Special Needs Adoption

China changes course: singles are now able to adopt

international-infant 082412This 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 →

Making the Decision to Adopt a Child with Clubfoot: Part IV

chinese_crawling_boyAfter 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:
Continue reading →

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

young-asian-doctor-filling-out-medical-chartIn 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

clubfeet in castsLast 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 →

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 →

Part III: What Parents Can Do If a Child Has an SPD

DaughterHelpingDadwithTieIf your child is having behavioral problems and seems to have difficulty in every day tasks, you may first want to assess if your child has sensory problems. Many counselors may first require your child to have a complete physical evaluation to rule-out certain physiological and neurological problems. There are self-reporting tests, based on your child’s behavior, which you can take to determine if your child meets one or more criteria of an SPD. EEGs and other brain imaging tests holds promise for making a diagnosis—especially of an auditory processing disorder.

If your child does have an SPD and does require occupational therapy, you will want to be actively involved in the exercises and play. An hour or two per week of therapy will not be as effective as your continuing these learned activities throughout the week with your child. Also, an OT can help you change the environment so that your child can better manage stimuli within your home.

SPDs are often associated with other disorders and disabilities, so other professionals may need to be involved. It is not uncommon for children with SPDs to have other delays and may need to be treated by speech pathologists and other specialists.

Continue reading →

Part II Why Children Develop Sensory Processing Disorders

BabyFeetWhy children develop SPDs is not clearly understood. The brain functions in these children may be different, and there may be a hereditary component to SPDs. Prenatal environment, including an exposure to alcohol stress hormones, may also increase the risk of SPDs.

Certainly early infanthood experiences may be related to SPDs. Babies who have difficulty with sleep and feeding patterns and are unable to calm themselves are more like to have sensory processing problems as toddlers .

Children living in an underprivileged environment, such as orphanages, are also at an increased risk of SPDs. Parents of Romanian orphans reported that 18 % of their children were hypersensitive to stimuli and another 11 % inappropriately under-responded to stimuli. Studies found that children who spent the first 12 months to 24 years in an orphanage had more problem behaviors and were the most likely to have sensory processing problems. Even when the children’s physical needs are met in an orphanage, including good medical care and proper nutrition, the lack of consistent care and stimulation can lead to sensorimotordelays. Continue reading →

Sensory Processing Disorders and Your Child: Part I–Description

This is a Part I in a three part series on sensory processing disorders. On Wednesday, I will address why children develop these disorders and on Friday, you, as a parent, can learn more about what you can do for your child.

flyingMany children adopted internationally have what are known as Sensory Processing Disorders (SPDs). These children have problems processing and appropriately responding to stimuli, such as touch and noise. The SPDs can affect children’s behavior and emotions and may impact their ability to learn and socially function. SPDs are found in 5-10% of non-disabled children and in 40 to 88 % of children with disabilities. It is also more prevalent in children with ADHD.

There are different types of SPDs. Some children overreact to stimuli that most others do not find annoying. These are the kids who cannot stand tags in their clothes or being lightly touched; others may have a “melt-down” if their nails are trimmed or their teeth brushed. If the children have auditory processing problems, they may over react to the vacuum cleaner or other “normal” noises. Others with auditory processing problems can hear just fine but can have difficulty understanding what is being said. These are children who are told, “You are not paying attention.” Continue reading →