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June is Apert Awareness Month

June is Apert Awareness Month

June is Apert Awareness Month!  In honor of these amazing children, we are thrilled to be able to offer a $1,000 grant to any eligible family who commits to adopting a child with Apert in the month of June!  Apert syndrome is a genetic disorder characterized by craniofacial differences, as well as often syndactyly of fingers and toes. 

Over the years, Madison Adoption Associates has found forever families for several children with Apert syndrome  – one those families is the Singleton family!  And we are honored to have Amie share her experience with you all about adopting a precious boy from China who just so happens to have Apert syndrome.

Thank you Amie, Jean, and James!!

Please ‘meet’ Ramona, Harley, and Daisy. Three amazing children who do not let having Apert syndrome slow them down! These kiddos are full of life! The only thing they are lacking is a family.

Harley (8) & Daisy (7)
Ramona (7 1/2)
Harley (8)
Daisy (7)

Interested in learning more about Harley, Daisy, Ramona, and other children with Apert syndrome available for adoption? Please complete our Prospective Adoptive Parent form to learn more! Or visit our website for more information.

Now We Are Six

Now We Are Six

Last night, my daughter fell asleep on my chest. Maybe not all that notable, except that she’s not a baby, she’s six years old. She still needs my husband or I to stay with her until she falls asleep, but last night she crawled on top of me, stomach to stomach, head on my chest, and fell asleep. It was so very sweet (though difficult to escape from!), but mostly, it reminded me how very little she still is. I get at least one piece of artwork from her every day, usually a picture of our family. She loves to hold hands and snuggle. Her favorite outfits these days are too-big t-shirts from her dad’s childhood, paired with jeans so she can stick her hands in her pockets and proclaim “Look, I’m Daddy!” as she struts around the room. When her dad and I both join in a silly dance game with her, she positively beams up at us, so happy just to be with her family. I’m often struck by how much she’s growing up, but truly, six years old is still so little. Six is running in the sprinklers, building forts, playing with baby dolls and believing in magic.

When I talk with adoptive families, they often want to adopt a younger child, and in many people’s minds “younger” seems to end at five years old. But six-year-olds still very much need their mommies and daddies, and there are so many six-year-olds who don’t have any. All these six-year-olds are still waiting for families. Some have only been listed for adoption recently, but many have been waiting since they were younger and still haven’t been chosen. Now they are six- “older,” in the eyes of many, but with so much childhood still to have. They just need a family to share it with.

Top Row: Atticus, Dominic, Evelyn, Sherman
Middle: Coco, Thatcher, Davis, Eric
Bottom: Peyton, Marc, Rece, Lyric
Top: Zavier, Jackson, Marigold, Birger
Middle: Wallace, Cecelia, Davis, Phoenix
Bottom: Carlin, Sean, Jed, Lucio

Interested in learning more about adoption or one of these waiting children? Complete our free Prospective Adoptive Parent Form to connect to an Adoption Specialist, or email

Madison’s Story

Madison’s Story

One family’s journey adopting a child with Scoliosis

Since June is scoliosis awareness month, it seems only fitting to introduce you to Madison. Not because she has scoliosis, but because she is a person whose spirit shines despite scoliosis. Madison was adopted from China about 4 years ago. Her story is like so many others who have been fortunate enough to have Madison Adoption Associates involved in their adoption journeys.

Madison had been on the shared list as a young girl, but was taken off that list because she was seen as “unadoptable”. Not only was Madison’s scoliosis severe, but it was complicated by a muscular dystrophy that left her in a state where any mobility at all was severely limited. Fast forward many years and Madison Adoption arrives to advocate for hard to place children. Our Madison was not on the list of kids to be interviewed, but the team saw her in the periphery, were drawn to her smile, and inquired about her. They took a personal interest in her and convinced the staff that she was indeed adoptable and they would find her a family.

Madison came home to us and her 16 siblings not long after that. She is a sassy, loving, considerate and strong individual. Her scoliosis was of utmost concern as it was so severe it had already caused most of her left lung to collapse. Her scoliosis put her in a position where any activities of daily living were impossible, and it left her at a level where she could not engage in life on the same level as others.

Surgery for scoliosis was not taken lightly. There were many unknowns and many factors to consider. Foremost in our minds was quality of life for Madison – that included physical quality of life as well as emotional and social quality of life. It was 2 years before we were able to get Madison to a place where she was physically strong enough to handle the major surgery.

