Pre-Adoption Special Needs Consultation

We are adopting from China's special needs program and as part of the home study process, must answer a four-page, single-spaced list of needs we will or will not consider.  I felt overwhelmed and scared when I first looked at the list.  I had never heard of the majority of the conditions (forget about being able to pronounce some of them!) and I tried Googling to learn more.  Bad idea!  I just felt depressed.  Chris and I made a half-hearted attempt to answer some of the questions, but felt unsure on even the ones that seemed like an obvious yes or no at first glance. 

On a tip from an adoptive parent who had adopted a boy last year from China, we made an appointment for a pre-adoption consultation with Dr. Eckerle at the University of Minnesota's International Adoption Clinic.  What a wonderful resource to have so close by.  So we wouldn't have to battle traffic, we scheduled a conference call over Skype.  Our nanny took the kids out to dinner while we received a mini medical lecture on every single condition listed on the form.  As a pediatrician at an adoption clinic, Dr. Eckerle has experience with the types of conditions typically presented in children who have lived in orphanages and/or were born in China.  She was so honest about what she was and wasn't concerned about and what she rarely or has never seen in the 1,000+ children she has seen for post-adoption exams. 

I finished our hour-and-a-half-long consultation feeling better informed.  Chris had a much different reaction.  He had migrated from my side at the dining room table to our living room couch and seemed very disinterested.  As soon as I logged out of Skype, he announced, "That was horrible! Every single thing you don't want to happen to your child and you have to go line by line through each one in excruciating detail." 

In that sense, it was horrible. A first parent has already said no to this child and before even meeting him or her, we're basically saying, you are too much for us to handle.  And if we say no, how many others will also say no?  And for the children with the most serious conditions, what will their quality of life and prognosis be without proper treatment and care, love, family and an advocate?  Thinking about the unfairness in health and circumstance makes me so sad.

A lot of joy can come from adoption, but there also a lot of tough choices.  And for adoptive parents, that's being honest with what we can handle.  Chris and I ended up checking "no" for many of the listed conditions, and at best, "willing to discuss."  Some conditions, like developmental delays, I hadn't thought at first would be so serious.  I knew that most children who grow up in orphanages come home with developmental delays for a variety of reasons.  The doctor was frank that if all the kids have developmental delays, though, and then a child, who compared with all those other children, is diagnosed with a developmental delay, then you can assume it's quite serious.  And some conditions aren't serious in some cases, but you won't know until the child is older, and when adopting a one- or two-year-old, the exact prognosis is not yet known. 

Many of the conditions we indicated we think we can handle still don't seem very minor to parents who have no experience with special needs.  Dr. Eckerle estimated that 60% of children available for adoption from China have cleft/lip palate.  Though this condition falls into the "minor and/or correctable" category, two to three surgeries are needed stateside, along with possible speech therapy, dental work and ear tubes. 

Right now we're talking about theoretical kids.  The difficult part is going to come when we receive a match.  Then we're talking about an actual child who could become our son or daughter.  We'll have 72 hours, with Dr. Eckerle helping us to evaluate the file, to make a decision, yes or no.