Posts tagged special needs

Statistics: Special Needs of Special Focus Children in China Age 0-5

Statistics: Special Needs of Special Focus Children in China Age 0-5

International adoption is an ever-changing world; some changes happen quickly, even overnight, and others are slow, gradual shifts over years as culture and societal systems change in sending countries. In China, we have seen a steady progression in the past several years, where fewer young children with needs adoptive families typically consider “minor” are listed for international adoption, especially girls. This shift is happening for wonderful reasons, because children are more often able to stay with their biological families, and more families in China adopting domestically are open to considering special needs. Additionally, in December 2019 the Chinese adoption authority, the CCCWA, made a change to the method for matching children designated “dossier only” or “LID.” These are the children who are typically younger and have needs many families consider minor. Under the new system families may wait years to be matched with a child designated “LID,” so we are encouraging all families considering the China program to be open to the type of needs seen in “Special Focus” children. “Special Focus” children are the children the CCCWA considers harder to place for adoption, due to their age, special needs, or both.

We wanted to get an accurate picture of the children who are in need of international adoption in China currently, so we looked at the last twelve groups of newly prepared Special Focus children’s files, from February 2019 to July 2020. For this first set of statistics, we focused on younger children (listed for adoption before their sixth birthday), since these children are typically matched directly with waiting families, so it’s harder to get a sense of the what the most common special needs are by looking only at waiting children. Most children over six wait for a family, and if you are interested in adopting an older child we are happy to talk with you about the many waiting children!

Notes:
We counted each child by their primary diagnosis, and did not list other special needs that are typically a direct result of that primary diagnosis (ie. a child listed with a brain abnormality diagnosis who also has an epilepsy diagnosis was only counted in the total for brain differences, since epilepsy is often a secondary diagnosis caused by their brain abnormality, a child diagnosed with spina bifida and hydrocephalus was only listed under spina bifida, etc). We did not note secondary diagnoses that are typically considered very minor, including hernia, undescended testicle, heart murmur, strabismus, etc. If a child had two apparently unrelated significant diagnoses, we counted both, but only counted the child once in the total number for their age/gender group. Since many of these children were matched directly to a family, we are not able to view the details of their files, and can only categorize as best we can given the basic information on the list of files from the CCCWA. Some additional notes about some of these special needs categories are below.

Down syndrome: Many of the children with Down syndrome had additional diagnoses, including heart defects, gastrointestinal issues, etc. We did not count any of these diagnoses in the other totals.

Heart defects: The majority of these children were only listed with the generic description “congenital heart defect,” so specific diagnoses were mostly unknown. That said, special focus children typically have more complex heart defects, including tetralogy of fallot, pulmonary atresia, complex dextrocardia, double outlet right ventricle, transposition of the great arteries, and single ventricle.

Gastrointestinal: This includes anal atresia/imperforate anus, jejunal atresia, intestinal atresia, necrotizing enteritis, pyloric stenosis, etc.

Developmental delay: We only counted children who did not have another significant diagnosis besides some type of developmental delay (motor, speech, cognitive, psychomotor, etc). Many children with other diagnoses also had secondary diagnoses of developmental delay of some type, these children were not counted in this category.

Brain Differences: This included a wide variety of diagnoses, including agenesis of corpus callosum, arachnoid cysts, widened septum pellucidum, cerebral dysplasia, enlarged ventricles, hypoxic ischemic encephalopathy, etc.

Urogenital: This includes hypospadias, ambiguous genitalia, micropenis, congenital adrenal hyperplasia, bladder extrophy, etc.

Cleft lip/palate plus 2nd need: While most children who are only diagnosed with cleft lip and palate are designated LID/”dossier only,” there were many Special Focus children who had cleft lip and/or palate along with one or more other diagnoses, so it’s still a need parents should research and consider. Many of the children had needs commonly associated with cleft lip/palate, such as hearing loss or speech delays, others had different birth defects, such as a heart defect or microtia, that could indicate an underlying genetic cause.

Limb Differences: Many children were only listed as “limb differences” so the specific diagnosis is unknown, others included one leg being shorter, missing fingers and toes, and hand deformity.

