International Adoption Clinic helps parents adopting foreign-born babies

June 25, 2003

Parents in the Chicago area who are adopting a child from another country can get expert advice from pediatric specialists at the new International Adoption Clinic at the University of Chicago Children's Hospital (UCCH).

The clinic helps parents interpret limited medical and developmental information before they adopt a child from abroad and provides comprehensive medical evaluations for the child as soon as he or she arrives in America.

The clinic was established by two UCCH pediatricians, Larry Gray, MD, who specializes in behavioral and developmental pediatrics, and John Kim, MD, who cares for chronically ill children. Both have experience overseas. Gray has taught many pediatricians from Asia to Africa about how to care for children with behavioral and developmental problems, and Kim has led medical trips to countries such as Cambodia, India and Guatemala.

Being located at the University of Chicago Children's Hospital allows for collaboration with experts like Thomas Keller, PhD, an assistant professor at the School of Social Service Administration at the University of Chicago, who provides guidance in child personality development, developmental change and attachment issues.

"We are excited about the first Chicago-based team that has focused on both the medical and developmental aspects of international adoption," said Gray. "Our goal is to better serve these children, who may have experienced adverse living conditions, and their new families." There are more than 20 adoption clinics across the country, but the UCCH International Adoption Clinic is the first Chicago clinic to incorporate an evaluation from developmental specialists.

An estimated 20,000 children were adopted from abroad in 2001, many of them less than one year old.  Because of the rapid increase in foreign adoptions, which have more than tripled in the past 25 years, there is a real and growing need for more specialized care for these families.

Children from the countries where most adoptions take place -- Cambodia, China, Guatemala, India, Kazakhstan, Korea, Romania, Russia, Ukraine and Vietnam -- may face complex medical conditions.  Many have been placed in orphanages during the early months of life, which can contribute to developmental delays, including poor balance and speech problems, or behavioral problems such as attachment or attention disorders. Others may have nutritional deficiencies or have been exposed to infectious diseases.

The clinic is designed to help families before and immediately after they adopt.  Gray and Kim are available to consult with prospective parents as soon as they get preliminary medical information on their child from the foreign country.  They look for potential health problems and discuss any concerns the parents may have.  "We try to get these new families off to a good start," said Gray.

Once the child is brought to the United States, the clinic provides a thorough medical, behavioral and developmental evaluation.  "Some of these children have problems not commonly seen in the United States," said Kim, "so it helps to have experience with the special medical needs of adopted children. You have to know the right questions to ask in order to recognize and address issues early, when there is a greater chance of correcting a problem."

Michele Seidl and Neil Shubin turned to the UCCH International Adoption Clinic as they were adopting their son from Korea. "It put us at ease," said Seidl. "It was the most thorough exam." The Hyde Park couple met with Gray to review their son Nathaniel's medical record and paperwork before bringing him to the United States. Gray was also there when the couple arrived home with the then 4-month-old Nathaniel. "He is a picture of health," said Gray. Kim now sees Nathaniel for follow-up exams.

"It's wonderful to have these specialists go through the process with you, to note your child's developmental progress," said Nathaniel's mother. "Without the service, I don't believe the level of care and compassion would have been as high."

Chris and Kim Wheaton of Chicago's Lake View neighborhood are waiting to adopt a baby girl from China, but have already tapped into the services offered at the UCCH International Adoption Clinic. They have been meeting with Kim to discuss such concerns as differences in their foreign-born child's growth or illnesses in which their child may be more susceptible. "The conversations have helped us be more aware of what to anticipate," said Kim Wheaton.

Even with this preparation, the Wheatons' adoption process had been put on hold for more than a month. On May 15, 2003, the China Center for Adoption Affairs postponed the mailing of confirmation letters and relevant documents to adopting families, due to the "epidemic situation" of the severe acute respiratory syndrome (SARS) in that nation. But on June 24, 2003, the delay ended when World Health Organization officials announced they're lifting their travel advice to China. As a result, the adoption affairs agency is resuming "normal adoptive formalities of travelling to China."

The Wheatons, who already have two biological children, are excited about receiving information soon on the new addition to their family. "Already we have so much love for this child," Kim Wheaton said.

Although the clinic primarily focuses on children under the age of two, it can provide assistance throughout childhood, often as a source of referrals for follow-up care. Kim and Gray partner with general pediatricians and family physicians to ensure the myriad of special concerns regarding these children are addressed.

The good news is that "in most cases, the impairments that we see in adopted children can be reversed with proper attention and care in the family setting," Kim said. "Typically, the child who is internationally adopted has a rosy future," Gray added, "but parents often have worries and our motivation is to support families during this process."