Articles on adoption, foster care, & pediatrics

long line 800 144dpi.jpg

Our Post-Placement Evaluations

Here's what we hope to accomplish during our hour-long initial appointments with new arrivals, ideally scheduled 1-2 weeks after you get home. We then like to see children roughly every 2 months until they've been home 6 months, to closely follow adjustment, growth, and developmental catchup. Our Welcome Home Guide is a printable summary of what we usually cover at our first visit, but here is a quick overview.

History and Physical Examination:

  • Review any newly acquired medical, educational, or institutional records
  • Interview older children, with interpreter
  • Discuss family concerns and adjustment issues including sleep, feeding, and attachment
  • Assess growth
  • Thorough physical examination
  • Developmental screening
  • Screen hearing and vision - hard to accomplish accurately <4 years old, so ...
  • Likely referral for audiology, opthalmology, and/or dental examinations
  • If delays are greater than expected, Early Intervention referral

Immunizations:

  • Immunizations from Korea (and sometimes Guatemala and Taiwan) are generally trusted
  • From other institutional settings, we usually combine checking titers (blood tests of immunity, not reliable <1yo) and repeating immunizations based on the individual child's age and shot record

Lab Workup:

  • Newborn screening panel (infants only)
  • Complete blood count and ZPPH or ferritin (iron deficiency tests)
  • HIV antibody; Hepatitis B panel; hepatitis C antibody (on arrival and 6 months postplacement)
  • Hepatitis A titers (asymptomatic in young children, but can make their older contacts quite ill)
  • Serologic test for syphilis
  • Thyroid function tests
  • Lead level
  • Stool examination for ova and parasites (three preserved specimens - you'll get vials at the visit to collect and drop off)
  • Stool examination for Giardia antigen (one fresh specimen)
  • Urinalysis if growth deficient, symptomatic, or any history of issues
  • Calcium, phosphorus, and alkaline phosphatase levels, if child has signs of rickets
  • If height deficiency is profound, further lab evaluation for short stature
  • Tuberculin skin or blood test (on arrival and 6 months postplacement - this is crucial)