March 28, 2003

VCH caring for internationally adopted children at new clinic

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Dr. Alice Rothman examines Nina Klein as her mother, Dabney laughs with Nina about the cold stethoscope. Vanderbilt opened the Clinic for International Adoption in July to meet the growing need of families with internationally adopted children.(photo by Mary Donaldson)

VCH caring for internationally adopted children at new clinic

Each year, there are an estimated 20,000 internationally adopted children brought into the United States.

Middle Tennessee sees close to 500 a year.

The Vanderbilt Children’s Hospital opened the Clinic for International Adoption in July to assist families with the medical, developmental and nutritional problems commonly seen in children adopted from other countries.

“The number of families adopting children from other countries is increasing,” said Dr. Alice M. Rothman, assistant professor of Pediatrics. “Many of the internationally adopted children have special medical and developmental needs. Area physicians provide primary care for these children. The clinic was established to work with primary care providers to provide the services needed by these children.

“We work closely with area physicians and are very excited to be able to provide this service not only to families, but to the local pediatricians, too.”

Rothman, one of five clinicians in the clinic, said the clinic works with families during all stages of adoptions. Prior to adoption, the staff can review medical records for potential adoptive parents as well as serve as a contact when a family travels overseas for consultation on a particular child or medical question. A few weeks after the arrival in the United States, the clinic staff is able to perform a full physical and developmental assessment of the child. Staff can also assist with the coordination of referrals to specialists when needed.

“Sometimes a family has very little time to make a decision about adoption,” said Rothman. “The more information that we are able to provide the better these parents can use medical records and information they are given.”

But according to Rothman, medical records provide general information and should not always be considered accurate medical documents.

“Many times a family provides a translated medical record for our review. We look for growth information, hospitalization, diagnosed illnesses as well as genetic information if it is available. Photos are helpful because we can look for abnormalities that offer information about a child’s condition,” she said. “We provide as much information to a family as possible based on the available records. We also assist families with travel information once they are returning with a child.”

Libby Bonds and her family say that the services the clinic provided allowed them peace of mind during the adoption process and beyond.

“There are so many people adopting internationally,” said Bonds. “With such a large number of people doing this, it has been reassuring to have a clinic like this at Vanderbilt. It has been such an amazing resource for us and for the community.

“It has helped us through the process of understanding the different cultures and the way medical information is presented. It gave us peace of mind that we were doing everything possible for our child to have the best care available.”

Libby and her husband, Andrew adopted Russian-born Alex in October, two days before he turned 1 year old.

Bond says her now 16-month-old son benefited greatly from the knowledge of the pediatricians at the clinic. They were able to develop a medical plan for Alex, both prior to his coming to America and once he arrived.

When the couple traveled to Russia, they obtained as much information as they could about their future child. They were able to bring back bits of health history on both Alex and his parents. From that, Rothman was able to evaluate the information, develop a medical road map and decipher various medical phrasing that could typically be misleading to the untrained physician.

“The Russian health system and ours are very different,” said Bonds. “On their medical charts, there will be information that can sound really scary.” But international adoption doctors are familiar with the terminology.

The Bonds were able to have a pre-adoption meeting with Rothman as well as follow-up once they arrived back in the United States with their child. They are currently on an “as-needed” basis at the clinic.

“We were very fortunate that Alex did not have any problems, but we have spoken to families whose children did need assistance and if they had been able to utilize this clinic, it would have been so much more helpful for them.”

This is Bonds’ first experience with parenthood. The clinic was able to provide them not only with general information on development, vaccination and general health issues, but most specifically information pertinent to internationally adopted children.

The Bonds credit Rothman with easing the adoption process, once Alex was in their care.

“She gave us a letter to provide to the Russian courts to help expedite our travel stating we had medical appointments in the States upon our arrival. It helped waive the 14-day wait. We stayed nine instead.”

Other than Rothman, the physicians seeing patients include Drs. Rebecca Swan, Gregory Plemmons, Christopher S. Greeley and Linda Ashford, Ph.D., member, Center for Child Development and Research.

The clinic currently sees patients on Mondays, but works with families to review records as needed. With patients from Middle Tennessee, Southern Kentucky and Northern Alabama utilizing the service, the group will look to expand its hours as the need for services increases.

Rothman said the Clinic for International Adoption is a growing service and Vanderbilt hopes to expand its service to include occupational therapy in the future.