Madison’s curve was the largest surgical  correction of its type that her surgeon had ever performed. Her plan of care was altered from the norm in order to give her the best chance for the fullest amount of correction. She entered the hospital and was placed in halo traction for 3 weeks. She underwent another surgery to release the muscles in her back and continued on traction for another 3 weeks. She then underwent rod and hardware placement to stabilize her back. She never lost her smile during all that time. We were looking forward to going home and getting our family back together, Madison missed her siblings more than anything.

However, there were complications. Madison had to be taken to emergency surgery for removal of the rods due to nerve damage. A few other complications occurred and Madison was starting to lose her smile for the first time ever. We consulted with doctors and determined a short reprieve at home with halo in place was what she needed. Family had become so important to her and she was missing that security so much. After 10 days at home we returned to the hospital once again to start the process over again. Since her back muscles had been released, she needed to have stabilizing hardware put in.  We could not just stop at this point in the journey. Madison was the smiling champion we knew her to be and sailed through the remaining time in the hospital. After almost 4 months in the hospital we came home with a much taller Madison who was able to engage in life like never before. She continues to thrive and build strength. Her smile only gets brighter.

We share our journey because we want to provide encouragement if you are considering adopting a child with scoliosis. Every case is different, but there is a person held up by that bent back that makes the journey so rewarding. One of the greatest rewards of adoption is having the privilege to watch your child grow and become the person they were created to be, and sometimes that happens through the challenges they face. It was so apparent that having a family to support her through the most difficult parts was what gave Madison the strength and motivation to endure. She fills our life with such joy and inspires each of us to live better lives as we watch her live a life full of joy despite her physical challenges.

Thank you to Madison and the Bernadsky family for sharing their journey! In honor of June being Scoliosis Awareness Month, Madison Adoption Associates is pleased to offer a $1,000 grant to any qualified family who commits to adopt a child with Scoliosis during the month of June. Please complete our Prospective Adoptive Parent form today to learn more about our adoption programs and the children who wait, like Quaid and Legend below!

Quaid – 10
Legend – 8

It Takes a Village

It Takes a Village

So often, a specific child touches the heart of one of our staff, and that staff member makes it their number one priority to do whatever they can to find the perfect family for that child.  Don’t get me wrong, ALL waiting children are our priority – we wouldn’t be in this work if they weren’t!  But for each of us, there are several children who, over the years, stand out in our minds.  Several that really imprinted on our hearts, and will stay there forever.  For me, the tears of joy were indescribable once ‘Max’ and ‘Jayne’ came home!  But the tears shed for ‘Lizzie’ were much different, as, despite our best efforts, she ran out of time to find a family.  At the end of the day, it is the tears and the passion from both outcomes that urge us to keep pressing on for the next child.  To keep marching forward, and to keep doing ALL we possibly can to get even just one.more.child home to a forever family.

‘Doing ALL we possibly can’ looks different for every child and every agency, especially in the midst of a global pandemic!  Once we have exhausted every single thing we know to do, we must sometimes think outside of the box.  So when we received the email from our colleagues at Agape, or rather, the plea, on behalf of Harry, to help advocate, to jump alongside them to collectively do ALL we possibly can to find this boy a home, we didn’t hesitate.  Not even for a moment.  Because it doesn’t matter what agency.  It doesn’t matter who finds a family for him.  ALL that matters is that his family IS found.  Before it is too late.

Harry is a sweet boy, who will ‘age-out’ of China’s child welfare system in October of this year, losing his last chance at a family.  He loves fried chicken, steak, and hamburgers (a boy after my own heart!).  And he’s very interested in learning how to cook.  From those who have met him, Harry has been observed to be very helpful and attentive towards others.

Harry (formerly Hudson with MAA) is waiting in China.  He is 13 ½ years old, and will ‘age-out’ in October.  Harry’s file is currently with Agape, and there are grants available to the qualified family who commits to adopt him.  Please contact or for more information about this precious boy.  Or feel free to complete and submit our Prospective Adoptive Parent form and an Adoption Specialist will be in touch to discuss your international adoption options!

Is Three a Crowd? What It’s Like to Adopt Three Siblings

Is Three a Crowd? What It’s Like to Adopt Three Siblings

When we talk to families about the children who typically wait for adoptive families, there are some common themes: usually children with medical or developmental needs, lots of boys, older children, and siblings. Many families will reply that they are open to siblings, however, the majority of those families are only open to a pair of siblings. So when we learn of a group of three or more siblings who must be placed together… a lot of those raised hands go down.

