Adopting a Child Internationally with Special Needs

The landscape of international adoption has changed throughout the years, with most countries focusing efforts to place children who are considered hard to place. A special needs adoption is defined as adopting a child with an additional need, a sibling group, or an older child. How it is defined can vary from country to country. Definitions and references to special needs can be vastly encompassing and wide ranging. Hard to place children can include older children sometimes starting as young as five or six years’ old who are considered “healthy” or children in sibling groups of varying ages. Sibling groups can be siblings of two, three or even four children that the country’s adoption authority does not want to separate, but who cannot be easily placed with a family. Finally, special needs can also include children with medical needs ranging from slight and correctable medical needs to more severe and lifelong medical needs to children exhibiting behavioral, emotional issues or developmental delays.

Sadly, a child with special needs can be categorized and statistically have a much smaller chance of finding a forever family. They are just as deserving as other children, but for many reasons, prospective adoptive families seek to adopt younger and healthier children. All countries have children who have been orphaned, and are considered hard to place. I have personally seen these children in each country I have visited and in every orphanage and am sadden when I realize some of these children will never realize a family and will age out of the orphanage to a life with little hope.

While your family may not initially think that an older child or a child with medical needs is something that you are open to, it is worth researching. You may be surprised the medical needs of some of the children that results in them being placed on a special needs waitlist or on Nightlight’s waiting child site, Adoption Bridge. Children with a medical need may be younger children and considered special needs due to correctable medical conditions such as cleft lip or palate, being born to a mentally ill birth mother, hepatitis, positive for the Sickle Cell trait as well as more serious illnesses such as HIV, Sickle Cell disease, epilepsy or limb deformities. Medical needs are wide ranging and should be researched fully before a family commits to being open to a child with a specific or medical need.

In most countries, the adoption authority does not want to split sibling groups. This can mean that one older sibling, or the size of the sibling group prevents multiple children from ever experiencing the love and commitment of a family. While it does take a special family to adopt siblings of two children or more, it meets a critical need in international adoption, and allows the sisters and brothers to remain together. In several of our international adoption programs, families who have been open to adopting a sibling group of two, three or even four children have been matched quickly, and the children have been considered healthy.

For families considering adopting older children, children with known medical needs or a large sibling group should not only have done research about the needs that the children potentially have, but should also have a strong support system and fully understand how the needs of the adopted children will impact their family.

Nightlight believes that every child deserves a loving and permanent family, regardless of their age, gender, ethnicity, number of siblings or health status. We are specifically seeking families to adopt a child with special or medical needs in many of our programs, including adoption from Bulgaria, Dominican Republic and Burkina Faso. Nightlight’s Ukraine and Colombia programs are focused on older children and sibling groups and both countries offer hosting programs.

Where to begin? Adoption Bridge connects harder to place children with loving adoptive families willing and able to meet their needs.

To make a donation to help a family overcome the financial barriers of adopting a child with special needs, please visit our donation page or Adoption Bridge.

By: Sonja Brown

Trends in Special Needs Adoptions

Why are there less “healthy” children or mild identified special needs available for international adoption?

Many families come into adoption wishing to adopt a young, healthy child and it is sometimes disappointing when they realize that this is not usually possible. Families sometimes look to international adoption because they want to adopt help a child in need. I have often had families ask me where there is the most need and my answer is always the same; we need families who want to adopt waiting children, which means children with special needs and older children. Why be a waiting family when you can adopt a waiting child?

The first thing I want to explain is how a child becomes available for international adoption.

Child is abandoned, removed from home due to abuse/neglect, or sent to orphanage after death of biological parents.
The first thing that happens: orphanage and authorities look for biological family to care for the child.
If biological family is not found, then the authorities look for a domestic family to adopt the child.
If a domestic family is not found, then the child is available for intercountry adoption.

This means that the children who are available in ANY country for international adoption are children who are older. Most biological and domestic families are willing to adopt younger children who have no special needs. This also means that even if a younger child is available that the child will have some type of special need that is not acceptable to biological or domestic families or requires more medical care than is available in the country. Domestic adoption has become more frequent in other countries which is why international adoption has changed over the years.

Even if a child is physically healthy, many of these children have emotional needs that may require them to see a therapist. The children have undergone a lot of trauma in being separated from biological family, being raised in an orphanage, and then leaving the only life they have ever known. Some children struggle to attach or bond to their adoptive families initially. It takes a lot of time and work on behalf of the family for the child to feel secure in their adoptive family.

