If you’ve recently adopted a child, you’re probably both excited about the new addition to your family and concerned about her health history. While adoption can bring unique health and developmental challenges, you don’t have to face them on your own: Your pediatrician can help you meet your baby’s specific needs. Here are tips from the American Academy of Pediatrics to get your child off to a healthy start:

* Get a medical evaluation. Your baby’s doctor can assess her growth and development and conduct age-appropriate screening tests, such as checking for possible anemia and a visual or hearing impairment. If your child hasn’t been immunized or if no record is available, she’ll get a full series of immunizations. (There’s no harm in repeating shots if the records are unclear.) You can also ask the doctor to review preadoption files, if available, in order to help you understand any current or potential medical, developmental, and mental health needs your baby may have.

* Be aware that international adoptees may have special medical needs. If your baby was born in a foreign country, the pediatrician may screen her for hepatitis B and C, HIV, intestinal parasites, syphilis, and tuberculosis, in addition to standard newborn screening tests. While some foreign-born babies may be malnourished, they usually thrive on a normal diet. These children can also get several illnesses soon after they arrive in a new environment, but this, too, is generally a temporary condition. Finally, babies from certain countries may be at higher risk of exposure to drugs or alcohol in the womb. Your pediatrician can help you anticipate and deal with any related health or developmental issues.

* Prepare for the future. Begin telling your child the story of her adoption now, and make “adoption” and other related words part of your everyday language. Any level of openness you can build when your child is young will help as she gets older and starts to ask questions. Plan to discuss adoption with your child as soon as she’s able to understand, usually around age 3.

* Deal with others. Even when adoption is handled well at home, there may be relatives who aren’t quite as understanding  — especially when a child is of a different race or from another country. If this happens, explain that your baby is as much a part of the family as anyone else. You may not be able to change their mind or correct old-fashioned thinking, but it’s important to show loyalty to your child. Your pediatrician can be a valuable source of support and can refer you to local community resources for adoptive families. The better you understand adoption, the better you can teach your child to be proud of who she is.

Children who are permanently or temporarily deprived of their family environment for various reasons such as poverty, armed conflict, labor exploitation, child abduction and trafficking, are entitled to special protection and assistance from the state. But what are the measures for special protection for these children and what are the measures of assistance provided by the legislators or the judges for them to be placed with nurturing environments away from the domestic abuse and neglect to which the children had been most seriously exposed and have traumatizingly experienced on a daily basis? What really is the governmental approach to the street­children phenomenon—well, the criminal justice approach, meaning children are put behind bars, in secure centers or in dilapidated shelters unfit for human habitation, where they are conveniently forgotten, without their personal documents being cleared for adoption purposes. Oftentimes, whenever there are international conferences and beauty contests held in the country, there are corollary round-ups of children and street vagrants who are imprisoned in city jails and shelters as they are traditionally looked upon as eyesores.

In promoting the adoption of children, promoting a higher level of assistance to and protection of children, which means that the child who has been abandoned and abused should be permanently placed in loving and nurturing families. When families experience the tedious, inconvenient and expensive procedures that child adoption entails, no matter how encouraging the Social Welfare Secretary can be in this regard, the prospective adoptive parents are often discouraged from pursuing their plans to adopt a child.

The United Nations Country Report has emphasized the “double standard” involved in the adoption system. It appears that intercountry adoption, which is administrative in complexion through an Intercountry Adoption Board (ICAB) endowed with quasi-judicial powers, is faster and easier than domestic adoption, which is judicial in nature, thus litigious and adversarial with traumatizing cross-examinations conducted by prosecutors, over-solicitous solicitors, and over-enthusiastic and power-craven Family Court judges. Adoption should be a single continuum, meaning that a child need not wait a minute longer for a permanent placement because of the divisive procedure. When one single Adoption Authority endowed with quasi-judicial powers, such as an expansive ICAB, is legally provided to assume jurisdiction over all adoption and family placement cases, whether intercountry or domestic adoption, guardianship or foster parenting, then the placement of a child with a suitable and nurturing family can be expedited and enhanced. Family dossiers and social case study reports need not get lost in the transmission from one agency or office to another or to a court when the creation of one Adoption Authority would no longer require transmittal of records because it becomes a central repository of all adoption records, and not the various Offices of the Local Civil Registrars or the National Statistics Office.

Foster care is a system by which a certified, stand-in “parent(s)” cares for minor children or young people who have been removed from their birth parents or other custodial adults by state authority.

In most cases, children placed in foster care have been subjected to some form of abuse or neglect, and being removed from familiar surroundings is, in itself, usually highly traumatic. Children in foster care may have nightmares, problems sleeping or eating, and may be depressed, angry, and confused. Many young children in foster care are unable to understand why they have been taken from their parents. Even if a child is in some sense relieved to be out of a home that was dangerous, the child may still miss the parents or legal guardians, and may imagine that there is something he or she must do to get back to them. There is evidence that children from abusive and neglectful homes start to feel better in foster care; however, separation is almost always difficult for children, regardless of the circumstances.