This is understandable, adopting two children already means more than the double the adjustment, so bringing home three is not something to undertake lightly. That said, I wonder how many families say “no” immediately, without considering- could we really bring three home? It’s not for every family, and we never want families to delve into something they aren’t prepared for, but we hope to encourage you to think about whether you might be the family to keep three siblings together. And who better to help you think through if you could than the families who have already done it?!

Shane, Sarah and their three girls

Shane and Sarah were first time parents when they adopted. After having their niece stay with them for a couple years in high school and college, they felt prepared to adopt older children, and joined MAA’s hosting program in summer 2018. “Originally, we thought we were more suited for hosting/adopting one child because the thought of three was overwhelming at first,” says Sarah. “When we learned of three girls who needed a hosting family, we went on a whim and gave it a try!  We felt an instant connection with our girls and had the space for three.” Shane and Sarah hosted when the twins were 9 years old and the eldest was 13, and they were able to travel to Colombia and finalize the adoption the following year.

Other families already have some parenting experience under their belt when they decide to bring home siblings, like Chelsea and Steven, who had one son adopted domestically when they brought home their daughters from Colombia at six, four and two years old. “We think it definitely helped. We had established our parenting style and knew (at least somewhat) what to expect from kids his age and younger.”

Richard and Leonardo also had experience parenting, having previously fostered a single child, and a pair of siblings, but never three at once. They knew they eventually wanted more than one child, but thought they would ease into it by adopting one child first. However, their views changed after a trip to Colombia and learning of the need for families willing to adopt larger sibling groups so that children could stay together. “We realized that we could keep these families together and do so much good from this while still keeping within our comfort level.” It was only a couple months into the process that they learned about the group of three children they would ultimately adopt, who were four, five and six years old when Rich and Leo brought them home earlier this year.

Bringing siblings home together has a lot of benefits and joys, for parents and kids! “Being able to see these beautiful children growing together in our home is hands down the most rewarding,” says Richard. “The children are so tightly bonded to each other that it made the transition emotionally easier on them.” Sarah agrees, “We are so happy they have each other to maintain some of their heritage and traditions.  I think one child would get lonely at our house and we didn’t think we could afford to go through the adoption process multiple times.” Siblings are often the one biological familial connection an adoptee has left, so maintaining that by keeping children together has enormous emotional benefits.

That doesn’t mean it doesn’t come without challenges though! “The most challenging thing about adopting three children is of course building on each child’s strengths and improving their weaknesses without any of them feeling left out,” reports Sarah. “These children have deep hurt, and strong emotions come out when recognition, praise, or discipline is given to one child and not the other.” Meanwhile for younger children, Richard says the biggest challenge was “hands down the temper tantrums that they learned from being in an orphanage”- times three! “The three would feed off of each other which made for some challenging times.” However, he says it didn’t last long, and with consistent parenting and structure new, more appropriate behaviors emerged within a month. 

Chelsea, Steven, and their four children

So what’s the most important quality for families who are considering adopting a group of three? “Flexibility. Life is going to change like never before and it’s going to keep changing. It’s easier when you can go with the flow and adapt,” says Chelsea. Richard says the key for them has been a strong family foundation- physically, financially, and emotionally. “Having a strong bond between my husband and I has made this transition so much easier for us and the children.”

So as you consider the type of children your family is open to adopting, take the time to think about whether you could adopt three siblings together. It’s important to be realistic about your resources, but don’t let fear prevent you from saying yes to something hard but beautiful. “It has been the hardest thing we have ever done. I was honestly terrified the entire 6 months we spent preparing for this adoption. Terrified we would regret our decision. Terrified we would fail at parenting 4 kids under age 7,” says Chelsea. “But it has been the BEST thing we have ever done. My husband and I and our son have grown so much as a result of this experience and we love our three girls to the moon and back! It feels like they have always been a part of this family and we truly believe we were meant for each other.”

We are currently advocating for sibling groups of three in Colombia, Bulgaria, the Philippines, and the Dominican Republic. To learn more about these children who wait, fill out the free Prospective Adoptive Parent form today to connect with an Adoption Specialist!

Thalassemia – A Parent’s Perspective

Thalassemia – A Parent’s Perspective

We caught up with Brooke Henningfeld, MAA Advocate and adoptive Mama, to pick her brain about parenting an adopted child with Thalassemia….

The Henningfeld Family

Brooke, can you tell us a bit about your son, Reid?

