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Finding the Right Fit: How to Choose an Adoption Agency

One of the most important decisions you will make during the adoption process is choosing the right adoption agency. With so many options out there, it can be overwhelming to know where to start. Let’s go over some things to consider when selecting an adoption agency.

1. Type of Adoption

Adoption, mother and girl outdoor, smile or happy being loving, bonding or happy together. Portrait.

The first factor to consider is the type of adoption you are pursuing.

There are several types of adoption, including:

Domestic infant adoption

International adoption

Domestic waiting children through foster care

Domestic Identified

Adoption of children with special needs

Adoption of sibling groups

Some adoption agencies specialize in one type of adoption, while others may offer multiple options. It’s important to choose an agency that is experienced in the type of adoption you are pursuing, as they will have the knowledge and resources needed to guide you through the process.

2. Licensure and Accreditation

Finding credentialed adoption agencies should be a primary concern for prospective adoptive parents. Adoption agencies should be licensed and accredited by the required designated authorized organizations. In the United States, the primary Hague accrediting bodies for International Adoption agencies are the CEAS (Center for Excellence in Adoption Services); and IAAME (Intercountry Adoption Accreditation and Maintenance Entity). Domestic adoption required accreditation and licensure are determined by the state the agency is working in. It’s important to check the agency’s licensure and accreditation status before working with them.

3. Reputation

Customer Experience Woman hand thumb up vote on five star excellent rating on blue background. Review and feedback concept.

Another key factor to consider is the agency’s reputation. Research the agency online and read reviews from other adoptive parents. Ask the agency for references and talk to other families using their services. There are many social media groups to join for prospective adoptive parents. You want to work with an agency that has a good track record and is well-respected in the adoption community.

4. Services offered

Different adoption agencies may offer different services, so it’s important to understand what is included in their adoption services. Agencies should include significant pre-adoption education classes on the types of adoption they offer and cultural education about the countries where they have programs. Learning more about special needs adoption, older child adoption, and sibling adoption should require even more specific education to prepare prospective adoptive parents for the future. Some agencies may provide counseling and support services for birth parents, while others may offer post-adoption support for adoptive families. Make sure you understand what services the agency offers and what their fees cover.

5. Communication

Communication is key when working with an adoption agency. Find an adoption agency that answers personally to your phone calls and emails. You want to choose an agency that is responsive to your needs and keeps you informed throughout the adoption process. Pay attention to how quickly they respond to your inquiries and how well they communicate with you.

6. Cost

Adoption, International adoption as well as domestic adoption, can be expensive, so it’s important to consider the cost of the agency’s services. Make sure you understand their fee structure and what is included in their fees. Some agencies offer grants or partner with organizations such as Brittany’s Hope, so be sure to ask about financial assistance options available with an agency.

7. Personal fit

It’s important to choose an adoption agency that feels like a good fit for you. Adoption is a deeply personal experience, and you want to work with an agency that understands your values and priorities. Schedule a consultation with the agency to understand their approach and how well they understand your needs.

Choosing the right adoption agency is a critical decision in the adoption process. Consider the type of adoption you are pursuing, the agency’s accreditation and reputation, the services offered, communication, cost, and personal fit. By doing your research and asking the right questions, you can find an adoption agency that is the right match for your family. Here at Madison Adoption Associates, we believe in the power of family and work hard to build an ongoing relationship with the families who choose us.

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Truly a Bundle of Joy: Darla and Glen’s Down Syndrome Adoption Story

In honor of Down Syndrome Awareness Month, we asked some of our families who adopted kids rocking an extra chromosome to share some of their stories! Here, Darla shares about her family’s journey to adopt their daughter from Bulgaria.

After having a biological daughter with Down syndrome and experiencing the amazing amount of joy that she brought to our family, the Lord placed on our heart to adopt again. We reached out to Reece’s Rainbow, because we knew of their focus on helping people adopt children with Downs.  We found a beautiful little girl and the team at Reece’s lead us to Madison Adoption Associates to learn more.

