Physician: What Can We Do to Help International Families Prepare?

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What can the adoption community do as a whole in order to better prepare their families for international adoption?

Child abuse occurs unfortunately too frequently in all cultures, societies and social classes. When an adoptive parent abuses a child, such case brings for worldwide attention. When a alcoholic, drug-using father from some small town somewhere abuses a child, other than a headline in the local newspaper, no one really knows about it. Why then all of the attention to adoptive parents? This occurs because the media feels that it makes for interesting reporting. Which headline sounds better and will bring will bring more television viewers:

  • "Small town alcoholic parent beats his child and places him in the hospital," or
  • "Well-to-do adoptive parents beat their internationally adopted child and place him in the hospital."

The media is what it is, it is a free country and anyone can write what they feel. There is nothing that can be done to lower the radar on adoptive parents in terms of child abuse. Professional can help to prevent child abuse by better preparing their adoptive parents for the challenges that they may encounter, and help them to deal with life's stresses created by their International Adoption, before the parents reaches the point where he may hurt the child.

In order to weed out the potentially bad parents that may be capable to abusing or neglecting a child, the adoption profession needs to have stringent system of check and balances to find a potential case before harm occurs to a child. A number of professions need work together with the adoption agencies to investigate the adoptive parent's background, but more importantly to follow-up on the child even many moths to years after the adoption is complete.

Prior to the adoption, social workers need to interview and weed out the few bad apples. During a home study, the social worker will look into the personal lives of the adoptive parents, look into their child rearing beliefs and determine their psychological readiness. The international adoption process can take a very long time from start to completion. Agencies can use this time to help educate and support their clients. Parents can also use this time to help themselves by reading everything they can about issues pertaining to their adoptive child. Agencies can be more efficient in their educational roles by mandating parents to take child-rearing classes and other classes pertaining to the medical and behavioral problems which may be encountered in the internationally adopted child.

A well-informed parent will be better able to handle a problem when it occurs as opposed to a family who feels that all they need to do in order for a successful adoption is to bring the child home, put him into GAP clothing and give the child lots of love and a good breakfast is all that is required for adoption. This unprepared parent is the one at risk of potentially hurting a child when faced with unusual amount of traumatic stress.

I once received a very disturbing phone call from an adoptive couple in their early 30s who adopted two children at the same time from Russia. One child was 15 months and the other child was 5 years old. The mother called me because the older child was very hyperactive, aggressive, bedwetting and having all sorts of other behavioral problems. She proceeded to mention that she now has to take care of the other child, with feeding, changing diapers while simultaneously dealing with the older boys behavioral problems. These problems were causing undue stress on the entire family unit. She wanted to know if she could return this child back to Russia?

I could understand how toddler issues such as diaper changes and preschool age issues can cause problems for a first time mother. Children are not objects that can be returned to the store. I later called their agency and inquired about the families preparation, and the agency responded by stating “the parents waived their opportunity for parenting classes because they felt they knew everything about raising children" Obviously, if they would have been better prepared, they would have realized that they can only handle one child at a time. Unfortunately, this child had to be taken out of the home and placed with another family in the U.S.A.

Adoption physicians and general pediatricians have a key role in helping the families with their newly adopted children. During the pre-adoption medical record review, a physician may provide some anticipatory guidance and tips on the immediate care of the child after the adoption is finalized. Parents need to educated on how to transition their child from the orphanage to the adoptive family unit.

During the post-adoption medical examination, other than just looking for unknown medical conditions, we need to help counsel parents on how to deal with the emotional and psychological needs of the child before it turns into a medical condition.

All of my successful adoptive families were those people who were educated on the potential medical and behavioral issues that may occur. They expected the worst, hoped for the best and worked with their child. When problems arouse, these parents sought out professional support services in order to help them deal with problems as they arise. By doing so we may be able to make child abuse in the internationally adopted child a preventable condition.

by George Rogu, M.D.

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The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

This material has been provided by, an innovative adoption medicine private practice and educational service, dedicated to helping parents and adoption agencies with the complex pre-adoption medical issues of internationally adopted children. All medical interactions are performed via, e-mail, express mail, telephone, and fax. There is no need to make a live appointment or travel outside of your hometown. For more information, visit or call 631-499-4114.

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