Prior to adoption |
Preview information on the child (eg, medical records,
prenatal information, family history, videotape of child) |
Advise on supplies to take to pick up the child (eg,
medicines, formula) |
Advise on vaccines, medicines for parents traveling
to a foreign country |
Plan for evaluation of the child upon return |
Refer family to support group for domestic or international
adoption |
Anticipatory guidance for new parents |
Medical evaluation |
Immediate visit (first week) |
Obtain available records, including prenatal and birth
history, growth curves, immunization records, hospitalizations,
results of health screening (eg, lead, anemia), and medications |
Evaluate/treat acute illnesses |
Measure baseline growth; check nutritional status
of the child |
For the foster child, become familiar with key personnel,
including caseworkers and attorneys |
Address any immediate concerns of the family |
Assess immediate family coping and adjustment |
Comprehensive examination (4–6 weeks) |
Complete physical examination: Check for congenital
anomalies, chronic conditions, nutritional disorders |
Screen vision, hearing, dental |
Update immunizations |
Recheck newborn screening if child is under 3 months
old |
Screening medical tests when appropriate to include
complete blood count, lead, iron (look for hemoglobinopathies),
urinalysis, tuberculosis (purified protein derivative), stool ova
and parasites, hepatitis B and C, human immunodeficiency virus,
syphilis, malaria (if appropriate) |
Developmental evaluation: gross and fine motor, communication,
adaptive and cognitive skills, initial behavior and coping responses |
Developmental screen for language, autistic spectrum
disorders, learning and attentional difficulties |
Anticipatory guidance: refer to support groups, appropriate
literature |
Periodic surveillance |
Examine children in sensitive and compassionate settings
(eg, it may be stressful to child if both biological and foster
parents are present at a visit) |
Well-child care, complete and update immunization
schedules |
Monitor own emotional responses to biological and
foster parents and child; avoid being pulled into adversarial relationships
or taking sides |
Monitor growth, nutrition |
Check for late signs of infection |
Close developmental and behavioral surveillance (at
any age) |
Episodic developmental screening using standardized
instruments to detect developmental and/or behavioral problems |
Counsel or refer for developmental or behavioral problems |
Monitor events related to visitation and permanency
planning for the child in foster care and communicate episodically
with caseworkers |
Advocate for the rights and needs for adoptive and
foster children in the educational and legal sectors |