We learned that our future daughter was currently in Bulgaria, and she had recently turned 2 years old.  Over the course of the next few months we learned more about her and spent lots of time praying for her.  It was fun to share the videos and pictures we received with our children, and we all grew in our excitement and anticipation to welcome her into our family.

Our first trip to Bulgaria was in late summer, and we were blessed with spending a week with our new daughter and the wonderful foster mom and social workers.  She was full of joy and enthusiasm, and oh so, so cute!  She was just learning to walk, so we spent a lot of time at parks and playgrounds and toddling around in the sand.  We laughed and laughed.  She loved swinging on swings, and sliding down slides, and climbing up steps, and being hugged and carried and fed.  She was very joyful and active, and walked and played with abandon.  Everything in life was met with smiles and giggles.  She was accepting and bright-eyed when engaging us, from the start and through the whole week!

Back at home we had weekly video calls to stay connected and continue to see and hear each other.  The language barrier at times made these calls seem slow and a bit long, but looking back we could see that this was a highly beneficial way to have our daughter continue to know us and bond with us, including seeing and hearing her new brothers and sisters.

We went back for a second time to bring her home 3 months later, and this time brought three of our other children.  The travel there was impacted by winter weather and had more than its share of surprises and adventure, but the Lord’s favor was on us every step of the way.  In great anticipation, we awoke on our “Gotcha Day” so eager to see our daughter again.  Through many hugs and tears we were able to welcome our daughter and with deep thanks to the foster family and social workers we set out to spend a week together finishing the adoption process as a family.  She welcomed us right away and seemed especially comfortable to be with us from the start, which we believe was due to the time we spent together 3 months earlier and the ongoing connections we made through video and talking while we were apart.

Back home all of our children have loved spending time with her.  Who wouldn’t want to spend time with an excited, joyful, eager, driven, fun-loving little sister that loved to give you a hug and smile and snuggle with you?  Teaching can take longer and with more repetition.  Growing can be slower and expect more practice and patience.  Some have commented that we’re doing a great thing for her, but we know that the truth is she is doing a great thing for us in ways we cannot even always put into words.  We are blessed beyond measure, and we wouldn’t change a thing.

Adopting a child with Down syndrome may not be for everyone, but for those who do we would say you will love more than you can imagine.  And while at times we do think that it would be great if our daughters did not have the limitations or challenges that come with Down Syndrome, when we think about what is most important to all of us – to experience and share joy, love, grace, peace, friends, family, contentment and have great faith – it is clear that those of us without Down Syndrome have the greater challenges in life.

Thank you to Glen and Darla for sharing their family’s story! If you are considering adopting a child with Down syndrome, fill out our free Prospective Adoptive Parent form to connect with an Adoption Specialist and learn about the children waiting for adoption!

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They Will Amaze You Every Day: Nate and Kelly’s Down Syndrome Adoption Story

In honor of Down Syndrome Awareness Month, we asked some of our families who adopted kids rocking an extra chromosome to share some of their stories! Here, Kelly shares about her family’s journey to adopt their son Jonah from the Philippines.

How did you come to the decision to adopt a child with Down syndrome? 

Since I was a child, I have loved spending time with people with special needs. I taught special ed before having our first biological daughter and worked with adults with intellectual disabilities between school years. I have always found people with Down Syndrome to be especially kind, loving, and fun. We chose to adopt because we wanted to bring a child into our family from the special home finding list who would be less likely to be adopted than a young developmentally typical child.  

What was the adoption process like for you? 

Our adoption moved quickly compared to the average for the Philippines. We submitted our Dossier on December 22, 2018 (my 27th birthday, the age requirement) and we picked up Jonah in August of 2019. The 8-month guardianship phase actually lasted about 14 months due to Covid delays but that wasn’t too difficult for us since Jonah felt like our son as soon as we brought him home. Sometimes all of the paperwork and bureaucracy felt overwhelming but taken one step at a time it was all manageable and of course, worth it. Katie and Diana at MAA were so helpful, kind, and knowledgeable, which was invaluable. We also met many wonderful people in the Philippines that we are still in contact with and I am grateful to know them. 

