When the agency or attorney tells you about a child who's already been born, you should be sure to ask plenty of questions about the child's health and her environment.
Here's a sampling of questions you might ask about a child of any age:
- When was the child born? (If unknown, approximately when? Who determined this, and how did they come up with that date?)
- How much did the child weigh as an infant?
- What was the head circumference of the child as an infant? If not available, what is the child's head circumference now? The child's head size is relevant to a physician. A head size that is too small in relation to the child's age or body can mean a problem with brain development. A head size that is too large may mean hydrocephalus (“water on the brain”), and there may be problems with development.
- Does the child appear to be developmentally on track? How does she compare to her peers?
- Can the child hear and see?
- Is the child shy or outgoing? Noisy or quiet?
- Does the child have any siblings? If so, where are they?
- What illnesses has the child had and at what age? What treatments did she receive? Has she had any surgeries? Does she take any medications on a regular basis? If so, what are they and what are they for?
- What is the child's best feature? Biggest problem area?
- Has the child been immunized, and if so, can you obtain the immunization records when you adopt her? (The pattern of immunizations, particularly in children born in the United States, can be indicative of how often the child was seen for health care.)
Growth charts for weight, length, and head circumference are available in most pediatricians' offices.
Usually, the primary source of medical information an adoption arranger receives in a U.S. adoption will be from the birthmother (or pregnant woman) herself. She generally will provide all her current medical information. (If you're adopting your child from another country, the information usually will come through the orphanage director to your agency or attorney.)
But think about this. Were you in pretty good shape when you were 18 or 21? Probably you were healthier then than now! The point is that most birthmothers have not yet encountered serious health problems that they may suffer as they age, including those that may have a genetic basis, such as diabetes and arthritis. So what you really should know are the health conditions of the birthparents' parents, and if possible, other older family members.
Information on birthparents is usually more difficult to obtain in international adoptions. In some cases, the agency may not even know who the birthmother is. You usually can forget about any information on the birthfather. It's still a good idea to ask for this information so that when it can be amassed, adoption arrangers will work to provide it to you.
If the child is older than age two, you might also consider asking the following questions as well:
- Where has the child lived since birth? In how many homes or with how many different caregivers?
- What major experiences have happened to the child—positive or negative?
- Has the child been physically or sexually abused? Has the child been neglected? Neglect can be as bad or even worse than abuse for children. (For example, not feeding a child is a form of neglect. Some children are underfed or even starved.)
- Has the child received any developmental interventions? (Such as speech therapy, physical therapy, or occupational therapy.) If so, from whom, and what were the results?
- Has the child received any counseling or mental health therapy? If so, from whom, for how long, and for what issues?
- Has the child been growing normally? Measurements, including weight, length/height, and head circumference (birth and current) are all helpful to assess a child's physical growth.
Aside from those basic questions, it's important to obtain as much medical background information about the birthparents (and their extended birthfamily) as you can. Unfortunately, much of the information you receive may be sketchy. If a child was abandoned, for example, there's no way to know the medical history of the birthfamily.
When the birthparents are available, however, the adoption arranger usually will provide them with a questionnaire they can respond to about their medical histories. The arranger should also ask for information from the birthparents' parents, if possible.
I strongly recommend that any health information provided on the birthparents and their parents be reviewed by a medical doctor before the adoption is finalized, so that the physician can give an evaluation on possible risks and problems. You can find more names of physicians who are experts in adoption and foster care through the American Academy of Pediatrics at the following Web address: www.aap.org/sections/adoption/adopt-states/adoption-map.html.
Born in the USA
The medical information on a U.S.-born child is only as good as whatever information the birthparents supply to your adoption arranger. The amount of information available may vary due to state law. Some states may require very specific medical information from birthparents, while many others leave the amassing of information up to the arranger.
Ask the adoption arranger for medical history information on both the birthparents and, whenever possible, their parents and other family members as well. Most birthparents are young and healthy when they place their child for adoption, but the health of their parents may provide possible clues to your child's future health. Is there a history of heart disease, cancer, rheumatoid arthritis, or any other serious diseases? If, for example, there is a history of cancer or heart disease, your child's doctor can keep an eye on potential problems.
Sometimes birthparents are not very well aware of the health of their own parents, so ask the adoption arranger if it's possible for him or her to obtain the medical history information directly from the birthgrandparents. If not, the birthparents can be asked to contact the birthgrandparents and request the information. Or a questionnaire can be provided for them to fill out, which may be less threatening than responding to questions from the birthparents or a social worker.