Toddler Adoption: Issues and Disorders to be Informed About

Adoptiong a toddler is a wonderful way to build a family. But if you want to adopt a toddler, either through your state’s child welfare system or from another country , the reality is there are some medical, physical and psychological issues that you may run into. Along with those issues come a lot of unfamiliar terms that may seem scary to a new parent. Here are just a few:

Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) . . . Probably everyone has heard of ADHD, which affects a child’s ability to concentrate or stay calm. But the condition is even more important in the world of adoption, because many youngsters “in the system” have been diagnosed with ADHD, even though the American Academy of Pediatrics says it can’t reliably be diagnosed under the age of 6. Make sure your rambunctious or spirited toddler is not being labeled incorrectly due solely to his or her social or ethnic background. Treatment includes medication, and sometimes counseling. Also important to consider, there are recent studies that show what appears to be ADHD in younger children may actually be a form of rapid-cycling early onset bi-polar disorder.

Autism . . . It’s a developmental disability that typically appears during the first three years of life. It’s more prevalent in boys than girls. The disorder makes it hard for them to communicate with others and relate to the outside world. Autistic children often take comfort in patterns, either in speech or mannerisms. The cause is unknown, but aggressive early therapy can reverse some (though not all) of the worst symptoms. Early socialization therapy especially seems to help children with a milder form of autism, known as Aspergers Syndrome

Cerebral Palsy (CP) . . . CP is a muscle control problem that results from brain damage, usually occurring either before, during or shortly after birth. Everyone can picture in their mind the “typical” person with CP . . . confined to a wheelchair and unable to speak. But CP can also be very mild, manifesting in just minor balance and speech issues. Physical therapy can help children with CP live a more comfortable life.

Cognitive Disability . . . This used to be called “Trainable Mentally Handicapped”. Cognitive disability means a child learns more slowly than his peers.

Developmentally Delayed . . . Children with developmental delays can’t understand or do the same things other children their age can do. Developmental delays show up a lot in toddlers adopted from other countries, due to the institutionalized settings they come from. But over time, with proper treatment, the delays often disappear.

Developmental Disability (DD) . . . A developmental disability is a severe, chronic condition caused by mental or physical problems. Specialized therapy and training can help babies and toddlers with a DD live better lives. But people with developmental disabilities often need life-long help with self-care, language, mobility and other issues that most people take for granted.

Down Syndrome . . . This life-long condition results from a chromosome disorder that interferes with the intellectual and physical development of a child. There are also common physical attributes, including a small head, large tongue, short/stocky body, and poor muscle tone. But a good home environment and early intervention can have a positive effect on toddlers with Down Syndrome. If you adopt a toddler with Down Syndrome, ask your pediatrician for a referral to a cardiac specialist, since many of these children can have hidden heart defects.

Drug-Exposed . . . Pre-natal exposure to drugs, legal or illegal, can put a baby at risk for physical and developmental disabilities. Many children are not significantly affected by pre-natal drug abuse, and researchers who once sounded a warning about “crack babies” in the early 1990’s are now backing away from their earlier statements. But some drug-exposed babies are born prematurely or with low birth weight, and others have behavior or learning problems that persist throughout life. Basically, it’s a crap-shoot whether a drug-exposed infant will turn into a troubled toddler or terrific two-year-old.

Early Intervention . . . Thanks to federal and state laws, early intervention programs (also called Zero To Three) are available free for just about anyone. It’s a great idea to get your newly-adopted baby or toddler screened for developmental issues as soon as possible. Call your local school district or your caseworker for more information.

Fetal Alcohol Syndrome (FAS) . . . Pre-natal exposure to alcohol is one of the most horrific (and preventable) forms of child abuse. Common symptoms include mental retardation, low birth weight, small size, central nervous system problems and special facial characteristics. Toddlers with FAS can’t make connections between cause and effect, have poor impulse control (even poorer than the average toddler) are hard to discipline, and can become prey for strangers and the unscrupulous. Later in life, toddlers with FAS grow into adults with little or no conscience or ability to reason. And again, it’s a crap-shoot . . . researchers are still not sure why some mothers who binge drink give birth to perfectly healthy children, while others who have just one drink a month give birth to children with FAS. There is a milder form of FAS, called FAE (Fetal Alcohol Effect), which often has the same symptoms, but none of the physical signs.

Hydrocelphalus . . . This is a condition that results in too much fluid within the brain. Doctors usually insert a shunt into the brain’s ventricular system to divert the flow of the fluid into another part of the body.

Legal Risk Placement . . . These are common when a baby or toddler is placed in an adoptive home by a state child welfare agency. It means the termination of parental rights for the child has not yet been completed, but the agency feels it’s important to give the child permanency as soon as possible. Usually the agency won’t do a legal risk placement unless they are pretty sure termination of parental rights is imminent, but beware . . . in child welfare, nothing is certain except uncertainty.

Microcephaly . . . This is another word for abnormal smallness of the head. A child with microcephaly may have seizures or developmental delays. On the other hand, babies and toddlers adopted from other countries may just have smaller heads due to ethnic characteristics, so make sure your doctor has a growth chart that’s appropriate for your toddler’s country of origin.

Post Traumatic Stress Disorder . . . Toddlers with this syndrome often re-experience traumatic events in their lives, and react unpredictably to current events. Symptoms can include sleeping problems, nightmares, intrusive thoughts and concentration problems. Toddlers who come from international orphanages, or who have gone through abuse or several foster care placements, can suffer from PTSD. Treatment includes counseling, and in some cases, medication.

Termination of Parental Rights (TPR) . . . This is a legal court action that removes parental rights and responsibilities from birth parents. Except for some high-profile exceptions, this is permanent and irreversible. Babies and toddlers are often placed in homes by state child welfare agencies before TPR is completed.

There are many other medical, physical and psychological issues that adopted toddlers may face, whether adopted domestically or from another country. Parents who are considering adoption of a toddler or older child should consult with their pediatrician, and have a support system in place before bringing the child home so that he or she can have the best start in their new family as possible.

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