We witness a miracle each time a child enters a life. But those who must make their journey home across time and miles, growing in the hearts of those waiting to love them, are carried on the wings of destiny. And placed among us by God's own hands.

Thursday, February 25, 2010

The Best Estimate of Correct Age?

Well there is not one, but I do have a personal theory. Just a little note of caution, if your pediatrician does not have extensive experience in international adoption they will think your child is healthy and completely on track with their development as long as they are in the size range of the age that the adoption records indicate. The problem is what if the adoption records are wrong? I posted a long time ago about this issue with our daughter from Ethiopia. Our doc at the time thought she looked great and was exactly the age that we were told she was. Well, he was completely wrong. After multiple developmental evaluations, a burst in growth from good nutrition, and exams from the dentist we learned that she was at least 2 years older then we were told. I am glad I questioned it and did my research and did not back down, because she is now a happy well adjusted kindergartner who looks, acts, and thinks just like a typical 6 year old child. I cannot imagine if we had trusted the doctor, she would still be in preschool and would be towering over her peers and most likely extremely frustrated socially and intellectually. It is any wonder that early puberty is a phenomenon in internationally adopted girls?

So back to my original point of this post. Based on my own observations of each of my adopted children upon coming home and the results of the developmental evaluations that they received, the best predictor of their actual age was their fine motor skills. Fine motor skills are things like the ability to hold a pencil, unlock a child safety lock, pick up small objects and so forth. Now you would initially think that this would be a delayed area of development in a child who has lived in an orphanage but if you think about it it is not an area of development highly affected my malnutrition like physical size and gross motor skills are. Also even if a child is stuck to a physically confined space they most likely are going to explore things with there hands. Also children living in orphanages have to develop adaptive skills to care for themselves and this is where fine motor skills can develop while other areas may be delayed. So I would highly recommend that if you are trying to evaluate your child's age to meet with an occupational therapist. This is the specialist who assesses fine motor skills (as well as sensory issues, an area that your child probably will have some concerns in) and there are tests that can be done at a very young age to determine their standardized as well as comparative age when looking at what is the typical ability level of same age peers. An evaluation from an experienced OT can be obtained through any outpatient hospital OT department, an internationally adoption clinic, or you can receive a free developmental screening through your local school district.

One test that I do not trust because it was wrong for our daughter is a Bone-Age Scan. This is the test that your doctor will recommend to you and it is when they take a picture of the child's wrist and hand. The problem is that the test does not take into consideration the impact of long-term malnutrition on growth and there is plenty of evidence to show that malnutrition will in fact cause delayed growth and in some cases the child will even display a growth hormone deficiency (which our little guy has tested positive for). Also the standard deviation for the bone-age scan is rather large, so no you cannot pinpoint the exact age of your child from this test (regardless of what the doctor tells you). Here is the truth about bone-age scans:

The standards in the Greenish and Pyle Atlas are derived from a study of healthy white middle-class children in the Cleveland area in the United States in the years 1931 to 1942. The study consisted of 6,879 hand radiographs from boys and girls. The ages ranged from 3 months to 16 years for girls and to 17 years for boys at the time of the radiographs. In the Greulich and Pyle Atlas a table is used to provide means and standard deviations for skeletal age1. At the time of its development Greulich and Pyle did not consider the estimation of chronological age as a potential use of their data and Atlas. Their original work was used to identify possible growth disorders, malformations and bone abnormalities.

This info came from a good article about determining chronological age in internationally adopted children written by Cec Pederson, 2004. You can access it on the web at http://eprints.usq.edu.au/3839/1/Pedersen_Chronological_age_determination.pdf

Sunday, February 21, 2010

I Miss the Green


We are buried in snow here in CO and I really miss the green of Rwanda! I think I have mentioned before, that despite growing up in North Dakota, I really do not like the snow or the cold. So right now, I LOVE this picture, it is very zen. It did not even catch my eye the first few times I went through our pics. It was taken at Akagera National Park. So simple and so beautiful.

Thursday, February 18, 2010

2010 South African World Cup Theme Song

A few weeks ago we were flipping channels and stumbled upon a mesmorizing performance by a unique hip hop/reggae artist on PBS, of all places. His name was K'naan, meaning "traveller" and he was born and raised in Mogadishu, Somali living there during the start of the Somali civil war. To make a long story short his family was eventually able to move to Canada where he taught himself English by phonetically copying rap lyrics. He eventually caught the attention of a Senegalese singer when K'naan performed a poetic piece to the UN criticizing their failed aid missions in Somalia. One thing led to another and he is now a major worldwide artist being compared by some to Bob Marley. Here is a video of his song "Wavin' Flag" which is going to be used by Coca Cola as their theme song for this year's World Cup in South Africa. Pretty cool. I really like the song because I think it well represents all the children throughout the world affected by war and the hope for peace.



And if you are like me, a little dual personality, here is a totally different version of the song:

Wednesday, February 17, 2010

Long Thoughts on CBS Ethiopian Adoption Scam Story

Have you seen this story that aired on the Monday evening news on CBS? Here is the link to watch it, if you have not seen it: http://www.cbsnews.com/video/watch/?id=6211026n  Just a FYI that it is similar to a story that was aired about the same adoption agency last year. Although the previous story made some stretches in their reporting and some unfair accusations. They basically hinted that the reason why Ethiopian adoption had exploded was due to Angelina Jolie (ignoring the fact that other international programs had shut down) and accused the government of profiting from adoptions. They also had some inaccurate facts regarding how an orphan is defined by the government. That story made me so mad that I decided to ignore it all together. I hate sensationalistic journalism, especially when it threatens people's opinion of my very family and the future of legitimate orphans. Anyways, for this story CBS seems to do a much better job of focusing on this single case and this specific agency.

