Pediatrics Article: Comprehensive Health Evaluation of the Newly Adopted Child

You can find the free pdf of the new recommendations for foster care and international adoption initial screen here.

It is disappointing. While they do finally acknowledge some specifics in a mental health screen, they do not mention where or how the adoptive parent should have that accomplished.

“TABLE 6 Behavioral and Mental Health Recommendations
• Review behavior, including past and present concerns
○ Adjustment
○ Fostering of positive relationships
○ Aggressive behavior
○ Hyperactive
○ Impulsivity
○ Internalizing behaviors (withdrawal, anxiety)
○ Sleep issues
○ Feeding issues, including overeating or hoarding food
○ Enuresis
• Document psychiatric medications used currently or in the past
• Document any past psychiatric hospitalizations
• Previous violent behavior or animal cruelty
• Sexualizing behaviors
○ Sexual promiscuity or acting out
○ Excessive or inappropriate masturbation
• Substance abuse
○ Tobacco, alcohol, illicit substances
• Suicide
○ Suicide ideology
○ Previous suicide attempts
• Children need to be monitored for issues related to loss and grief, attachment disturbances,
posttraumatic stress disorder
○ Children may not admit to previous abuse or neglect until they are secure in an adoptive home
○ Even children placed as newborn infants may have issues related to their history of adoption
(ie, identity development) that do not necessarily rise to the level of mental health issues”

Some reviews of this article focus on the need to delay identifying the age of the child as they acknowledge there are falsifications in birth certificates…but there appears to be no questioning of why they is such corruption of the documents.

But the worst advice this article gives is the following:

(1) They want pediatricians to discuss the pros and cons of OPEN ADOPTION with prospective adoptive parents!

“Open adoption describes a continuum of communication between the birth parents and the adoptive family. Pediatricians should discuss with families the extent of communication between the adoptive family and the biological family and provide needed support by identifying potential and real benefits and drawbacks to the relationship.”

Say what???What in the world would THEY know about open adoption and what is a “real benefit and drawback”?Seriously? This is frightening!

(2)The social worker is supposed to be “skilled” in conducting genetic AND medical interviews of the birthfamily!

“The adoption agency social worker (who should be trained appropriately to do a skilled genetic, medical, and prenatal interview) should take an extensive history from the birth parent(s), if possible, and enter these data into the formal medical record for the future adoptive parent.”

Um…shouldn’t the social aspects of the adoption be covered by the SOCIAL worker and the genetic and medical aspects be covered by MEDICAL personnel?

So for that, we award this article as the 2011 REFORM Talk’s Worst Advice Award.