What were your first days of meeting your son and taking custody like 

Our trip to pick up Jonah was the adventure of a lifetime! Nate had served a two-year mission for our church in the Philippines so he is fluent in Tagalog and familiar with the culture which allowed us to socialize and explore. With two young children at home (2 and 4 at the time), Nate and I let loose for the first time in a long time and we had SO MUCH FUN!  

The first morning that we woke up (for the 18th time thanks to a doozy of a time-zone change) we were so excited to meet Jonah. We got ready, ate breakfast, then requested a tric (motorcycle with sidecar used like taxi). Only standing on the residential road outside the hotel did we realize that we had no idea how to get to the orphanage. We showed the address to our tric driver and he got us closer to the area, then we hoped from tric to tric until we were close enough that someone recognized the address and could take us to the orphanage which was still unrecognizable right in front of us as it was a nondescript building behind a wall, tucked away with homes on a dirt road. Meeting Jonah was a joy, we now know he has a certain flair for making everyone feel special, but we were no exception. We were able to play and bond at the orphanage and eventually travel nearby with Jonah and even some of the teenagers he lived with, eating street food, sightseeing, and playing in rain downpours thanks to the encouragement of the older kids.  

We weren’t sure before arriving whether or not Jonah, who was 4.5 at the time, would be potty trained. On our second day when we were going to take him outside of the orphanage for the first time, I asked one of his caretakers. She answered “yes, he’s potty trained, I don’t know why someone put a pull-up on him today.” In hindsight there may have been a language barrier. We got him dressed sans pull-up and hopped on a tric, with him on my lap. We weren’t yet to our destination when I got a more accurate answer to my question. Our next stop was a change of clothes for Mr. Pee Pants.  

Jonah is the opposite of our daughters who need routine and consistency, making him a great travel companion. Where ever we were he would happily take in the new sights and when he needed a nap, he would power down for a few minutes in our arms or on our laps and pop back up ready for action. His on/off switch was very beneficial on our 14 hour flight home. It was sort of a strange feeling taking Jonah from the life he knew and the people who had cared for him and loved him, but he was eager to go with us. The hardest part for me was taking him away from the only remaining “baby” in the orphanage who has Cerebral Palsy and was close to Jonah. They had come in together in a group of ten babies about 3.5 years earlier. The eight others with no disabilities had been adopted, so they would have been like brothers. 

In terms of taking custody, the first few days and weeks were a honeymoon phase. I remember at the two-week mark saying, “wow, he always listens right away when I say “no” and he never cries.” Then the very next day the flood gates or tantruming opened up. I wish I could say that after two years we’ve figured out exactly how Jonah fits into our family and that parenting him has become completely natural. I’m sure others would disagree and every adoptive parent has a unique experience but to me, adoption feels a lot like marriage. The beauty of Jonah’s unique personality is that every moment is a new moment. You’ll never meet a person who lives more in the now. So, while he may not be considering the consequences of sneaking out of bed at 2am to test out the handheld bathtub sprayer, he will also totally forgive you for losing your cool about the bathroom carnage, 75 seconds later. 

What has been the biggest joy in parenting a child with Down syndrome? The biggest challenge? 

Jonah’s joy is infectious. At the orphanage they told us he brought sunshine wherever he went. It’s true, and he brings a smile to other people whenever we are out. He doesn’t know the meaning of self-consciousness or discrimination on the basis of…anything…so he will attempt to make friends with anyone he can. He’s easy going and flexible, I joke that if he was our only child, we could live traveling aimlessly in a camper van with no structure or routine and he would thrive. He’s a total dandelion, flourishing in his own way under any circumstances.  

