When families adopt an older, special needs or waiting child from the United State Foster Care system they may assume a great deal of testing and evaluations have been done for the child they adopt. The truth is we are dependant on the system and the people who have cared for our child to pursue these evaluations. Many times children have had very little evaluation or identification of medical or mental health issues.
In most cases a child’s records and files are considered confidential until the pre adoptive family has been selected. Foster families generally do not have all the records for the child and will not obtain them unless the state has decided the child will be adopted by the Foster Family.
When the adoptive family has been identified the state will generally hold a disclosure meeting. Where the adoptive parents are given the full history, medical records, copy of original birth certificate and other information including the confidential records.
Some adoptive parents receive the disclosure records and are amazed by the lack of any substance or information there is about the child. It can come as a big surprise how little anyone appears to really know about you new family member.
Depending on the age of the child being placed many adoptive parents expect to find far more then we do. Typically, we receive the records of birth and immunizations and any other known medical information. It can be disheartening to find a child born with illegal drugs in there system has had few if any evaluations about the possible damage the child has received. Some adoptive parents assume a battery of tests and evaluations would naturally have been done. This is not usually the case.
The majority of medical, mental health, and developmental tests given to a child are typically requested by referrals. Meaning someone at some point has asked for these things to be looked at. The sad fact is that all of these tests require effort and care by someone interested in the child’s needs. They are also expensive, time consuming and can take months and years to be completed.
The logistics of all these tests and evaluations can be mind boggling for any loving parent to accomplish. Add to this in most cases our children come from foster homes where several other children live as well, or from very abusive early starts where parents simply failed to meet the child’s basic needs. With well over a half million children in the United States Foster Care system it is unrealistic for an adoptive family to expect much more then the basic facts of a child history.
The best we can do as adoptive parents is review the disclosure information we do receive and look for any issues we might want more evaluations of. We also need to provide our children with time to settle in and be who they really are before we start having a lot of testing done. Clearly getting a new family is stressful and traumatic. We would not want any outcomes to be based on evaluations made during the early period of placement, in some areas. Of course, when we do have any diagnosis or medical issues it would be our responsibility to continue and follow up with any services or treatments a child is already evaluated as needing.
The areas families might start looking for services and evaluations would be physical medical health matters, dental, vision and other areas that are not usually affected by circumstance or trauma. Establishing a good relationship with a pediatrician and have a full physical completed. Depending on the age of the child some post placement therapy may be helpful. As these things are marked off the list the child is much more likely to be settling in and parents are more likely to understand the child better. As you discover issues you may be concerned about you can add the various evaluations you feel are important and would most help your child.
It is very important that as adoptive parents of children from the foster care system we understand the “Full File” is dependant on all those who have cared for the child and reported or asked for services or evaluations.