171 Ashley Ave.
Charleston, SC 29425
843-792-1414
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December 2008
Center helps parents bring home "blessings" and joy
In 2005, Patrick and Marchie Thornton traveled to Russia and brought home the toddler, Anna Vera, who would make them a family of four. The Mount Pleasant residents were prepared to make this new addition's transition into the family and the country as easy as possible, but it hadn't been an overnight process.
"Many experts and close friends, including physicians, had looked over Anna Vera's medical records-including a Russian native who read the un-translated versions-so we felt good about her overall health," says Patrick Thornton.
Yet to be sure, the couple took the advice of their social worker, Anna Johnson, and scheduled an appointment for Anna Vera with the International Adoption Center at MUSC, where they'd received pre-travel vaccinations and medicines.
"While we knew she'd been born prematurely with syphilis, we had a couple of surprises, some diagnoses that had not been disclosed," explains Thornton.
During her medical evaluation at the center's clinic, Anna Vera tested positive for hepatitis C and tuberculosis. "The center's pediatricians felt sure they were false negatives, but after discussion we did as they suggested and gave her the treatments," recalls Thornton. "On their advice, we also agreed to a CAT scan because her head was a little larger than normal." After a couple of follow-ups, Anna Vera got a clean bill of health.
Today she's a happy four-and-a-half-year-old who attends Palmetto Christian Academy and enjoys soccer, tennis, ballet and gymnastics.
"The center gave us peace-of-mind," says Thornton. "We were relieved to know that specialists and experts were here and available if we needed them."
There is a steady flow of children like Anna Vera through the MUSC adoption clinic, which since opening has provided comprehensive medical and developmental evaluations for close to 300 internationally adopted children from 18 different countries.
Headed up by pediatrician Andrea Summer, MD, an expert in international medicine, and developmental pediatrician Angela LaRosa, MD, it's one of about 70 international adoption centers in the U.S. that help families like the Thorntons with post- and pre-adoption needs.
Adoptive parents use the clinic in three ways, explains Dr. LaRosa. "During a pre-adoption analysis, we try to identify red flags, things that might be of concern to the parents. I can tell a lot from a video about a child's developmental level. We prepare parents for any issues they might see." A small head size, she explains, can often indicate genetic disorders like fetal alcohol syndrome or infection during birth.
"Pre-adoption, we review and help interpret medical records, photos, and video clips; discuss common health problems for which international adoptees may be at risk; and provide appropriate anticipatory guidance," says Dr. Summer.
"Sometimes all we have are photos, but they can be very helpful," says center coordinator Stephanie Aston-Jones. "We sometimes have reason to suspect fetal alcohol spectrum, particularly in children from Eastern countries, and that's a condition we can often recognize in facial features. We can help prepare the parents of these children for what kinds of medical and behavioral problems they might expect to see in the future."
"Often we get little information on a child," points out social worker Johnson, who's helped coordinate adoptions for 21 years. "The MUSC clinic alleviates a lot of anxieties by helping families ask the right questions of the agency, to ask for more information if possible. It also helps them know what to be prepared for. If it's a special needs child, is it one they can handle? It also allows them to put special services in place when the child comes home."
It can also help parents during their visits to other countries with email and video exchanges, to advise them on things they might want to request while they're in the country, says Dr. LaRosa.
"It's amazing to be able to talk to parents while they're actually with the child," she notes. Sometimes a parent has to make a decision quickly, and the center is able to provide immediate feedback by phone, fax or email.
"Many times countries want a decision right away," says Johnson. "The center helps make that possible, usually responding to parents within 48 hours."
"These families are on-the-spot sometimes, so it's reassuring to them to be able to talk with us without a time lag, not to feel rushed. We guide them about what to consider as they make their decision," explains Dr. LaRosa.
Thirdly, she concludes, parents turn to the clinic for help once they've returned to the U.S. "Three to four weeks after their return, we provide a multidisciplinary analysis of the adopted child."
That includes any common childhood medical conditions as well as unique problems that may be related to living in an institutionalized setting, such as growth and nutritional concerns, and certain infectious diseases, says Dr. Summer.
"Identifying and treating these medical conditions optimizes the adopted child's potential for catch-up growth and development," she says. "Some of the infectious diseases we identify can have serious public health implications if they're not diagnosed and treated in a timely manner."
Approximately 25 percent of the children evaluated in the clinic have been diagnosed with an intestinal parasite, while another 25 to 30 percent tested positive for latent tuberculosis infection.
"Even if parents already have a pediatrician for other children, it may not be the best one for the child they're adopting," says Johnson. "The center's physicians are skilled in issues common to different countries and regions. They can be an important liaison with the child's regular pediatrician."
"We consider all of these kids at-risk, but we feel that early intervention makes their outcomes so much better," says Dr. LaRosa. On arrival, most of the adopted children she sees have developmental delays, yet that begins to drop quickly.
"I'd estimate that a third of our patients continue to have significant delays, a third continue to have minor issues, and a third go on to have no significant concerns. This mirrors what we see nationwide."
"It's extremely rewarding to see a severely growth and/or developmentally delayed child thrive once placed in a nurturing environment," notes Dr. Summer.
"The more we know about international adoption, the more vital a resource the adoption center becomes," says Johnson. "Without these families and their care, these kids would graduate from their orphanages at age 15 or 16 - a bleak existence. Their lives are saved, and the joy they bring is priceless."
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