Please visit AdoptionBridge.org to see the children currently available through many of our programs. Below are some children currently waiting in our programs:

We also would encourage you to research some special needs further. A good resource for this is http://www.adoptspecialneeds.org/. Many families also seek the opinion from a doctor when looking over the list of special needs. You can either contact your pediatrician or seek out a clinic that specializes in international adoption (contact us if you need help locating one).

Keep in mind that there are many countries where it is possible to adopt older children or younger children with special needs who are not able to advocate for the children on Adoption Bridge. There are many waiting children in these countries as well. Some of these would include India, Burkina Faso, and more.

How COVID-19 Will Impact the Foster System

COVID 19 has quickly swept through the nation as an unparalleled crisis. There is hope that the preventative social distancing steps will continue to protect at-risk health communities. However, this comes at a cost for children who rely on protective adults to keep them safe.

Lengthy school shutdowns have been detrimental for many at-risk children. They rely on school as a haven, a place that provides meals and emotional resources. Having teachers, coaches and school counselors involved in a child’s life help provide touchpoints to identify abuse or neglect that may be going on in the home. School can also often be the safest place for children to be seen and distance themselves from abusive caregivers. With nationwide stay-at-home orders in effect, there are far fewer mandatory reporters who have access to children that may need assistance. This was proven by over the news that there has been over 50% drop in calls made to Child Protective Services (CPS) in Colorado since the beginning of school closures.

Most children coming into the foster system are coming from situations where their parents are struggling with extensive mental health histories, substance abuse or other crisis that are preventing them from having the necessary resources available to provide for their family. COVID-19 will bring an increased need for family support, as many are losing jobs and resources that normally help keep them afloat. When mental health issues and addiction are mixed with a crisis of this kind, it is reasonable to expect a larger than normal increase in the number of phone calls made to The Colorado hotline over the next year as children return to school.

Colorado was already facing a foster care crisis, with not enough foster parents available to provide safe homes and beds for children in need. Now more than ever we need families and individuals to consider foster care or support for those who are fostering. Here are four simple ways anyone can help children in need due to the COVID-19 crisis.

Adopt a foster family- Consider “adopting” a local foster family, Nightlight has over 50 families caring for children who would love the extra support! This can be as simple as mailing encouraging cards and making a meal once a month, to more involved options like helping with laundry or assisting with transportation for kids.

Support Homes for Home a local emergency foster care program- A local program designed to provide stability and a safe landing place for emergency foster placements could use your support. The biggest need is respite care, or childcare within the family’s home, as it provides them a much-deserved and needed break. Learn more about Homes for Hope and other ways to support the program here.

Consider becoming a certified foster home- Learn more about providing a safe space in your own home for children in the foster system. Children are needing families open to temporary, short and long-term foster homes, as well as families open to adopting children who cannot reunify with their families. Email deb@nightlight.org to learn more about your options or check out our website at https://nightlight.org/colorado-foster-care/

Donate your stimulus check towards helping foster children in need- COVID-19 has impacted families in different ways. If you have been fortunate enough to not need the stimulus check to meet your needs, consider donating it to support your local community’s children. Your donation will help provide resources to local foster families as they take on the increased needs of the foster system.

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CDC: Lead Exposure and International Adoption

Neurochemistry and the Adopted Child

Karyn Purvis, a professor at TCU and the author of The Connected Child, discusses how children’s brain neurochemistry can be negatively changed due to early life experiences, causing the child to have learning, social, and behavioral issues. Neurochemicals are the chemicals in the brain that send signals. So if the brain is not sending the right signals this can affect the brain directly as well as the child’s behavior.

There are six major risk factors to a child’s healthy brain development:

Difficult pregnancy:
This can include drugs, alcohol, and a mother’s dealing with stressful situations.
Difficult birth:
If the mother had a prolonged labor in which child was removed harshly by forceps, this can cause bleeding in capillaries in brain.
Early hospitalization:
Usually an infant will have received less touch, disrupted time with mother, painful procedures, and overstimulation due to medical equipment and procedures. This can be experienced as neglect by the infant and the overstimulation can result in impaired sensory response. Continue reading →

Adopting the HIV Positive Child, Part II

Because HIV infection is so serious, and children and adults alike are more prone to other infections, keeping a child strong and healthy is very important. And because children do not have the same reserves as adults, good nutrition is especially important for them. In poorer countries and in orphanages, where children oftentimes receive less than optimum nutrition, their bodies are further compromised and more prone to infection.

