(Also read Adoption and HIV, Part 1: Know the Facts and Adopting the HIV Positive Child, Part II.
You can study and learn lots about the HIV/AIDS, how a child may become HIV positive, how the child will fare, what medications are available, and even how contagious the child is to other family members. But all the facts still do not answer the questions that every prospective adoptive parent must ask: “What is it like to raise an HIV Child?”; “What does the future hold?”; “What will others think?“
Before you adopt a child—any child—it is only natural to consider what the response of friends and family will be. After all, this is one of the steps in the adoption process—telling others.
As with all adoptions, your family members may expect that you will adopt a child who will be like a birth child. But instead of announcing that you are adopting a healthy, newborn infant, you may then be explaining to them that you are adopting a child of another race, an older child, or a child with special needs. Continue reading
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
Many families are now choosing to adopt children who are HIV positive. The children can come from any country, but the majority of HIV positive children come from Africa. About 3 million children in sub-Saharan Africa are infected with the HIV virus, and 90% of all children with HIV come from this region.
Because of parents dying from AIDS there are an estimated 25 million more children who are orphaned.  In Uganda, there are about 2 million orphans. Of those, 1.2 million have lost one or both parents to AIDS.  There are millions more who will become orphans.
In the U.S. and Western Europe, the incidence of HIV infection in children has been drastically reduced due to pregnant women taking what are called antiretroviral drugs, which lower the rate substantially of a mother’s passing on the infection to her unborn child.
Even in poorer countries, such as Uganda, this medication is available. However, many people, especially those in rural areas, do not have access to the medication. Unlike children in Western countries, those in sub-Saharan Africa are much more likely to die from the infection. For these children who do become HIV infected, 50% will die before they reach their second birthday. In fact, the mortality rate due to HIV/AIDS in children under 5 years old has increased by 20-40%.  Continue reading
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  Continue reading
Welcome to the first in a 6-part series on Spina Bifida. In the following posts we will discuss each of the types of Spina Bifida (SB); making the decision to adopt a child with SB; and the treatment and prognosis for these children.
SB is a condition that occurs during the first month of fetal development in which the bones on the child’s back, called the vertebrae, do not fully enclose over the spinal cord. It can be very mild and never noticed or it can be very severe, causing a child to have paraplegia or quadriplegia. It is a neural tube defect, and here in the US, with more women taking folic acid before conceiving and during pregnancy, the incidence of SB has decreased significantly.
In the US, the condition is most common among Whites and least common among Asians. However, in China there are reportedly 200 infants born with SB for every 10,000 births (see footnote); in the US, the incidence is 5-10 for every 10,000 births. Certainly, SB is represented among the more than one million Chinese children born each year with special needs.
There may be a genetic component to SB as well as environmental factors that contribute to the condition. Continue reading
The China Centre for Children’s Welfare and Adoption released some new home study and post-placements requirements. These new guidelines and regulations for the home study go into effect as of October 1, 2011; and those regarding post placement visits and reports apply to families who receive Notice of Coming to China for Adoption after August 1, 2011.
First, you must have a home study completed by a Hague accredited adoption agency. Please contact Nightlight before you begin the home study process so we can advise you as to the selection of a home study agency. (As a Hague accredited agency, Nightlight provides adoption home study services in Southern California, Colorado, and South Carolina.)
China also requires certain applicants — anyone who has a history of alcohol or drug abuse, has experienced emotional loss or trauma or abuse, or is in counseling — to provide a psychological report as part of the home study process. The type of report required and the contents are not specified: it will be up to the home study provider to determine the type of evaluation that the family may need. For example, emotional loss is a common experience — especially among those who have gone through infertility and possibly miscarriages — and the home study provider will want to address these issues with the couple. If someone has experienced serious trauma and abuse, then it may be more appropriate for counseling to be recommended if certain issues have not been resolved.
This week we received two breaking news items from China. The first is that the CCAA, as of February 15, 2011, is now referred to as the China Centre for Children’s Welfare and Adoption (CCCWA).
The greater news, however, is that single women are now permitted to adopt from China. Years ago, when single women could adopt, there were quotas for each agency. Now there are no restrictions as to the number of single women who can adopt. The CCCWA is now permitting single women to adopt the 2,000 or so Special Focus Children – children who have been waiting for a family for more than 60 days.
The requirements for singles are nearly the same as they are for married couples. In addition, the CCCWA knows that these children who are older or have special needs will require more attention and, therefore, requires that single women indicate the extra resources they have in place. Most of the requirements are in line with Nightlight’s conditions as well as good social work practice.
Adoptions from China to the US were at an all-time high in 2005, with nearly 8,000 children finding homes. In 2009, 3,000 children were adopted by US citizens from China. As we are all aware, back in 2005 more babies and non-special needs children were being placed for adoption. Continue reading
After reading about clubfoot and the treatment and outcome for these children, you may then be considering if you have the resources to adopt a child with clubfoot. As nearly all of us would answer if we gave birth to a child with clubfoot, we would definitely be prepared to do what it takes to see that our child got the treatment necessary.
In adopting a child, this can-and-will-do attitude is a plus. But adoption does include choices, and when you are considering adoption, knowing what will work with your family’s lifestyle can make the transition of having a new child in the home much easier. After all, children who come from an orphanage or foster home into new adoptive families can have other adjustment issues as well.
When adopting a child with clubfoot, you may plan on taking your child to an orthopedic specialist, but if your child also has more serious attachment issues, your child may need much more of your time than you anticipated. The type and level of care may be different than what you first envisioned.
So here are some questions you may want to ask if you are considering adopting a child with clubfoot:
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
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. 
Treatment usually begins at 1 week old to 2-and-a-half years old. 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.  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