Clubfoot: A Special Need of Children from China – Part I

This is part one in a 4-part series on clubfoot.  Next week we will discuss the treatment for clubfoot, the prognosis and what you can expect as a parent of a child with clubfoot.  In addition, we will discuss the types of children who are available and what you can do if you are interested in adopting one of these children who are members of the In His Image program.
clubfeet - infantMany of the more than 2,000 children who are on the China special needs list have clubfoot.  In general, it is condition that can be readily treated and treatment may begin while the child is still in China.

What is Clubfoot?

It is called congenital talipes equinovarus,  and is one of the most common deformities of the lower limbs [reference 1].  It involves the bone and soft tissue, usually causing one or both feet to be turned sideways or upward. In most cases, a club foot twists the top of the child’s foot downward and inward. If it is severe, the foot will look like it is upside down.

This is congenital malformation, which means the child is born with the condition. Talipes equinovarus (TEV) is a type of clubfoot that occurs in 95% of children with the condition. Continue reading

Nutrition and the Child from China: Part II

child-smiling-in-schoolOverall, children from China do very well. In one study in looking at children adopted into Canada from China,in which the children on average were 13 months old when they arrived home, they were doing as well as other children in Canada at three years old.(Incidentally, these children arrived home about 10/11 years ago, when orphan conditions were not as good as they are today.) The children’s receptive language skills—even at a very young age—were just as good as other children. The good news is that children’s receptive language skills—which is the ability to understand what others are saying and respond—are related to positive cognitive and social development. Also, by the time the children were about three years old, they had caught up with their peers in their ability to talk, called expressive language skills [1].

So how do children’s language skills relate to nutrition? Children’s ability to understand language is related to the child’s height-to weight ratio as well as the child’s head circumference.A lack of stimulation in the child’s early years in an orphanage can have an impact on physical growth. That means that your child’s growth can be delayed because of lack of stimulation and not just lack of nutrition. The factor that related most to mental development and language skills was the child’s height.In the study of children adopted into Canada, the children from China did have growth spurts, but they stayed a bit shorter than other children their age. The weight of the child seems to have had less impact; in this same study the children’s weight upon arrival home did not indicate a child’s cognitive function at 11 years of age. Continue reading

Nutrition and the Child from China

ChildNutritionIf you listen to the webinar “Food for Thought” on Adoption Learning Partners, featuring Dr. Dana Johnson, you will see that parents are very concerned how the nutritional status of their children may affect their cognitive abilities [1]. What the parents are really asking is, “Will my child be smart, even if my child had a less than optimum diet while living in the orphanage?” The answer is usually “Yes,” but there are a few things you should know.

Overall, children from China have good nutrient status upon arrival home. In one study Dr. Johnson noted the percentage of children from China who were low or deficient in the following nutrients: iodine or selenium (20%), iron (8%); zinc (50%); and vitamin D (13%). None of the children were deficient in vitamin A, folic acid, or vitamin B 12. Of course, this is only one sampling of children [1]. The dates the children came home were not mentioned but, overall, the care of the children in the orphanages in China has been improving.

For nearly all children living in orphanages, the primary concern is getting enough calories and protein for growth and development. In general, babies in orphanages may receive less than adequate nutrition. In some cases, even if they are given plenty of formula, the children’s bottles are usually propped up, so the children may have limited ability and time to get the milk out of the bottles. Continue reading

Waiver on Vaccines: International Adoption Simplification Act

vaccinationOn November 30, 2010, President Obama signed the International Adoption Simplification Act.  This Act provides the same waiver for  required vaccination documentation for Hague Convention adoptions as is available for non-Hague adoptions.  Effective immediately, I-800 families can follow the same procedure as used by I-600 families to apply for a vaccination waiver by completing a DS-1981 (Affidavit Concerning Exemption from Immigrant Vaccination Requirements) which must be signed and notarized.  The DS-1981 can be downloaded from: The DS-1981 may be revised in the future to indicate that it also applies to Hague cases; until then, the current form will be accepted.
Continue reading

Adoption Seminars in SC, Nov. 18 & 20

Next week, our China facilitator Sabrina Chang and Russia coordinator Kate Zyubenko will be in South Carolina at two adoption seminars, one in Lake Wylie (Nov. 18) and the other in Moore (Nov. 20).

These are very special events featuring the China Special Needs Program, the Russia program, and the Ukraine/Hosting Program.

In addition to our China facilitator and Russia coordinator, we will have a panel of adoptive parents who have adopted from these programs present. Attendees will be able to ask questions to the families.

