Comprehensive Health Evaluation of the Newly Adopted Child

Abstract

Children who join families through the process of adoption, whether through a domestic or international route, often have multiple health care needs. Pediatricians and other health care personnel are in a unique position to guide families in achieving optimal health for the adopted children as families establish a medical home. Shortly after placement in an adoptive home, it is recommended that children have a timely comprehensive health evaluation to provide care for known medical needs and identify health issues that are unknown. It is important to begin this evaluation with a review of all available medical records and pertinent verbal history. A complete physical examination then follows. The evaluation should also include diagnostic testing based on findings from the history and physical examination as well as the risks presented by the child's previous living conditions. Age-appropriate screenings may include, but are not limited to, newborn screening panels and hearing, vision, dental, and formal behavioral and/or developmental screenings. The comprehensive assessment may occur at the time of the initial visit to the physician after adoptive placement or can take place over several visits. Adopted children can be referred to other medical specialists as deemed appropriate. The Council on Adoption, Foster Care, and Kinship Care is a resource within the American Academy of Pediatrics for physicians providing care for children who are being adopted. Pediatricians have played a significant role in the adoption process, in some cases providing counseling to parents during the preadoption phase and subsequently providing health care for these children. Special needs among adopted children need to be identified so they may be evaluated and treated appropriately. The pediatrician also needs to become knowledgeable about the resources available to help families integrate the new adoptee into the family unit. The purpose of this Clinical Report is to provide the general pediatrician with practical guidance that addresses the initial comprehensive health evaluation of adopted children.

Italian multicentre study found infectious and vaccine‐preventable diseases in children adopted from Africa and recommends prompt medical screening

“…All the children underwent a standard operative protocol, developed by National Working Group for Immigrant Children following international recommendations . The sociodemographic data that were collected included their age on arrival in Italy, their age at their first evaluation, their sex and their country of origin.…”

Assessment of the Clinical and Economic Impact of Different Immunization Protocols of Measles, Mumps, Rubella and Varicella in Internationally Adopted Children

“…However, the performance of serologic tests varies according to the considered VPDs. Limited data suggest that this strategy could be cost-effective for older children [5]. This approach reduces the number of unnecessary injections.…”

Discrepancies Between Protocols of Immunization Targeting Internationally Adopted Children in Western Countries

“…Vaccine documentation is not always available or, when available, can be incomplete or even false. The vaccine documentation's poor reliability has already been described in the literature [10]. It is important to make the immunization status of the child adequate without delay because numerous studies have correlated the immunization records poor reliability with IAC unprotection or under-immunization [10][11][12][13].…”