117 South Saint Asaph Street, Alexandria, VA 22314
Phone: 703-535-8045, Fax: 703-535-8049, http://www.jointcouncil.org
Post-Placement Guidelines
and Tools for Adoption
Professionals
2005 Revised Edition
For use by Joint Council Member Adoption Agencies, Social Workers,
and Other Professionals Providing Post-Placement Services to Adoptive
Families
© Joint Council on International Children’s Services
117 South Saint Asaph Street
Alexandria, VA 22314
703-535-8045
Fax : 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures
that better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an
educational tool for its
member organizations,
signifying the importance we
place on quality postplacement services.
POST-PLACEMENT GUIDELINES
AND TOOLS FOR ADOPTION
PROFESSIONALS
Section One
Purpose and Use of These Guidelines
4-6
Section Two
Interagency Working Agreements
and Post-Arrival Reporting
7-19
Section Three
Assessing a Child’s Development
20-42
Section Four
Citizenship Information
43-45
Section Five
Forever Family Certificates
and LifeBooks
46-51
Section Six
Adoption Resources
52-63
As a group of adoptive parents and adoption professionals, we are excited by the possibilities for
making all post-placement contacts truly helpful to adoptive families, and we hope that you will
be, too.
The Committee thanks Lynn Balzer-Martin, Ph.D., OTR, who gave permission to reprint the
Balzer-Martin Screening Program. We also gratefully acknowledge the assistance of Jerri Ann
Jenista, M.D., Boris Gindid, Ph.D., Gregory Keck, Ph.D. and Carol Kranowitz, MA.
The JCICS Education Committee for Spring 2005
Chairperson: Donna Clauss, MA, LMSW
Sonia Baxter, BA
Maureen Evans, MA
Sidne Goodwin, BA
Laura Hofer, MSSW, LCSW
Betty Laning, BA
Deborah McCurdy, MSW, LICSW
Deborah Riley, MFT
Pamela Thomas, BA
Rainbow House International
Rainbow House International
Joint Council on International Children’s Services
North Bay Adoptions
Holt International Children’s Services, Inc.
Open Door Society of MA
Beacon Adoption Center
Center for Adoption Support and Education
Adoption Resource Center at Brightside
117 South Saint Asaph Street
Alexandria, VA 22314
703-535-8045
Fax : 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures that
better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an educational
tool for its member
organizations, signifying the
importance we place on quality
post-placement services.
POST-PLACEMENT
GUIDELINES AND TOOLS FOR
ADOPTION PROFESSIONALS
Section One
1. The Importance of Our Agencies Providing PostPlacement Services
2. How These Concise Guidelines and Tools May be
Used
1. THE IMPORTANCE OF AGENCIES PROVIDING POSTPLACEMENT SERVICES
All newly placed infants and older children,
who are unable to express their needs
clearly, need our agencies to intervene on
their behalf while they are adjusting to their
new homes. They need us to know and
understand them, to empathize with their
most painful feelings and challenging
behaviors, and to interpret those feelings and
behaviors sympathetically to their
inexperienced adoptive parents. Without
our professional intervention in the fragile
new parent-child relationship, the families
are at risk of a poor initial adjustment that
may lead to disruption or dissolution of the
adoption – or to long-term unresolved
painful feelings that may be even worse for
the family.
All adoptive parents need our
agencies’ services for at least the six-totwelve month adjustment period following
placement, even though some may resist our
continued involvement, either as a reflection
on their skills as parents or as a needless
expense. They need us to make sense of
their child’s feelings and behavior, to
reassure them when appropriate, and to
guide them toward the most helpful
discipline and parental support for their
child. Embattled parents can benefit greatly
when we interpret their child’s withdrawn,
demanding or rebellious behavior in the
light of the child’s feelings of grief and rage
over perceived abandonment in the past and
his fear that future abandonment will follow
if he allows himself to love his new parents.
Such “reframing” of the child’s feelings and
behavior by an adoption professional, over a
period of time, enables the parents to rise
above their battle fatigue and to develop
more understanding and empathy for the
child. If the family is in need of a referral to
resources for ongoing counseling, early
intervention or assessments of any kind,
their social worker – armed with the
materials which follow in this packet, and
whatever other knowledge she can
contribute – is in a critical position to help at
this vulnerable stage.
The countries of origin need our
agencies to demonstrate to them – through
our continuing contact with the family and
several reports with photographs – that their
children are treasured, well cared for and
developing optimally in their new homes.
Without our reassuring reports and pictures,
the inter-country adoption system in the
children’s birth countries may break down in
the face of unfounded rumors and
misconceptions about what adoptive parents
are like.
2. HOW THESE CONCISE GUIDELINES AND TOOLS MAY BE
USED
For purposes of clarifying our agencies’
responsibilities, we are defining the postplacement period as the six-to-twelve month
adjustment period following a child’s arrival
in his new home, whether or not the child
has been legally adopted overseas. The brief
guidelines and tools in our post-placement
packet represent a minimum standard for
adoption professionals, and they are
intended as a springboard for future learning
about the many issues that are covered in the
one-page and two-page summaries that
follow.
These summaries (which include
helpful descriptions of attachment issues,
fetal alcohol syndrome, developmental
delays, speech and language problems,
sensory integration dysfunction, learning
disabilities and other challenges of adoption)
may prompt us to refer certain children for
early evaluation and treatment. Please note
that these guidelines have been written with
the intent that they will be read and utilized
by professionals. The purpose is to make
professionals familiar with the symptoms of
various issues so that if during a postplacement assessment it becomes apparent
that a child may be experiencing difficulty
in one of the areas, the social worker can be
a source of encouragement to the family to
seek further evaluation by a specialist or
professional and take advantage of early
intervention services.
The summaries are not intended to be
distributed to parents.
However, there are some forms and
materials that should be shared with parents.
These include a post-placement progress
questionnaire, a checklist for medical tests, a
life book outline, and “forever family”
certificates – in addition to instructions for
obtaining citizenship, tracing or replacing a
missing Alien Registration Card, readopting or reconfirming an adoption and
obtaining a social security number for the
child. Other sections of the packet include
guidelines for an interagency working
agreement – an essential tool for clarifying
the respective responsibilities of any
cooperating international placement agency
and direct service agency and federal forms,
as well as guidelines for post-placement
reports and a list of resources. (Parents
should order their own forms, as forms may
become outdated.)
1403 King Street, Suite 101
Alexandria, VA 22314
703-535-8045
Fax : 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures that
better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an educational
tool for its member
organizations, signifying the
importance we place on quality
post-placement services.
POST-PLACEMENT GUIDELINES
AND TOOLS FOR ADOPTION
PROFESSIONALS
Section Two
1. Components of a Good Interagency Working
Agreement
2. Guidelines for Post-Placement Reports
3. Parents’ Post-Placement Questionnaire
1. COMPONENTS OF A GOOD INTERAGENCY WORKING
AGREEMENT
It is important for cooperating agencies to
have a mutually acceptable Interagency
Working Agreement in place well before the
first child is placed. Such an agreement
clarifies the respective responsibilities of the
“direct service agency” (which is the local
agency providing the home study and postplacement services) and the “international
placing agency” (whose chief
responsibilities are establishing programs in
the foreign country, identifying children
available for placement, obtaining
information on the children and referring the
children for placement).
Fortunately, there is a traditional
division of labor that is acceptable to nearly
all agencies, and our suggestions for a
generic agreement are based on this
understanding. (The parties to an agreement
are free to modify the standard agreement of
either agency if they so choose, but in
practice this rarely happens.) The most
important thing is for each agency to be
clear as to its own responsibilities and those
of the other agency. Some agencies prefer
to have a separate agreement signed for each
child placed, but others have a provision that
the first agreement signed will serve for
future placements unless it is modified later.
As we have indicated below, it is necessary
for each agency to keep the other informed
of any developments that might affect a
child’s or family’s readiness for adoption or
that could jeopardize a placement.
Responsibilities of the direct service agency
typically include:

Home study assessment of the
adoptive family, usually based on at
least three interviews

Home study report written according
to USCIS guidelines and any birth
country requirements

Preparing and educating the family
on adoption issues, cross-cultural
adoption and risks of intercountry
adoption

Assistance to the family with filing
Form I-600A and other local USCIS
procedures

Pre-adoption and post-adoption
counseling to the adoptive family, as
needed

Post-placement visits and support as
required by the international placing
agency and birth country

Sending the international placing
agency the required post-placement
reports suitable for the child’s
country (specify the exact number)

Keeping the international placing
agency fully informed of significant
issues or new developments in the
family

Referring the child for appropriate
evaluations and early intervention
when indicated

Obtaining copies of the child’s preadoption documents for the family
and the direct service agency

Cooperating with the international
placing agency’s plan for the child in
the event of disruption or dissolution

Informing parents and the direct
service agency of the progress of the
pre-adoption process, delays and
setbacks

Assisting the parents with legal
adoption in their state, and readoption

Advising parents in writing as to
documents they will need in child’s
country for USCIS/Embassy filing
Providing instructions to the family
regarding citizenship filing for the
child at their local USCIS office

Arranging for placement of the child
in US or assisting parents with
arrangements for overseas travel
Post-finalization counseling of
family as needed and/or referral to
other resources as appropriate

Providing in-country support and
assistance to parents through a
representative, insofar as possible

Furnishing full set of certified
documents on the child for obtaining
visa, re-adoption and citizenship

Making ongoing orphanage contacts,
including translation and mailing of
post-placement reports

Willingness to take planning
responsibility for the child, including
interim foster care, if re-placement is
needed and in accordance with
applicable laws

Exchanging copies of current
licenses with the direct service
agency.


Responsibilities of the international placing
agency (or its overseas representatives)
include:



