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-The child has their own culture and norms that they are used to and they will be coming from. Helping the child with what they truly need rather than what you think they need is crucial because those are two completely different lenses.

It's the child's life that is being affected; however you help them whether it's a good or bad thing, the child will be the one who is affected. Yes, it is a big transition for you, but think of how much of a change it is for the child to be leaving the place they are used to, going with strangers, potentially not understanding the language, etc.

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OVC 110

S2024

Dr. Sisson

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-All children - especially older children in foster care - need and deserve a family with no expiration date. When a child is adopted, it is transferred to one set of parents/guardian to a new set of parents.

-While adoption is a wonderful thing, for children who have spent time in an orphanage, it can also prove to be a difficult and confusing thing as they transition from the only world they may have ever known into your world.

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I Am an Orphan | Get to know our mission, our vision, and our heart for the orphaned and vulnerable. And then partner with us. 

Together, we can—and will—restore hope.... | By Orphan OutreachFacebook

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Get to know our mission, our vision, and our heart for the orphaned and vulnerable. And then partner with us. 

Together, we can—and will—restore hope....

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Kaylyn Gates

Sophomore and OVC major

Amanda Bowman

Sophomore and CMI major

Meski James

Freshman and Social Work major

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https://kahoot.it/?pin=200854&refer_method=link

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Join a game of kahoot here. Kahoot! is a free game-based learning platform that makes it fun to learn - any subject, in any language, on any device, for all ages!

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391,000 children are in foster care

115,343 children are adopted each year

1 out of 25 families with children have adopted

95% are open adoptions

114,000 foster children are eligible for adoption

58% of children spend 2-5 years in foster care

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When adopting a child, you will work closely with adoption experts throughout the process including:

Legal representatives like adoption lawyers

Adoption agencies and local child welfare agencies

Social workers

Pediatricians - they help with physical, medical, mental, developmental, and emotional care.

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What is adoption?

Adoption is the social, emotional and legal process in which children who won't be raised by their birth parents become members of another family.

There are several forms of adoption, like open or closed adoptions and individual or sibling adoptions. And no two adoptions are the same. In the United States, you may be able to adopt a child through:

Foster care.

Private agencies.

Extended biological or nonbiological family (kinship or stepchild adoption).

Another country (international adoption).

If you're planning on adopting a child, you'll work closely with adoption experts throughout the process, including:

Legal representatives (like adoption lawyers).

Local child welfare and/or adoption agencies.

Social workers.

Pediatricians.

Pediatricians play a crucial role in helping families with the medical needs of children who go through the adoption process. This includes physical, mental, developmental and emotional care.

What medical issues are related to adoption?

Just like anyone else, children who go through the adoption process can already have or develop any type of health condition. Several studies show that children who go through the adoption process are at an increased risk of physical, developmental and mental health conditions compared to their peers who haven't been through this process.

These risks are real, but the care, resources and support you provide can help your child grow and thrive despite these health conditions.

Why are adopted children at an increased risk of health conditions?

Early life experiences that may contribute to this increased risk of health conditions include a lack of access to:

Healthcare before and after birth.

Nutrition.

Physical or emotional needs (developmental stimulation).

Protection from toxins (like substances) or pathogens (like infectious diseases) before or after birth.

Many children also experience adverse childhood experiences (ACEs). ACEs are negative experiences that happen between the ages of 1 and 17 years. These experiences are usually traumatic events. ACEs can affect a person's health - both mental and physical - throughout their lifetime. Examples of ACEs include:

Child abuse (physical, emotional or sexual) and neglect.

Exposure to violence, like domestic violence and community violence.

Housing insecurity (homelessness, moving frequently or having an unstable home environment).

Inconsistent caregivers, multiple caregivers or divorce.

Natural disasters.

Death of a family member or close loved one.

Studies show that early traumatic experiences like these can have long-term effects on brain development. Chronic stress from these experiences can have lasting impacts on physical health.

Physical conditions

About 30% to 80% of children in foster care have at least one physical health condition. About 33% of them have a chronic (long-term) health condition. Some of the most common physical health conditions include:

Growth failure and nutritional deficiencies.

Vision issues.

Hearing loss.

Neurological conditions.

Sexually transmitted infections (STIs).

