Why You Should Stop Waiting and Switch to the China Special Needs Program

If you have you been waiting for a “healthy” referral from China or are signed up to receive a referral from another country and have been waiting, you may want to consider making a change.  Last year, 2,040 children entered the United States through Intercountry adoption from China.  China remains the largest Intercountry adoption program and the majority of these children are children with special needs.  However, let’s talk about what China considers special needs versus what we here in the US consider special needs.

In the United States, when we hear the term “Special Needs” we usually think of a child in a wheelchair or in a special classroom.  For the sake of adoptions, please know that special needs can certainly encompass those children, but more often than not, these children have a medical condition which made them “undesirable” in China.  First, China does not have a good support system for families who have a child with special needs. Secondly, because of their one-child policy history, most parents desire a “perfect” only child. Any medical condition, even the most minor, will cause the child to be abandoned.  This means children are available for adoption who have repairable heart conditions, cleft lip/palate, club feet, were born premature, have thalassemia, and various other repairable or manageable conditions.

China classifies their children into “Special Focus” and “non-Special Focus”.  Typically, Special Focus children have more moderate to severe special needs and the CCCWA gives us up to 3 months to match those children with families.  The non-Special Focus children are usually younger and have more minor special needs.  The CCCWA only gives us 3 weeks to match these children with families and they can only be matched with families who are logged-in and who have a valid home study and USCIS approval.

__ Pan Xue with pig art June 2011Lately, we have had much success in matching many of our families who are waiting for children with special needs, and because we have expanded our One to One partnerships and are now working with 3 orphanages, we anticipate receiving an increased number of files for children who would be considered non special focus.  These are the children who can only be matched with logged in families who have a valid immigration approval.  We want to encourage those of you waiting in the China traditional program or waiting in another country program with Nightlight to consider the special needs program.  If you are in this position, please contact us to discuss.  Nightlight desires to place waiting children into waiting families and does not desire to see families waiting in other programs.  Because of this, we are willing to credit these NCA transferring families with fees already paid to another NCA program, as much as possible, toward fees due in the China program.

For those of you who have a dossier logged-in through the traditional program, we encourage you to update your home study and apply for a new I-800A USCIS approval so that if we receive files of children with minor special needs, we can at least call you and tell you about them.  As of now, we are prohibited from matching a child with a family if the family does not have the proper government approvals to be matched.   China places this restriction because they want the children to come home to a family as soon as possible.

It can take 3 to 4 months to update your home study and immigration approval for China.  If you are also completing a dossier for China, it will likely take 4 to 6 months to get your dossier logged in so that you are ready to accept a referral.  Don’t delay getting started as soon as possible.

Once you make the decision this is something you will consider, we will have you complete a Medical Conditions Checklist and provide information to help you research various special needs which are commonly seen from China.  You and your family would have an opportunity to review these medical conditions and mark those you would be willing to consider.  When we received the file of a child which meets your preferences, we will call you to discuss and you will have the opportunity to review the file prior to accepting or declining the referral.

If you would like to discuss the possibility of switching to the China Waiting Child program from either the traditional China program or another NCA adoption program, please call or e-mail Stephanie@nightlight.org or Hannah@nightlight.org.

Spina Bifida Occulta: Part II

bigstock_Adorable_Asian_Baby_With_Spark_938600Spina Bifida Occulta (SPO) is considered the least detrimental of the Spina bifida disorders, and is estimated to affect 10-20% of the population, so clearly many people have the disorder and do not know. The children from China or other countries who have no symptoms would not be classified as having special needs. However, there are types of SPO that do have symptoms.

