Conduct metabolic screens.
In the United States, all states require testing at birth for metabolic disorders that will result in mental retardation if left untreated. Physicians should verify that this testing has been done, or, if results are unavailable, repeat the test. Children under 1 year old who have been adopted internationally should have a metabolic screen sent to their state's Department of Health.
- If records cannot be validated, most immunizations can be repeated without harm to the child.
- Blood testing can be done to examine for antibody protection from previous immunizations.
- With few exceptions, immunization records of internationally adopted children should not be accepted as written. Vaccines given to orphanages might have been old or not refrigerated properly, compromising their effectiveness.
Conduct hearing and vision screenings.
The American Academy of Pediatrics recommends hearing screenings 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.
Conduct developmental evaluations.
Children who have lived in foster homes or institutions are at risk for developmental delays.
It's worth assessing a child's psychological needs too. Is there reason to believe there is a history of abuse or neglect? Its effects might not surface until months or years after your child comes home, so this aspect of your child's health warrants ongoing assessment. Deborah Borchers, MD, FAAP, is the mother of two daughters adopted internationally.