The biggest challenge of parenting Jonah has been figuring out how to respond to his negative behaviors. As a parent with both biological children and an adopted child, I want to feel I am treating all of my kids consistently and equally. For example, with my girls I might say “if you put your pajamas on all by yourself, we’ll read an extra book” or “because you didn’t do what Mommy asked, you lost a warm fuzzy” (a jar they fill up to earn fun experiences). Jonah doesn’t grasp a lot of language, abstract concepts, or future consequences. He is non-verbal and by cognitive assessment standards, on the low-functioning side of the Down Syndrome spectrum. I call him my patience sensei because he understandably feels the need to assert control on a regular basis and I am constantly deciding which battles to choose and how. His stubbornness and impulsive behavior have forced me to face demons in myself I previously didn’t know existed. 

What is your advice to parents considering adopting a child with Down syndrome? 

First of all, I am no expert. I would say be excited for the magic that awaits and be realistic about the challenges that will come with it. For us it means having a child who is the majority of the time delightful, hilarious, and sweet, and it means waking up to the poopy pull-up of an almost 7-year-old and hoping he hasn’t committed any major crimes in the middle of the night. Before adopting Jonah, I had spent plenty of time with individuals with Down Syndrome but they were mostly teenagers and adults. You may want to seek out parents of children in the age range you are considering to adopt for a better understanding of what to expect. Then there’s the adoption variable. Jonah didn’t have the same early interventions and optimal pre- and post-natal care that children in an ideal situation would have. I have my suspicions that if he had, he would be different in many ways. That might sound scary and undesirable but it’s not meant to. Jonah is in many ways our easiest child and he brings happiness to everyone he interacts with. In good moments he makes me laugh and smile and in challenging moments he teaches me patience and compassion. There is a pre-natal genocide being waged against individuals with Down Syndrome. My message to anyone faced with the possibility of parenting a child with Down Syndrome is that they will amaze you every day with their goodness and unique intelligence and you will feel privileged to have them as a part of your family. If you are considering adopting a child with Down Syndrome, there is a child worthy of your love and your last name, waiting for you to be brave enough to take the leap. 

Thank you to Nate and Kelly for sharing their family’s story! If you are considering adopting a child with Down syndrome, fill out our free Prospective Adoptive Parent form to connect with an Adoption Specialist and learn more about the children waiting for adoption!

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Changing the Story for Maddox

Maddox is an active kid who loves to spend time outside, playing soccer and swimming. In many ways he sounds like a lot of ten-year-old boys, but he has been through more than any ten-year-old should. He first came into the child welfare system in Colombia in 2014, and after reunification efforts failed he came into care again in 2016. Through all of this, he had his brothers by his side, but that is about to change. Colombia is separating Maddox from his two brothers for adoption, so that they can all get their needs met the way they deserve in their adoptive families. While we are saddened by this we trust the judgement of the social workers in Colombia, who always try to keep siblings together if it is in their best interest. So we turn to the goal of finding families for all of them so they can continue their relationship, even in separate families. Maddox’s brothers have a family interested in adopting them, but sadly we have not yet found a family for Maddox. Our hope is that he can find a family quickly so they can be adopted around the same time and will not have to watch his brothers leave, not knowing if a family is coming for him.

So who is Maddox, and what kind of family does he need? He is a shy boy, and can be insecure, so he needs a family who will take the initiative to bring him out of his shell and help him find areas he can shine in to build his confidence. On the occasions where he has been able to interact with animals he is calm, friendly and playful, and would probably love a family with pets! He is careful, kind and protective of younger children, and equally respectful of teenagers, as long as they are respectful to him, and he would likely do well with a small number of siblings, older or younger, but not close in age to him.

Maddox is diagnosed with ADHD and has had many of the challenging behaviors common for kids with this diagnosis. However, he has really grown during his time in care and is making improvements! He has had surgery for a cleft lip and palate, and while his speech is on target for his age in terms of building sentences, expressing his feelings and needs, he does have some challenges with pronunciation. He has been teased by peers for his cleft palate and speech, and is sensitive about his appearance as a result.

Maddox has been through a lot in ten years, but this isn’t the end of his story and it doesn’t define him. We imagine a story for him where he is embraced by a family who gives him affection and nurture, structure and opportunities to boost his confidence, and we see a future where he is happy and loved. Could your family play a role in that story? Maddox has a $2500 Grant available for families adopting through MAA. Email Lindsey Gilbert or complete a free Prospective Adoptive Parent form to learn more about this sweet boy!

