Sep 25, 2012
“According to a 2007 National Survey of Adopted Children, about 2% of the U.S. child population is adopted, with 38% coming from foster care and another 38% coming from private domestic adoption. About 25% of children are adopted internationally, according to an American Academy of Pediatrics (AAP)statement.
“Clinicians should teach adoptive parents to be open about the nature of the adoption with their child while still establishing that an adopted family is still a real family, wrote Veronnie Jones, PhD, and Elaine Shulte, MD, MPH, of the AAP’s committee on early childhood and council on foster care, adoption, and kinship care in Pediatrics.
“Children who join families through adoption can have unique medical, educational, developmental or behavioral issues, and it is important for both pediatricians and families to be aware of the psychological challenges that many adopted children experience,” according to the AAP statement.
“Parents should also tell their children through resources and pictures, if possible, “the story of how their family came to be.”
“The authors noted adoptive parents should “model positive adoption language” for their children, including:
- Identifying siblings in the family through adoption as “real siblings”
- Noting that the biological parents did not “given up [the child] for adoption,” but instead made “an adoption plan for a child”
- Not identifying the biological parents as “natural” parents to avoid implying adoptive families are unnatural
- Not identifying the child solely by their race, birth in another country, or adopted status
“Healthcare professionals should discuss with parents pre-adoption health records, including complications in pregnancy, poor nutrition, preterm birth, lack of prenatal care, genetic diseases, alcohol use, substance abuse, early brain cognitive development, and growth trends.
“Pediatricians should make all attempts “to obtain a complete medical and psychological history of the child, particularly in assessing potential special needs of a child” so parents can assess their resources and abilities to meet the child’s needs.
“Psychological and emotional problems facing adopted children, by age, included:
- Age 3: asking questions about what adoption means and more pronounced separation issues or worry that their adoptive parents may leave them like their biological parents
- Age 5: recognizing that his or her peers do not come from adopted families
- Age 6 to 12: internalizing questions about the loss of the biological family and denial of differences with other families or the adoption itself. Children at this age may have self esteem issues due to feeling that some flaw caused them to be put up for adoption, and may also develop problems between peers.
- 13 and older: distance between the adoptive parent and child, intense periods of self- reflection and attempting to shape the child’s identity. Children at this age are also more likely to engage in risk-taking activities, such as unprotected sex or substance abuse.
“Children of school age may also have difficulty with some family history-based school assignments, such as with family trees, availability of biological family information, and potential complications with tracing genetic traits.
“Adopted children also may experience adoption-related feelings of loss, which “may be more rooted in societal expectations of genetically based attachments rather than in any inherent biological loss,” the authors wrote. They may also experience “anniversary reactions” of loss at certain points during the year, such as birthdays, Mother’s Day, and the day they were adopted.
“In families who have adopted a child of a different race or culture, parents should “acknowledge openly the racial differences that exist between their child and themselves,” and the child “should be given the opportunity to learn more about the heritage of the country of his or her birth or of his or her ethnic group.”
[excerpts from an article by By Cole Petrochko, Associate Staff Writer, MedPage Today Published: September 24, 2012Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner] Primary source: Pediatrics
Jones VF and Schulte EE “The pediatrician’s role in supporting adoptive families” Pediatrics 2012; DOI: 10.1542/peds.2012-2261.]
Loi Eberle is an educational consultant, college placement consultant and parent coach.