These are the main categories of Spina Bifida Occulta

  • Thickened filum terminal: The spinal cord is too thick.
  • Fatty filum terminale: There is fatty tissue at end of the spinal cord.
  • Diastematomyelia (split spinal cord) and diplomyelia: The spinal cord is split in two and this split is often caused by a piece of bone.
  • Dermal sinus tract: The spinal cord and the skin on the back are connected by what looks like a band of tissue.
  • Tethered spinal cord in which the end of spinal cord is attached in the wrong way and, therefore, becomes stretched
  • Dipomyelomeningocele and lipomeningocele where the spinal cord is attached to a fatty tumor [1] Continue reading

New Home Study and Post-placement Requirements for China Adoptions

The  China Centre for Children’s Welfare and Adoption released some new home study and post-placements requirements. These new guidelines and regulations for the home study go into effect as of October 1, 2011; and those regarding post placement visits and reports apply to families who receive Notice of Coming to China for Adoption after August 1, 2011.

personwritingHome Study

First, you must have a home study completed by a Hague accredited adoption agency. Please contact Nightlight before you begin the home study process so we can advise you as to the selection of a home study agency. (As a Hague accredited agency, Nightlight provides adoption home study services in Southern California, Colorado, and South Carolina.)

China also requires certain applicants — anyone who has a history of alcohol or drug abuse, has experienced emotional loss or trauma or abuse, or is in counseling — to provide a psychological report as part of the home study process. The type of report required and the contents are not specified:  it will be up to the home study provider to determine the type of evaluation that the family may need. For example, emotional loss is a common experience — especially among those who have gone through infertility and possibly miscarriages — and the home study provider will want to address these issues with the couple. If someone has experienced serious trauma and abuse, then it may be more appropriate for counseling to be recommended if certain issues have not been resolved.

Continue reading

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:
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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

Nutrition and the Child from China: Part II

child-smiling-in-schoolOverall, children from China do very well. In one study in looking at children adopted into Canada from China,in which the children on average were 13 months old when they arrived home, they were doing as well as other children in Canada at three years old.(Incidentally, these children arrived home about 10/11 years ago, when orphan conditions were not as good as they are today.) The children’s receptive language skills—even at a very young age—were just as good as other children. The good news is that children’s receptive language skills—which is the ability to understand what others are saying and respond—are related to positive cognitive and social development. Also, by the time the children were about three years old, they had caught up with their peers in their ability to talk, called expressive language skills [1].

So how do children’s language skills relate to nutrition? Children’s ability to understand language is related to the child’s height-to weight ratio as well as the child’s head circumference.A lack of stimulation in the child’s early years in an orphanage can have an impact on physical growth. That means that your child’s growth can be delayed because of lack of stimulation and not just lack of nutrition. The factor that related most to mental development and language skills was the child’s height.In the study of children adopted into Canada, the children from China did have growth spurts, but they stayed a bit shorter than other children their age. The weight of the child seems to have had less impact; in this same study the children’s weight upon arrival home did not indicate a child’s cognitive function at 11 years of age. Continue reading

Nutrition and the Child from China

ChildNutritionIf you listen to the webinar “Food for Thought” on Adoption Learning Partners, featuring Dr. Dana Johnson, you will see that parents are very concerned how the nutritional status of their children may affect their cognitive abilities [1]. What the parents are really asking is, “Will my child be smart, even if my child had a less than optimum diet while living in the orphanage?” The answer is usually “Yes,” but there are a few things you should know.

Overall, children from China have good nutrient status upon arrival home. In one study Dr. Johnson noted the percentage of children from China who were low or deficient in the following nutrients: iodine or selenium (20%), iron (8%); zinc (50%); and vitamin D (13%). None of the children were deficient in vitamin A, folic acid, or vitamin B 12. Of course, this is only one sampling of children [1]. The dates the children came home were not mentioned but, overall, the care of the children in the orphanages in China has been improving.

For nearly all children living in orphanages, the primary concern is getting enough calories and protein for growth and development. In general, babies in orphanages may receive less than adequate nutrition. In some cases, even if they are given plenty of formula, the children’s bottles are usually propped up, so the children may have limited ability and time to get the milk out of the bottles. Continue reading