Complex chronic conditions.

Children may also be at risk for iron, calcium and vitamin D deficiency due to past malnutrition. Approximately 20% of children in foster care have significant dental issues.

Emotional difficulties

Removal from their first family and all that is familiar is emotionally traumatic for children. Children who experienced several transitions - such as in the foster care system - may have more intense emotional difficulties. It's important to address - and understand - your child's adjustment difficulties when they join your home and family.

Your child may:

Be withdrawn.

Have temper tantrums.

Be aggressive or defiant.

Cry inconsolably.

Regress in previously obtained skills.

Have difficulty sleeping.

Have a lack of interest in enjoyable activities.

Even if transitions into an adoptive home are gradual, most children experience grief with the change in their caregivers, peers, school and home environment. Educate yourself as much as possible about how to ease this transition. Be patient, but don't hesitate to reach out to your child's pediatrician or mental health professional for guidance if these emotional issues are severe or long-lasting.

Mental health conditions

Most children with a history of foster care involvement in the U.S. have experienced psychological trauma. This increases their risk of developing mental health conditions. Common mental health diagnoses for children in foster care include:

In addition, adolescents in foster care are more likely to have attempted suicide and have a substance use disorder compared to their peers who haven't been through foster care.

Behavioral conditions

About 50% to 75% of children who go through foster care have difficulty with behavioral or social skills that require care from health services. Common diagnoses include oppositional defiant disorder and conduct disorder.

Childhood trauma, adversity and toxic stress, which children in foster care often experience, correlate with the following behaviors:

Poor emotional regulation.

Aggression.

Hyperactivity.

Inattention.

Impulsivity.

These outcomes can increase their risk of behavioral conditions and difficulties.

Developmental conditions

About 46% to 60% of children younger than six in foster care have a developmental disability. These can include:

Speech delays.

Fine motor delays.

Gross motor delays.

Learning inabilities or intellectual disabilities.

Social-emotional dysregulation.

These conditions begin during child development. They may impact day-to-day functioning and usually last throughout a person's lifetime.

Speech and language developmental delays are especially common. Examples include:

Attention-deficit/hyperactivity disorder (ADHD) is also a common neurodevelopmental diagnosis for children in foster care.

Health considerations for international adoptions

Children who go through international adoption are highly likely to have physical health needs and developmental delays.

Infectious diseases and nutritional deficiencies are among the most common medical diagnoses healthcare providers identify after a child arrives in the United States. Children adopted internationally nearly always have delays in at least one area of development, with nearly half having global delays.

It can be especially difficult to get medical records of children from other countries. And the records may be sparse or inaccurate. Many countries follow different immunization schedules than the U.S. If a child coming from another country got their vaccines, it's important you review these records with their pediatrician in order to make sure they aren't missing any immunizations recommended in the U.S. If you're planning to adopt a child from another country, talk to experts about what you can expect and how you can prepare for their health needs. They may have medical guidance based on the specific country of origin.

Health concerns for other family members

When you add another member to your family, it's important to consider the health and well-being of existing family members. Talk to adoption experts about how family members can positively adapt to this big change. Ask about warning signs to look out for with things like sibling rivalry or jealousy. Be sure to give attention or have one-on-one time with existing family members when you can to help with this.

It's also common for parents to experience caregiver burnout when they go through the adoption process. This is a state of physical, emotional and mental exhaustion that can happen when you dedicate time and energy to manage the health and safety of someone else.

Consider joining a support group and seeing a mental health professional to help you and your family through challenging times. It's also essential to lean on loved ones you trust for support.

What should I know about a child's health before I adopt?

Before - or shortly after - you adopt, try to gather as much health information as possible. You'll likely work with several people and groups to get this information, including:

The adoption agency or foster care system.

Your adoption lawyer.

Your child's birth parents and/or family.

Hospital systems and your child's previous or existing healthcare providers.

Your child's past and/or current school.

Health information you should try to get includes:

Any physical, mental health, developmental or behavioral conditions your child has or had. This includes any hospitalizations and surgeries as well.

Birth record information, like their gestational age, birth weight, length, head size and any complications during pregnancy or immediately after birth.

Your child's growth chart, including their weight, height and head circumference.

Documentation of developmental milestones.