Bao Sha Hao came into the care of his orphanage at the approximate age of one. Our family met this child we lovingly refer to as Reid Sterling ShaHao Henningfeld in Guangzhou, China on his 6th birthday!  Reid was born in Shenzhen with beta thalassemia major, the most severe form of thalassemia.  He is now nearing thirteen and thriving!  When we were deciding to adopt a child with thalassemia, we didn’t really have any concerns because our hearts were so drawn to the photos and videos we saw Madison Adoption Associates advocating for.  We weren’t thinking about his special need, but saw him for the adorable little boy he was!   Thalassemia didn’t, and still doesn’t, define who Reid is.   He’s never really had any limitations because of his medical need.   My husband, Rick, and I knew we had good medical insurance and an excellent children’s hospital within an hour drive.  We had learned a fair amount of information from adoptive parents of children with thalassemia that had gone before us, but figured we’d learn as we go; that we did, and we continue to do!

Reid’s referral photos

What is thalassemia?

Thalassemia is a big word, but it isn’t a scary special need.  It is, in fact, a very manageable medical condition.  The first few months after a ‘thal’ child comes home can be a little overwhelming, with trying to get the child’s hemoglobin to a stable level, going to some extra appointments that ultimately become annual appointments, and trying to get into a regular transfusion day schedule.   All of this becomes another part of routine life quite quickly though!  There are various forms of thalassemia.  Some require regular transfusions and others don’t.  As I already mentioned, our son has the most severe form of thalassemia.  Because Reid has the most severe form and his red blood cells do not make hemoglobin correctly, Reid needs regular transfusions.  Hemoglobin is what moves the oxygen around our bodies, which helps give us energy.  The blood transfusions Reid receives keep him alive and are 100% necessary!

The downside to the transfusions is that it puts a lot of extra iron into Reid’s body.  Transfusion dependent patients often have iron overload and need to take a daily chelator to remove the excess iron from their bodies, which likes to store up in organs like the heart and liver.  This can be damaging to these vital organs, so the chelation medication is necessary when the iron levels are higher than they should be.  There are currently three chelation options.  Two of the chelators are oral medications and one is not.  Our son has taken both oral chelators.  At one time, he needed both at the same time.  This is another part of our regular routine and has never really been much of an issue for our son.  To monitor the heart and liver iron content, Reid receives an annual MRI.  In addition to this, we visit with the ophthalmologist and ENT annually for a quick check of the eyes and ears, due to risk factors from one of the chelation medications he’s been taking.   

How often are transfusion dependent thal children transfused?


Transfusion dependent thal kids receive a transfusion approximately every two to four weeks.  The younger children can often make it every four weeks before needing a ‘fill-up.’  Older children and adults generally need to go every two to three weeks.  This varies from person to person and by the type of thalassemia a patient has.   I would recommend any family considering adopting a child with thalassemia to be prepared that the child could have the most severe form of thalassemia and to be prepared for transfusions every two to three weeks.  Transfusions are scheduled based on the child’s current hemoglobin levels, and the amount of blood the child receives is based on their current weight.  Reid has been transfused just about every three weeks since he came home at age six.  Occasionally, and often in the summertime, his hemoglobin levels get a little lower than we’d like to see and he goes in every two weeks for a few transfusions and then is back to the every 3-week rotation.  Normally, we can bank on every third Friday and we plan life around those dates.  We are fortunate that our clinic is very open to us changing the day of the week we come, if we needed to do that for any reason.

What does a transfusion day look like? 

Reid on transfusion day

Well, it’s going to look different for every family for multiple reasons.  For our family, Reid and one of his parents generally leave the house at around 7:30 a.m. on a transfusion day.  We make the 50-60 minute door-to-door drive to Children’s Hospital of Wisconsin-Milwaukee.  We leave our car with the wonderful Children’s valet team and walk straight into the hospital (except during the corona virus), check-in at the front desk, and head up to the amazing 5th floor MACC Day Clinic for children with cancer and other blood disorders for our 8:30 a.m. appointment.   We check in at their desk and get sent to a private room.  Within minutes of getting into the room, Reid has his height and weight checked.  We then wait for the team to come in and draw blood for the labs needed to match the blood for that transfusion.  They also put an IV in at that time.  Reid has just about always had that put in the fold of one of his arms.  In the past, when we transfused on a Tuesday, we would do labs on a Saturday morning at a Children’s facility a little bit closer to home and then make a day of it with our family in that area, such as a family trip to the zoo.  Labs can be done up to 72 hours before a transfusion.  When we moved our transfusions to a Friday, we didn’t want Reid missing more school than he already does, so we just decided to do labs on the same day.  Labs on the same day make for a longer transfusion day, but haven’t turned out to be as difficult as we thought they might be.  Once labs are drawn, we wait for the blood to arrive.  Reid works on his homework if the transfusion day is a school day and he puts his lunch order in for the approximate time he wants it to arrive.  If it’s a non-school day, Reid might watch some tv, play some video games, or make some art projects in the commons/shared area of the MACC clinic.  There are even wonderful child-life staff and volunteers who come around asking if Reid would like to play a game or do a craft with them!  The staff and volunteers have become like family to us!  