Hepatitis A vaccinations: new recommendations related to international adoption

Reported by AP on February 25, 2009. (I can’t find the actual recommendation online — if you do, please let me know, and I’ll post it.)

ATLANTA (AP) – A federal advisory panel is recommending hepatitis A vaccinations for everyone who has close contact with children adopted from countries where hepatitis A is common.

That includes Guatemala, China, Russia and Ethiopia – four countries that are currently the major sources of international adoptions.

International adoptees trigger fewer than 1,000 of the estimated 32,000 hepatitis A infections that occur in the United States each year. But the potentially deadly illness has been a tragic surprise for many adopting families, officials said.

The Advisory Committee on Immunization Practices made the recommendation Wednesday. The panel advises the Centers for Disease Control and Prevention.

JCICS issues position statement on I-600A renewals

The Joint Council on International Children’s Services has worked tirelessly to ensure that the spirit of the Intercountry Adoption Act (IAA) of 2000 is honored by the government bodies responsible for implementing it. A particular problem recently has been USCIS’s decision to allow only one renewal of the I-600A pre-approval for families waiting to adopt from China and Haiti. Soon, families who have already renewed once may be required to start their homestudy and other adoption paperwork over again. This requirement will be disruptive and expensive, and as JCICS articulates below, the requirement would be a violation of the intent of the IAA.

Caroline Hope is a member of JCICS, and we, too, urge the USCIS to solve this problem without putting an onerous burden on adoptive families.

Joint Council Position on I-600A Renewals

As previously noted, Joint Council and others in our field have great concern regarding the one-time renewal of I-600A approvals and the impact on Potential Adoptive Parents (PAPs). Following is Joint Council’s assessment and statement on this very important issue facing over 10,000 U.S. families.


U.S. Citizenship and Immigration Services (USCIS) has again confirmed that PAPs with an approved I-600A in a Hague country may only file for a renewal one-time. Thereafter, families must ‘start from the beginning’ and file an I-800A petition.

It is very clear that the authors of the Intercountry Adoption Act of 2000 intended to ‘grandfather’ all I-600A petitions filed prior to the date on which the Hague Convention went into force in the United States (April 1, 2007). At the time the legislation was drafted, the authors did not foresee the lengthy processing time now associated with adoptions from countries such as China and Haiti. Yet the intent was clearly to Continue reading

Al Jazeera, JCICS, and adoption (part 2)

Two days ago I posted about an adoption interview/debate on Al Jazeera’s English network. This post is about the second half of that interview with Tom DiFilipo, President and CEO of the Joint Council on International Children’s Services (JCICS), and Louise Melville, a Care and Protection Adviser for Save The Children.

You can watch the clip of the 2nd half of the interview below, and (if you’re interested) you can read my commentary below the interview. If you cannot see the interview below, you can go to the interview on YouTube.

Part 2:
(Click on the play button in the center of the box or at the bottom of the box to watch the video right here. If you click anywhere else in the box, you will be taken to YouTube’s website.)

Now for my own summary of the inteview’s key points, along with some additional comments of my own:

Anti-Adoption Language

This topic — the language used to discuss international adoption — greatly interests me, especially because Continue reading

Al Jazeera, JCICS, and adoption (part 1)

The English wing of the Arab news network Al Jazeera produced a piece last month about international adoption on their “Inside Story” program: “Guatemala Adoption Scandal” aired on 13 August 2007. The program featured two interviewees who went head-to-head on inter-country adoption: Tom DiFilipo, President and CEO of the Joint Council on International Children’s Services (JCICS), and Louise Melville, a Care and Protection Adviser for Save The Children.

This piece came to my attention not because I’m a regular Al Jazeera watcher, but because Carolina Hope is a member of JCICS, which advocates for international children’s welfare and supports international adoption as a legitimate option for providing permanency to children in need of homes.

I’m dividing this topic into two posts because the television program is available on the internet in 2 segments (and I only have time to blog about one of those today!) You can watch the first clip below, and (if you’re interested) you can read my commentary below the interview. If you cannot see the interview below, you can go to the interview on YouTube.

Part 1:
(If you click on the main box, you will be taken to the YouTube website. If you simply click on the play button at the bottom of the box, you can watch the video right here.)

[09/07/07 update: You can now view and read about part 2 of this interview here.]

Now for my own summary of the inteview’s key points, along with some additional comments of my own:

The Role of Inter-Country Adoptions

In part 1, the interviewer asks Tom and Louise about the role of inter-country adoption in the broader spectrum of solutions available for Continue reading