Known allergies

Current medications.

Immunization records

Infectious disease exposures.

Any history of malnutrition or feeding difficulties.

The results of any medical tests (like imaging or blood tests) they've had.

Any reports of physical, sexual or emotional abuse or neglect of your child.

School history and performance.

Relationship history, like important ongoing relationships (including with biological family members, foster parents and/or friends) and significant relationship losses.

Medical history of your child's first-degree relatives (biological parents and siblings).

Medical conditions that run in your child's extended biological family.

It's also helpful to know your child's birth history and information about their birthing parent's pregnancy, especially if you're adopting a baby or young child. This includes if the birthing parent:

Used substances during pregnancy, like alcohol, tobacco (like smoking), marijuana or opioids (for example).

Took any prescription or over-the-counter medications during pregnancy.

Had any sexually transmitted infections (STIs) or other infectious diseases during pregnancy.

Had any complications during pregnancy, labor or delivery.

Depending on the situation, you may only be able to get some of this information. In some cases, you might not be able to get any of it. Try your best to get the answers you can.

In an ideal situation, you'd take this information to a pediatrician for review before your child joins your family. This way, they can help you plan for the care your child might need and give you general guidance on what to expect. They can also provide referrals to specialists or certain services, like community support services. This can help ease the transition for your family.

If it's not possible to do this review before the adoption, you'll take your child to a pediatric appointment shortly after they join your family.

What is the role of pediatricians in the adoption process?

Pediatricians play an important role in the adoption process. They'll work with you to identify your child's health needs. They can also provide emotional support to help families through the adoption process.

Adoption and foster care medicine is an evolving subspecialty within the field of pediatrics. You may want to ask your social worker or pediatrician if they have a referral for a pediatrician who has experience in this area.

Roles of pediatricians include:

Assisting in getting the medical records and history of your child.

Providing thorough medical evaluations, well-child care and follow-up visits.

Providing ongoing care for your child and their health needs.

Making referrals for medical specialists, like child psychologists, pediatric cardiologists or speech-language pathologists, for example.

Recommending resources that can help your child and family in the long term.

Counseling families about potential adjustment issues after adoption.

Recommending strategies to promote strong, healthy attachments within your family unit.

Helping with documentation for your child's Individualized Educational Program (IEP) and/or 504 Plan for school, if necessary.

What can I expect at my adopted child's first health appointment?

Shortly after your child joins your family and home (ideally within 30 days), they should have a comprehensive health evaluation with a pediatrician. This evaluation can establish care for known health issues and identify any new ones. These initial evaluation visits are much more in-depth than regular well-child visits.

Your child's pediatrician will need as much information about their medical history (like medical records) as you can provide. Depending on your child's overall health and age, one visit may be enough, or their pediatrician may recommend several visits to complete a thorough assessment.

The evaluation(s) will likely include:

Confirming and clarifying existing medical diagnoses.

Thorough physical exam.

Neurological exam.

Age-appropriate screenings, like newborn screening panels, hearing, vision, dental and behavioral and/or developmental screenings.

Assessing for any previously unrecognized medical issues.

Discussing any developmental and behavioral concerns.

Assessing your child's vaccination status.

Making any referrals to other healthcare providers and specialists.

Testing

Your child's pediatrician may recommend certain diagnostic tests depending on their evaluation. These may be blood, urine (pee) and/or imaging tests.

Your child's pediatrician may also recommend certain blood tests that can check if your child received the vaccines appropriate for their age.

Mental health evaluation

Experts recommend that a child in foster care should have a mental health evaluation within 30 days of joining your family. Ideally, this would be with a child mental health professional trained in trauma-informed care.

How can I prepare for adoption?

The adoption process requires an immense amount of preparation and steps. Before you decide to adopt, it's important to understand what bringing a child into your family entails, especially the considerations related to their health and well-being.

Questions to consider include:

What are your motivations for adopting? Are you ready for this lifelong decision and commitment?

Are you able to provide a caring, nurturing and stable environment for your child?

Do you have access to adequate support services and healthcare your child may need?

Are you willing to advocate for your child's health and well-being in various settings (like at school and in hospital systems)?

Are you willing to educate yourself and your family as much as possible about the special physical, mental, developmental and emotional health needs of your child?