Reid and his brothers

Once the blood arrives, two nurses ‘tag-team’ and get everything entered into the computer and get Reid hooked up.  Once the transfusion starts, Reid is hooked up to an IV pole, but can move fairly freely around the room or the commons area, except during flu season/this corona virus time when he needs to stay in his room unless using the bathroom.  Reid continues to work on his homework or play games, videos games, or do art.  His food comes for him and the parent with him either brings lunch from home or goes down to the cafeteria basement to get a lunch to bring back to the room.  Based on Reid’s weight, he currently receives 2 full units of blood.  His vitals are monitored and checked regularly by the staff.  When one unit is done, the second unit is attached fairly quickly thereafter.   Once the second unit is complete, Reid has his IV removed and is no longer attached to the IV pole.  He has a 30-minute wait period to watch for any sort of reaction. His vitals are then checked again and we are free to go home!   By this time, it is generally somewhere between 2:30-3:30 p.m. and we wait for our car and return home between 3:30 and 4:30 p.m.  As Reid gets older and continues to grow and gain weight, we realize that transfusions may need to be a bit closer together or the days may get a little longer because of increased blood volume. 

What should a prospective adoptive family considering adopting a child with thalassemia know?

Reid on Family Day!

Good insurance is definitely important for a family considering adopting a child with thalassemia and a prospective adoptive family should know that life with thalassemia is a marathon and not a sprint!  The hemoglobin and iron levels kids with thalassemia come home to their families with is the worst they will ever be at that moment.  It will and does get better with time and they will thrive with the love of a forever family, good nutrition, and optimal medical care.  It’s amazing to witness the changes in an adopted child with thalassemia over time and a true blessing to be the one they call mom or dad.  There is a terrific support network for families with children with thalassemia, from the Cooley’s Anemia Foundation who give $1,000 grants to families adopting transfusion dependent thal children, hold annual conferences for thal patients and their families, and who provide very helpful standards of care for thal patients to the ever-supportive and helpful thal families’ Facebook groups, where someone is always ready to answer questions you have and have your back!  You and your adopted child with thal will never feel alone!

Boys and children over 5 with a special need like thalassemia are at a unique disadvantage because the majority of prospective adoptive parents are hoping for a child 0-5, with minor needs, and because girls are preferred to boys.  There are often ten or less children with thalassemia who are paper-ready and waiting at any given time.  More families are stepping up to adopt children with thalassemia, which is awesome, but the boys and those who are older tend to wait and wait.  Right now, there are some amazing waiting kids (mostly boys) with beta thalassemia who are 7-13 years old.  They desperately need families. Often the biological families of these children desperately want to keep their children, but they cannot afford their medical care.  In many cases, families in China have abandoned these children with the hopes that they will be adopted and be able to live a longer and healthier life because of the medical care they cannot provide their child.  It is often a matter of life and death for these children and their lives will forever change once they are in a loving home and getting that medical care they so desperately needed.  Thriving with thal can be a real reality for these children!

Please note that Brooke is not a medical professional, and she is only sharing information about Thalassemia based on her own personal experiences. Please consult with a medical professional to discuss individual treatment options for you, your child, or any child with Thalassemia who you are considering adopting.

THANK YOU BROOKE for sharing your experience and encouraging others to consider adopting a child with Thalassemia!  

As Brooke mentioned, many children with transfusion dependent Thalassemia are waiting for a family!  Like Sutton, Peter, Duncan, and Bradley!

Sutton, 7
Peter, 5
Duncan, 11
Bradley, 11

In honor of World Thalassemia Day, Madison Adoption Associates is honored to provide a $1,000 grant to any family who commits to adopt a child with transfusion dependent Thalassemia by the end of May. This is in addition to MAA’s $1,500 Holding Hope grant that is available through May 31!

Interested in learning more about adopting a child with Thalassemia? Please complete our Prospective Adoptive Parent form and an Adoption Specialist will be in touch!

