Results of POSitive Study-Testing and Intervention sections

Analyses of testing, and interventions including parenting techniques will be available in 2010.

Here are some general results.


Testing
The four most common screening tests that adoptees received include Hepatitis B and C serology (65%), HIV serology (64%), stool testing for ova and parasites (64%) and Tuberculosis screening (57%). The CDC outlines all of the recommended tests that international adoptees should receive at http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-7/international-adoptions.aspx

Interventions
We asked adoptive parents about ninety different interventions. Speech therapy was the most commonly used intervention(39%). Occupational therapy with or without sensory processing specialty was used in 30% of the adoptees. Corrective lenses were used in 21%, physical therapy in 12% and Handwriting without tears program in 9% of the adoptees.

We asked adoptive parents about biomedical testing. Food allergen testing was the most prevalent with blood testing being the most common of those. Heavy metal testing was the second most common type of testing and inhalant allergy testing was the third most common type of testing.

We asked adoptive parents about supplements, nutritionals and chelators. Twenty-two percent used fish oil, thirteen percent used multivitamin ,twelve percent used melatonin, eleven percent used a form of probiotics and nine percent used vitamin C.

Next week we will be sharing a summary of adoptive parent concerns captured in our comment section.










Ethics, Transparency, Support
~ What All Adoptions Deserve.
http://www.pear-now.org/

DOS Adoption Notice: CDC Recommendations Relating to Intercountry Adoption, Hepatitis

DOS Notice for Intercountry Adoptions:
CDC and Prevention Recommendations

November 18, 2009

On Hepatitis A Vaccinations and Hepatitis B Screening

The Centers for Disease Control and Prevention (CDC) now recommends hepatitis A immunization for household members (including babysitters or anyone who anticipates close personal contact) with arriving intercountry adoptees from countries where hepatitis A is prevalent. For more information from the CDC click on: Updated Recommendations from the Advisory Committee on Immunization Practices (ACIP) for Use of Hepatitis A Vaccine in Close Contacts of Newly Arriving International Adoptees

Screening for hepatitis B is recommended for persons (including adopted children) who were born in geographic regions where the disease is common. For more information from the CDC click on:

“Recommendations for Routine Testing and Follow-up for Chronic Hepatitis B Virus (HBV) Infection” http://www.cdc.gov/hepatitis/HBV/PDFs/ChronicHepBTestingFlwUp.pdf

“International Adoptions”http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-7/international-adoptions.aspx

Under current law, children adopted from countries with which the Hague Convention on Intercountry Adoption is in force for the United States are required to present documentation of having received certain required vaccinations and screenings, including hepatitis B.

More information about hepatitis A and B and specific guidelines is available at http://www.cdc.gov/hepatitis/

http://www.cdc.gov/vaccines/vpd-vac/

http://adoption.state.gov/visas/Hep%20A%20vaccinations%20&%20Hep%20B%20screening.html

Ethics, Transparency, Support
~ What All Adoptions Deserve.
http://www.pear-now.org/

Results of POSitive Study-Mental Health, Faith-based and school-based sections

Mental Health
Partial results are as follows. Thirty-four percent of respondents had their child screened or used mental health or attachment services. Of those, 86 percent pursued this based on their own assessment and 19 percent had a primary care doctor recommend it.

Of those using mental health services (multiple professionals sometimes were selected), 42 percent used a psychologist with attachment expertise, 39 percent used a social worker with attachment expertise, 29 percent used a psychologist with no attachment expertise, 25 percent used an educational psychologist, 23 percent used a psychiatrist with no attachment expertise, and 21 percent used a social worker with no attachment expertise .

Of those using mental health services, the conditions that the respondents’ children were labeled with were as follows: 41 percent labeled as ADHD and 5 percent ADD, 31 percent as PTSD, 25 percent as an attachment disorder, 21 percent as generalized anxiety disorder, 18 percent as RAD, 18 percent as ODD, 13 percent as ARND/FAS/FAE, and 11 percent as bipolar. Twenty-one percent were not diagnosed with a condition. For some respondents, the comment space was not large enough to provide all of the diagnoses. Others had questionable diagnoses or had children that were still in the process of being diagnosed.

