Welcome to University of Iowa Health Care Today. When a child is adopted from another country, there are unique issues affecting internationally adopted children and their families including medical, social, educational, and psychological issues. The University of Iowa Children’s Hospital has an International Adoption Health Program to assist new parents with questions and concerns they may have. Dr. Shannon Sullivan joins me now by phone to tell us more about the program. Dr. Sullivan is a clinical associate professor, pediatrician, and director of the International Adoption Health Program at UI Children’s Hospital. Dr. Sullivan,
What are some of the special concerns parents may have when adopting a child internationally?
Children adopted internationally often times have very unique health needs. For example, some of these children come from parts of the world where certain infectious diseases are far more prevalent than here in Iowa. Some of these children have spent variable lengths of time in an orphanage setting, with limited opportunity for bonding and play. So these children might experience problems with sensory integration or attachment to a primary care giver; as well as the concerns regarding growth and nutrition.
Does a medical history generally accompany the child to their new home?
The medical histories that accompany the children can be quite extensive, or they can be very, very minimal. It really depends upon the country of origin, as well as the region within a particular country, or even the specific orphanage where the child resided prior to being adopted.
Who should consider bringing their child to the International Adoption Health Program?
We believe that all children adopted internationally should be evaluated by a health care provider who is familiar with the health care needs of the internationally adopted child.
Do parents need to be referred or can they schedule an appointment when their child arrives?
Parents should definitely contact their insurance provider prior to the visit to see if a referral from their primary care provider is required. They should also inquire about what might be covered from the insurance company and what will not. For example, some insurance providers will cover the visit to our clinic for medical evaluation, but will not cover the immunization. Now in this situation, we will work very closely with the child’s primary care provider and set up an individualized immunization schedule for that child at his or her local physician’s office. Once the family gets the OK from their insurance company that the child can be seen by us, then the parents can call and make that appointment.
What should parents bring with them to the first appointment?
Parents should bring everything that they have related to the medical history of their child. This would include any written report from the orphanage or foster parents. Often times these will detail certain developmental milestones. They should also bring any surgical reports, if any; growth charts; immunization records; results from laboratory testing done; as well as any pictures or videos that might have been taken prior to the child arriving in the United States. I would also suggest that it can be very, very helpful if parents get these materials to the clinics—say a week or so prior to that first visit—so that those of us in the clinic can review them, and this can often times save quite a bit of time at that initial visit.
What should parents expect to happen at the first visit to the International Adoption Health Program?
We call this first evaluation a post-placement medical evaluation and it should be performed within one to two weeks after the child arrives in the United States. This is really a very comprehensive examination to assess any medical issues, growth, nutrition; as well as some developmental screening assessments. We will also review any previous immunization records and make recommendations for future immunizations. At this visit we also screen for medical conditions, as well as infectious diseases of particular concern to international adoptees. Generally this appointment will last approximately one to two hours.
Do visits to the International Adoption Program replace seeing a pediatrician for well care checks or are they in conjunction with the child’s pediatric care?
The International Adoption Clinic does not replace regular visits to the pediatrician or family physician for routine well child care. The International Adoption Clinic is meant to provide a service by helping our community physicians care for these children.
How long does the program follow these internationally adopted children?
We’ll follow children for really however long the family and the local physician would like us to. For some of the internationally adopted children who live here in Iowa City, I also function as their pediatrician and I have seen these children all the way up through school-age years and it’s really fun to watch these children grow.
If someone were interested in scheduling an appointment, where should they call?
I would also like to add that in addition to the medical evaluation that we’ve been talking about, we also have two other services that I’d just like to briefly mention. One is the pre-placement medical record review and this is a review of any information that a family might receive prior to accepting a child. We also offer a multidisciplinary behavioral, emotional, and developmental assessment service. Families can access any of these services by calling 877-686-0031 (toll-free) or 319-353-6900.
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