Not in a position to adopt right now? You can still help! Donations like yours help allow us to continue to provide grants to families!  Please consider donating today, so the waiting children can have a chance at a tomorrow.

And please remember, in honor of Reid, and all of the children worldwide who rely on blood transfusions for survival, consider donating blood! Contact your local American Red Cross to find out more information on how to do so!!

How to Choose a Country for International Adoption: Five Questions to Ask Yourself

In my role at MAA, I talk with families who are just starting to look into adoption, and often trying to determine the right path forward. An important first step when considering international adoption is to see which programs you are eligible for. You can view general eligibility guidelines for each country on our Country Comparison Chart, but to confirm which programs you qualify for, please fill out our free Prospective Adoptive Parent form so our program staff can review your information and clarify any potential issues in eligibility.

Sometimes you are only eligible for one program and so the choice is clear, but when there is more than one option, how does one choose? Here are some of the questions I ask families to help them think through which country is the best fit for their family:

1.What age, gender, and special needs are you open to?

While essentially all international programs today are considered “special needs,” each program varies slightly in what the common special needs are. This post goes more in depth about the types of special needs we see in each program. Most programs allow families to choose a gender, but families waiting for referral of a young child in the Philippines must be open to either gender. While we see children of all ages in all countries, in Bulgaria, young children in need of international adoption all have special needs that are usually considered more complex.

2. Do you want to adopt siblings?

We see siblings in four of our five international programs: Colombia, Bulgaria, the Philippines, and the Dominican Republic. While we very rarely see twins in China, it is so rare that China is not a good option for a family who has their heart set on adopting siblings.

3. What is your travel availability?

The length of travel requirements ranges from just one week in the Philippines, to 4-6 months in the Dominican Republic, so how long your family is able to travel will impact your program options. Bulgaria requires two trips, while other programs are only one. While MAA always encourages both parents to travel in order to experience their child’s country and culture, for families where that isn’t possible there are countries that allow just one parent to travel, including China, Bulgaria, and the Philippines.

4. What are your cultural resources?

If you live in an area with a large Chinese community, but almost no Spanish speakers, it may make more sense to adopt from China than Colombia. This isn’t to say that you can’t adopt from a country if you don’t have people of that heritage in your area, but if you do so, you need to commit to providing those cultural opportunities for your child. It may mean long drives to other cities where there is more diversity, or paying for a tutor who can teach your child their native language via Skype lessons. You’ll need to consider if you’re prepared to make those greater efforts to keep your child and your family connected to their culture.  Remember, their culture is now your culture too!

5. What is most important to you?

Every country program is different, and the reality is there may not be a program that fits exactly what you are dreaming and hoping for, so you’ll have to consider what your priorities are. Is it adopting a child who is as physically healthy as possible? Then you may want to look at the Philippines, though the wait for a referral is around three years. Or is it more important to you to adopt a child more quickly? Then you may want to research special needs, find some you are open to considering, and adopt from a country like China or Colombia, where the process is often a year or less. Is it adopting from a country where there is a big need for adoptive families? Then you may want to consider the Dominican Republic, where the long travel requirement scares most potential families away.

These questions are personal, and the answers will be different for every family. It’s important to be honest with yourselves about your hopes and expectations so that you can choose a country where you are prepared for what the process will be like, and ultimately bring your child home.

Ready to get started considering international adoption? Call today or fill out our free Prospective Adoptive Parent form to connect with an adoption specialist and find the path for your family!

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!


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.


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.


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!



Cancelled.  A word we’ve all become far too familiar with this past month.  School – CANCELLED.  Non-essential office work – CANCELLED.  Wedding – CANCELLED.  Sports – CANCELLED.  The list goes on and on.  But we are adapting.  School and work is being done at home.  Guests are witnessing nuptials over zoom.  Coaches are holding virtual practices.  We are getting by.  We are surviving.  We are looking forward to the future envisioning, “This time next year, this will all be a memory.” 

But when I heard this morning that our 2020 Hosting has been CANCELLED, my heart sank.  You see, hosting isn’t just a moment in time.  Well, it is, but it isn’t.  Yes, it is three weeks.  But it is so much more than those three weeks.  Hosting is an opportunity for waiting children to find permanency.  To find the loving family they have been longing for for years.  It is an experience that will likely pave the way for a brighter future for that child.  So when I got the email with the subject line HOSTING CANCELLED, it took everything in me not to slam my laptop shut and pretend it wasn’t there.  This isn’t a vacation that is cancelled.  It isn’t something that can just easily be put off until next year.  Because that year is an eternity for a waiting child.  It might as well have said FUTURE CANCELLED.  Or DREAM CANCELLED.  Or FOREVER FAMILY – CANCELLED.    