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How You Can Support Post-Adoption Families and Adoptees

Dear Friend,
What a year it has been! We pray that you and your family have weathered this crazy COVID storm, and that this letter finds you and yours healthy. We surely are living through history, with the pandemic affecting every aspect of life, adoptions included. While many countries are allowing adoptive families to travel, others have not yet reopened, and our hearts break for the families and children waiting to be united. Despite the closures, despite the painful delays, and despite the unknowns, MAA remains dedicated not just to finding families for the children who wait, but supporting those families and children for life, and this is the reason I’m writing to you today.

We know that when an adoptive family finally meets their child, that’s not the end of the journey, it’s just the beginning. Attachment, culture shock, and challenging behaviors of all kinds are the norm for adoptive families, and the uncertainty of the pandemic has only exacerbated the challenges. Prior to the pandemic, we were already busy working behind the scenes to strengthen our post-adoption support for all of our families, and now that work is more needed than ever.

Over the past several years, we have recognized that the face of ‘the adopted child’ is changing. The children in need of adoption are almost all older, medically fragile, and/or sibling groups, all with histories of trauma, and families frequently need support and guidance to successfully emerge as a bonded family. Adriana Chaves initially joined the MAA team as the Hosting Coordinator, but as hosting became impossible this year due to covid, a new purpose emerged. Adriana has her master’s degree in Clinical and Family Psychology, so it was a natural fit for her to step into a new role as MAA’s Post-Adoption Wellness Therapist. She has been running virtual support groups for adoptive parents and adoptees, helping families identify needed resources in their area, and providing one-on-one post-placement support to families going through significant challenges. Additionally, she’s provided cultural education for families in our Colombia program, with 30 families attending her recent webinar on Colombian culture!

The Colombia Kids Group has been a great safe place for our daughter to socialize during these unusual times with kids just like her. She has been able to connect with children that she interacted with at her orphanage and has also been able to talk with other children with similar stories to her. It is a unique, friendly, no pressure group that she looks forward to participating in.

-Michelle, MAA Adoptive Mom

So on this Giving Tuesday, we are reaching out to ask for your help in supporting our mission to bring hope, love, and connection by serving children, individuals, and families in the areas of adoption, foster care, and support services. Thanks to a generous donation this summer, we were able to offer our post-adoption support groups to all families, whether they adopted through MAA or not, but for that work to continue and grow, we need donations to continue too. Visit our new donation page, and when you select “Post-Adoption Services” 100% of your donation will go to our work supporting post-placement families and their children. For those who can, please consider a recurring monthly donation, so we can consistently provide these essential services to any family who needs them!

From the bottom of my heart, and on behalf of adoptive families and children, thank you for your consideration. We are all ‘in this together’, in more respects than one.

Please stay safe and God bless!

Sincerely,
Diana Bramble, MBA, LMSW
Executive Director of Operations

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Why Not Us?

An advocacy post on Facebook changed my life forever.

In the spring of 2016, God broke my heart for a little girl who was waiting for a family in China. She was precious – an adorably chubby baby sitting on the floor, arms stretched above her head, sweetest little joyful grin on her face. My heart shattered as I realized when she reached up to be held that there was no Mama (or Dada) to pick her up and love on her. This precious little one also happened to have Down syndrome.

Before her little face, we’d always talked about adoption. “Some day.” When we were more ready, when our children were older, when we had more money in the bank. Before her little face, I never thought that WE could say YES! to parenting a child with Down syndrome. Only “special” families were called to do something like that. We weren’t spiritual enough, rich enough, brave enough to walk that road.

After her little face, I began to wonder “Why not?” Why not adopt? Why not Down syndrome? If not US, who?

Many tears were shed, many prayers said on behalf of a little girl whose joy-filled face I could not forget. Were we missing out on our daughter? God eventually granted me peace through a dream that this little girl’s family would give her older brothers (something our family could not provide) and that she would be HOME. Over the years, I’ve continued to think about and pray for her.