The primary goal of foster care is family reunification. If this is not possible, then an alternative permanent plan is followed.

Reunification with a biological parent is when the child was temporarily removed from the home then reunited back with the biological parent when the state decides the conditions are suitable. This generally includes some older foster children who may be strongly bonded to their family of origin and unwilling to pursue adoption. It also may include cases where children are placed with grandparents or other relatives, where the placement is likely to be permanent but those relatives don’t want to fight the birth parents in court.

Foster parents have the responsibility of helping children and their parents achieve this goal. Foster parenting then, is not a lifetime commitment to a child/adolescent, but a commitment to be meaningful to a child’s lifetime. Foster care often means “families helping families.”

There are two kinds of foster care, the voluntary foster care and the involuntary foster care. Voluntary foster care may be utilized in circumstances where a parent is unable or unwilling to care for a child. For instance, a child may have behavioral problems requiring specialized treatment or the parent might have a problem which results in a temporary or permanent inability to care for the child(ren). Involuntary foster care may be implemented when a child is removed from their caregiver because it is believed such removal is necessary for his/her own safety. A foster parent receives monetary reimbursement from the placement agency for each child while the child is in his/her home to help cover the cost of meeting the child’s needs. The amount of financial assistance typically varies from state to state and even city to city.

The basic requirements for becoming a foster parent generally include that you:
• are 21 years of age, or older;
• are in good physical and emotional health;
• meet state and local requirements for housing safety, space and equipment;
• have the skills, attitude and stamina to effectively deal with the many behaviors and feelings displayed by children and youth;
• have a non-punitive attitude and can demonstrate some level of acceptance toward the birth parents of the children in care;
• can work cooperatively with the representatives of the Department of Human Services and other team members;
• are accepting of the temporary nature of foster care and can help a child transition back to his family or move on to a permanent or adoptive placement.
Children and youth may need foster care placements for a variety of reasons:
• they have been emotionally, physically or sexually abused;
• the physical or mental incapacity of their parents;
• they are abandoned;
• the drug, alcohol or other chemical abuse by their parent;
• the child’s behavioral or emotional problems; or,
• the separation, divorce or death of their parent(s).

Children and youth needing foster care placement come from a variety of social and economic backgrounds; from every race, religion and nationality – and every age from birth to young adulthood.
Half of all foster children spend as much as two years in foster care and are moved from placement to placement at least three times. This leads not only to uncertainty and lack of stability in the child’s life, but some of these placements may be inappropriate for the child’s specific circumstances. This often is due to the lack of qualified, licensed foster caregivers, but it can also occur as a result of inexperienced or overloaded caseworkers trying to get through their caseloads.
Foster care can be difficult for foster parents as well. A child who has been neglected or abused suffers psychological damage that may make him or her withdrawn, immature, aggressive, or otherwise difficult to reach. Children with severe medical and mental problems can tax caregivers. Foster placements sometimes fail because these surrogate parents simply cannot handle the demands of a troubled foster child.

THE ROLE OF THE FOSTER PARENT
How is foster parenting similar to parenting your own children?
• Provide daily care and supervision of a child
• Provide for child’s basic physical needs
• Work with schools, medical personnel, and other professionals
• Guide child’s development in all areas: physical, emotional, social, spiritual, etc.
• Provide structure, rules, and discipline
• Teach values and self-direction
• Model appropriate family relationships

How is foster parenting different from natural parenting?
• Must accept child at a variety of developmental levels which may not match his/her chronological age
• Must accept having only limited time working with the child
• Must accept agency/department involvement and responsibilities
• Must comply with certification standards
• Must keep records
• Must work with birth parents or family (if appropriate)
• Will be able to make only limited decisions
• Must respect confidentiality
• Must respect and nurture the child’s cultural, social and religious background
• Must report changes in family household to the agency
• Must be able to offer flexibility and follow though in caring out the objectives of the case plan (transportation, visitation, therapy, etc.)

How is foster parenting similar to a job?
• Have distinct duties and responsibilities
• Negotiates with “employer” (Department of Human Services)
• Held accountable
• Works with other professionals
• Keeps records
• Maintains confidentiality

How is foster parenting different from a job?
• Involves the entire family
• Requires warm environment, involving love and commitment
• “On duty” 24 hours a day/7 days a week/365 days a year
• Requires high level of job interpretation and autonomy

Unfortunately, the number of foster caregivers has been declining since the mid-1980s as the demand for placements has increased. States have responded by licensing responsible adults who were not married (even divorced men and women) and reaching out to seniors and children’s relatives. In some areas, single mothers make up a large proportion of foster parents.