It is devastating, and we are grieving with and for the kids.  The kids like Elise.  Elsie is a quiet girl who loves to sing and play basketball and volleyball.  She is also interested in drawing and writing.  Elise is 15, and this was her last chance to participate in hosting.  She will age out when she turns 16.  We are also grieving with the host families who were committed to the children.  We will allow ourselves this sadness on behalf of them all.  But only for a moment.  Because then we must dry our tears, regroup, and figure out a way to continue to stand by these children.  And we can’t do that without YOU. 

We will absolutely reschedule our hosting sessions the moment we can!  We will hit the ground running the instant we get the go-ahead.  But in the meantime, we urge you to act NOW.  Reach out to us.  Ask us all of your questions related to hosting and adoption.  Get the process started!  That way, the moment those doors open, we can all run through together! 

In honor of the host children who have lost this opportunity, we are humbled to offer MAA’s Holding Hope Grant of $1,500 for ALL qualified Prospective Adoptive Parents who apply and contract with MAA by May 31, 2020 for any of our international adoption programs.  Complete your Prospective Adoptive Parent form today to connect with an Adoption Specialist. 

Not in a position to adopt right now?  Donations like yours help allow us to continue to provide grants to families!  Please consider donating today, so the waiting children can have a chance at a tomorrow.

The Most Difficult Decision

The Most Difficult Decision

Guest post by Rich and Ginger Kruiswyk, MAA Colombia adoptive family

Buckle up … this is a long post, full of twists and turns. When we last updated you, we were facing a four-day mandatory lock-down, which we are now on the second day of. We are confined to our hotel room during this time. No one is allowed to be out in the city, with very few exceptions. Our hotel does not have cleaning staff or restaurant service. There are a few food services that are allowed to deliver food (restaurants and grocery stores). But, all in all, the city street we can see from our hotel room, that is usually crammed with people and vehicles (and lots and lots of motorcycles), is eerily quiet.

Thursday morning we had another little adventure as Naomi was complaining of pretty intense tooth pain. Naomi has some minor disabilities, including speech delays, and is not always easy to understand. Plus, she has some processing delays that make it harder for her to understand what we are asking. We understood the pain to be pretty bad (she had mentioned it to Rich the previous day when Ginger was not around), and, knowing the lock down went into affect the following day, we messaged our agency. These people are truly amazing!! One of our local contacts reached out to her dentist, who was only a 5 minute walk from here. Ginger zipped over there with Naomi (made sure they had their masks on) and we were in and out in about 20 minutes. Praise God it was nothing serious and she is doing just fine now.

But, while Ginger was there, she received truly devastating news … the Colombian president decided it was in the best interests of his people to close his borders to all incoming traffic beginning Monday, March 23rd … FOR 30 DAYS!!! This means no planes flying in for 30 days. So while there is no ban on leaving the country, there will not be any planes here to take people home.

We were put in a terrible position … do we stay with the girls, knowing we have no way home to our other children for 30 days at minimum, or do we return the girls to FANA (transition home) and fly home to our other children?

When we were together again, we had the one of the most difficult discussions (if not THE MOST difficult) we have ever had. At the end, after looking at how rapidly things have changed over the last week, we made the decision that it was best to return to the United States at this time. This was primarily influenced by several big factors: the thought that 30 days might turn into 60 or 90 days, or more (this seems a very real possibility when schools and universities are canceling activities 2 months out) and the fact that we know the girls will be very well cared for at FANA. They are truly the most amazing and loving people, and we know the girls are loved by the staff. They will get to be with friends, continue with some education, and will receive love and counseling. We will get to Skype with them weekly as well. Yes, we considered having one of us stay here while the other returned home, but rejected that option because 1) we didn’t feel living in an apartment for 30 or more days (with no opportunity for social interaction with peers or semi-formal education) would be a good outcome for the girls, and 2) we had not yet completed integration, which means the remaining parent would be able to do very little to advance the adoption process until we were both together again.

Next we had to tell the girls. We cannot tell you how absolutely horrible it was to have to tell them .. no words can adequately describe that conversation. So so so many tears cried by all four of us as we talked. We are all truly devastated at this turn of events. We tried to emphasize to the girls that we will be back AS SOON AS WE CAN, as soon as the borders are open, we will be back. Again, we are blessed because the girls have the BEST counselor at FANA who will help them understand, especially where our Spanish cannot get across to them all we really want to say.

