Anticipating Potential Medical Problems in Adopted Children
September 21, 2006
LDS Family Services, Sandy, Utah
Gordon Glade, MD
Medical Conditions Child
Allergies/Asthma Manageable. May need to
alter family habits and
administer medication
Cancer Many medical interventions.
Hard to see child suffer or
die.
Cystic Fibrosis Many medications and
hospitalizations. Shortened
life expectancy.
Diabetes Lots of blood testing, shots or Poorly controlled maternal
pump and doctor visits
Major organ diseases or Probably means more
defects. medical care
Epilepsy Usually can be controlled.
Rarely uncontrollable.
Associated with other
problems sometimes.
Hearing impairment Find out through newborn
screening
Hemophilia Altered life style. May have
many hospital/doctor visits.
Blood Diseases Sickle Cell Disease is huge
challenge. Thalassemia
major associated with early
death.
Huntington’s Disease May not know until later in
life
Muscular Dystrophy May be progressive,
debilitating & lethal.
Sometimes less severe.
Obesity Many medical & psychosocial
complications.
Spina Bifida Depends on severity
Visual impairment Many types are treatable.
Blind children develop and
Birth parents
Increases likelihood of child
having
Some cancers are inherited.
Child will carry gene but
must have gene from both
parents to have disease.
1/20 Americans are
carriers.
diabetes associated with
many birth defects and
neonatal problems.
Increased risk of
inheritance with some
conditions.
Maternal use of some anti-
seizure drugs associated
with birth defects.
90% of deaf parents have
hearing children.
Most commonly inherited
from mother (who is a
carrier) to son. 50% chance
of son not being affected.
50% chance of passing on
trait which can be
managed.
50% chance that child will
be affected.
Some forms are inherited
by 50% of children.
Genetics only partially
responsible.
Can be familial. Incidence
decreased if mother takes
folic acid.
Usually blindness not
inherited.
Comments
Avoid some foods during
infancy if strong family history
Ask health care provider for
details once type is known.
Huge commitment.
Child can live very healthy and
happy life.
Ask health care provider once
specifics are known.
Lots of help available. High
cost and time commitment.
Sometimes child may become
deaf later on.
Other bleeding disorders are
more common and can be
treated.
Easy to test child if parent
affected. Screen all black
children for SSD. Check CBC in
international adoptees.
Progressive neurologic
deterioration.
Better information once
specific type is known
Treatment most successful
when entire family is involved.
Extremely complex. May lead
to severe complications.
 learn differently.
Mental/Emotional
ADHD Treatable with behavior
modification and/or
medication. Increased
incidence of problems if
untreated.
Anxiety/Panic Disorder Treatable
Bipolar disorder Very challenging
Depression Diagnosed more in
adolescents, though can
affect children.
Schizophrenia Rarely diagnosed until late
teens or young adulthood
Tourette’s Syndrome Wide spectrum of disease
OCD Responds to cognitive
behavioral therapy
Learning Disability Requires specific educational
interventions. Hard to
diagnose before age 5+.
Personality Disorder Not usually diagnosed until
late teens
Autism spectrum Care is resource and time
disorders intensive
Emotional/attachment Very hard to overcome
issues
Substance Abuse
Alcohol
Tobacco
Cocaine
Opiates Excessively irritable
Congenital Infections
HIV Can have no symptoms or be
devastating. Treatment may
allow for normal life.
CMV, Toxoplasmosis, Rubella, Syphilis, Chicken pox, Herpes simplex, Parvovirus,
Increases chances for child
to have ADHD
50% of cause is genetic.
50% of cause is genetic.
50% of cause is genetic.
10% of offspring also
affected
Increased chance of
affected offspring
Increased chance of
affected offspring
Dyslexia: ¼ to ½ of offspring
affected.
May be more related to
trauma in childhood than to
genetics.
Genetic predisposition
Will affect child
Very worrisome if mom
drank alcohol
Maternal use leads to
intrauterine growth
retardation.
Compromises blood flow in
infant affecting brain,
abdominal wall and
kidneys.
Addicted but can function
If treated correctly and she
doesn’t breast feed, baby
can be born without HIV.
Variable, hyperactive type is
most challenging for parents.
Usually not diagnosed until
later childhood
Chronic
May resolve completely.
Treatment is frequently
effective.
Chronic, severe, disabling brain
disorder
Variable severity and many
associated conditions
Need for increased guided
parental help.
A serious mental illness
characterized by pervasive
instability in moods,
interpersonal relationships,
self-image, and behavior
Problems of attachment and
language
Frequently a result of early
childhood experiences. May
lead to giving up child.
Associated with poor prenatal
care
Sometimes no treatment
necessary. Other times
treatment for withdrawal lasts
months.
Serial tests are required on
infant born to mother with
HIV.
All associated with mild to
Malaria, etc.
Other special needs
Mental retardation Depends on severity.
Cerebral palsy Many additional resources
needed
Down Syndrome Increased associated birth
defects.
Fetal Alcohol Syndrome Poor growth, mental
retardation, small head,
heart defects
Physical Abuse Can leave life time emotional
and physical scars
Physical Deformity
Physical Neglect Can have long term effects
Premature birth Can have long term effects
Sexual abuse Can have long term effects
lethal effects on infant.
Genetic factors not well
understood
Not significant Impairment of movement and
posture. Many causes
Problems with growth,
development, hearing, vision
and cognition. Increased
leukemia, heart defects
Frequently passed on to
offspring
Obtain details
If not prolonged, effects can be
reversed.
Obtain details
Age of incident, timely
counseling, subsequent safe
and stable environment can
aid healing