Medical and Social Information

March 1, 2003

What kind of information should parents receive about a child?

Medical and social information on a child may be sadly lacking in intercountry adoption. However, it is the responsibility of the agency to make every effort to obtain and record as much information as possible about the child’s medical and social history.

Medical information should include:

  • The child’s current height, weight, and head circumference; and should also preferably include previous measurements taken at various intervals to track growth and development;
  • Copies of all medical tests completed on the child; including, but not limited to blood tests for HIV, Hepatitis B and C; and STD’s. Whenever possible, children should receive the most accurate test available in the child’s country–preferably a PCR test for HIV infection. Families should also receive information on medical diagnosis the child has received in-country and a complete medical conducted by a physician.
  • Developmental information. If possible, a Denver Developmental Screening should be done on children. Notes from caregivers, agency employees who have seen the child; or teachers are helpful.
  • Pictures and videotape of the child. The family should receive clear, close-up photos of the child’s face; and also full-body pictures of the child, unclothed if possible, or at least minimally clothed. Photos of the child’s hands and feet are helpful to assist in pre-adoption screening. If possible, videos should show the child engaging in day to day activities and interacting with both peers and adults.

    • Social information should include all available information about the child’s birth family; their reasons for placing the child in care; and the child’s current developmental status. If a child is older, information about the child’s schooling, relationships with peers and teachers, feelings about adoption, and the child’s behavior and personality should also be included. Information about the birth family’s circumstances, living conditions, and medical and social backgrounds can help determine what an older child’s early life may have been like.

    What steps should be taken to ensure the child does not have undiagnosed medical problems?

    Adoptive families should seek out an evaluation by a medical professional; preferably one who has extensive experience in evaluating internationally adopted children. Many agencies provide names of doctors who perform such evaluations.

    Generally, the family will send all available information, including video and pictures, to the doctor, who will then review the information and consult with the family by telephone regarding the child’s health and developmental status. Often, the doctor will request that the agency or orphanage obtain more information on specific concerns. While no one can guarantee a child’s health and development, families should not skip this important step.

    How long should a parent be given to decide if a child is appropriate for their family?

    Agencies should allow sufficient time for a family to review their referral information–a minimum of one week is essential. In some cases, medical evaluation can take a couple of weeks, and parents should not allow their agencies to pressure them into making a decision before they are comfortable. If additional information is requested by a medical professional, sufficient time should be given for the follow-up evaluation as well. Families should never be pressured to take a child who has special needs the family does not feel qualified to handle. Although it can be difficult to say no to a child, adopting a child whose needs are not a good match for the family is unwise for all involved.

    What assurances can agencies give regarding the child’s information?

    The only assurance an agency should give a family is that they have obtained, and delivered, all available information. Agencies should never guarantee the health of a child; that a child will be normal developmentally; or that the obtained information is 100% correct. False assurances do nothing to aid families in making wise decisions about their adoptions. If information is not available, agencies should be able to document their efforts to locate the information.

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