Just when we were settling into the reality of leaving, we were given the news that we might not be allowed to leave. We are not going to go into the details of the reason behind that so that we can protect the privacy of our girls, but after preparing the girls to get picked up Thursday afternoon and making flight arrangements for Saturday, we were told to change our flights to Sunday, and then, that we might not be able to leave AT ALL….that we might have to remain in country indefinitely, until the travel ban is lifted. This was too much for Ginger, who basically had a meltdown (behind closed doors, so the girls did not see or know).

Our expectation was that we would find out for sure on Friday. After waiting all day, we received word that our agency made arrangements to be sure we could get out of the country on Sunday. We were simultaneously relieved and crushed. So, our flight leaves tomorrow morning at 7:30. The girls went back to FANA this afternoon. To say it was a difficult good bye would be an understatement.

The people at our agency have been absolutely amazing throughout all of this. They sent us groceries Thursday morning to help us get through the citywide lock down (before the travel ban was announced), they have kept in constant contact with us as we have waited for news, they answered all our questions, and have been a very understanding and sympathetic ear as we have struggled with (and continue to struggle with) the decisions we have had to make. Several of the local staff have even taken the time to talk to and reassure our girls. And, mind you, we are not the only family here! There are several others at various stages of the process that they are working with and we know are helping in similar and other ways throughout this nightmare. We are truly blessed by them! And, the psychologist at FANA has also been in contact and is very supportive.

Finally, a shout out to our kids at home!! We skyped with them yesterday, at the request of the girls, and filled them in with what was going on. We did not know the final outcome at that time, so we had to tell them we might not be home for 30 – or more – days. They are troopers. While they may also be struggling with the current situation, they understood and were willing and are very able to hold down the fort for as long as needed. We know we have several friends who have checked in on them while we’ve been gone this last week (so much has changed at home since we left, it is unbelievable), and we are beyond grateful for them, too. We hope to be pressing everyone back into service in a little over a month so we can come back down to Colombia and BRING OUR GIRLS HOME!!

In the meantime, we have a list of prayer requests:

1. Pray for the girls, for their peace and that they know in their hearts that they are loved, that we are coming back, that they are Kruiswyks now.

2. For our safe return home. We are flying through Houston, and we will immensely grateful to be back on US soil. We will be wearing masks, gloves, basically keeping our hand in our pockets, and taking every conceivable precaution.

3. That the measures being taken, by people all around the world, are enough to stop the spread of COVID-19 so we can get back to Colombia ASAP

4. That the 30-day ban is enough, so we can be back with our girls sometime in late April or early May

5. For peace for us – this has been incredibly difficult, we have questioned our decision more times than we can count as we have looked into the eyes of our daughters here in Colombia and into the future.

6. That we won’t be judged by others for our decisions. If only people could understand the agony experienced by us and others in similar (and different) positions, maybe there would be more empathy and less judgment. In fact, shouldn’t we always strive to leave judging up to God and instead just love? We’re pretty sure that is what God calls us to do.

This journey has not gone how we expected it to go in any way .. ANY WAY!! However, we know that God knew about this all along. While Ginger definitely struggled, she also stated that if we have to remain here, then God must know we need to be here in Colombia more than we need to be home. She would be lying if she didn’t admit that she is still very grateful that she gets to return home. Happy … no, not happy. Happy only if our daughters were coming with us. But grateful to know the girls are loved and safe here, and we can return home to make sure our other children stay safe as well.

Finally, one last little push – if you feel God is leading you to adoption … DO IT!!! These children are worth every bit of it. These last few weeks have been scary – including, no toilet paper!! We have eight (soon to be ten) people living in our house, so we need toilet paper! What we are facing is nothing compared to what many orphaned children around the world face. We miss and need toilet paper, they miss and need a home. We are blessed, and we should do something with all we have been blessed with.

Thank you for your prayers, and we ask you to pray us home. God willing, we should get home by 8:00 pm Sunday evening … hopefully we’ll be coming back to you in about 30 days to tell you our next departure date.

Blessings, Rich and Ginger

Interested in adoption?  Complete our Prospective Adoptive Parent form today, and an adoption specialist will be in touch with you to discuss potential adoption options.  Not in a position to adopt right now?  Please consider donating to Madison Adoption Associate’s general grant fund.  Every dollar goes directly to finding families for waiting children.