A week before we left for China to meet our own darling girl, I connected with the Mama of the child God used to crack my heart wide open. She does, indeed, have a Mama and Dada. And two older brothers (and two big sisters to boot!) who love her dearly. I am so thankful that God orchestrated her story so beautifully. I will also be forever grateful that God used her face, and the idea of her, to change me and my family forever.

When you see the photos of little ones waiting for their families maybe you think the same things: “Not now!” or “Not me!” But maybe – just maybe – God will break your heart for that specific child, or one of the MANY other children, who waits.

We did not know anyone with Down syndrome before adopting. In fact, Cora was the first person with DS that we ever knew in person. I found so much support through online groups, where parents had already walked some of the roads we were about to take. There are so many groups, so many resources. Don’t be afraid to reach out and ask to connect! Most families in “The Lucky Few” (because WE are the lucky ones!) would love to talk to you about raising a child with DS, or can point you in the direction for resources that may help you. Places to start: The Lucky Few Podcast, the Down Syndrome Adoption Questions Facebook group, or start following families or people with Down syndrome on social media!

The best thing about parenting a child with Down syndrome is getting to see the world from a new perspective. Cora has changed the way we think about almost every aspect of our lives. After our relationships with Jesus, getting the privilege of parenting her has been the next biggest catalyst for adding joy to our days, slowing down to appreciate the truly important things, and having a more eternal view of what our purpose is in this life we’ve been given!

On the flip side, the hardest thing about parenting a child with Down syndrome has been adjusting and responding to how the world views our child. Even though we thought we were prepared, there have been so many instances where I’ve been taken aback by people’s archaic, negative, or prejudiced views of people with Down syndrome. We knew we’d have to advocate for her in certain educational situations, but I’ve learned that advocacy is a day-in day-out process as we navigate the world. Helping others see beauty and worth where the world doesn’t can be exhausting, but what a joy and privilege it is to shout their worth. So much is changing in the world for inclusion. I cannot wait to see what the world looks like for Cora when she’s my age!

I wish others understood that each person with Down syndrome, like every other human who has ever walked this planet, was created in the image of God. We are ALL more alike than we are different. We are all created to contribute good and beautiful things to our world. I’ve had others tell me how tough adopting a child with Down syndrome would be, ALL the things that our child would likely never do, all the “hard” we were walking into by saying yes. But you know what? Zero of that matters. Because every child is worthy and deserves a family. 

Emily and her family are currently on their adoption journey to bring home their second child with Down syndrome. Thank you for sharing your story! Are you considering adopting a child with Down syndrome? Email Lindsey Gilbert to learn about the children who wait, or complete our free Prospective Adoptive Parent Form today!

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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

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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!

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It Really Is a Big Dream

Dear Madison Adoption,

I have known Luke (previously known as ‘Ashton’ with MAA) 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 Luke couldn’t get paperwork, and when I found out that he could finally be adopted, I was so happy!  Luke 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 Luke, 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 Luke and adoption!

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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!

Thailand

We work with the Thai Red Cross Children’s Home in Bangkok, a small children’s home that is part of a large hospital complex. As a result, many of the children come into the TRC’s care because they were born in the hospital, but their biological families are struggling in ways that make it hard to care for their child, including addiction and mental illness. As a result, most of the children placed are toddlers and young children who may be medically healthy, but have background risk factors. The TRC also receives children from government orphanages who need the additional medical monitoring the hospital can provide, so there are also waiting children with a variety of medical needs.

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 six 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, and who may have developmental delays. Families who are open to Down syndrome or neurological needs 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.

Ecuador

In Ecuador, there is a thriving domestic adoption program, which allows many young children with minor needs to stay in their country of birth! As a result, most children in need of international adoption are over the age of six, though there are occasionally younger children with more complex needs, or who are part of a sibling group with older children. Many older children have been removed from their homes due to abuse or neglect, so there are many sibling groups over the age of ten in need of adoption.

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!

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