Communicating with the child’s
birth country and compliance with
all relevant laws
Providing child’s available medical
and social history and exam results
to the parents and the direct service
agency and attempting to obtain
additional information when
requested
Referring a child that matches the
type of child requested by the family
and consulting with the direct service
agency for clarifications
2. GUIDELINES FOR POST-PLACEMENT REPORTS
Following are two models for completing a
The abstract version is often used to
written post-placement report. The first and
prepare the written report, which is sent to
longer version is for use by the social
the foreign country. Often the foreign
worker in preparing a complete report. A
country does not require long, extensive
complete post-placement report is generally
reports. Long reports are costly to translate
prepared by the direct service agency and a
and are often ignored by the foreign country
signed copy is forwarded to the cooperating
if they are too expensive.
international placement agency, if there is
A model for obtaining family input is
one. These reports are also often forwarded
also included. The family questionnaires
to interstate compact offices and remain on
include instructions to the family to provide
file with the direct service agency. State
multiple photos of the child and family.
licensing authorities generally review these
reports.
______________________________________________________________________________
Identifying Information
Family Name
Family Address
Family Telephone
Child’s Arrival Date
Child’s Original Name
Child’s Present Name
Child’s Date of Birth
Name and Credentials of Social Worker
Date of Report
Contacts
This includes dates of contacts, type of contacts
(office visit, home visit, cultural event, etc.),
duration of contacts, and who was present.
Description of Child
Describe the child’s personality, provide a
physical description of child and indicate the
child’s favorite activities, toys or interests.
Comment on the child’s behavior and indicate if
there are unusual or problematic behaviors.
Initial Adjustment (For first report only)
Describe any grieving or loss behaviors the child
has shown since placement (extended periods of
crying or being extremely stoical, sleep
disturbances or wanting to sleep all the time,
tantrums, hoarding, avoidance of being
comforted, preoccupation with eating or refusal
to eat, etc.)
Describe initial adjustments, which have
been necessary for the parent, child or siblings.
What are the sleep patterns? Has the child had
any difficulty eating or issues with the food?
Have routines emerged, and are they
established? What are the family’s methods of
coping with the new responsibility and changing
roles? Describe any behavioral problems that
are difficult for the family, and state how the
family is handling the problem(s). Does the
child test limits or show resistance to rules? Do
the parents feel the child is manageable? What
has the language adjustment been like? How
does the family feel things are going?
Describe the relationship between parent
and child. Does the child enjoy hugs and
closeness from the parents? Has discipline been
necessary, and if so, what type of discipline has
been used, and is it effective? Is the family
experiencing any problems, and if so, how are
they managing them? What is the language
communication like for the child, and do the
parents feel they are able to communicate
effectively with the child? How do the parents
like the child and the child the parents? Is there
evidence that bonding is emerging? Does the
child look to the parents for help or reassurance?
Family and Child Interaction (in subsequent
reports this section replaces initial adjustment)
Describe the parent, child and sibling
relationships and the dynamics of the
interactions. What is the adjustment like at this
time? Describe eating and sleeping habits. Is
there a routine? How is the child’s emotional,
physical, language and social development?
What developmental and emotional gains has
the child made since the last visit? Has the child
acquired any new skills?
How does each parent feel about this
child? Does the child have any annoying
behaviors? Is the child manageable? Has
discipline been necessary, and if so, what has
been used? Do the parents enjoy this child, and
what are their feelings about the child’s
personality? Do the parents feel this child fits
into the family? What has the adjustment been
to siblings, if there are siblings? Do the parents
have any concerns? Do the parents feel attached
or have a growing attachment to the child? Do
they feel the child is attaching to each of them?
Has there been any crisis, or has the family
experienced any unusual changes since the last
visit? What has been the most difficult part of
placement? What has been the most enjoyable
part of placement?
Are there arrangements for daycare, and
if so, what are they? What is the child’s reaction
to the daycare arrangements?
Health and Development of Child
Report the findings of the post-arrival medical
report. Indicate the child’s height, weight and
head circumference. How does this compare to
the child’s measurements at arrival? Is the child
teething, or has he/she gained or lost any new
teeth? What is the condition of his or her teeth?
Is the child up to date on immunizations? Are
there any medical problems that have been
identified, and if so, how is the family coping?
Has the child had any illnesses, and if so,
indicate the recommended treatment, and
whether or not the problems are resolved. Has
the family experienced any problems because of
racial or cultural differences?
What is the level of the child’s development
with respect to fine motor skills, gross motor
skills and language (both expressive and
receptive)? Does the child show symptoms
indicative of problems with sensory integration?
Does the child show any signs of processing
difficulties or other symptoms, which might be
indicative of a learning disability? Have any
recommendations been made to the family to
seek further evaluations or early intervention
programs? What is the child’s emotional and
social development like?
Community and Extended Family
Has this child been accepted by the community?
What has the response been to the child by the
extended family and friends of the family? Has
the family experienced any cultural difficulties
or prejudice?
Legal Process
Has the family filed a petition with the court for
adoption or re-adoption if necessary? What is
the timetable?
Evaluation and Recommendations
Summarize the family’s adjustment, including
social, emotional and financial areas. Is
attachment and bonding occurring? How is the
family coping and adjusting to the placement?
Indicate what adjustment seems likely for the
future. What recommendations have been made,
and how does the social worker feel about the
placement? If this is the final report, is there a
recommendation for finalization and/or any
request for Consent or Agreement to Adoption?
_________________________
Social Worker
_________________________
Placement Supervisor
_________________________
Date
Post-Placement Report Number _________
Family Name: ____________________________________________________________
Child’s Original Name: ____________________________________________________
Child’s Date of Birth: ______________________________________________________
Date of Contact: __________________________________________________________
Report Completed by: _____________________________________________________
Agency Name: ___________________________________________________________
Agency Address: _________________________________________________________
Description of Child and Personality of Child:
Overall Condition of Child:
Emotional Adjustment:
 Happy
 Doing Well
 Is Difficult
 Bonding between family and child is occurring
 Intervention services being utilized
______ Speech
______ Occupational
______ Physical
Other difficulties: (speech, fine or gross motor, physical, emotional, etc.)
Specific Improvements:
______ Other
Skills that have improved, with examples, and child’s health:
 Fine Motor Skills
 Gross Motor Skills
 Social Skills _______________________________________________________
 Language Skills ____________________________________________________
 Emotional Skills ____________________________________________________
 Pediatrician is satisfied with child’s progress _____________________________
 Diseases child has had since placement __________________________________
 Surgeries _________________________________________________________
Child’s Daily Routine:
Family Interactions:
Additional Comments:
Social Worker: __________________________________ Date ___________________
Name Printed: ___________________________________
Subscribed and sworn to before me this ____________ day of ______________ 20____.
_______________________
Notary Public
My commission expires: ___________________
Parents’ Post-Placement Questionnaire
Family and Child Data
Family Name: ____________________________________________________________
Address: ________________________________________________________________
Child’s Original Name: ____________________________________________________
Child’s Present Name: _____________________________________________________
Child’s Date of Birth: ______________________________________________________
Date of Arrival: __________________________________________________________
Date of Report: ___________________________________________________________
Child’s Alien Registration Number: __________________________________________
Child’s Adjustment Health and Development
What adjustment problems are the child and family experiencing?
______________________________________________________________________________
______________________________________________________________________________
How does the child relate to family members and others?
parents/siblings.)
(Describe adjustments to
______________________________________________________________________________
______________________________________________________________________________
What are your child’s favorite foods, and are there any problems with food or eating?
______________________________________________________________________________
______________________________________________________________________________
What are your child’s strengths?
______________________________________________________________________________
______________________________________________________________________________
What developmental milestones has your child reached since placement or since the last visit?
______________________________________________________________________________
______________________________________________________________________________
What are your child’s favorite activities at present?
______________________________________________________________________________
______________________________________________________________________________
What is difficult for your child? (Please indicate social, developmental, language and emotional
difficulties.)
______________________________________________________________________________
______________________________________________________________________________
How does your child show that he/she is attached to the family?
______________________________________________________________________________
______________________________________________________________________________
Does your child smile and have eye contact with parents, siblings, extended family or others?
______________________________________________________________________________
______________________________________________________________________________
What is the child’s daily routine?
______________________________________________________________________________
______________________________________________________________________________
Describe your child’s appearance (height, weight, hair, skin, etc.).
______________________________________________________________________________
______________________________________________________________________________
Describe your child’s personality, disposition, habits and behavior.
______________________________________________________________________________
______________________________________________________________________________
What are your impressions of your child’s health?
______________________________________________________________________________
______________________________________________________________________________
Do you feel that your child has any developmental delays?
______________________________________________________________________________
______________________________________________________________________________
How well is your child acquiring language skills?
______________________________________________________________________________
______________________________________________________________________________
Is your child’s receptive language good?
______________________________________________________________________________
______________________________________________________________________________
How is your child comforted?
______________________________________________________________________________
______________________________________________________________________________
Has your child shown any signs of grieving or loss? Explain extended periods of crying, sleep
disturbances, sleeping all the time, tantrums, clinging to parents, etc.
______________________________________________________________________________
______________________________________________________________________________
Describe any behavior problems your child has.
______________________________________________________________________________
______________________________________________________________________________
Does your child test limits or rules?
______________________________________________________________________________
______________________________________________________________________________
Describe any illnesses your child has had since arrival or since the last report.
______________________________________________________________________________
______________________________________________________________________________
Is your child up-to-date with immunizations?
______________________________________________________________________________
______________________________________________________________________________
Have you taken your child to the doctor for a post-arrival medical checkup? If so, did the doctor
have any concerns?
______________________________________________________________________________
______________________________________________________________________________
Are you using a daycare or child sitter? If so, what has the child’s reaction been?
______________________________________________________________________________
______________________________________________________________________________
For School Age Children
Have you had any difficulty enrolling the child in an appropriate class?
______________________________________________________________________________
______________________________________________________________________________
How well does your child get along with peers?
______________________________________________________________________________
______________________________________________________________________________
Is your child in English as Second Language (ESL) or does he/she have an Individual Education
Plan (IEP)?
______________________________________________________________________________
______________________________________________________________________________
Describe any problems or special achievements related to school.
______________________________________________________________________________
______________________________________________________________________________
Family Adjustment
How does it feel to be a parent of this child?
______________________________________________________________________________
______________________________________________________________________________
What has been the most difficult part?
______________________________________________________________________________
______________________________________________________________________________
What has been the best part?
______________________________________________________________________________
______________________________________________________________________________
Describe the special qualities of this child.
______________________________________________________________________________
______________________________________________________________________________
What are special activities or favorite moments you spend with your child?
______________________________________________________________________________
______________________________________________________________________________
How have your sleep patterns been affected by this placement?
______________________________________________________________________________
______________________________________________________________________________
Does the child seem equally attached to each parent?
______________________________________________________________________________
______________________________________________________________________________
How has this placement affected other family members?
______________________________________________________________________________
______________________________________________________________________________
Is the family considering any important changes, such as a move, job change or one parent
returning to work?
______________________________________________________________________________
______________________________________________________________________________
Have you had to use discipline? If so, please describe the type of discipline and the behavioral
problem.
______________________________________________________________________________
______________________________________________________________________________
What resources might be helpful during the remainder of your post-placement period?
Check all that apply.
Support Group
__________
Learning Disability Resource __________
Adoptive Family Resource
__________
Speech/Language Resource __________
Sensory Integration Therapist __________
Parenting Education
__________
Educational Resources
__________
Attachment Resource
__________
Family Therapist
__________
1403 King Street, Suite 101
Alexandria, VA 22314
703-535-8045
Fax : 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures
that better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an
educational tool for its
member organizations,
signifying the importance we
place on quality postplacement services.
POST-PLACEMENT GUIDELINES
AND TOOLS FOR ADOPTION
PROFESSIONALS
Section Three
1. Assessing An Adopted Child’s Receptive and
Expressive Language
2. What is Attachment Disorder?
3. Symptoms of Attachment Disorder
4. Signs of Fetal Alcohol Syndrome or Alcohol
Related Birth Defects
5. Learning Disabilities in Adopted Children
6. Special Education and Help for Children With
Delays
7. Post-Arrival Medical Report Form for Adopted
Children from Overseas
8. Problems in Adopted Children Related to Sensory
Integration
9. The Balzer-Martin Preschool Screening Program
10. Balzer-Martin Preschool Screening – Teacher
Checklist
11. The Balzer-Martin Preschool Screening Program
Content
1. ASSESSING AN ADOPTED CHILD’S RECEPTIVE AND
EXPRESSIVE LANGUAGE
An important tool in assessing the level of a
child’s receptive and expressive language
involves teaming up with a native speaker of
the child’s language as soon after placement
as possible. The earlier this evaluation is
done, the more accurate the assessment will
be because children start to lose their native
language soon after arrival in a new country.
Someone proficient in the child’s native
language needs to hear the child speak and
to be able to comment about his or her
syntax, pronunciation, correctness of
vocabulary and level of both receptive and
expressive language. It is important for the
adoptive parents to be aware of their child’s
proficiency base. Children who have
established proficiency in their first
language and who are under ten years of age
learn a second language much more easily
than those who have not established a first
language base.
By the age of one year, a child
already has the circuits in place that
represent the sounds that form words. The
baby is then primed to turn sounds into
words. The more words a child is exposed
to, the larger the vocabulary will be by age
two. As the sounds of words build neural
circuitry, they can then absorb more words.
Conversely, the child who has had limited
exposure and experience with language has
already been thwarted in establishing basic
circuitry for language to emerge. An
institution is not the optimal environment for
a child to acquire a well-developed language
base. Children coming from orphanages are
often delayed in their speech and language
development due to deprivation or limited
language exposure.
A good first step, in the case of
infants and preschool children, is for parents
to contact the nearest early intervention (EI)
program for a developmental assessment
that includes language skills. In the case of
school-age children who have recently
arrived, it may be helpful to have
comprehensive interviews with the adoptive
family, a teacher, a psychologist and a
native speaker-interpreter. It is also helpful
to utilize behavior scales such as the ABS,
Vineland and CARS. The Bilingual Verbal
Ability Test is recommended for
determining language proficiency. The
Universal Nonverbal Intelligence Test and
the Lieter-R Test are considered the most
informative nonverbal tests for cognitive
assessment. The Brigance Inventory for
Early Development is a good tool for
measuring the orphanage child’s functioning
in relation to the skills of other children his
age.
When there are clearly observable
delays in the child’s speech and language
development, it is imperative that the family
initiate speech and language evaluations,
administered by professionals, as soon as
possible. Early intervention optimizes the
outcome. Because communication is the
key to interacting in society, a child with
limited ability to communicate is essentially
locked out of the world around him.
It is helpful for social workers to ask
adoptive families whether they are in
possession of any videos that were made of
their child prior to placement. If the family
has such a video of their child, it is best to
have the video evaluated for speech
development/understanding by someone
proficient in the native language.
2. WHAT IS ATTACHMENT DISORDER?
When children are not able to form a
trusting bond in infancy and early
childhood, for a number of reasons,
attachment disorder (or less severe
attachment issues) can develop. A bond of
trust is essential for a child’s personality and
conscience to continue developing. When
there is a lack of trust, it generates pervasive
anger, a need for control and feelings of
aloneness.
Children with attachment disorder
have constant control issues and are
extremely effective at distancing their
parents and other adults by either physical or
emotional withdrawal. The more the parents
attempt to become close, the greater the
resistance is from the child. Over time, the
child becomes more disruptive and the
parents become more frustrated and angry.
Children with attachment issues
often are indiscriminately affectionate, have
a poorly developed sense of cause and effect
thinking and may have difficulty with
abstract thinking. There seems to be an
inappropriate balance between dependency
and autonomy.
Attachment is a process that occurs
over time. Attachment is the process of
attaching to a caregiver and a caregiver
attaching to the child. This generally
happens as a child has needs, expresses them
and receives a response to his needs. This
understanding forms a bond of trust between
the caregiver and the child.
Attachment is dependent upon a
meaningful, consistent relationship, so it is
often difficult to determine how secure or
ambivalent an attachment relationship is, or
whether there is a reactive attachment
disorder. Reactive disorder occurs when a
child reacts to events in their early life that
have caused a lack of trust to form. Newly
placed children and those in the adjustment
phase of placement may exhibit many of the
symptoms of attachment disorder.
However, some symptoms disappear or are
mitigated as trust develops and the child
feels secure in the placement. Multiple
symptoms that persist long after an
adjustment and transition period may need
to be evaluated by a therapist specializing in
attachment disorder problems.
3. Symptoms of Attachment Disorder
Symptoms of Attachment Disorder (or
symptoms of more transient attachment issues
or delays) occur in six areas: behavioral,
cognitive, affective, social, physical and
moral/spiritual. An unattached child may
exhibit some but not all symptoms.
Conversely, multiple symptoms are not
necessarily indicative of entrenched attachment
issues that will persist long after a child is
placed.
Behavioral
Self-destructive (head banging, picking, cutting
or burning themselves)
Destroy property of themselves or others
Lack of impulse control
Aggression toward others
Physically violent
Passive-aggressive and manipulative
Exaggerated lying
Stealing
Cruelty to animals
Preoccupation with fire, blood and gore
Hoarding and gorging
Controlling
Sleep disturbances
Enuresis and ecopresis
Demanding and clingy
Consistently irresponsible
Inappropriate sexual conduct
Frequently defiant/oppositional
Incessant chatter and/or persistent nonsensical
questions
Difficulty with novelty and change
Cognitive
Lack of cause and effect thinking
Learning disorders
Perceives self as victim
Grandiose sense of self-importance
Affective
Not affectionate on parent’s terms
Intense displays of anger
Inappropriate emotional responses
Frequently sad, depressed or helpless
Marked mood changes
Social behaviors
Superficially engaging and charming
Lack of eye contact for closeness
Indiscriminately affectionate with strangers
Lack of or unstable peer relationships
Cannot tolerate limits and external control
Blames others for own mistakes and problems
Lacks trust in others
Victimizes or is victimized
Manipulative, controlling and bossy
Physical
Poor hygiene
Chronic body tension
Being accident prone
High pain tolerance/overreaction to minor
injury
Tactilely defensive
Moral/Spiritual
Lack of meaning and purpose
Lack of compassion and remorse
4. SIGNS OF FETAL ALCOHOL SYNDROME OR ALCOHOL RELATED BIRTH
DEFECTS/ALCOHOL RELATED NEURODEVELOPMENTAL DEFECTS
Fetal alcohol syndrome, alcohol related
neurological defects and alcohol related birth
defects (FAS, ARND, ARBD) are characterized by
a cluster of birth defects that occur as the result of
prenatal exposure to alcohol. There are no
biochemical or pathological tests that can be
administered to establish these diagnoses. A child
with a cluster of symptoms in one or more of the
following areas should be evaluated by a
professional with experience in fetal alcohol
syndrome and prenatal alcohol effect, to confirm or
rule out a diagnosis of FAS, ARND, ARBD or
alcohol exposure.
Growth Retardation Before or After Birth May
Include:

Weight below the tenth percentile (in
relation to other children of the same age
and sex)

Height below the tenth percentile

Head circumference below the tenth
percentile
Facial Features May Include:
Central Nervous System Anomalies and Other
Problems May Include:

Microcephaly (head circumference below
third percentile of children of same age and
sex)

Cognitive impairment

Behavioral problems

Poor coordination

Speech and language dysfunction

Feeding dysfunction

Sensory hypersensitivity

Developmental delays (walking, toilet
training, etc.)

Failure to thrive

Non-specific brain anomalies

Cerebral Palsy

Flattened maxillary area

Seizures

Flat philtrum (the two vertical lines under
the nose)

Vision and other eye abnormalities

Thin upper lip or upper lip thinner than the
lower lip

Short palpebral fissures/short opening from
the inside corner to the outside corner of the
eyes

Ptosis or drooping of eyelids

Posterior rotation of ears or low-set ears

Upturned or scooped-appearing nose

Wider than usual distance between the nose
and the upper lip, despite normal variations
In addition, prenatal alcohol exposure may result in
other birth defects such as heart disease, heart
murmur, abnormal palmar creases, skeletal changes,
prematurity and so on.
There must be a known maternal history of
gestational alcohol use or abuse to confirm the
diagnosis of FAS. Children having symptoms in
each of the three areas described above, plus a
known history of gestational alcohol exposure, may
have fetal alcohol syndrome and should be referred
for evaluation. Children who have symptoms in
one or two of the areas but not all three, and have
suspected history of gestational alcohol exposure,
may have other alcohol related birth defects. Early
evaluation and resource support services are
recommended for any child with suspected
problems of prenatal alcohol exposure.
5. LEARNING DISABILITIES IN ADOPTED CHILDREN
Learning disabilities are differences in
learning styles and perceptions and
differences in processing information from
the learning styles of most people. Children
and adults with learning disabilities have
difficulty taking in, processing, storing,
retrieving and expressing information.
(Types of information include: listening,
thinking, speaking, reading, writing, spelling
and/or math.) They have perceptual
inefficiency.
The general public often has a
misconception that having a learning
disability means having inferior intelligence
or an intellectual defect rather than a
different approach to processing
information. The term “learning disability”
does not include individuals who have
learning problems that are primarily the
result of visual, hearing or motor disabilities,
mental retardation, emotional disturbance or
environmental, cultural or economic
disadvantages.
One way to think of learning
disabilities is to compare them to the use of
technology. If the majority of the world
were to save their computer data with
Microsoft Word, and then one individual
using HTTP wished to send an attachment to
the majority of the world uses, there would
be a processing difficulty that would have
nothing to do with the quality (intelligence)
of information the sender was trying to send.
One of the greatest obstacles to a child’s
diagnosis of a learning disability is the
stigma associated with the diagnosis.
The most common learning
disabilities relate to language, reading,
writing and spelling. Another group of
learning disorders revolves around
difficulties in learning to compute or reason
mathematically. Children with learning
disabilities typically display underdeveloped learning strategies, time concepts
and physical abilities, attention disorders
and/or an inability to follow directions
compared to their peers. They may also
have difficulty with memory. The specific
causes of learning disabilities are still
unclear. In general, they are believed to be
caused by abnormalities or malfunctioning
of the brain. Heredity, prenatal and
perinatal circumstances are all thought to be
contributing factors to learning disabilities,
as are circumstances such as low birth
weight, prematurity, prenatal exposure to
alcohol or other drugs and complications
that occurred at birth.
Some of the common learning
disabilities are defined on the next page.
One of the most prevalent learning
disabilities is Attention Deficit
Hyperactivity Disorder (ADHD). This
disability is estimated to occur in 3 to 5% of
the general population. Adopted Child,
January 1990 Newsletter stated, “Among
adoptees, the incidence is estimated to be at
20 to 40 percent.”
In recently placed children, what
appears to be ADD or ADHD may be what
Claudia Jewett calls “newness panic” and
may soon disappear. As Mary Hopkins-Best
has written in Adoptive Families,
“Inattentiveness, impulsivity and
hyperactivity in a recently adopted
preschooler may be evidence of stress and
confusion associated with a change in
placement…Even trained and experienced
professionals sometimes have difficulty
determining whether a child truly has ADD
or another condition with similar
symptoms.”
Attention Deficit Disorder and Attention
Deficit Hyperactivity Disorder (ADD and
ADHD)
A child with ADD or ADHD typically is
easily distracted, has difficulty following
through on instructions from others, fails to
finish tasks, has difficulty sticking to one
activity before jumping into another, has
difficulty organizing work, often loses things
necessary for tasks or activities, often engages
in physically dangerous activities without
understanding the danger involved, often
doesn’t seem to listen to what is said, is
fidgety or always on the move, has angry
outbursts, is very sensitive to criticism and/or
is very impulsive. This condition generally
shows up before the child is seven years old.
be a visual perception problem, which is
commonly characterized by letter and word
reversals. This is one of the most common
disabilities and generally causes reading
difficulty.
Auditory Processing/Discrimination
Problems with auditory processing refer to the
inability to recognize and interpret things that
are heard. The child has difficulty
discriminating similar sounds, can confuse the
sequence of spoken sounds and has difficulty
following a string of commands or directions.
He or she has difficulty understanding when
there is a lot of background noise and
frequently requires repetition of material at a
slower pace, clearly and concisely stated. The
child’s hearing is perfectly normal.
Dyspraxia
A child with dyspraxia has difficulty
performing complex movements, including
muscle motions necessary for talking.
Aphasia
Aphasia is the complete inability to use
language to communicate effectively.
Apraxia
A child with apraxia has difficulty making or
planning movements. There is no paralysis.
Dyslexia
A child with dyslexia has unusual difficulty
sounding out letters and a tendency to confuse
words that sound or look similar. There may
Dysgraphia
A child with dysgraphia exhibits unusual
difficulty in expressing thoughts on paper and
with the act of writing itself. Symptoms
include difficulty grasping pens and pencils,
and illegible penmanship.
Dysphasia
A child with dysphasia has difficulty in using
language to communicate that is not caused by
physical impairment.
Dyscalculia
A child with dyscalculia has difficulty
comprehending simple mathematical
functions. Children with this disability often
do not perceive shapes and may confuse
mathematical symbols.
Dysomia
A child with dysomia does not have the ability
to recall the names of common objects.
Visual Perceptual Processing Disorder
Problems with visual processing cause the
child to be unable to differentiate between
foreground and background and causes
difficulty in differentiating between similar
looking numbers, letter, shapes, objects and
symbols. Problems may include habitually
skipping over lines.
The social worker who observes the child demonstrating symptoms in one or more of the above areas (or
where the parents report that the child demonstrates symptoms indicative of a learning disability) is
encouraged to refer the family for a complete evaluation with a specialist. Early diagnosis and
intervention can teach the child ways to compensate for and cope with their learning difficulties.
6. SPECIAL EDUCATION AND HELP
FOR CHILDREN WITH DELAYS
Most parents have the ability to recognize
the progress and development of their
children. Adoptive parents often have
heightened concerns for their children
because of their early life experiences. It is
best to take action early when children
appear to have developmental delays or
uneven progress. Research has repeatedly
shown the value of early intervention.
It is important for adoption agencies
to be aware of local and national resources
for parents whose children have special
needs. Agencies can direct parents to
services through their public school system
where the federally-mandated special
education system is available to everyone.
Agencies should also be able to inform
parents about the nearest specialists who
have experience with some of the very
specific needs of children who have
experienced institutionalization,
malnutrition or early trauma that may be
impacting their progress.
The Special Education System and Early
Intervention Programs
Parents who are concerned about the
progress of their children can access services
through the special education system. All
children between the ages of 0 and 21 are
guaranteed special education services if
evaluations determine they are eligible.
These rights are provided through federal
law, which each state must support.
There are strict timelines for each
process in obtaining services and clear
guidelines for all parts of the process.
Parents need to exercise the rights they have
in order to ensure the best learning
environment for their children, such as
rights to access to all records, notification of
any meetings and testing that considers
children’s cultural background and
language.
The first step in obtaining services is
to request an evaluation, which will then
determine if the child is eligible for special
education. For school-age children, parents
begin this process at the local public school
(even if the child is in private school).
Parents should write a request to the
principal and outline their concerns. A
school professional can also put forward this
request. At an initial review of the child,
professionals will determine whether the
child should be “screened” for services.
In the case of infants, toddlers and
pre-schoolers, parents can contact the local
school district, state department of public
health or department of social services to
find the nearest program that screens or
assesses children between the ages of 0 to 5.
Universities may also have referral
resources for parents. Children ages 3 and
younger are often referred to early
intervention (EI) programs, which are
generally open to assessing and treating any
child who is suspected of showing
developmental delays.
Nearly all orphanage children are in this
category.
The School-Age Child with Special Needs
The screening process is conducted by a
school committee and involves reports by
school personnel, parents and other adults
who know the child. The goal is to
determine whether there is sufficient
evidence of disabilities and the kinds of
assessments or tests that should be done to
determine the child’s educational needs.
If the committee recommends
assessments, parents need to consent to the
tests. Information is also gathered in greater
depth about the child’s performance in
school or developmentally. Parents play a
critical role in providing information about
the child’s early progress and current
challenges. Assessments must be provided
at no cost. If parents want to use an
independent evaluator, the committee must
approve him in order to have the costs
covered.
After the assessments are finished
(within 45 days) the committee has 30 days
in which to meet to determine what services,
if any, are appropriate. This is a very
important part of the process, and parents
should be prepared to advocate for the kinds
of services they believe their child needs.
To receive services, children must be
“coded” with disabilities in: mental
retardation, serious emotional disturbance,
learning disabilities, autism,
deafness/hearing impairment,
blindness/visual impairment, physical
disabilities, speech and language
impairments or other health impairments.
Every student with a disability that
affects his or her ability to learn is entitled to
receive a free, appropriate public education
in the least restrictive environment that
effectively meets his or her needs. The
program and its goals will be defined in a
critical document called the Individualized
Education Program, or IEP. This document
should set goals and objectives that can be
measured and outline exactly how and when
the child will receive services. Parents can
include goals that they define. Progress and
additional issues will be considered with the
IEP in mind, so parents must concentrate
energy on making the document work for
them.
Despite the depth and breadth of
special education services and laws in the
United States, parents are likely to be
unhappy unless they become knowledgeable
and involved in the process.
Private Services
Parents sometimes prefer to turn to
professionals in a private practice to support
their children. They may feel that those
professionals understand their children
better or that they can receive more
intensive services in a quicker time. For
adoptive parents, this often involves turning
to professionals who understand some of the
unique issues of adoption, which may be
impacting or causing their children’s
disabilities.
The costs for private services will
not be reimbursed by the school system
unless they are recommended in the IEP.
However, if the school system cannot
provide an appropriate education in a public
school, they must pay for a private school.
To Obtain the Best Services
One of the most important aspects of special
education is that the more parents know, the
more they can be equal partners with
education professionals, and the more likely
they are to obtain the services they want for
their children. Parents will need to do
considerable research and outreach to find
the best help for their children. Section Six
lists some useful informational and
professional resources.
7. Post-Arrival Medical Report Form for Adopted Children from Overseas
Note to physician:
Please refer to the American Academy of Pediatrics 1997 “Redbook”, The Report of the
Committee on Infectious Diseases if there are any questions about a procedure or the
need for testing. All tests should be performed, regardless of any tests or results reported
from the other country.
________________________
Name of Child
________________________
Date of Birth
__________________________________________
Address
Completed
Tests
_________
Hepatitis B profile, to include hepatitis B surface antigen and antibodies to hepatitis B
surface and core antigens. (If positive for hepatitis B surface antigen, child was evaluated
for the presence of hepatitis Be antigen, transaminase evaluation and hepatitis D
serology.)
Hepatitis C antibody test
PPD (Mantoux) test
Fecal examination for ova and parasites. (If symptomatic, child also received stool
culture for salmonella, shigella, yersinia and compylbacter.)
VDRL or RPR
Complete blood count with erythrocyte indices
Urinalysis
Vision and hearing screening
HIV-1 antibody test for all children and HIV-1 culture or PCR for infants under 15
months of age
Lead level testing (for all children irrespective of age)
Thyroid function testing, if child comes from an iodine-deficient area such as China or
central Russia
Start immunizations. (If child is >2 years, may check titer first. Otherwise, repeat all
series with the exception of Korea.
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
Comments:
________________________________________________________________________
________________________________________________________________________
Child’s Measurements (age at determination)
____________Height
___________Weight
_________ Head Circumference
Recommendation for any further screening or evaluations:
________________________________________________________________________
________________________________________________________________________
_____________________________
M.D. Signature
Address
____________________
____________________
________________
Date
Physician, please return this
report to address at the top of this
form as soon as the tests are
completed. Thank you.
8. PROBLEMS IN ADOPTED CHILDREN RELATED TO SENSORY
INTEGRATION
Sensory integration is the neurological
organization of our senses – the way in
which the brain organizes and interprets
information that is received from our senses.
Sensory experiences include touch,
movement, body awareness, sight, sound
and the pull of gravity. In most cases,
children develop sensory integration through
normal, everyday activities. Their brains
receive information through the senses,
process it, then respond automatically to
incoming stimuli. Sensory integration is the
foundation for moving, learning, speaking
and interacting with the environment.
There are some children for whom
sensory integration does not develop as
efficiently as it should, and this can
contribute to later problems in behavior,
learning and development. Sensory
integration dysfunction often interferes with
the development of children who have been
institutionalized. It frequently co-exists with
learning disabilities and attention deficits.
Children with SID can be either hyporeactive or hyper-reactive, meaning they
either avoid sensation or seek more
sensation. Children who have sensory
integration dysfunction benefit from early
treatment services, so it is important for the
social worker to be aware of the symptoms
of this condition.
If a child is suspected of having SID,
the adoptive family should be encouraged to
seek a professional evaluation and take
advantage of early intervention treatment
services. Listed below are descriptions of
symptoms associated with SID. When a
child exhibits one or more of the symptoms