Partial Vision Impairment: includes glaucoma, cataracts, ptosis, and loss of vision in one eye. Some of these children may be fully blind, it’s unknown without seeing their full files.

Other: Each of these children was the only child with their diagnosis, includes diabetes, widened button hole/low nose root, teratoma, neurocutaneous syndrome, leukemia, spinal muscular atrophy, myocardial enzyme, skull malformation, and Rett syndrome.

Liver: Most of these children had biliary atresia or similar diagnoses, one child diagnosed with hepatocele

Skin: Includes nevus, epidermis bullosa, eczema, ichthyosis, and scars.

Esophageal/Trach: Most of these children had esophageal atresia

Orthopedic: Includes scoliosis, missing ribs, and hip dysplasia

Kidney: Includes hydronephrosis, missing or malformed kidney

Wait For Your Child, So They Don’t Wait For You: Down Syndrome Adoption in Bulgaria

Madison Adoption Associates has always focused on finding families for waiting children, so we were surprised when our NGO partner in Bulgaria encouraged us to have families submit their dossiers requesting referrals of children with Down syndrome, instead of requesting to be matched with a waiting child. But once they explained their reasoning, it made so much sense.

First, it’s important to understand what we mean when we say “waiting child”- a waiting child is simply a child who has been deemed eligible for adoption, but when adoption authorities in the child’s country reviewed families with completed dossiers, none of those families were open to a child of that age and gender, and with their particular medical or developmental diagnoses. So instead of being referred to a family, the child is listed with adoption agencies who will advocate and try to find a family who will start the adoption process in hopes of adopting that child. Nothing is inherently wrong in this process, but as our partner NGO explained, there are a couple reasons the referral process can be better for both families and children.

Waiting children with Down syndrome are periodically listed in Bulgaria, and usually pursued quickly by a family who steps forward and starts the adoption process from scratch, but when a family has already submitted their dossier before being referred a child, it’s a much shorter time until that child comes home. For families, this means less time between seeing your child’s face, and holding them in your arms. More importantly, for children, this means less time spent in an institution, and a quicker path to their family. In Bulgaria, for example, when pursuing a waiting child it takes about one year from the time a family starts their home study until traveling to complete the adoption, but for a family who has already submitted their dossier, after receiving a referral the first trip is done within one month, and the second trip to pick up their child is 3-4 months later.

So instead of families waiting until they see a child with Down syndrome on the waiting child list before they start the adoption process, MAA and our NGO partner hope to find families to submit their dossier to Bulgaria. Then we can see more children matched before getting to the waiting child list, and home with their families sooner. For young children with Down syndrome, those months saved mean they are in their families receiving medical care, physical and speech therapy, and devoted attention that much sooner, at a time that is so crucial for their health and development.

In some ways, this route is harder on families; you are taking a leap of faith without seeing a specific child, and waiting for the day you get the phone call that there is a child who needs you. But think of it this way- you are giving your child a gift. You are doing the waiting for them, so they don’t have to wait on you. If you are open to adopting a child with Down syndrome, consider whether this could be the path for your family to bring a child home, and take that first step forward knowing your child is out there, and you’ll be waiting for them when they need you.

For families who submit their dossier open to Down syndrome, our NGO will charge the waiting child fee (6600 Euros) instead of the typical fee for the traditional program (8000 Euro), and at time of dossier submission only 600 Euros are due. Families can expect to receive a referral approximately one month after dossier submittal. Couples, single women and men age 25 and older are eligible to adopt from Bulgaria. There are no specific criteria for marriage length, family size, finances or health. Email LindseyG@madisonadoption.org or complete our free Prospective Adoptive Parent form to connect with an adoption specialist!

It Really Is a Big Dream

It Really Is a Big Dream

Dear Madison Adoption,

I have known Ashton since 2014. We were together at our orphanage in Northern China (at Shepherd’s Field). He was one of my four closest friends and I felt like he was my brother. I have always hoped that he could find a family. He has been in the orphanage for a long time. He has watched so many friends get adopted. When I got to our orphanage he had just lost another friend who had been adopted. He was so sad.

