Most families who adopt waste no time having their children seen by a pediatrician or other appropriate physician. Particularly when children are adopted internationally, there are all sorts of things to rule out and check for (parasites and malnutrition being two we’re still battling, three months later). Those who adopt newborns domestically with known drug and/or alcohol exposure also are typically given a medical care plan at placement, and older, domestically adopted children can have their own medical issues that need to be addressed. A medical evaluation is a crucial first step, but another step that is more often overlooked is a full developmental assessment. With the possible exception of domestically adopted newborns with no known in-utero drug or alcohol exposure, there are many reasons adopted children should be evaluated.

Why assessments are needed

Drug and alcohol-exposed babies get a double-whammy because they must suffer through withdrawal at birth, and many go on to experience long-term complications. Attention deficit-hyperactivity disorder, sensory integration dysfunction and learning differences are among the most frequently observed problems, although some can be so subtle that they aren’t identified until late childhood or beyond. But especially in the area of sensory integration, there are differences that can be observed even in very young babies, and identifying these differences early can help parents and professionals identify appropriate treatment.

For the internationally adopted child, assaults on the developing brain can come from a variety of sources; malnutrition, chronic illness, lack of stimulation and attachment in the orphanage setting, lead exposure, and lack of opportunity for physical exploration, in addition to possible in-utero substance exposure, all have the potential to interfere with a child’s development.

And for older, domestically adopted children, and especially those whose prenatal exposure is compounded by abuse, neglect and multiple foster placements, the impact on the developing brain can be significant.

Within the last five or so years, the numbers of studies looking at trends of developmental delays, speech/language disorders, sensory integration dysfunction, ADHD and learning differences in adopted children have sky-rocketed. The data are revealing that while some children can and do outgrow the delays they come home with, others need skilled intervention to address their delays and learning differences. Identifying and treating children’s developmental delays early is just as important as addressing any medical conditions that exist.

Benefits of assessment

Just like parents who give birth to a child, most of us hope that our adopted child will be able to grow to be a happy, healthy, successful adult. Acknowledging that there may be a problem doesn’t mean that we cause one to rear its ugly head, and this acknowledgement can help us to take the appropriate steps to help prevent and problems from worsening. Just like early and regular weeding of a garden keeps it healthy, early identification and treatment of delays and disorders can prevent greater problems down the road. Ignoring weeds rarely does the trick. (I know, I’ve tried it.) ;)

One benefit of early assessment is being able to obtain a baseline of performance. While it’s important for a newly adopted child to have time to settle into his or her new surroundings, it’s also important that the assessment take place fairly soon after placement so parents have a complete profile that can be compared to in future testing. This is crucial for being able to show that the implemented interventions (if needed) are actually working, and for allowing parents and professionals to track progress in various goal areas.

Another major benefit of assessment is that parents can get access to tools and professionals that can provide ongoing help to their child and family. Adopting a child can be a joyous time, but also a stressful time, and anything that can be done to reduce the stress level is generally a positive thing. If you happen to adopt a child who has significant sensory integrative issues, and they don’t yet speak English, and they scream and cry all day because they can’t stand the way the cute sweater you put them in makes their skin feel like it’s on fire (but you don’t know this!), the seemingly pointless “temper tantrum” has the potential to put a damper on YOUR bonding experience with the child, especially if you have lots of these darling sweaters you hope to dress your new child in. ;) Having an early evaluation can help you figure out the sweater conundrum, as well as provide a way that your child might be able to tolerate her new wardrobe! Studies have shown again and again that children who receive early intervention fare far better than their non-treated peers down the road.

Accessing an assessment (and qualifying for services – more about that in a moment) can also connect you with resources you may not have considered. In addition to access to evaluating and treating therapists, many families can get funding for therapy equipment, for attending conferences and courses dealing with their child’s needs, and for covering therapy expenses not covered by insurance. Early intervention programs generally provide case management services, and these professionals help with anything to identifying goals and funding, to providing transportation, to assisting with transitions into school-based services, to obtaining respite care for families.

continued