These descriptions are being printed with the
permission of the author, Lynn A. Balzer-Martin,
Ph.D.
with frequency, intensity and duration, the
social worker should strongly encourage the
family to seek a sensory integration
evaluation with an occupational therapist
specializing in SID. In addition to the
descriptions below, there is a two-part
assessment questionnaire, the Balzer-Martin
Preschool Screening Questionnaire for
parents and the questionnaire for teachers,
included in this Post-Placement Packet that
could be a useful screening tool for social
workers.
Poor Tactile Discrimination
Poor tactile discrimination refers to
difficulty in identifying touch.
Characteristics include:

Constantly touching everything

Using his hand as though it were an
unfamiliar object

Difficulty holding a pencil or pen

General difficulty with fine motor
tasks

Putting on gloves or socks in unusual
ways

Child may know he has been touched
but be unable to identify where he
has been touched

Relying on vision to do certain motor
tasks where this should not be
necessary (e.g. buttoning or
unbuttoning)

Using mouth to explore objects (in
children above 2 years of age)
because mouth gives more
information than the hands

Preferring long sleeves and pants
even in warm weather or short
sleeves and pants even in cold
weather

Fails to orient to messiness around
the mouth or nose

Disliking getting hands or feet in
messy materials such as sand, grass,
finger paint, paste, mud or similar
things
Tactile defensiveness is a tendency to react
negatively and emotionally to touch
sensations. A child who is defensive may
not only react to the actual touch, but also to
the possibility that someone may touch her.

Acting silly in the classroom, playing
the role of the “class clown”

Displaying unusual needs for
touching some surfaces or textures
Characteristics include:

Touching and feeling everything in
sight, may include bumping or
touching others

Experiencing difficulty in social
situations

Sensitivity to light
Tactile Defensiveness


Disliking when people touch him,
even in a friendly or affectionate
way. Rubbing off kisses
Reacting more negatively to being
approached from behind than do
other children
Under-responsiveness to Touch

Appearing distressed when people
are near him, even though he is not
being touched (i.e. difficulty
standing in line, sitting in a circle)
Under-responsiveness is a tendency to NOT
react to some touch.
Characteristics include:

Avoiding touching certain surfaces
or textures, such as some fabrics,
blankets, carpets or stuffed toys

Appearing to be unaware of touch
unless it is very intense

Responding better to firm touch and
to touch from familiar persons

Appearing not to react to pain from
cuts, shots, scrapes or bruises

Avoiding being touched on the face,
hair or head. Washing his face,
shampooing or getting a haircut may
be especially difficult

Biting own skin

May especially enjoy hanging by
arms or feet or particularly enjoy
vibration. (These create strong
sensory feedback.)

Disliking being bathed or having
fingernails cut
Poor Processing of Proprioceptive Input
This is a difficulty in interpreting sensations
from the muscles, joints, ligaments and
tendons.
Vestibular Processing (Gravitational
Insecurity)
Gravitational insecurity refers to a difficulty
tolerating passive movement off one’s
center of gravity.
Characteristics include:
Characteristics include:


Difficulty knowing where his body is
in relation to objects
Frequently breaking toys because he
cannot judge how much pressure he
is exerting. An older child may also
break dishes when washing them or
drop other delicate objects

Unnatural fear of falling or heights

Not enjoying playground equipment

Becoming anxious when his feet
leave the ground

Disliking having his head upside
down or tilted backwards, as in
somersaults, rolling on the floor or
rough-housing

Tripping over obstacles in the
environment or bumps into them

Walking along banging a stick on a
wall, fence or other objects

Avoiding stepping or jumping down
from a higher surface to a lower one
Seeming to physically “tackle”
everything

Afraid to walk on a raised surface
(although it seems low to others)
Difficulty maintaining a seated
position in a chair, poor posture

Slow in performing movements such
as getting into a car, moving from
the front seat to the back or walking
up or down a hill or over bumpy
ground

Taking a long time to learn to go up
or down stairs and using the railing
more than other children



Messy written work, often with
erasure holes

Pressing too hard or too softly with a
pencil

Deliberately falling or crashing into
things

Constantly chewing on things such
as gum, shirt, pencil, etc.
Inefficient Processing of Vestibular Input

Generally poor regulation of physical
force. Seems like a “bull in a china
shop”
Inefficient processing of vestibular input
refers to the difficulty interpreting gravity
and movement sensations and knowing the
position of the head in relation to the surface
of the earth.
Characteristics include:

Increased tolerance to movement
(under sensitivity). May seem to be
a “thrill seeker”

Decreased tolerance to movement
(overly sensitive). May be fairly
sedentary or cautious and hesitate to
take risks

Combined under-sensitivity AND
over-sensitivity to movement. May
seek intense movement experiences
yet be unable to tolerate them

Frequent stumbling and falling

Poor postural responses, including
low muscle tone. Child with low
tone may have characteristics
including:
o Tendency to slump in chair
or sprawl over chair and table
o Constantly leaning head on
hand or arm
o Preference to lie down rather
than sit upright
o Not feeling solid or firm
when you lift her up or move
her limbs to help her get
dressed
o Fatigues easily during family
outings or during physical
activities
o Has loose grasp on objects
such as a pencil, scissors or
spoon
o Has a tight, tense grasp on
objects

Difficulty coordinating movements
of the eyes

Speech and/or language difficulties
with problems processing auditory
input
Oral
The child is sensitive to food textures (slimy
or lumpy foods, crunchy foods or foods that
require a lot of chewing) or is irritated with
brushing teeth.
The Balzer-Martin Preschool Screening Program
(BAPS)
MANUAL
By
Lynn A. Blazer-Martin, Ph.D., OTR
And
Carol Stock Kranowitz, MA
Developed at
St. Columba’s Nursery School
4201 Albemarle Street, NW
Washington, DC 20016
Karen O. Strimple, Director
Funded by
The Katharine P. Maddux Foundation
McLean, Virginia
Printed with permission from the authors
Sensorimotor History Questionnaire for Parents of Preschool
Children
Child’s Name ___________________________
Date______________
Name of person(s) filling out form ___________________________________________
Your responses will probably be most accurate if you first read all the statements below the question,
checking off those that describe your child. Then circle “YES” if you have checked one or more
statements; circle “NO” if none applies. Please include additional or different descriptions under
“OTHER”.
1. Is your child particularly sensitive to touch?











YES
NO
Did not always find touch to be calming or pleasurable as an infant
Is more annoyed than other children the same age by a shampoo or face wash
Reacts negatively to a haircut or having nails cut
Is very picky about textures of clothing
Is very fussy about clothing (e.g. dislikes collars or turtlenecks, is very annoyed by labels, often
complains about socks, coats or hats, prefers only loose clothing)
Is uncomfortable with long sleeves and pants, prefers as little clothing as possible
Prefers long sleeves and pants, even in warm weather
Avoids messy activities such as playdough, clay, mudpies, fingerpaints and cooking
Overreacts to physically painful experiences
Underreacts to physically painful experiences
Tends to withdraw from a group, or to bump or push others in a group, is irritable in close
quarters
Other: _______________________________________________________________
_______________________________________________________________
2. Does your child particularly enjoy fast-moving or spinning activities at the
playground or at home, perhaps with little or no dizziness?