That is why in other countries, orphanages dedicated to the care of HIV positive children receive extra funding and attention so that the children can receive the extra medical and nutritional care that they need.

If you are considering adopting an HIV positive child, most likely you are adopting a child who is a true orphan and you will truly be giving a child the gift of life. We at Nightlight will be featuring children from Eastern Europe and Africa who are HIV positive. There are certainly considerations that need be taken before you and your family decide to adopt a child who is HIV positive and you will want to be well educated regarding HIV and AIDS in general and the issues you and a and HIV-positive child will face. Continue reading →

Medical Providers and Therapists for Internationally Adopted Children

If you are adopting internationally, you know that there are two particularly critical times that you want professional medical assistance from someone who knows about international adoption: when you get a referral, and when you come home. Nightlight has compiled a state-by-state listing of Medical Providers that specialize in helping internationally adopted children. The list also includes Therapists we know of that have experience counseling families that have adopted internationally. This guide can be found at our International Adoption Resources page.

Spina Bifida Occulta: Part II

Spina Bifida Occulta (SPO) is considered the least detrimental of the Spina bifida disorders, and is estimated to affect 10-20% of the population, so clearly many people have the disorder and do not know. The children from China or other countries who have no symptoms would not be classified as having special needs. However, there are types of SPO that do have symptoms.

These are the main categories of Spina Bifida Occulta

Thickened filum terminal: The spinal cord is too thick.
Fatty filum terminale: There is fatty tissue at end of the spinal cord.
Diastematomyelia (split spinal cord) and diplomyelia: The spinal cord is split in two and this split is often caused by a piece of bone.
Dermal sinus tract: The spinal cord and the skin on the back are connected by what looks like a band of tissue.
Tethered spinal cord in which the end of spinal cord is attached in the wrong way and, therefore, becomes stretched
Dipomyelomeningocele and lipomeningocele where the spinal cord is attached to a fatty tumor [1] Continue reading →

Clubfoot: Pre-Adoption Assessment of a Child Referral–Part III

In the past two blog posts, we discussed what clubfoot is, the types, and the treatments. Certainly what causes clubfoot may impact the type of treatment your child will receive. So how do you know the severity of clubfoot your child may have?

What treatment, if any, has the child already had in China? What medical services will your child need once here in the US? And how well will your child fare after receiving castings or surgery?

These are all questions you should ask when presented with a referral of a child with clubfoot. At Nightlight, we will answer as many of these questions as possible. Often we may not have all the information on a child, but we can usually get more as it is always our goal to provide our families with all the information present.

Also, you will want to have a child‘s pictures and medical reports sent to an international medical specialist. There are many health care professionals who provide evaluation services as well as post-adoption services once your child is home. Nightlight has an extensive list of health care providers—some who provide assessment services. Contact Michelle@nightlight to send you this list. For a child with clubfoot, you may want someone whose specialty is clubfoot to evaluate your child’s referral pictures and medical report.

Once a physician looks at your child’s record and sees their pictures, the doctor may have more specific questions. This may require our China coordinator to contact the orphanage staff to gather further information– if the information is available. Continue reading →

Clubfoot: Treatments – Part II

Last week we discussed what causes clubfoot. Depending upon what caused the clubfoot and the severity of the clubfoot, there are different levels and types of treatment. For example, if a child has clubfoot because of the child’s position in the womb, then the foot may be adjusted through physical therapy. Nearly all children with clubfoot are treated with serial castings and braces. Those who have other complications, such as spina bifida, may need surgery. Yet, one study showed even children with other medical issues may be able to be also treated through castings and braces, [reference 1] although some studies show that they probably need more intensive treatment. [2]

Treatment usually begins at 1 week old to 2-and-a-half years old.[2] Most children are treated with the Ponseti method, which involves serial castings. These are casts that are put on every week to few weeks; each time the castings go on, they slowly change the position of the foot. [1] For example, a child may have 6 castings done between one and 3 months old. Of course, if your child is in China, he may not be receiving such treatment.

Once the series of castings are done , the child will usually wear a foot adjunction brace to keep the foot in proper position — much as people wear retainers after having braces on their teeth. Like a retainer, these shoe braces are initially worn nearly all the time and then just at night. Continue reading →