Do you have a strong support system of friends and family to lean on?

Like anything in life, it's impossible to predict the future and what life with your newest family member will be like. But the more you can prepare and think realistically about what adoption brings, the more you can manage your expectations and provide a secure and supportive environment for your family.

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Children who go through the adoption process often have special health needs, like physical, psychological, behavioral and developmental conditions. Pediatricians can help guide you and your family.

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%10-%25 adoptions fail in the US. 66,000 adoptees end up in foster care again after a failed adoption. About 12 every day. This can be for various reasons, but some include:

Unrealistic expectations

Lack of preparation

Inadequate counseling

Most of these issues take place in the transition phase from the child living in an orphanage to bringing a child home.

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Similar to what we talked about in class, there are stages in a child's life that are considered critical and sensitive.

If children are not taught those crucial elements in the time they are supposed to be taught, they will have a much harder time learning them or even may never learn them.

With children who spend time in an orphanage, especially children who are older, once they get moved into home-care, sometimes it is assumed that they know basic life skills. However, oftentimes they are not prepared for life after orphanage care. They have not been taught basic skills such as how to shop, cook, or manage money.

For younger children, the first five years are especially crucial for physical, intellectual, and social-emotional development. It is vital that the needs of children between these ages are met. If they are not, the child may develop attachment issues, trust issues, and other interpersonal connection issues.

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Questions to ask yourself when considering adoption:

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Questions to ask yourself when considering adoption:

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What are your motivations for adopting? Are you ready for this lifelong decision and commitment?

Are you able to provide a caring, nurturing and stable environment for your child?

Do you have access to adequate support services and healthcare your child may need?

Are you willing to advocate for your child’s health and well-being in various settings (like at school and in hospital systems)?

Are you willing to educate yourself and your family as much as possible about the special physical, mental, developmental and emotional health needs of your child?

Do you have a strong support system of friends and family to lean on?

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-Relief-

Children who need adopted are removed from difficult situations  and unsafe environments.

Focus is on reducing immediate suffering from a natural of man-made crisis.

“Stop the bleeding”

-Rehabilitation-

During this phase the focus is on providing the basic needs of the child and enabling them to grow and thrive.

Giving them time, making them feel safe, and providing the care the child needs.

-Development-

Help them meet their goals in life.

Graduating and finding a job and their family still supporting them through it all.

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Relief - Rehabilitation - Development Figure

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How can we restructure our thinking to be more open-minded and individual toward each child rather than putting all orphans into a one-size-fits-all box?

What would be practical ways to be supportive of foster/adoptive parents?

When talking to an adoptee about their experiences, what are some questions to avoid and how can you be sensitive?

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Children in orphanages do not cry, not because they are so well-behaved, but because they have learned that there is no one to come for them if they do cry.

Most people believe that orphanages are a necessary evil because what would we do with all the children without them?

Large institutions seriously the harm health and development of children, especially babies.

We do not realize the impact being in a family has on children. They need facial expressions to copy and sounds to mimic.

Attachment between parent and child is powerful and provides the building blocks for social, physical, language, cognitive, and psychomotor development.

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Georgette Mulheir: The tragedy of orphanages

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Orphanages are costly and can cause irreparable damage both mentally and physically for its charges -- so why are they still so ubiquitous? Georgette Mulheir gravely describes the tragedy of orphanages and urges us to end our reliance on them, by finding alternate ways of supporting children in need.

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From Leaving Care to Leading Care in Ethiopia with Tamrat Kebede (Meski James) 

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From Leaving Care to Leading Care in Ethiopia with Tamrat Kebede (Meski James) 

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Parents put their kids in the orphanage more often than we think, you can have both of your parents and still be put in the orphanage.

Growing up in the orphanage you don't have a lot of hope because there is no talk about having your own family. There is no social and emotional support, you have to figure out life on your own. There are no guides besides being fade, clothed, or going to school these things are not done intentionally.

Tamrat was in the orphanage from the age of 3 until he was 18 and he aged out of the orphanage.

Tamrat's journey displays the transformation power if resilience, education, leadership, advocacy, and as well as community engagement in shaping a brighter future for vulnerable individuals.

Transformative impact of community empowerment by mobilizing resources

to address pressing needs in the community.