YES NO
Likes to swing very high and/or for long periods of time
Frequently rides the playground merry-go-round where others run around to help keep the
platform turning
Especially likes movement experiences at home such as bouncing on furniture, using a rocking
chair or being turned in a swivel chair
Enjoys getting into an upside-down position (feet up, head down)
Likes to initiate games where vision is occluded, such as putting a bandana over eyes, a bag
over head, or just keeping eyes closed for fun
Enjoys most of the fast and spinning kiddie rides when at an amusement park
Other: _______________________________________________________________
_______________________________________________________________
3. Does your child show particular caution in approaching activities involving fast
movement or movement of the body through space?







YES
NO
Tends to avoid swings or slides or uses them with hesitation
Does not like riding a see-saw or going up and down an escalator
Is cautious about heights and climbing
Enjoys movement, which she/he initiates but does not like to be moved by others, particularly
if the movement is unexpected
Dislikes trying new movement activities or has difficulty learning them
Has difficulty climbing or descending stairs or hills
Tends to get motion sick in a car, airplane or elevator
Other: _______________________________________________________________
_______________________________________________________________
4. Does your child have unusual sensitivities to smell?



YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
Has difficulty identifying things by their smell
Tends to complain that fairly normal odors are unpleasant
Tends to ignore unpleasant odors when they are present
Other: _______________________________________________________________
_______________________________________________________________
5. Is your child particularly sensitive to noise (e.g. putting hands over ears when
others are not bothered by sounds?
Comments:___________________________________________________________
_____________________________________________________________________
6. Have you ever had concerns regarding your child’s hearing, either in general, or
in conjunction with ear infections?
Comments:___________________________________________________________
_____________________________________________________________________
7. Have you ever had concerns regarding your child’s speech and/or language skills?
Comments:___________________________________________________________
_____________________________________________________________________
8. Have you ever had concerns regarding your child’s vision?
Comments:___________________________________________________________
_____________________________________________________________________
9. Does your child have a more “loose” or “floppy” body build than others?






YES
NO
Tends to slump in chair or sprawl over chair and table
Does not feel very firm when you lift child up or move child’s limbs to dress
Has difficulty turning knobs or handles that require some pressure
Fatigues easily during family outings or during physical activities
Has a loose grasp on objects such as a pencil, scissors, spoon or something she/he is carrying
Has a rather tight, tense grasp on objects (to compensate for underlying looseness)
Other: _______________________________________________________________
_______________________________________________________________
10. Can your child easily orient his/her body effectively for dressing activities such
as putting arms in sleeves, fingers in mittens or toes in socks?
YES
NO
YES
NO
YES
NO
YES
NO
Comments: ___________________________________________________________
_____________________________________________________________________
11. Do you feel that your child has already established a definite hand preference
when using a crayon, marker, pencil, etc.?
Comments: ___________________________________________________________
_____________________________________________________________________
12. Does your child spontaneously engage in active physical games involving running,
jumping and use of large play equipment?
Comments: ___________________________________________________________
_____________________________________________________________________
13. Does your child spontaneously seek out activities requiring manipulation of small
objects?



Enjoys Duplo, Legos
Enjoys building with blocks
Enjoys arts and crafts projects using small objects such as beads, straws, buttons, felt, cotton
balls, etc.
Other: _______________________________________________________________
_______________________________________________________________
14. Does your child spontaneously choose to do activities involving the use of
YES
“tools” such as crayons, pencils, markers, scissors, etc.?
Comments: ___________________________________________________________
_____________________________________________________________________
NO
15. Do you feel that your child has an adequate attention span for things, which
she/he enjoys?
YES
NO
YES
NO
YES
NO
Comments: ___________________________________________________________
_____________________________________________________________________
16. Do you feel that your child tends to be restless or “fidgety” during times
when quiet concentration is required?
Comments: ___________________________________________________________
_____________________________________________________________________
17. Has your child had difficulty regulating sleep patterns?





Took longer than other infants to sleep through the night
Had colic as a baby
Never took naps, or gave up naps sooner than most children
Now has difficulty falling asleep
Still does not consistently sleep through the night
Other: _______________________________________________________________
_______________________________________________________________
18. Please share any other characteristics of your child, which you think it would be appropriate for us
to know. Thank you.
10. BALZER-MARTIN PRESCHOOL SCREENING – TEACHER
CHECKLIST
Child’s Name___________________
Age (yrs. & mo.)________________
Teachers____________________________
Date________________________________
Compared to his/her peers, is this child ADEQUATE in:
1. Ability to tolerate touch stimulation?
YES
NO
2. Willingness to participate in messy activities (e.g. sand, playdough, fingerpaints, etc.)? YES
NO
Comments: ___________________________________________________________
___________________________________________________________
Comments: ___________________________________________________________
___________________________________________________________
3. Ability to sit upright in a chair without slouching or sprawling over the table?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
Comments: ___________________________________________________________
___________________________________________________________
4. Ability to enjoy or participate in intense movement experiences such as swinging
high, bounding vigorously or spinning around?
Comments: ___________________________________________________________
___________________________________________________________
5. Ability to get outer clothing on and off?
Comments: ___________________________________________________________
___________________________________________________________
6. Ability to move body in a smooth, coordinated manner (i.e. not moving in an
awkward or unusual way?
Comments: ___________________________________________________________
___________________________________________________________
7. Use of both hands together in two-handed activities, such as catching a large ball,
using a rolling pin or beating rhythm sticks?
Comments: ___________________________________________________________
___________________________________________________________
8. Method of grasping a pencil, marker or crayon?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
Comments: ___________________________________________________________
___________________________________________________________
9. Ability to use a pencil, marker or crayon effectively?
Comments: ___________________________________________________________
___________________________________________________________
10. Ability to grasp scissors and to cut with them effectively?
Comments: ___________________________________________________________
___________________________________________________________
11. Consistent use of one hand as dominant (i.e. preferred hand) when using
markers, crayons or pencils? (Ages 4 and up)
Comments: ___________________________________________________________
___________________________________________________________
12. Ability to maintain sufficient attention span for things she/he enjoys?
Comments: ___________________________________________________________
___________________________________________________________
13. Ability to remain calm during routine classroom activities without becoming
restless or fidgety?
Comments: ___________________________________________________________
___________________________________________________________
14. Ability to eat and chew normally without noticeable difficulties such as
being excessively messy, refusing certain textures or cramming food in mouth?
Comments: ___________________________________________________________
___________________________________________________________
In comparing this child with his/her peers, do you see PROBLEMS such as:
1. Overflow of movement in body parts not directly involved in an activity
(e.g. tongue protrusion, jaw motion, movements in nondominant hand, etc.)?
Comments: ___________________________________________________________
___________________________________________________________
2. Over-sensitivity to noises (e.g. putting hands over ears or complaining about sounds
when others are not bothered)?
YES
NO
YES
NO
4. Auditory language difficulties (e.g. when following directions child looks to others
YES
for cues before responding, has difficulty changing or rephrasing verbalizations when
she/he is not understood, gives short or very limited verbal responses, cannot recall names
of people or objects)?
NO
Comments: ___________________________________________________________
___________________________________________________________
3. Vision stress (e.g. inattentiveness when drawing or doing puzzles, insistence on
“sameness” in day-to-day activities, lack of good consistent eye contact, excessive
shyness or unusual awkwardness)?
Comments: ___________________________________________________________
___________________________________________________________
Comments: ___________________________________________________________
___________________________________________________________
5. Other behaviors that you feel may be atypical for his/her stage of development
(e.g. drooling, stuttering, unusual postures or movements, etc.)?
Comments: ___________________________________________________________
___________________________________________________________
YES
NO
11. THE BALZER-MARTIN PRESCHOOL SCREENING PROGRAM
CONTENTS
A. “Catching Preschoolers Before They Fall: A Developmental Screening Using a Neurological Approach”
by Carol Stock Kranowitz (Child Care Information Exchange, March 1992)
B. Screening Program Schedule – when to plan a teacher-training workshop, when to advise parents about
the screening, when to contact parents about results, etc.
C. Pre-Screening Letter to Parents – a sample of an explanatory letter that accompanies the Parent
Questionnaire
D. Sensorimotor History Questionnaire for Parents of Preschool Children – 18 categories regarding child’s
sensitivity to touch, reactions to playground equipment, language skills, motor skills, etc.
E. Teacher Chicklist – 19 questions regarding a student’s use of classroom tools, ability to concentrate
when necessary, use of both hands together when required, etc.
F. Class Chart to help teachers gather information for Teacher Checklist
G. Blueprint to prepare room for screening activities, equipment list, description of 11 screening items and
3-point scoring criteria for each
H. Data Sheet to record the performances of children (6 per sheet) doing 11 items, with spaces for adding
notes from parents’ and teachers’ information (sample provided)
I. Post-Screening Letter to Parents – a “thank you” for parents’ cooperation, a review of what sensory
integration is, why the screening is a valuable tool
J. Promoting Sensory Integration at School and at Home – enjoyable activities that parents and teachers
can encourage
K. Copies of letters from parents whose children already receive therapy, addressed to parents whose
children have recently been identified – articulate expressions of parents’ initial feelings
L. “How to Start a Parent Group” – pointers from an experienced leader
M. Follow-up Chart – for tracking the future progress of identified children (sample provided)
To order, please fill out the form provided below, and send it with a check for $60.00 (U.S.), payable to St.
Columba’s Nursery School, to the following address:
BAPS
c/o St. Columba’s Nursery School
4201 Albermarle Street, NW
Washington, DC 20016
The Balzer-Martin Preschool Screening Program Manual Order Form
Name _________________________________________________________________________
Title__________________________________________________________________________
School, Clinic, Etc.______________________________________________________________
Street Address__________________________________________________________________
City, State, Zip Code_____________________________________________________________
1403 King Street, Suite 101
Alexandria, VA 22314
703-535-8045
Fax: 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures
that better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an
educational tool for its
member organizations,
signifying the importance we
place on quality postplacement services.
POST-PLACEMENT GUIDELINES
AND TOOLS FOR ADOPTION
PROFESSIONALS
Section Four
Information on Social Security, Recognition of the
Adoption in State of Residence, Citizenship and
Replacing Documents
Joint Council provides this section for informational
purposes only. Adoptive parents should check with the
appropriate agencies to ensure that the information
continues to be up-to-date.
This resource guide may be freely reproduced and
distributed to adoptive parents by member organizations
of the Joint Council on International Children’s
Services.
SOCIAL SECURITY, RECOGNITION OF THE ADOPTION IN
STATE OF RESIDENCE, CITIZENSHIP AND REPLACING
DOCUMENTS
This is intended for distribution by agencies to social workers and adoptive parents.
Obtaining a Child’s Social Security Card
Once the child has arrived, it is necessary
for parents to apply for a social security
card. They may apply for and receive a card
even if the adoption is not considered final.
It is necessary to have a social security
number for all dependents that will be
claimed on federal returns, so parents should
apply well before their tax form is due.
In addition to completing this
application for a social security card, parents
need the following documentation to apply
for the card:
1. The child’s original birth certificate
from birth country, plus adoption or
guardianship papers
2. Proof of the child’s U.S. citizenship
– a passport or certificate of
citizenshipAlien Registration Card or
his passport
3. Parent’s identification (passport,
driver’s license, military I.D. but not
a birth certificate.
Parents will be asked to show original
documents, so it is essential to bring their
documents and to complete this process in
person. Parents should never mail or
surrender their child’s original documents,
which may be difficult or impossible to
replace.
advisable to re-adopt the child or, in states
whose laws provide for it, to have the
foreign adoption decree recognized,
reconfirmed or validated. All families are
strongly advised to either have their
completed foreign adoption reconfirmed or
validated in their state of residence, if the
state has this provision in its laws, or
complete the adoption in the state of
residence in cases where the adoption has
not been finalized overseas or even when it
has been finalized abroad and the state
allows re-adoption. However, if the child
obtained automatic citizenship pursuant to
the Child Citizenship Act (see below), proof
of citizenship (Social Security card, U.S.
passport, etc.) are valid methods of
identifying the legal rights of an adopted
child.
Obtaining Citizenship for an Adopted Child
As of February 27, 2001, the Child
Citizenship Act grants foreign-born
children, including adopted children, who
are living at a permanent United States’
residence automatic U.S. citizenship IF the
children meet the following criteria:



The Importance of Adoption or Re-adoption
in the Family’s State of Residence
Not all of the U.S. states recognize an
adoption granted in the foreign country as a
final adoption. Even in states that do, it is

At least one adoptive parent is a
U.S. citizen,
The child is under 18 years of
age,
There is a full and final adoption
of the child, and
The child is admitted to the
United States as an immigrant
The Child Citizenship Act does apply
retroactively if the above characteristics held
true on February 27, 2001. If the final
adoption was completed overseas, upon
entry into the United States, the child
becomes a citizen; if the adoption is
completed in the United States, the child
becomes a citizen on the day the adoption is
finalized.
Effective October 31, 2003, to apply for a
Certificate of Citizenship, the parents need
to fill out the form N-600, Application for
Certificate of Citizenship. A copy of the N600 can be viewed and printed from the
USCIS website http://www.bcis.gov.
Children adopted after January 20, 2004 and
brought to the U.S. on an IR-3 visa will
automatically receive a Certificate of
Citizenship approximately 45 days after
entry into the United States. However, if a
child enters on an IR-4 visa there is
currently no automatic issuance of the
certificate so families will need to file a N600 Form.
Recovering a Child’s Adoption Documents
from USCIS Files
Occasionally a family returning from
adopting their child overseas accidentally
surrenders their only set of the child’s
original documents to the U.S. Immigration
at the port of entry. (This happens because
the originals are generally included in the
sealed visa packet, if the family or their
representative did not provide photocopies
to the U.S. Embassy when getting the
child’s visa, since the sealed envelope must
be surrendered to USCIS.) Using Form G884 with the office where you submitted the
original document(s), families can request
the return of those documents. The Form G884 is available for those in the United
States by mail.
1403 King Street, Suite 101
Alexandria, VA 22314
703-535-8045
Fax: 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures
that better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an
educational tool for its
member organizations,
signifying the importance we
place on quality postplacement services.
POST-PLACEMENT GUIDELINES
AND TOOLS FOR ADOPTION
PROFESSIONALS
Section Five
1.
Putting Together Your Child’s Life Book
2.
The Importance of a Forever Family
Certificate
3.
Forever Family Certificate
4.
Forever Mother Certificate
5.
Forever Father Certificate
This section may be freely reproduced and distributed to
adoptive parents by member organizations of the Joint
Council on International Children’s Services.
1. PUTTING TOGETHER YOUR CHILD’S LIFE BOOK
One of the most helpful things you can do for your
adopted child is to prepare a Life Book especially for
him or her, telling his or her story in words that a 4year-old can understand. (We use the age of four
because that is when you will want to introduce the
birth parents.) Often adoptive parents may not want
to bring up what is feared to be a painful subject for
everyone concerned, but the good news is that this
necessary task can be presented in a very positive and
productive way. A well-constructed adoption story,
presented in pictures and text, can accomplish this
Text
task quite easily. Your child will want to take out the
book again and again in his preschool years, so
choose a photo album with plastic pages that you can
leave out on the coffee table.
The purpose of the Life Book is fourfold.
You want to explain your child’s relationship with
his or her birth parents and you, stress that he was
loved and wanted, reassure him that you are a
“forever family” (this is important because you want
to assure him he will not lose you as well) and prove
to him that you are your child’s “real” family.
Picture
Here is your forever family. Mom, Dad, and
________________ (child’s name).
You, the child, and other family members (change
the photo if new members are added).
These are people from ___________(child’s
country), the place where you were born.
Color pictures from magazines or your own
snapshots (include children).
Mom and Dad wanted a child very, very much.
Photo of Mom and Dad by themselves before the
new child.
Here is a picture of you when you were _______
(child’s age).
Referral photo or pre-placement photo.
You started out with another Mom and Dad. They
were your first mother and father. Maybe they
looked something like this man and woman.
Artist’s representation; get an artistic friend if you
don’t want to try, or use a magazine picture.
Your first mother grew you inside her from a seed,
but she couldn’t take care of a baby. She wanted
to. You were a good baby.
Picture of mother holding child, or child alone (can
be drawn if no actual or magazine photo can be
found).
Your first mother and father wanted you to have a
family that could take care of you. So they made a
plan to have you adopted. That was when you
came to us!
Picture of Mom and Dad holding the child at the
time of placement or soon thereafter. You can also
mention that child came on an airplane and include
a photo of a plane.
Mommy and Daddy were SO happy when you
came!
Another photo of parents and child, with parents
smiling.
Now we are a family forever – Mommy, Daddy
and you.
A recent photo of the entire family.
We are your real parents and you are our very own
child!
Photo of Mom, Dad and child.
2. THE IMPORTANCE OF A FOREVER FAMILY CERTIFICATE
Adopted children may be distressed by the
inevitable conflicts that arise within all
normal families. “Will our family break up,
like the last one did?” can be their unspoken
fear. This may be hidden even from the
child’s own consciousness. “Do my new
parents really love me if they get mad at me
sometimes?”
The Forever Family Certificate,
framed and hung in your children’s rooms,
is a reminder that the love of their new
family is strong and secure no matter what.
Of course, you’ll be telling your children
this from time to time, but a gold-seal
certificate makes it official and conveys an
explicit promise. It also provides a reminder
of your enduring love at times when you
may not even know your child is hurting and
in need of reassurance.
The Forever Family Certificate is
also a reminder of the permanence of your
family bonds. Adopted children who have
already lost their first parents (and often at
least one set of beloved caretakers as well)
need ongoing reassurance in their early
years that you are truly their parents forever.
For you to keep repeating this explicitly
over the years is not as helpful as an everpresent visual reminder on their wall, which
they’ll be drawn to when they need it.
Unfortunately, our society’s outdated
definitions of adoption will inevitably lead
some of your children’s playmates saying to
them, “They’re not your real parents.” You
should anticipate this problem and explain to
your children, even before kindergarten, that
you are their real parents because you are
the ones that are raising them.
THIS IS A SPECIAL WAY OF SAYING
TO OUR VERY OWN CHILD
________________________________
We Are Your Forever Family
We love you with a forever love.
We will love and care for you always.
We will share love and joy and happiness.
And sometimes there will be problems
and hurts and arguments,
because all families are like that.
But we will always love you no matter what,
because forever parents are like that.
_________
Mom and Dad
THIS IS A SPECIAL WAY OF SAYING
TO MY VERY OWN CHILD
________________________________
I Am Your Forever Mother
I love you with a forever love.
I will love and care for you always.
I will share love and joy and happiness.
And sometimes there will be problems
and hurts and arguments,
because all families are like that.
But I will always love you no matter what,
because forever mothers are like that.
________________
Mom
THIS IS A SPECIAL WAY OF SAYING
TO MY VERY OWN CHILD
________________________________
I Am Your Forever Father
I love you with a forever love.
I will love and care for you always.
I will share love and joy and happiness.
And sometimes there will be problems
and hurts and arguments,
because all families are like that.
But I will always love you no matter what,
because forever fathers are like that.
________________
Dad
POST-PLACEMENT GUIDELINES
1403 King Street, Suite 101
Alexandria, VA 22314
703-535-8045
Fax: 703-535-8049
http://www.jcics.org
The Joint Council on
International Children’s
Services from North America
is an association of licensed,
not-for-profit child welfare
agencies that serve children
through intercountry adoption
and relief efforts. The Joint
Council advocates for
homeless children around the
world, provides a forum for
sharing information enabling
children to be served more
effectively, promotes
legislation and procedures
that better meet the needs of
children, disseminates
information related to
children’s issues and
establishes guidelines and
standards of practice that
protect the rights of children,
birth parents, and adoptive
parents.
JCICS has prepared the PostPlacement Guidelines and
Tools for Adoption
Professionals as an
educational tool for its
member organizations,
signifying the importance we
place on quality postplacement services.
AND TOOLS FOR ADOPTION
PROFESSIONALS
Section Six
1.
International Adoption Resources
2.
Specialized Therapy Resources
3.
International Adoption Medical
Professionals
4.
Publications
Joint Council provides this Resource Guide for
informational purposes only. It is not an all-inclusive
list, and parents should seek out all available resources
and agencies.
This resource guide may be freely reproduced and
distributed to adoptive parents by member organizations
of the Joint Council on International Children’s
Services.
1. International Adoption Resources
Joint Council on International Children’s
Services from North America
1403 King Street, Suite 101
Alexandria, VA 22314
703-535-8045
http://www.jcics.org
JCICS is an association of licensed, non-profit
international adoption agencies, the membership
includes parent/advocacy groups as well. Our
primary mission is advocacy for homeless
children around the world. We promote ethical
practices in adoption and support efforts to
improve services to children.
Parent Network for the PostInstitutionalized Child
PNPIC
Box 613
Meadowlands, PA 15347
724-222-1766
http://www.pnpic.org
PNPIC supports and educates about the
medical, developmental, educational and
emotional needs of children adopted from
institutions around the world. It publishes The
Post newsletter and provides other
informational resources.
Adoptive Families of America
PO Box 5159
Brentwood, TN 37024
1-800-372-3000
http://www.adoptivefam.org
AFA supports, educates and advocates on behalf
of adoption-built families. It publishes Adoptive
Families magazine and sells adoptive parenting
resources.
U.S. Department of State
Office of Children’s Issues
Room 4811
Overseas Citizens Services
Washington, DC 20520-4818
202-647-2688
http://www.travel.state.gov/adopt.html
The Office of Children’s Issues provides general
information about international adoption and
U.S. visa requirements. They can ensure that
foreign authorities or courts do not discriminate
against U.S. citizens, but they cannot become
directly involved in the adoption process in
another country.
American Academy of Adoption
Attorneys
PO Box 33053
Washington, DC 20033-0053
202-832-2222
http://www.adoptionattorneys.org
This organization consists of attorneys who
make adoption a part of their legal practice.
National Adoption Information
Clearinghouse
PO Box 1182
Washington, DC 20013-1182
1-888-251-0075
http://naic.acf.hhs.gov/index.cfm
NAIC provides information on all aspects of
adoption.
2. Specialized Therapy Resources
Administration on Developmental
Disabilities
Administration for Children and Families
U.S. Department of Health and Human Services
Mail Stop: HHH 300-F
370 L'Enfant Promenade, S.W.
Washington, D.C. 20447
202-690-6590
http://www.acf.dhhs.gov/programs/add/
The Administration on Developmental Disabilities
ensures that individuals with developmental
disabilities and their families participate in the
design of and have access to culturally competent
services, supports, and other assistance and
opportunities that promote independence,
productivity, integration and inclusion into the
community. The website gives information on
federally-funded programs that provide
developmental disabilities programs.
with speech, hearing and language disorders have
access to quality services to help them communicate
more effectively. They provide free brochures and
referrals to therapists in your area.
American Occupational Therapy
Association Inc. (AOTA)
PO Box 31220
Bethesda, MD 20824-1220
301-652-2682
http://www.aota.org
AOTA is the nationally recognized professional
association of more than 40,000 occupational
therapists, occupational therapy assistants, and
students of occupational therapy. These individuals
work with people experiencing health problems
such as stroke, spinal cord injuries, cancer,
congenital conditions, developmental problems, and
mental illness. They provide fact sheets, products
and books about occupational therapy.
ARC (formerly Association for Retarded
Citizens of the U.S.)
1010 Wayne Avenue, Suite 650
Silver Spring, MD 20910
(301) 565-3842
http://www.thearc.org
The ARC works to include all children and adults
with cognitive, intellectual, and developmental
disabilities in every community. They provide
informational resources and other information
regarding cognitive, intellectual and developmental
disabilities.
American Speech-Language-Hearing
Association
10801 Rockville Pike
Rockville, MD 20852
1-800-638-8255
http://www.asha.org
ASHA is the professional, scientific and
credentialing association for audiologists, speech
pathologists and speech, language and hearing
scientists. Their mission is to ensure that all people
Attachment and Bonding Center of Ohio
Gregory Keck, Ph.D.
12608 State Road, Suite 1
Cleveland, OH 44133
440-230-1960
http://www.abcofohio.net
The Center specializes in treating children who
