Adopting a Child with a Developmental or Chronic Disability

Developmental disabilities and emotional, mental, or physical disorders are common among older children waiting for adoption.

By Martha Henry and Daniel Pollack, author of Adoption in the United States

Developmental disabilities and emotional, mental, or physical disorders are common among older children waiting for adoption. These disabilities can include cerebral palsy, autism, cleft lip and palate, cystic fibrosis, fetal alcohol syndrome, learning disabilities, mental retardation, and epilepsy.

It has been estimated that between 30 and 50 percent of children awaiting adoption have a developmental disability (Glidden, 2000). These disabilities may be emotional, mental, or physical disorders and vary in severity. Children may be afflicted with differing degrees of cerebral palsy or autism, physical malformations such as cleft lip and palate (which, in some cases, can be indicative of a larger disorder), genetic conditions such as cystic fibrosis, disorders resulting from prenatal maternal substance abuse (e.g., fetal alcohol syndrome), learning disabilities or mental retardation varying in basis, or genetic environmental conditions such as epilepsy.

One well-known disorder affecting multiple children awaiting adoption is Down syndrome. Down syndrome occurs in approximately one if eight hundred live births and is caused by the presence of an extra copy of chromosome 21 in the child's cells. As in other cases of genetic anomaly, individuals affected with Down syndrome exhibit varying levels of functionality. Some children born with Down syndrome have no sign of the disorder aside from some level of mental retardation and characteristic features such as upward slanting eyes and epicanthal folds (i.e., folds of skin at the inner corner of the eyes), a flattened nasal bridge, short broad hands, and a single deep crease in the palms. Others also possess heart abnormalities or vision and hearing impairments and may require extensive medical treatment throughout their lives. Ultra sound examination and maternal blood tests can indicate the risk of Down syndrome in their developing fetus; however, a definite prenatal diagnosis of their condition must be done through amniocentesis.

As with all children, those awaiting adoption may be afflicted with several other disabilities of varying natures. These conditions may have a genetic or non-genetic basis, and some may be identified through prenatal testing, while others may only manifest after birth. Cerebral palsy results when brain damage occurs, often as a result of the failure of oxygen to reach the brain near the time of birth. Muscle control is often difficult or unattainable for children with cerebral palsy. Cystic fibrosis, another chronic condition that may be present in children awaiting adoption, is a genetic condition that affects the lungs and digestive system. The body produces thick, sticky mucus that clogs the lungs and obstructs the pancreas, leading to lung infections and poor food absorption (Cystic Fibrosis Foundation, 2007). Some children in care may also show signs of autism, a developmental disorder affecting the areas of the brain responsible for abstract thought, language, and social skills. Children with autism can have both physical and behavior disabilities. Epilepsy is another condition found in some children .This disorder is characterized by seizures and can result from genetic or environmental causes. Seizures can occur in the form of muscle convulsions, loss of consciousness, or other mental or physical anomalies. Spina bifida, a condition that may be present in some children and is often detected prenatally, is a birth disorder that affects the spinal cord Vertebrae do not develop completely, which result s in varying levels of difficulty with leg movement, sensation, and bowel/bladder control.

The most common disorders affecting children awaiting adoption, however, are fetal alcohol syndrome and alcohol-related neurodevelopmental disorders. These conditions may be characterized by physical and/or mental challenges resulting from maternal usage of alcohol or other controlled substances during pregnancy. Possible manifestations of the disability include behavior issues, characteristic facial features, and some level of mental retardation (Centers for Disease Control and Prevention, 2006).

Required medical services and other treatments are dependent upon each individual child's needs. Treatment may include physical, speech, and /or occupational therapy in addition to medical intervention. Prospective adoptive parents who wish to adopt a child a with a disability must demonstrate the ability to care for a child with the disorder in question and should live near any required medical or related services.

Martha J. Henry and Daniel Pollack are associated with the renowned Center for Adoption Research at the University of Massachusetts. Martha Henry is a developmental psychologist and Daniel Pollack is social work professor and honorary fellow of the American Academy of Adoption Attorneys. This article is excerpted with publisher permission from their excellent overview of adoption, Adoption in the United States: A Reference for Families, Professionals and Students.