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ThinkOrphan | Resources for Excellence in Loving Orphaned Children

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In episode 185, you will hear from Tamrat Kebede who is the Ethiopia Director for Selamta Family Project. Tamrat talks with Phil and Brandon about his own experience growing up in an orphanage and how that has informed his work overseeing Selamta's family and community based model of care. Tamrat also explains the current conflict unfolding in Ethiopia and how that is adversely affecting orphans and vulnerable children in the country.

Introduction (4:25)

Hear about Tamrat's tough personal experiences growing up in an orphanage (10:25)

How the Church can reverse the orphan stigma, provide dignity to orphans, and become trauma informed (14:45)

The reason behind Selamta Family Project's programs for prevention and transitional care (17:40)

More about programs like the Salama forever family home and a community center (21:40)

The breakdown of the ethnic and political divisions within Ethiopia (25:30)

Responding to the layers of needs: to the greater numbers of children going hungry, or needing education, due to displacement and Covid-19 in Ethiopia (35:00)

Recommendations (41:30)

Resources and Links from the Show

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185. From Leaving Care to Leading Care in Ethiopia with Tamrat Kebede | ThinkOrphan

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In episode 185, you will hear from Tamrat Kebede who is the Ethiopia Director for Selamta Family Project. Tamrat talks with Phil and Brandon about his own experience growing up in an orphanage and how that has informed his work overseeing Selamta's family and community based model of care.

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Rethinking Orphanages: Brandon Stiver- Theology in the Raw (Kaylyn Gates)

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Rethinking Orphanages: Brandon Stiver- Theology in the Raw (Kaylyn Gates)

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Corruption in orphanages and the issues with short term mission trips

Globally, 80-90% of orphans still have a parent alive.

Focus needs to shift from profit driven to getting children into homes or reunited with their families.

Places with high tourism = more orphanages because it brings a profit. Trafficking into orphanages happens to keep them full. If that isn't happening, there's little effort to reunite families or get children into homes.

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Are orphanages helping orphans? Most Christians would say: obviously yes. But Brandon, who's been working in orphan care for over a decade, says that they are actually perpetuating a system of care that is ultimately not helpful for orphans. Kids belong in families, and there are many other more healthy ways to help kids be raised in a family.
Brandon is the senior director of global programs and partnerships for 1MILLIONHOME-an organization aimed at revolutionizing orphan care through broadly shifting mindsets and scaling up proven community-based models that reunite children with families and eradicate practices that lead to family separation. Brandon has worked in the child welfare and nonprofit sectors for over twelve years. Before joining 1MILLIONHOME, he led a family based care and advocacy program in Tanzania for several years. Brandon has also worked at a Tanzanian orphanage, in the Californian foster care system, at various churches and teaches on issues facing at risk chi...

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‎Theology in the Raw: Rethinking Orphanages: Brandon Stiver on Apple Podcasts

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Are orphanages helping orphans? Most Christians would say: obviously yes. But Brandon, who's been working in orphan care for over a decade, says that they are actually perpetuating a system of care that is ultimately not helpful for orphans. Kids belong in families, and there are many other more hea...

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Tourists create attachment with children, they think that going up to strangers is good and all people are nice. The visitors then leave and the children are left in the orphanage; the attachment they made cut off.

Kids need love, from a committed parent, not a short term missionary who will love them for 2 weeks and then leave, creating further attachment issues.

"Helping" communities could be hindering

When planning a STM trip, you should be talking to local people and leaders

Recap: Do your research for both adopting and STM

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From Orphanage To Home. (n.d.). Retrieved April 17, 2024, from https://adoption.com/from-orphanage-to-home

https://adoption.com/from-orphanage-to-home

https://www.unicef.org/uzbekistan/en/stories/growing-

orphanage#:~:text=It%20is%20a%20time%20of,on%20a%20family%20support%20system.

https://www.cde.ca.gov/sp/cd/re/caqdevelopment.asp#:~:text=The%20first%20five%20years%20are,child%20care%20experiences%20and%20activities.

Georgette Mulheir: The tragedy of orphanages | TED Talk

Miracle Foundation | International Nonprofit Organization For Children

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Take a look around your house–the kitchen where you gather each morning to eat breakfast, the…