.

It would be a good question if one asks why local orphanage doctor can’t be used as a preadoption expert. There are many reasons for this. One of them is that local doctors are those doctors, who created famous russian medical terms, that are dificult for understanding - please, visit this nice link from Adoptmed. Another reason is low professional level of doctors and/or lack of information about evidence-based medicine and western medical diagnosctic and teratment standards..

Another incredibly important thing about preadoption evaluations is professional approach to the collection of medical information. Every child, especially from an orphanage, has some medical background. It is kept in his medical file. If a health professional is not involved, huge part of information is lost after adoption. When you adopt a child and bring him for the first medical check up in your country, some facts from his medical history may be of paramount importance for the future treatment of his conditions, for instance, some data about delivery process. These details are rarely included in official medical summaries that orphanages prepare for agencies. The only way to get them is to look purposefully for all valuable details. Our experts always try to look at a child as if they were pediatricians, who should take care for the baby with you i.e. we try to put ourselves on a place of your local pediatrician.

Preadoption medical evaluation is usually performed on site i.e. in the orphanage. It typically includes atalk with social worker, a talk with orphanage doctor and medical examinationitself. It is essential to perform the last in an appropriate time, when the child is not hungry and had his day nap already. It will help to perform developmental tests and medical examination. This is especially crucial for toddlers and infants. The examination itself usually takes 30-45 minutes and includes:

• Denver developmental screening test . With use of simple tools we try to see what developmental milestones were reached by the kid. Sometimes children are not cooperative and refuse to “open” themselves- throw cubes and toys, cry when you approach etc. In that case it is wise to ask for his personal caregiver’s help- in the presence of familiar people infants and toddlers usually demonstrate all they can. Standards of Denver testing allow to ask a caregiver if a child can, for instance, “wave bye-bye” due to same reasons. Caregivers are usually open and sincere in their observations.
• Complete physical exam. Regular pediatric check-up of all systems and organs (skin, eyes, nose, throat, heart, lungs, digestive system, sexual organs and nervous system). If possible, weight and height measurements are taken. If not, the recent growth parameters are taken from the chart. Head circumference measurement is taken anyway.
• Fetal alcohol syndrome screening include measurements of philtrum, upper lip and palpebral fissure length using a special lip-philtrum guide and 4 digits diagnostic code (please, visit link for detailed description of the method).
• Talk with a caregiver- this is an essential part of a check up: during an interview one can collect some priceless information about child’s character, behaviour, likes and dislikes, habits, sleep pattern, potty training etc.
• Study of medical information. During this part all data on medical history of a child is collected. It includes data on mother and father health, pregnancy history, birth history, hospitalisations, diseases, laboratory tests and instrumental investigations. Special attention is paid to the reports of speech therapists and psychologists- their professional observation carry unvaluable information. Please, see the sample of a report below.
• Talk with parents. Doctor tries to digest all collected data on a child for the parents in a simple and understandable form. All questions are welcome.

As a result, you get a full picture, which helps you to make an informed decision on adoption just on site. Additionally, you get a full medical report, including growth charts, Denver test and FAS screen. The report is written in accordance with western medical approach and will be highly appreciated by your local pediatrician