Our Post-Placement Evaluations

Here's what we hope to accomplish during our hour-long initial appointments with new arrivals, ideally scheduled 1-2 weeks after you get home. We then like to see children roughly every 2 months until they've been home 6 months, to closely follow adjustment, growth, and developmental catchup. Our Welcome Home Guide is a printable summary of what we usually cover at our first visit, but here is a quick overview.

History and Physical Examination:

• Review any newly acquired medical, educational, or institutional records
• Interview older children, with interpreter
• Discuss family concerns and adjustment issues including sleep, feeding, and attachment
• Assess growth
• Thorough physical examination
• Developmental screening
• Screen hearing and vision - hard to accomplish accurately <4 years old, so ...
• Likely referral for audiology, opthalmology, and/or dental examinations
• If delays are greater than expected, Early Intervention referral

Immunizations:

• Immunizations from Korea (and sometimes Guatemala and Taiwan) are generally trusted
• From other institutional settings, we usually combine checking titers (blood tests of immunity, not reliable <1yo) and repeating immunizations based on the individual child's age and shot record

Lab Workup:

• Newborn screening panel (infants only)
• Complete blood count and ZPPH or ferritin (iron deficiency tests)
• HIV antibody; Hepatitis B panel; hepatitis C antibody (on arrival and 6 months postplacement)
• Hepatitis A titers (asymptomatic in young children, but can make their older contacts quite ill)
• Serologic test for syphilis
• Thyroid function tests
• Lead level
• Stool examination for ova and parasites (three preserved specimens - you'll get vials at the visit to collect and drop off)
• Stool examination for Giardia antigen (one fresh specimen)
• Urinalysis if growth deficient, symptomatic, or any history of issues
• Calcium, phosphorus, and alkaline phosphatase levels, if child has stigmata of rickets
• If height deficiency is profound, further lab evaluation for short stature
• Tuberculin skin test (on arrival and 6 months postplacement - this is crucial)

Comments

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