The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers

The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers

The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers

The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers

Synopsis

Since 1989, American families have adopted more than 230,000 children from other countries. Many of these children have lived in crowded conditions, sometimes with poor standards of hygiene, inadequate nutrition, and limited numbers of caregivers. Some suffer from endemic infectious diseases. Upon arrival, practitioners often fail to recognize the unique concerns of this group.
This text provides an overview of the specialized medical and developmental issues that affect internationally adopted children, offering guidelines to the physicians caring for these children and their families before, during, and after adoption. The reader will learn how to advise families prior to an international adoption, how to perform an effective initial screening assessment of the newly arrived child, and how to recognize and manage developmental and other more long-term problems as they emerge.

Excerpt

It has been an extraordinary pleasure of my professional life to care for internationally adopted children and their families. Every pediatrician recognizes the surprising ability of children to overcome illness and misfortune. Nowhere in pediatrics is the incredible resilience of children so obvious as in international adoption. Although it is disheartening to see children live (or in some cases subsist) in orphanages, their transformation after adoption is miraculous. Abandoned children who have suffered multiple adversities change into happy healthy thriving kids by the "simple" act of adoption. The metamorphosis is sometimes visible within days.

The opportunity to work with prospective adoptive parents has also been a privilege. Most prospective parents deeply yearn for a child. It is a joy to behold the fulfillment of these dreams as a family is created or enlarged. The energy, devotion, and love of pre- and post-adoptive parents is unsurpassed.

When I visit orphanages, I often find myself wishing I could write "orders" for each child who lives there. I'd love to write a prescription for each child to have a loving, attentive family. No amount of medical care, education, interventions, or special activities can replace family love. For children from difficult backgrounds, adoption is the perfect remedy.

The medical model sometimes overlooks the importance of this fundamental human need. When I show colleagues the phenomenal growth recovery charts or "before-and-after" photos of recently arrived international adoptees, I'm often asked what was done to evoke such a transformation. Did the child have a medical problem that had been missed? Was a surgical procedure performed? Was some particular medication prescribed? Mistakenly, credit is given to a medical therapy, rather than the most profound intervention of all: adoption. Adoption allows children to belong to a family. It is no news to pediatricians that chil-

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