Medical Evaluation and Diseases of Children Adopted Abroad

All children from international adoption have a history of exposure to potential health risk factors. Therefore, most of the physical health, neurodevelopmental and social adjustment problems that they present upon arrival, or that may arise in the future, will be the result of exposure to these factors.

The initial medical checkup

The first medical check-up should be carried out within the first three days of the child’s arrival. It is recommended that it be performed by a pediatrician specialized in international adoption medicine. In this medical check-up, the following should be evaluated
– Physical growth. Weight, height and head circumference are determined, compared with WHO or adoptive country reference standards and observed for catch-up growth after 6 or 12 months.
– Nutritional status. Body Mass Index is calculated, arm circumference and skinfolds are determined, and screening for rickets is performed.
– Psychomotor development. In children under 6 years of age, a child development test (Denver, Haizea-Llevant, Battelle) is applied in the first month; it is repeated at 6 or 12 months, at which time the real level of development will be more representative.
– Dysmorphic features. Especially of suspicion of fetal alcohol syndrome.
– Pubertal development. Determining the Tanner stage.
– Chronological age. When in doubt, bone, dental, psychomotor/cognitive and social maturity ages are determined and repeated at 12 months, an appropriate transition period for formal evaluation.
– Immunization status. Immunizations administered in the country of origin are reviewed and matched to those in the adoptive community. However, having a certificate of immunization does not ensure protection against the disease, so in children older than 18 months it is recommended that vaccination serologies be performed.
– Vision and hearing. Of special importance in children with a history of prematurity, prenatal exposure to toxic or infectious agents, neonatal hypoxia, craniofacial malformations, history of frequent otitis or who present a significant neurodevelopmental delay.
– Dentition. Evaluate the integrity of the primary dentition and prevent further damage to the secondary dentition.
– Skin. Identifying infectious-parasitic dermatitis, congenital anomalies, scars and signs of suspicion of previous physical or sexual abuse.
– Cardiopulmonary, neurological, digestive, urinary and orthopedic systems. Identifying pathological signs or symptoms.
– Laboratory tests. There are a series of tests that should be performed in all children and others that will depend on the country of origin, the existence of previous medical reports, age, physical examination and clinical signs or symptoms. Of special importance are the studies indicated to detect infectious and parasitic diseases, since they are frequently observed and there is the possibility of transmission to members of the adopting family or the community.

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The most prevalent health problems

About 80% of children from international adoption have some of the following health problems:
– Delayed physical growth.
– Delayed psychomotor development.
– Iron deficiency with or without anemia.
– Absent, incomplete immunizations or immunizations that did not create protective antibody titers.
– Transient behavioral and adaptive disorders.
– Dermatological pathology.
– Intestinal parasitosis.
– Acute infections of the ENT and respiratory systems.
– Latent tuberculous infection.
– Refractory ocular pathology, amblyopia and strabismus.
– Uncertain chronological age.
– Caries and damage of dental enamel.
– Orthopedic disorders of the lower extremities.
– Fetal alcohol spectrum disorders.
– Hepatitis virus infection (A, B, C).

That is why it is always important to prevent any of these diseases or their development by having a medical check-up.