The following interventions were used: 47 percent used play therapy, 47 percent used rewards systems, 37 percent had parent counseling, 36 percent used behavioral management, 30 percent used some form of parent holding technique, 27 percent used sensory integration techniques, 24 percent used parent support groups, 15 percent used Theraplay, 15 percent used regression with baby bottles, , 13 percent used art therapy ,12 percent used blanket wrap, 12 percent used applied behavioral analysis (ABA).

Eighty-eight percent had services provided in an office. Forty percent of parents provided therapies in their home.

Cost of therapies/lack of comprehensive mental health coverage are often cited as major barriers to therapy. Thirty-eight percent paused therapy due to cost. Twenty-two percent stopped therapy due to cost.

Fifty percent of children were prescribed medicine. Of those, 60 percent have used multiple medications. The most common medications used were clonidine, Ritalin, Strattera, Risperdal, Focalin, Zoloft and Concerta. When asked about positive and negative experiences about mental health providers and interventions, the majority had negative experiences due to expense, not able to find professional that understands the complexity of attachment/ neglect issues, medication side effects and in many cases, great frustration with being lied to or not being fully informed about the mental health condition of the child by adoption service providers or country of origin. The positive experiences were mainly associated with children that have had positive results from use of ADHD medications for ADHD. The negative experiences involved children that have attachment and severe neglect issues.

Faith-Based Services
Thirteen percent used a faith based services with seventy–nine percent being satisfied.

School-Based Services
Seventy-eight percent of respondents have children that are three or older who would be old enough to qualify for a school-based service in the US. Thirty-five percent of those have never had a school-based service. Interventions provided by a school are as follows: 35 percent received a speech assessment, 30 percent received speech therapy, 25 percent received reading assistance, 23 percent received occupational therapy assessment, 20 percent received IQ testing, 20 percent received psychological testing, 19 percent received math assistance, 17 percent received occupational therapy, 17 percent received test-taking modifications, 16 percent received early intervention (public) preschool, 14 percent received English as a second language (ESL) services, 14 percent received homework modifications, 14 percent received special reward system, 12 percent received summer school in a class setting, and 11 percent received screening by a professional outside school system that the school paid for.

Of those who had services, 31 percent had a teacher refer to school services, and 18 percent were referred to school services from their Early Intervention services.

Not all parents feel that school is meeting their child’s needs. Twelve percent of parents feel that the school should be providing occupational therapy for their child, eleven percent would like organizational assistance, nine percent would like speech therapy, nine percent would like tutor in the classroom, nine percent would like reading assistance and nine percent would like therapy by an outside professional.

Thirty-one percent of children have an Individualized Education Plan (IEP). An additional twenty-four percent believe their child should have an IEP. Four percent have a 504 plan. Seventy-five percent feel that the school district respects the privacy of their child.

In-depth analyses and complete results will be available in 2010.Next week we will be sharing some testing and interventions results.









Ethics, Transparency, Support
~ What All Adoptions Deserve.
http://www.pear-now.org/

Where is the JCICS Ethiopia Report?

According to information posted on the JCICS website, a team undertook a fact-finding mission to Ethiopia from October 2-October 9, 2009.


This mission was partly in response to allegations made by an investigative television show in Australia called “Fly Away Children” about improprieties, trafficking, and "harvesting" of non-orphans from Ethiopia to the US. http://www.abc.net.au/foreign/content/2009/s2686908.htm . One JCICS member agency, Christian World Adoptions (CWA), bore the brunt of the allegations in this program. It is worth noting that the CEO of CWA, Tomilee Harding, lists herself as a current board member of the JCICS, http://www.cwa.org/staff.htm . However, the JCICS website does not include Ms. Harding in its current list of board members. http://www.jcics.org/Board_Directors.htm

On October 12, 2009 , the JCICS claimed that a report on their activities would be published soon. See http://www.JCICS.org/Ethiopia.htm . This report, however, has not been published as of today, November 11, 2009.

PEAR respectfully asks why there has been such a long delay in posting a response to this mission, particularly as the JCICS said they would “collaboratively identify all abuses, take action consummate with our mandate and policies, and, as appropriate, to demand a thorough investigation by the appropriate authorities.”

Prospective adoptive parents considering Ethiopia as a viable and ethical country from which to adopt need to have this information in order to make informed choices about both the country program as a whole and individual agencies working there. Adoptive parents and adoptees concerned about unethical practices surrounding their adoptions are also awaiting this report. We hope the JCICS will release the report in a timely fashion, as their delay poses many questions and answers none.









