Event Title

Health Expectations for Internationally Adopted Children

Start Date

7-4-2010 4:00 PM

End Date

7-4-2010 5:30 PM

Description

The goals of this study were twofold: (1) to examine preadoptive health expectations of parents prior to their child coming into the U.S. and compare these to the diagnoses given to the children by their U.S. healthcare physician 6 months after the adoption; and (2) to examine both the types of health care parents anticipated seeking for their adopted children prior to adoption, and which services they actually utilized 6 months after the children were home. One hundred and forty-three adoptive mothers and their children (86 girls, 56 boys; age range = 3 to 129 months; M = 16.44 months, SD = 18.36), for whom both preadoptive and 6-months post-adoption data were available, participated in this study.

Based on pre-adoption information, 49 (34.27%) children were identified with at least one medical problem (as identified by the country of origin), and of those 15 (30.61%) had two or more health issues. The 6-months post-adoption survey indicated that 68 (47.55%) children were identified with at least one medical problem, and of those 28 (41.17%) had two or more health issues. There was a significant increase from pre- to 6-months post-adoption in the mean number of parent-reported medical conditions, t (142) = -3.32, p = .001. Adoptive mothers reported significantly more visual problems; recurrent ear/sinus infections and hearing problems; and intestinal parasites, lice, or scabies 6-months post-adoption relative to their reports at pre-adoption, suggesting that these conditions were unexpected. Other conditions, such as cleft lip/palate, were consistently reported across both time points. There was a trend for over reporting of heart defects and hepatitis B at pre-adoption relative to the information provided 6-months post-adoption, suggesting that these conditions might have been overdiagnosed by the country of origin. Regarding service utilization patterns, nearly 60% of mothers planned on having their child’s healthcare provided solely by their primary care physician. Very few parents (2.7-5.0%) utilized services of an “adoption medical specialist.”As anticipated, pediatric subspecialty care became more commonly used as the number of health issues increased.

Overall, our data suggested that parents were generally well informed. Health conditions, such as heart birth defects, cleft palate, and infectious diseases were anticipated. On the other hand, undiagnosed eye and ear related issues emerged 6 months post-adoption. A lack of a constant caregiver in recognizing health nuances in these children, or a lower index of suspicion and surveillance for these conditions may explain this finding. Similarly, adequate time is needed to confirm failure of the Eustachian tube apparatus, which may explain the increase in the number of recurrent ear infections. Also, while the average age at adoption was about 15 months, the health information available for each child may not have been entirely up to date at the time the parents received the referral. Our data suggest that referral of the child for a hearing evaluation, and pediatric eye exam, as well as counseling of prospective adoptive parents regarding the possibility of undiagnosed medical conditions (i.e., eye and ear problems) may be warranted.

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Apr 7th, 4:00 PM Apr 7th, 5:30 PM

Health Expectations for Internationally Adopted Children

The goals of this study were twofold: (1) to examine preadoptive health expectations of parents prior to their child coming into the U.S. and compare these to the diagnoses given to the children by their U.S. healthcare physician 6 months after the adoption; and (2) to examine both the types of health care parents anticipated seeking for their adopted children prior to adoption, and which services they actually utilized 6 months after the children were home. One hundred and forty-three adoptive mothers and their children (86 girls, 56 boys; age range = 3 to 129 months; M = 16.44 months, SD = 18.36), for whom both preadoptive and 6-months post-adoption data were available, participated in this study.

Based on pre-adoption information, 49 (34.27%) children were identified with at least one medical problem (as identified by the country of origin), and of those 15 (30.61%) had two or more health issues. The 6-months post-adoption survey indicated that 68 (47.55%) children were identified with at least one medical problem, and of those 28 (41.17%) had two or more health issues. There was a significant increase from pre- to 6-months post-adoption in the mean number of parent-reported medical conditions, t (142) = -3.32, p = .001. Adoptive mothers reported significantly more visual problems; recurrent ear/sinus infections and hearing problems; and intestinal parasites, lice, or scabies 6-months post-adoption relative to their reports at pre-adoption, suggesting that these conditions were unexpected. Other conditions, such as cleft lip/palate, were consistently reported across both time points. There was a trend for over reporting of heart defects and hepatitis B at pre-adoption relative to the information provided 6-months post-adoption, suggesting that these conditions might have been overdiagnosed by the country of origin. Regarding service utilization patterns, nearly 60% of mothers planned on having their child’s healthcare provided solely by their primary care physician. Very few parents (2.7-5.0%) utilized services of an “adoption medical specialist.”As anticipated, pediatric subspecialty care became more commonly used as the number of health issues increased.

Overall, our data suggested that parents were generally well informed. Health conditions, such as heart birth defects, cleft palate, and infectious diseases were anticipated. On the other hand, undiagnosed eye and ear related issues emerged 6 months post-adoption. A lack of a constant caregiver in recognizing health nuances in these children, or a lower index of suspicion and surveillance for these conditions may explain this finding. Similarly, adequate time is needed to confirm failure of the Eustachian tube apparatus, which may explain the increase in the number of recurrent ear infections. Also, while the average age at adoption was about 15 months, the health information available for each child may not have been entirely up to date at the time the parents received the referral. Our data suggest that referral of the child for a hearing evaluation, and pediatric eye exam, as well as counseling of prospective adoptive parents regarding the possibility of undiagnosed medical conditions (i.e., eye and ear problems) may be warranted.