International Adoption Medicine (S1:E18)

International adoption and life in an overseas orphanage create unique challenges for children. Their health, growth, development and behavior are all impacted to varying degrees. Years of institutionalization, multiple caregivers, potential neglect and trauma add additional layers of difficulty, especially when children experience these conditions during their most critical years.

Primary care providers (PCPs) who see these children should be prepared to address specific international adoption health problems and behavioral issues. Learning more about pre-adoption reviews and post-adoption evaluations will also be helpful when caring for this unique population of kids.

Listen to our international adoption expert discuss health and behavioral considerations in internationally adopted kids

On this episode of Charting Pediatrics, we're diving into the topic of international adoption and international adoption medicine best practices. We explore how PCPs can support families who are expanding their families through international adoption.

Joining us is Gretchen Domek, MD, Director of the International Adoption Clinic (IAC) at Children's Hospital Colorado, a specialized outpatient clinic designed to evaluate and properly care for internationally adopted children. Dr. Domek is also the Senior Investigator for the Center of Global Health and an assistant professor of pediatrics at the University of Colorado School of Medicine.

In this episode, our experts explore:

• Why international adoptions require a different approach from domestic adoptions
• Why pre-adoption reviews are critical for families, and how providers can provide a realistic picture of the child's health challenges and needs
• The importance of a post-adoption evaluation four to six weeks after the child comes home
• How the IAC at Children's Colorado conducts comprehensive post-adoption evaluations that address health problems and potential international adoption behavioral issues
• Why internationally adopted children should visit the PCP within their first week of arrival in the country
• Expectations and guidelines for conducting a post-adoption evaluation that PCPs can use when evaluating internationally adopted children
• Common health issues to look for in internationally adopted children, such as ringworm, giardia, cleft lip and palate, and others
• Why PCPs should conduct several stool studies
• The most common international adoption behavioral issues including sensory defensiveness, ADHD and other conditions
• The reasons many internationally adopted children have a scarcity mindset around food, plus guidance that PCPs can use to support the family and child
• Methods for adapting to culturally different feeding techniques
• School readiness in internationally adopted children
• The difficulties providers face when determining a child's true age
• Why it's important to limit the number of caregivers an internationally adopted child interacts with, especially in daycare and preschool settings
• Common questions adoptive families may ask and how to respond

Addressing international adoption health and behavioral issues at Children's Colorado

Children in the Rocky Mountain Region who have recently been adopted from abroad are seen by a multidisciplinary team of pediatric experts in our International Adoption Clinic. Services provided include pre-adoption reviews, post-adoption evaluations, specialty medical consultations, nutrition counseling, psychological and neuropsychological consultations, occupational therapy and physical therapy evaluations. Refer a patient to Children's Colorado.