Ethics, Transparency, Support
~ What All Adoptions Deserve.
http://www.pear-now.org/

Results of POSitive Study -Financial, International Adoption Clinic and Early Intervention Sections

Financial
Financial planning for expected and unexpected post-adoption issues (health- and education–related) and trusts have been a frustration for some adoptive parents. We asked if agencies, social workers or attorneys provided information prior or after adopting. Twenty-three percent discussed financial planning or trusts prior to adopting with their adoption professional and two percent afterwards. Eighty-eight percent received financial services from their own resources and six percent were unable to get their desired financial services.

Sixty-three percent currently feel that they do not need further information about financial planning. Twenty-four percent would like information on 529/educational trusts, eighteen percent on wills; sixteen percent on trusts; fifteen percent on special needs trusts.

Ninety percent of people never received information about child life insurance from their adoption professional yet thirty-three percent did try to obtain a child life policy. Of those who applied for one, eighty-nine percent were able to obtain one.

We asked adoptive parents what types of financial services should be mandatorily discussed by adoption professionals with prospective /adoptive parents. Forty-one percent feel that financial planning and trusts should be discussed pre-adoption and thirty percent feel it should be discussed post-adoption.

International Adoption Clinic and Primary Care Provider
For those that internationally adopted (90% of our sample), we asked about the use of international adoption (IA) clinics. Fifty-seven percent of people used IA clinics prior to adopting and thirty-one percent never had contact with an IA clinic or doctor with expertise in international adoption. Furthermore, forty-three percent of parents only corresponded with IA clinic via phone, fax or email, likely to review child referral information.

Of those who physically went to IA clinics, thirty-five percent saw a doctor prior to adoption, thirty percent one to two weeks after the child came home, twelve percent saw the doctor three to four weeks after arriving home and ten percent within one to three months after arriving home.

Fifty-four percent saw a general pediatrician first, twenty-nine percent saw a developmental pediatrician first, eight percent saw an infectious disease specialist first. Forty-five percent were not referred to any specialist following IA doctor appointment. Referrals to early intervention providers accounted for 16 percent; to speech therapist for 15 percent; to occupational therapist for 13 percent and to audiologist for 10 percent. Eighty percent of those who used IA doctor services rated their experience as good or excellent.

Seventy-three percent said that their child’s primary care provider took the child’s past history/adoptive status into account when first examining the child.

Primary care providers referred patients to the following types of specialists: speech therapist 18%, early intervention provider 17%, audiologist 12%, pediatric dentist 11%. Eighty-six percent rated their primary care provider services as good or excellent.

Early Intervention
Eighty-six percent of respondents adopted a child 5 years of age or younger while residing in the US. Of those respondents, fifty-seven percent had their child screened or used their state’s Early Intervention services. Eleven percent of parents contacted Early Intervention before their child even came home. Fifty-two percent contacted Early Intervention services after returning home without a health care provider suggestion.

Of those who had their child screened, 60 percent had their child screened for speech, occupational, physical and developmental/educational interventions. The rest did not have assessments in all categories. For those who did not get screening in all four categories, the reasons given were not feeling child needed all the assessments: 43%; childs’ doctor did not feel all assessments were needed: 25%; early intervention services discouraged a full screening: 24%.

Seventy percent of those screened in any category qualified for services with speech therapy at eighty-five percent, developmental/education intervention at fifty-two percent, occupational therapy at forty-five percent and physical therapy at thirty-nine percent. Eighty-two percent of those who had services for their child rated their experience as good or excellent.

While people from some localities reported excellent services, there is a great inconsistency across the US. There were a number of people who did not get services or had to “fight” to get early intervention. Some of the more common reasons for not having services include: that speech services were denied because the child was learning English, uncertainty of child’s true age led to disqualification, international adoption is not a reason for screening, services not adequate or unprepared for developmental services for children effected by trauma, occupational therapy screening missed sensory issues, some localities base services on income, making it very expensive for the adoptive parent, screening too basic, speech services denied because some localities require a delay in another area before speech services are given, no one to assess in child’s native language, program was full and no more slots were available.

Next week we will be sharing mental health, faith-based and school-based services results.









Ethics, Transparency, Support
~ What All Adoptions Deserve.
http://www.pear-now.org/