Evaluate Birth History and Past Medical History
1. Blood-borne pathogens and sexually transmitted diseases, including syphilis, hepatitis B, hepatitis C, and HIV.
2. Children who have been significantly malnourished, have been in institutional care, or who have lived in northern latitudes (where they may not have been exposed to much sunshine) should be tested for rickets.
3. Repeat testing for children adopted domestically at birth if records are unavailable or unreliable, and for all children adopted from another country.
Assess Risk for Diseases
1. Children from orphanages or institutional care should be tested for tuberculosis.
2. Any child who has been adopted abroad should be evaluated for giardia and other stool parasites.
3. A complete blood count should be done to check for anemia. Non-Caucasian children should have a hemoglobin electrophoresis to evaluate abnormalities in the structure of the blood hemoglobin.
4. All children beyond the newborn stage should also have a test done for lead toxicity.
5. A urinalysis can detect kidney disorders and urinary tract infections.
Metabolic Screens
1. In the U.S., all states require testing at birth for metabolic disorders that, if left untreated, will result in mental retardation. Physicians should verify that this testing has been done, or, if results are unavailable, repeat the test. Children under the age of one who have been adopted internationally should have a metabolic screen sent to the Department of Health of the state in which they live.
Validate Immunizations
1. If records cannot be validated, most immunizations can be repeated without harm to the child.
2. Blood testing may be done to examine for antibody protection from previous immunizations.
3. With few exceptions, immunization records of internationally adopted children should not be accepted as written. Vaccines given to orphanages may be old or not refrigerated properly.
Hearing and Vision Screening
1. The American Academy of Pediatrics recommends hearing screening for all newborns and an eye exam in the first six months of life. Whatever your child’s age, screening early for problems will ensure that she is fully able to respond to her new environment.
Developmental Evaluations
1. Children who have lived in foster homes or institutions are at risk for developmental delays.
2. It’s worth assessing a childs psychological needs, too. Is there reason to believe there is a history of abuse or neglect? Its effects may not surface until months or years after your child comes home, so this aspect of your childs health warrants ongoing assessment.
