Almost 22,000 children per year have been adopted internationally. The most common countries of origin included China, Guatemala, Russia, Ethiopia, and South Korea. The adoption process involves many steps. Finding a child, gaining custody, and bringing that child to the United States are only the beginning. Difficulties with international adoption include the absence of a medical history, an incomplete family history, living standards prior to adoption, obtaining a resident visa, and a risk of developmental delays.

Most important is a child’s health. Although children are required to have a medical exam in their host country before traveling, it may not be thorough and key information might be overlooked. Additionally, many international children are not properly vaccinated and still at risk for infections.

Chances of an Ill Child

To ensure an adopted child is healthy, a medical exam is required in the host country. The exam must be performed by a physician specially designated by the U.S. Department of State. The exam generally checks for major infection or contagious diseases, particularly HIV, tuberculosis, syphilis, and any epidemic illnesses that would prevent them from leaving the country.

Although the medical exam looks for serious diseases, it is still considered limited and does not account for all conditions. The main goal of this medical exam is to screen for those contagious diseases, not to give an overall view of a child’s health. Prospective parents are recommended to schedule a doctor’s appointment in the United States within two weeks of the child’s arrival.

The First Physical Exam

Once a child arrives to the United States, a doctor’s visit is necessary, but not the moment they get off the plane. The child has gone through a jolting experience and may need a week or two to become more comfortable. Unless the child shows signs of fever, vomiting, or diarrhea, a trip to the doctor can be arranged within the first two to four weeks.

It is extremely important to have your child checked out. Studies have shown more than half of newly adopted children had a medical condition that went undiagnosed, and more than half of those conditions were infectious.

The medical visit consists of a medical history, physical exam, and laboratory tests. In the physical exam the doctor will evaluate:

• Temperature to determine fever

 

• Ensuring the child is alert, actively participating, and smiling

 

• Evaluation of height and weight in relation to age

 

• Hair texture and color

 

• Examination of eyes and ears

 

• Examining the thyroid in the neck and lymph nodes

 

• Making sure the skin is free of spots and scars

 

• Checking the abdomen for liver or spleen enlargement

 

• Examining the facial features to detect fetal alcohol syndrome

 

• Neurodevelopment examination to ensure a child’s faculties are functioning properly

In addition to the physical exam, a number of laboratory tests will be run to check for both infectious and noninfectious disease.

Infectious Disease Screening

Gastrointestinal parasites can be found in a little over half of all children adopted internationally. It is most common in children from Russia, Eastern Europe, and China. Children are also tested for hepatitis A, B, and C. Hepatitis B is found in up to five percent of internationally adopted children. HIV testing is performed twice, one month apart to confirm a negative diagnosis. A test is also done for malaria.

Tuberculosis is a major concern for children. The risk is four to six times greater than U.S. born children. A tuberculin skin test is performed and repeated three to six months later.

The initial visit to the doctor will reveal crucial health information. Many times, a child will require minor treatment such as immunization, dental work, and aids to help them see or hear better. Rarely, serious problems such as mental retardation will arise. Nutrition is an important part of a child’s growth, so careful attention should be paid to their diet.

Child’s Health History

The information gathered from medical exams and child’s family history can provide insight to their health, but often the information is incomplete. Family history can be difficult to gather if a child has been in foster care. Finding more information requires contacting the foster home or orphanage. It is important to find out about the child’s biological mother. If a history of alcohol or drug abuse is uncovered, it can prepare a family for any potential problems that may arise.

International Adoption Medical Clinic

Several medical doctors and specialized clinics in the United States specialize in international adoption. Their services often go beyond just medical examination. International adoption medical clinics can also help in pre-adoption evaluation, offer referrals for specialists, and review the child’s medical records. These clinics provide a number of adoption resources in one location.

Immunization

In order for a child under the age of 11 to receive their United States visa, the parents must agree to vaccinate the child as soon as possible. Vaccines given in other countries are not considered reliable because they may have been stored improperly or given at the wrong age. It is possible to safely re-immunize in most cases.

A child’s immunity can be tested through their blood to discover what vaccines they need. This can be done for diphtheria, polio, hepatitis, tetanus, measles, mumps, and influenza.

Additionally, new families of internationally adopted children should be immunized against measles, hepatitis A and B, and influenza.