American Academy of Pediatrics Recommends Comprehensive Health Evaluations for all Newly Adopted Children

Families may have little or no information on the child’s medical background but can prepare with guidance from a pediatrician.

Thousands of children are adopted in the United States each year, and many arrive with limited information about their early life, medical history or biological parents. Whether the adoption is domestic or international, each child needs a thorough health evaluation as soon as possible to help identify potential care needs, according to a clinical report published by the American Academy of Pediatrics (AAP).

The clinical report, “Comprehensive Health Evaluation of the Newly Adopted Child,” to be published in the May 2019 issue of Pediatrics (published online April 29), observes that pediatricians are uniquely qualified to help families identify the health needs of adopted children – even before the adoption is complete.

“The physician can help families prepare and work through expected questions and concerns during an early visit, even if they have limited information about the child’s past,” said Veronnie Faye Jones, MD, PhD, MSPH, FAAP, lead author of the report.

“We know that many adopted children have previous chronic illnesses or are at risk for developing physical or mental health problems. Adoptive parents may also need support if there are special circumstances, such as if the biological parents are expected to remain involved in the child’s life.”

About 120,000 children are adopted in the United States, annually, according to the report.

The AAP recommends:

• A comprehensive health evaluation should include a review of the child’s medical history, complete physical examination and necessary diagnostic testing.
• Age-appropriate screenings may include newborn screening panels and hearing, vision, dental and formal behavioral/developmental screenings.
• The child may need to be brought up to date on immunizations, and children adopted internationally should be tested for tuberculosis, HIV, HBV, and sexually transmitted infections.
• Children, whether domestically or internationally adopted, may be at risk for iron, calcium and vitamin D deficiency, due to past dietary inadequacies.

“Children who are adopted from foster care or institutions have often experienced physical and/or psychological trauma or high levels of stress that may affect them in the long term,” said the report’s coauthor, Elaine E. Schulte, MD, MPH, FAAP. “It’s important to recognize these children may need special medical services, mental health support or educational plans.”

The child’s primary care physician can help the family identify and access additional resources during ongoing well-child care and follow-up visits.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds