In all of the hoping, wishing and praying that comes with an adoption, there is also a fair amount of anxiety. Medical reviews of a child’s file can be one of those scary moments in the process. As anxiety producing as it is though, it is necessary. When you have a child that you hope is yours, but who also has a medical or developmental need, it is important to understand as many possible scenarios as you can when it comes to their future. And, most agencies require that a doctor review a file before the adoptive family is truly allowed to sign the paperwork to accept a referral.

I worked with an Adoption Medicine Pediatrician for several years. I saw the process of medical reviews from both sides. I was the hopeful, already in love, would-be adoptive parent who handed the documents over to someone I hoped I could trust. And, I was the medical professional that understood what my review of this child’s medical history meant for a family. As we have discussed many times here at the Adoptive Parent Toolkit, China is now referring larger numbers of medically complex children for adoption. This adds a whole new layer of fear to this process. Sometimes, even the best and brightest medical professional doesn’t have answers when a file is complex, incomplete or outdated.

Sometimes, the medical professional comes back to a family with seemingly grim news. It is important to remember that their job is to give you the worst case scenario so that you, as a potential parent to this child, can understand what your life might look like with this child in it. It is important to hold on to the fact that this is only what your life might look like though. No medical professional should ever tell a would-be parent what they believe the future potential of a child to be. There is no way to know this. There are far too many unknowns for children who have faced institutionalization. It is also not a medical professional’s job to tell you if they feel this child is worthy of adoption. That is your choice. They should only give you the medical facts. This is what you are paying them for.

Never let anyone steal your hope. Facing a grim possible reality is one thing, walking away from a medical review feeling a child is worthless is not. If you’ve encountered this type of situation, please get a second opinion. Seek a specialist out who might know more about your child’s condition. Investigate further, and then make a decision. The first answer doesn’t have to be the last.

Guilt should also never be your motivation to accept a referral though. It is absolutely okay to say no. You know your family. You know your community. You know your limits.

Occasionally, a child will have more than one diagnosis in their file. Sometimes, these diagnoses mean something when put together. A group of symptoms that consistently occur together or a condition characterized by an associated set of symptoms is defined as a syndrome. When this word pops up in a medical review, I cringe. Not because of what the word actually means, but because of the perception of the word. I know what parents think about this word. I know what the mere mention of the word means for the child. Often, it means the child won’t be chosen.

A diagnosis of a syndrome does not mean a child will never walk.

It doesn’t mean a child will never play.

 It doesn’t mean a child isn’t going to fit beautifully into your family.

 There are thousands of different types of syndromes. Some aren’t ever even detected. Some come with cognitive delays, some don’t. Some require multiple hospitalizations, while some require none. Hearing the ‘s’ word in a medical review shouldn’t preclude you from learning more about a child. It shouldn’t mean you have to hand the file back.

There is so much more to a child then just their diagnosis. Please keep this in mind as you hope, wish and pray for your child-to-be.

If you need an Adoption Medicine Clinic to review a child’s medical file for you, the University of Washington has a highly respected program. http://adoptmed.org

 Please also keep in mind that there are medical providers in most subspecialties of pediatrics willing to review files for free. Contact your local children’s hospital, explain your situation and ask for help. You have nothing to lose!