have experienced developmental interruptions. Dr.
Keck, author of Adopting the Hurt Child: Hope for
Families with Special-Needs Kids, and his staff also
treat individuals and families who are experiencing
a variety of problems in the areas of adoption, such
as attachment, substance abuse, sexual abuse and
adolescent difficulties.
ATTACh
Association for Treatment and Training in the
Attachment of Children
PO Box 11347
Columbia, SC 29211
803-251-0120
http://www.attach.org
ATTACh is an international coalition of
professional and lay persons who are involved with
children who have attachment difficulties. They
provide clinical education, training and research
on attachment, offer family support, including an
open referral service to qualified professionals, and
hold an annual conference on attachment and
bonding.
Children and Adults with Attention
Deficit/Hyperactivity Disorder
8181 Professional Place, Suite 301
Landover, MD 20785
1-800-233-4050
http://www.chadd.org
CHADD provides informational resources and
conferences on ADD/ADHD. CHADD also
produces a bimonthly magazine, Attention!,
dedicated to providing detailed and relevant
information on ADD/ADHD.
Developmental Delay Resources
4401 East West Highway
Suite 207
Bethesda, MD 20814
301-652-2263
http://www.devdelay.org
DDR is dedicated to meeting the needs of those
working with children who have developmental
delays in sensory motor, language, social, and
emotional areas. DDR publicizes research on
determining identifiable factors that would put a
child at risk and maintains a registry, tracking
possible trends. DDR also provides a network for
parents and professionals and current information
after the diagnosis to support children with special
needs.
Federation for Children with Special Needs
95 Berkeley Street, Suite 104
Boston, MA 02116
http://www.fcsn.org
The Federation is a center for parents and parent
organizations to work together on behalf of
children with special needs and their families. It
also provides lists of parent centers for education
and training in the special education process and
system.
Institute on Disability and Human
Development
1640 West Roosevelt
Chicago, IL 60608-6904
312-413-1647
http://www.uic.edu/depts/idhd
The Family Clinic and the Children’s Program at
IDHD provides family-focused, comprehensive
assessment services for children identified with, or
at risk of, developmental delays or other
developmental problems. Consultation and training
are available in the areas of child development,
child language stimulation, behavioral change and
early interventions.
Learning Disabilities Association
4156 Library Road
Pittsburgh, PA 15234-1349
412-341-1515
http://www.ldanatl.org
LDA is a national association of professionals and
parents that provides free listings of state learning
disability associations as well as a list of resources.
National Organization on Fetal Alcohol
Syndrome
216 G Street, NE
Washington, DC 20002
202-785-4585
http://www.nofas.org/main/index2.htm
NOFAS is committed to raising public awareness of
FAS—the leading known preventable cause of
mental retardation and birth defects—and to
developing and implementing innovative ideas in
prevention, intervention, education and advocacy in
communities throughout the nation. They provide
updated information on studies of FAS and
applicable conferences.
Sensory Integration International
The Ayres Clinic
1514 Cabrillo Avenue
Torrance, CA 90501-2817
310-320-2335
http://home.earthlink.net/~sensoryint
SII was founded by a group of occupational
therapists dedicated to helping people with
disabilities related to sensory integration problems.
They bring together professionals, individuals,
families and researchers who want to know more
about SI. They offer workshops to introduce
parents and teachers to sensory integration and its
connection with learning and behavior, train
occupational and physical therapists in the
evaluation and treatment of sensory integrative
dysfunction in children and offer publications and a
resource system to connect parents and teachers
with therapists and programs providing sensory
integration services.
3. International Adoption Medical Professionals
International adoption specialties are relatively
new in pediatrics, but are certainly increasing.
Most of the physicians listed below have
traveled extensively in the countries that place
children for adoption; many are adoptive parents
themselves; most have excellent written
materials regarding common medical issues
involved in intercountry adoption. They are
generally available for pre-adoption and postadoption consultations. Many clinics and
doctors will review videos and medical records
of children. Parents can consult with these
doctors via phone, fax and e-mail, sometimes at
no charge.
Parents are strongly urged to have their
internationally adopted children evaluated by
medical professionals as soon as possible after
arrival in the U.S. Professionals with experience
evaluating these children can suggest specific
interventions and referrals (to occupational
therapists, speech/language pathologists, etc.),
can recommend general and country-specific
tests, and can provide family counseling on
medical issues.
The list below represents some of the
best-known adoption medical professionals, but
we suggest that you contact your agency or
parent support group to see if there is a clinic or
international adoption specialist in your
geographical area, if one is not listed here.
This is not meant to be an all-inclusive
list, and we will inevitably have overlooked
some fine resources. Joint Council would
appreciate hearing about any international
adoption clinics or specialists who are not listed
here, and will try to include them in our next
update.
Andrew Adesman, M.D.
Evaluation Center for Adoption
Schneider Children’s Hospital
269-01 76th Avenue
New Hyde Park, NY 11040
718-470-4000
The Evaluation Center for Adoption provides
comprehensive pre-adoption and post-adoption
evaluations. Pre-adoption evaluations include a
review of videotapes, photographs and medical
referral information. A detailed assessment of
the child’s medical and developmental status is
generally provided within 24 to 48 hours. If
additional information is needed, specific
follow-up questions are formulated and the
supplemental information reviewed when
available. For emergencies overseas, telephone
consultation with the Medical Director is
available around-the-clock.
Families living near or traveling through New
York City may bring their newly adopted child
for a baseline medical examination and
developmental assessment. Parents will be
provided with a written list of recommended
laboratory tests and other suggested diagnostic
studies for their pediatrician.
Jane Aronson, D.O.
International Pediatric Health Services, PLLC
151 East 62nd Street, Suite 1A
New York, NY 10021
212-207-6666
http://www.orphandoctor.com
International Pediatric Health Services, PLLC
provides medical guidance for families adopting
from abroad from the very beginning of the
process. Written materials are available. Dr.
Aronson reviews medical abstracts and videos of
Russian and Eastern European children and
does pre-adoption consultations in the office as
well as by phone, fax or e-mail.
Travel kits and travel preparation can be
provided by Dr. Aronson’s office. The travel
preparation class is actually a childcare class to
help parents with basic health issues of young
children. Special attention is given to the
transition behavior of children recently adopted
from orphanages. Dr. Aronson is available for
consultation with families who have medical
questions while they are abroad and provides
complete medical and developmental services in
New York after the child’s arrival.
Julia M. Bledsoe, M.D.
The Center for Adoption Medicine
University of Washington Pediatric Care Center
4245 Roosevelt Way N.W.
Seattle, WA 98105
206-598-3006
Dr. Bledsoe is a general pediatrician in Seattle
whose practice includes more than 50%
adoptees, primarily from overseas. Dr. Bledsoe
provides ongoing pediatric care as well as preadoptive consultation and overseas on-call
support to families who reside both locally and
afar. Her pre-adoptive consultations are
performed by telephone, usually in the evenings
and on weekends. In addition, Dr. Bledsoe is
employed at the University of Washington Fetal
Alcohol Syndrome Clinic, working on the
diagnosis of FAS.
The Section of Pediatric Infectious Disease at
Riley Hospital created an International
Adoption Clinic in 1999. The clinic is staffed by
physicians trained in Pediatric Infectious
Disease, Geographic Medicine and General
Diagnostic Pediatrics. Referrals can be made
before planned adoptions. (Pre-adoptive
sessions and review of medical information
provides important education information for
parents prior to arrival.) After adoption,
children undergo a comprehensive evaluation
with special emphasis on issues related to
infections, immunization, nutrition, birth defects
and psychosocial development. Nutritionists,
physical therapists, developmental pediatric
experts and the world-class pediatric
subspecialists at Riley Hospital are available as
needed to assist in the evaluation and
management of adopted children.
Margaret Hostetter, M.D.
Deborah Borchers, M.D., F.A.A.P.
Dr. Borchers is a pediatrician in private
practice with a strong interest personally in
adoption, as she is the mother of two daughters
adopted from China. She is a local resource in
the Cincinnati area for adoption information
and networking. Dr. Borchers can review
videotapes and other medical materials before
placement and can provide medical and
developmental assessments after a child’s
arrival. She can make referrals for families to
specialists and can provide ongoing follow-up
care for children in her geographical area.
Professor of Pediatrics
Director, Yale International Adoption Clinic
464 Congress Avenue
New Haven, CT 06519
203-737-1623
Dr. Hostetter, together with colleagues Dr.
Dana Johnson (see listing), Sandra Iverson and
Kay Dole, pioneered the concept of specialized
medical evaluations for internationally adopted
children at the University of Minnesota in 1986.
Dr. Hostetter has personally examined more
than 1500 adoptees and brought the “Minnesota
model” to Yale in July of 1998. Evaluations
include history and physical exam by a nurse
practitioner, full developmental exam by a
developmental pediatrician and complete
medical testing by Dr. Hostetter of her
colleague, Dr. Michael Capello.
James H. Conway, M.D.
Jerri Ann Jenista, M.D.
Center for International Adoption and
Geographic Medicine
Riley Hospital for Children, University of
Indiana
702 Barnhill Drive – 1740X
Indianapolis, IN 46202
317-274-7260
http://www.rileyhospital.org
551 Second Street
Ann Arbor, MI 48103
734-668-0419
Eastgate Pediatric Center
4357 Ferguson Drive, Suite 150
Cincinnati, OH 45245
513-753-2820
In terms of pre-adoption services, Dr. Jenista
can review any country’s medical records
and/or videos. She provides post-adoption
medical consultation for parents, schools and
healthcare providers. She has extensive written
educational materials for physicians, parents
and agencies. She provides primary care for
adopted children with more complex medical
issues. She provides workshops and seminars
for all parties involved in adoption.
consultation, including a preliminary medical
and developmental evaluation and referral
assistance if the child requires ongoing care by
medical or development specialists.
Dana Johnson, M.D., Ph.D.
Winthrop University Hospital International
Adoption Program
120 Mineola Blvd, Suite 210
Mineola, NY 11501
516-663-4570
http://www.winthrop.org
Co-Director, University of Minnesota
International Adoption Clinic
MMC211
420 Delaware Street SE
Minneapolis, MN 55455-0378
Dr. Johnson, along with Sandra Iverson, CPNP,
is Co-Director of the University of Minnesota’s
International Adoption Clinic. With Dr.
Margaret Hostetter, Sandra Iverson and Kay
Dole, Dr. Johnson pioneered the concept of
medical evaluations for internationally adopted
children at the University of Minnesota in 1986.
The International Adoption Clinic can provide
the following services: pre-adoption evaluation
and interpretation of referral medical
information and videotapes, post-arrival
medical and developmental assessments, postplacement assistance in developmental,
behavioral and school issues, free literature on
a wide variety of adoption/medical issues, and
opportunities to participate in ongoing research
on the effects of early childhood
institutionalization.
Edward M. Kolb, M.D.
Internationally Adopted Children’s Clinic
8200 Dodge Street
Omaha, NE 68114-4113
402-955-4165
http://www.chsomaha.org
The Internationally Adopted Children’s Clinic at
Children’s Hospital helps families and their
primary care physicians in the process of
welcoming a newly adopted child from abroad
into their new American family. The clinic can
be consulted at several stages of international
adoption. They provide: pre-placement
evaluations of children, including a review of
foreign medical records, post-placement medical
Paul Lee, M.D.
The International Adoption Program at
Winthrop University Hospital can provide
medical reviews of any health information,
including videotapes and pictures. They offer a
travel preparatory consultation for families to
provide simple management guidelines for
common medical problems encountered and
basic childcare needs. Once the child arrives in
the U.S., Dr. Lee performs a comprehensive
medical evaluation, including a complete
physical examination, developmental assessment
and laboratory testing. Immunizations to bring
the child up to date are also available.
Anna M. Mandalakas, M.D., M.S.
Karen Olness, M.D.
Adoption Health Service
Rainbow Center for International Child Health
11100 Euclid Avenue, MS 6038
Cleveland, OH 44106-6038
216-844-3224
http://www.rainbowadoptionclinic.org
The Rainbow Center pre-adoption consultation
includes a lengthy meeting with a staff
physician to review both medical record
information and concerns about postinstitutionalized children. The post-adoption
assessment includes infectious disease