I had heard that Ashton couldn’t get paperwork, and when I found out that he could finally be adopted, I was so happy!  Ashton is a kind boy and he is really cute. He always just wanted to live a normal life.

I know that he would be happy to be in a family and he really wants one. It really is a big dream for him.

Love his friend,
Xinlu/Vicki

MAA is advocating for Ashton (known as “Luke” at his foster home, Shepherd’s Field Children’s Village), a 13 year old boy waiting in China. Through his foster home he received desperately needed heart surgery last year, but he still needs a family to give him the love and support every child deserves. Thanks to generous donors we are able to offer a $5000 grant for a family that adopts him through MAA. Email LindseyG@madisonadoption.org or complete our free Prospective Adoptive Parent form to learn more about Ashton and adoption!

Common Special Needs by Country Program

Common Special Needs by Country Program

While nearly all international adoption is considered “special needs” these days, what needs we see varies widely country to country, depending on that country’s medical system, social services, and culture. Considering what special needs are common is one way to narrow down which adoption program is the right fit for your family, so read more below about each of MAA’s programs!

China

In the China program we see a wide range of medical needs. Typically medical care in China requires full payment up front before care is provided, so sadly many families place their child in institutional care so that they can receive the medical care they desperately need. There also continues to be cultural stigma around disabilities in China, especially visible disabilities, which plays a role in some children being abandoned. Thankfully, as resources grow more biological families are able to keep their children who have correctable conditions, and more and more domestic Chinese families are open to adopting young children with needs like heart defects and club foot, so there are fewer children with those needs in need of international adoption today.

Colombia

In Colombia, some children are relinquished by their birth family, sometimes because they aren’t able to care for their medical needs. Other children have been removed from their birth families due to neglect or abuse. As a result, we see many older children who may not have any diagnosed needs, but have experienced trauma. Because we often have information about birth families, it’s sometimes known if a child had prenatal exposure to drugs or alcohol, or other risk factors in their background. Many young children referred for adoption have these risk factors and developmental delays, and need families who will help them meet their full potential, whatever that may be.

The Philippines

While the Philippines allows families to submit their dossier and request referral of a child considered “healthy,” families still need to be open to some concerns or risk factors in their child’s background, such as prematurity, speech delays, or corrected medical needs. There are also waiting children of all ages with a variety of medical needs, including many children who have developmental delays. We also see many older children, sibling pairs and groups who are medically healthy, but experienced neglect or abuse in their biological families.

Bulgaria

Since there is now a robust domestic adoption program in Bulgaria, there are very few young children with needs families consider “minor” in need of international adoption, as those children are usually adopted within Bulgaria. Children under eight years old typically have neurological conditions like cerebral palsy, spina bifida, hydrocephalus, and epilepsy, or multiple diagnoses and risk factors in their background. There are also many older children and sibling groups who were removed from their biological families due to abuse or neglect. Families who are open to Down syndrome can receive a referral very quickly after submitting their dossier.

The Dominican Republic

Since the Dominican Republic is a small country, it’s also a small adoption program, but there are still many children waiting for adoptive families! We see a range of different medical needs, as well as many young children with broad developmental delay diagnoses who need families prepared for whatever their future may be. Many of the children came into orphanage care very young when their biological families were unable to care for them. Since it is a small program, it is best for families who are open to a variety of different needs if they have not identified a specific waiting child.

Though these are the specific medical and developmental needs we see in each country program, it’s always important to keep in mind that every child in need of adoption has experienced loss and trauma, regardless of where they live. The behavioral, emotional and attachment needs that result from those experiences may be not be diagnoses in their file, but will be some of their biggest needs. We encourage all our families to research how to meet all of their child’s needs to be as prepared as possible for when you finally bring them home!

Interested in learning more about international adoption? Check out the Country Comparison Chart to view general info about each program, and fill out our free Prospective Adoptive Parent form to connect with an adoption specialist!

MAA Adoption Programs

Madison Adoption Associates currently offers international adoption programs in the countries of China, the Philippines, and Bulgaria. Our programs mostly focus on placing children who have special medical needs.
August 2020
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