screening, developmental assessment, and in
some cases, various specialty referrals. Followup visits are scheduled, and all information is
passed on to the child’s primary care physician.
A developmental and behavioral consult is also
available, which can help identify behaviors and
developmental delays that could be missed,
misunderstood or inappropriately diagnosed in
cases of children from institutions. The consult
can help sort out concerns, develop a plan and
make appropriate referrals. The Rainbow
Center also offers a Child Traveler Health
Service, pediatric expertise for families and
children traveling overseas.
speech and language evaluations, which are
available at the center. Audiologic evaluations
are also available. She gives talks on adoption
and post-institutionalization issues to local
groups.
Laurie Miller, M.D.
Kathleen Comfort, PT, MHA
841 W. Bradley Place
Chicago, IL 60613-3902
773-975-8560
International Adoption Clinic and Floating
Hospital for Children
New England Medical Center Box 286
750 Washington Street, 2nd floor
Bston, MA 02111
617-636-8121
http://www.nemc.org/adoption
At the International Adoption Clinic, children
and their families receive individualized
attention and a comprehensive evaluation. Preadoption consultation and review of medical
records, photos and videos is available.
Evaluation after arrival includes medical,
developmental and nutritional issues as well as
screening tests. The clinic provides evaluation
and treatment of children with behavior,
learning or neurological problems. Long-term
coordinated and comprehensive care for
children with special needs, including school
consultations, is also available.
Lisa Nalven, M.D.
Valley Health Center for Child
Development and Wellness
505 Goffell Rd.
Ridgewood, NJ 07450
201-447-8151
Dr. Nalven can provide pre-placement
consultations and medical record and video
reviews. She can also provide medical and
developmental evaluations of internationally
adopted children upon arrival in the U.S. and
consultation for children with ongoing
developmental and behavioral concerns. She
can provide case management and referral to
appropriate specialty therapists, including
physical therapy, occupational therapy and
Todd Ochs, M.D.
Dr. Ochs can evaluate and interpret referral
information and videotapes prior to adoption.
He can also provide post-arrival medical and
developmental assessments. He can provide
post-placement assistance in developmental,
behavioral and school issues, plus free literature
on a wide variety of adoption and medical
issues. Dr. Ochs is the adoptive father of a child
with special needs from China.
Alice Rothman, M.D., M.P.H.
Vanderbilt Children’s Hospital Clinic for
International Adoption
5028 Medical Center East
Nashville, TN 37232
615-936-6800
The Clinic for International Adoption at
Vanderbilt Children’s Hospital was established
to provide a resource for internationally
adopted children, their families and their
primary care providers in Tennessee. The clinic
is staffed by general pediatricians and
developmental psychologists and provides a
medical and psychological consultation service
for internationally adopted children. The clinic
staff is able to provide pre-adoption review of
medical records and travel advice. The clinic
performs post-adoption medical, developmental
and behavioral evaluations and works with the
family and the primary care physician to provide
follow up as needed.
Elaine Schulte, M.D., M.P.H.
Albany Medical College
Department of Pediatrics, MC-88
47 New Scotland Avenue
Albany, NY 12208
578-262-6086
Dr. Schulte provides care to children in both an
outpatient, ambulatory setting and an inpatient,
tertiary care at Children’s Hospital. The
mission of the College and Hospital is to provide
medical care to children, educate medical
students and medical residents and conduct
research. Dr. Schulte specializes in
international adoption, lead poisoning
prevention, immunization practices and
pediatric residency education.
Sarah Springer, M.D.
Department of Pediatrics, Mercy Hospital of
Pittsburgh
1515 Locust Street
Pittsburgh, PA 15219
Dr. Springer can provide pre-placement
consultations, including medical record and
video reviews of internationally adopted
children. Upon the child’s arrival, the medical
and developmental evaluations include the
following: medical and developmental
screening, immunizations and medical
treatments, ongoing medical care,
developmental monitoring for geographically
close families and case management and
referral to appropriate specialty therapists. Dr.
Springer also gives talks on adoption and postinstitutionalization issues to local groups. She
does not provide ongoing counseling or
psychotherapy, but she can provide referrals.
Mary Staat, M.D., M.P.H.
International Adoption Center
Cincinnati Children’s Hospital Medical Center
3333 Burnet Avenue, mail location 7036
Cincinnati, OH 45229-3039
513-636-2877
http://www.cincinnatichildrens.org/iac
The International Adoption Center located at
Children’s Hospital Medical Center in
Cincinnati is designed to offer four coordinated
services for internationally adopted children:
pre-adoption consultation, post-adoption
evaluation, community outreach and research.
Dr. Staat can evaluate videotapes and medical
histories of potential adoptees, assist the family
in preparing for the trip abroad and include
information on immunizations, medical supplies
and disease prevention. The Center has a
collaborative relationship with Occupational
Therapy and the Cincinnati Center for
Developmental Disorders as well. As part of a
comprehensive multi-disciplinary center, the
International Adoption Center can readily call
on experts in gastroenterology, neurology,
genetics, psychology, cardiology, physical
therapy and other specialties as needed.
4. Publications
Newsletters
Books
Getting Started
Adopted Child
No longer published; back issues available
http://www.raisingadoptedchildren.com
202-882-1794
Adoption/Medical News
Editor: William Pierce
Subscription - $36/year
Back issues can be ordered ($10/issue nonsubscribers, $4/issues subscribers)
PO Box 1253
State College, PA 16804
http://www.adoptionmedicalnews.com
814-364-2449
Newsletter published ten times per year
The Post
Parent Network for the Post-Institutionalized
Child
Po Box 613
Meadowlands, PA 15347
724-222-1766
http://www.pnpic.org
Magazines
Adoptive Families Magazine
42 West 38th Street, Suite 901
New York, NY 10018
1-800-372-3300
Bimonthly magazine
Fostering Families Today
246 S. Cleveland Avenue
Loveland, CO 80537
http://www.fosteringfamiliestoday.com
Quarterly magazine
Roots and Wings Adoption Magazine
PO Box 577
Hackettstown, NJ 07840
908-637-8828
http://www.rootsandwingsmagazine.com
Quarterly magazine
Are Those Kids Yours? American Families
with Children Adopted from Other Countries
By Cheri Register (The Free Press, 1991)
The author’s interviews with many parents and
adoptees make this an excellent, comprehensive
overview of the joys and challenges of living in
and parenting an international family.
Report on Intercountry Adoption
By International Concerns for Children (ICC,
2001)
This essential book includes a directory of most
U.S. agencies placing children from overseas,
with descriptions of their programs. It also
includes a selection of articles on aspects of
intercountry adoption. The $25 price includes
ten updates during the year.
Transracial Parenting Project Self-Awareness
Tool: Are You Ready to Parent a Child of
Another Race, Culture or Ethnicity?
By Jeanette Wiedemeier Bower (North
American Council on Adoptable Children, 1998)
This workbook is designed to educate parents on
what it truly means to parent a child from
another race or culture. Parents can work on
the exercises by themselves or with their agency
or parent support group. A training curriculum
is available to accompany the workbook.
Lifebooks: Creating a Treasure for the
Adopted Child
By Beth O’Malley (Adoption Works, 2000)
LifeBooks:Creating a Treasure for the Adopted
Child is an easy to read guide which explains all
the details. Beth O'Malley offers concrete
suggestions and tips on everything from tricky
text to adding your precious photos
The Growing Child
Being Adopted: The Lifelong Search for Self
By David Brodzinsky, Marshall Schechter and
Robin Henig (Doubleday, 1993)
This book explores the inner world of adoptees
as they develop, mature, and seek answers to
questions of loss and identity.
Helping Children Cope with Separation and
Loss
By Claudia L. Jewett-Jarratt (Harvard Common
Press, 1994)
This book provides many practical techniques
for easing a child through the normal stages of
grieving.
Adopting the Older Child
By Claudi L. Jewett (Harvard Common Press,
1990)
This book is still the class volume for families
adopting or considering adopting an older child.
It is filled with caring advice on handling the
transition from “honeymoon” period through
the testing phase to full integration into the new
family.
How to Raise an Adopted Child
By Judith Schaffer and Christina Lindstrom
(NAL/Dutton, 1991)
This book addresses many concerns of parents
and children as they grow. It is meant to be
reread and consulted over the years.
Attachment, Trauma and Healing:
Understanding and Treating Attachment
Disorder in Children and Families
By Terry M. Levy and Michael Orlans (Child
Welfare League of America, 1998)
This book examines the causes of attachment
disorder, and provides in-depth discussion on
effective solutions - including attachmentfocused assessment and diagnosis, specialized
training and education for caregivers, the
controversial "in arms" treatment for children
and caregivers, and early intervention and
prevention programs for high-risk families.
Real Parents, Real Children: Parenting the
Adopted Child
By Holly van Gulden and Lisa M. Bartels-Rabb
(Crossroads, 1993)
Indispensable to understanding how adopted
children commonly think about and understand
adoption, this book offers practical advice from
bonding with an adopted baby to adolescent
issues.
Don’t Touch My Heart: Healing the Pain of
an Unattached Child
By Lynda G. Mansfield and Christopher H.
Waldmann (Pinon Press, 1994)
This story of Jonathan, a child with attachment
disorder, provides insights into beneficial
therapies as well as hope for families of children
who have an inability to trust due to early abuse
and neglect.
Your Baby and Child
By Penelope Leach (Alfred A. Knopf, 1997)
This is a popular parenting book by a
psychologist who emphasizes building a strong
bond with your child by responding fully to his
or her needs.
Helping the Child Who Doesn’t Fit In
By Stephen Nowicki and Marshall Duke
(Peachtree Publishers, 1992)
This book is a guide to helping a child who has
difficulty with expressive and receptive nonverbal communication. It gives concrete
examples and suggestions to help your child
adjust.
Children with Special Needs
Adopting the Hurt Child
By Gregory C. Keck and Regina M. Kupecky
(Pinon Press, 1995)
Written by two of the foremost authorities on
attachment problems, this book gives hope and
encouragement to parents whose children resist
attachment.
How to Reach and Teach ADD/ADHD
Children
By Sandra Rief (Jossey-Bass, 1993)
This book is comprehensive resource that
addresses the "whole child, " as well as the team
approach to meeting the needs of students with
attention deficit hyperactivity disorder. It
includes management techniques that promote
on-task behavior and language arts, whole
language, and multi-sensory instruction
strategies that maintain student attention and
keep students involved.
The Out-of-Sync Child: Recognizing and
Coping with Sensory Integration Dysfunction
By Carol Kranowitz and Larry Silver (Perigee,
2002)
This guide, written by an expert in the field,
explains how SI Dysfunction can be confused
with ADD, learning disabilities, and other
problems. It tells how parents can recognize
the problem-and offers a drug-free treatment
approach for children who need help.
Reaching Out to Children with FAS/FAE: A
Handbook for Teachers, Counselors and
Parents Who Live and Work with Children
Affected by Fetal Alcohol Syndrome/Effect
By Diane Davis (Center for Applied Research in
Education, 1994)
This important resource makes available a
wealth of ready-to-use information and
procedures for diagnosing, teaching and
parenting the child affected by FAS/FAE.
Included are detailed activities for working with
children so affected and a special section with
useful teaching, training and resource materials.
Troubled Transplants
By Richard J. Delaney and Frank R. Kunstal
(Wood’n Barnes, 1993)
This book provides strategies and insights on
helping children with behavioral difficulties and
their families.
Empowered Families, Successful Children:
Early Intervention Programs that Work
By Susan Epps and Barbara Jackson (American
Psychological Association, 2000)
This book presents a family-centered model for
early childhood intervention based on the
developmental concerns of children as well as
their specific strengths and competencies,
emphasizing the importance of environmental
and family supports and integration with the
community.
Behavior Management
The Challenging Child
By Stanley Greenspan (Addison-Wesley, 1996)
This book is an optimistic and reassuring book
that describes the five “difficult” types of
children and how to live happily with them
Child Behavior
By Frances Ilg, M.D., Louise Bathes Ames and
Sidney Baker (HarperCollings, 1992)
Along with a discussion of what is typical,
normal behavior for children at various ages
and stages up to 9 years old, this classic has
sections on how to handle typical problems. It is
highly recommended as a quick reference book
for parents to consult again and again as their
child meets new challenges.
Children: The Challenge
By Rudolf Dreikurs (NAL/Dutton, 1991)
This and other books by Dreikurs are classics
that teach logical consequences and stressreducing parenting skills that are useful with all
children.
The Parent’s Guide
By Stephen McCarney and Angela Bauer
(Hawthrone Educational Services, 1992)
This valuable guide presents alternative
approaches to each and every behavior problem,
so parents can explore what works for their
particular child.