So I have been debating on whether or not to respond and finally decided that I needed to get my thoughts of my chest. My first thought is why the heck can't the media ever portray positive stories of adoption? Are we really that starved for more news about corruption and loss? Even during adoption awareness month it is not uncommon for major news stations to portray families with adopted children with attachment and behavior problems. Now that I got that off my chest the thing is that I do believe that corruption is happening in Ethiopian adoption. Let me preface though, that I know my daughter's adoption was completely ethical and legitimate. How do I know this? Because we used a very reputable and ethical adoption agency called Children's Home Society and Family Services. They currently have one of the longest wait times for the referral of a female infant and for good reason. Because they follow the correct process for every child that they match with an adoptive family. The reality is that in Ethiopia the children who are most in need of adoption are not healthy infants. As far as our experience in Ethiopia, we were able to meet a member of our daughter's birth family and this person was sincere is telling us that if she was not put up for adoption she would die. This was the hardest meeting I have ever had with a person in my life. We were all in tears, including the interpretor. I am not going to tell you the specifics of her story, to protect her history for her, but I will say that at age 4 years old she weighed only 24 pounds. She also sadly bears the scars of multiple desperate attempts to heal her many illnesses.

So one thing to look for in a reputable Ethiopian adoption agency is whether or not they arrange birth family meetings and if they have an active pre and post adoption support network. The interesting thing is that the US government, the very same entity that is quick to question whether a child is a legitimate orphan tried to shut down the birth family meetings in Ethiopia, saying that US law does not permit a birth parent who has relinquished their child to have any contact with the child afterwards. Now I understand the concern that it would not be right for adoptive parents to have regular post adoption contact and especially to provide financial support to the family as that would constitute the appearance of "paying off a family". This is the part of international adoption that the general public does not understand. I once saw an article in Parenting Magazine about an international adoptive family that had maintained regular contact with their child's birth family many years after the adoption and was financially supporting the family. I was shocked that the article was featured in a major US magazine and that they did not understand that this was against international adoption ethics as well as US immigration rules. So it only takes one major mistake to shut down an entire country's adoption program. And unfortunately the US based agency featured in this news article was obviously not following ethical adoption practices. Recruiting children for adoption form intact birth families is never acceptable. Especially when those families live in a third world country and are desperate for help and do not understand the long term consequences. I fear that they are not the only agency doing this however. When I researched Ethiopian adoption a year after our daughter was home and we were looking into a second adoption I learned that there had been a drastic spike in the number of abandoned babies in Ethiopia. The reason this does not make sense is that it is legal to relinquish your child for adoption (unlike Rwanda). There had an also been a disproportionate number of female infants being adopted out of Ethiopia. Add this to the high number of agencies working in Ethiopia, with few regulations, and the high increase in the number of Ethiopian adoptions and something did not feel right. You do not have to search too far on the adoption chat boards to find stories of adoptive families, as well as birth families in Ethiopia, who claim that they were not fully informed of what it meant to give a child up for adoption and facts about the children that did not add up.

Now I pray that Ethiopian adoption is not shut down and that the children who need families get them. I also pray that vulnerable mothers and fathers in Ethiopia are not being manipulated into giving their children away when they do have the means to care for them and raise them in their birth country. I know that there are many reputable agencies that are doing the right thing, so please if you are considering adopting from Ethiopia do your research. You may also want to consider an alternative African country like Rwanda, Lesotho, Uganda, Ghana, or the Democratic Republic of the Congo. We choose Rwanda because all the children residing in the orphanage (1 orphanage which the government allows adoption from) are true orphans and "waiting" children by definition. The older children have lived most of their lives at the orphanage and they were all abandoned, because in Rwanda it is illegal to relinquish your child. They will actually seek out and prosecute a parent that abandons their child if they can find them. So I guess in summary, as hard as it is, as international adoptive parents we do need to educate ourselves about unethical practices and do our research, for the sake of our children, their birth families, and our own family.

* Just for the record, and to the "anonymous" person who tried posting a comment that it is illegal for agencies to arrange birth family meetings in Ethiopia, it is in fact not illegal but yes does need to be done under careful and supervised circumstances. If the anonymous poster would like to lead my readers to this law in Ethiopia that says that birth parent meetings are illegal then feel free to repost with your identity and your source of legal information. If it was illegal then how could many large and reputable adoption agencies continue these meetings?

Monday, February 15, 2010

Keep a Child Alive


I watched a documentary tonight called "We are Together" http://us.wearetogether.org/ about a group of orphans residing at Agape Child Care Center in South Africa. They were a inspiring group of kids affected by the AIDS epidemic in South Africa who with some help put together a music cd. At the end of the film was a plug for a organization called "Keep a Child Alive" http://keepachildalive.org/, which provides life saving anti-retroviral medications, care, education and food to HIV positive youth in South Africa, Kenya, Rwanda, Uganda, and India. They look like a great organization and on the home page of their website they are featuring a chance to be one of 5 individuals who will accompany Alicia Keys on her second trip back to South Africa. All you have to do to enter, is text ALIVE to 90999 to donate $5 to the organization.

Saturday, February 13, 2010

Video: Our Journey to Leo


Here is our Rwanda adoption video. Turn off the music player at the bottom of the blog so that they are not playing over each other. But you will notice that I must really like that first song on my playlist!

Wednesday, February 10, 2010

Nightime Diapering Solution and $10 Coupon Code

Our little guy is a super soaker at night and has frequently woken up with a mess when he has a loose stool very early in the morning. I was using a double layer Indian Cotton prefold diaper with two hemp inserts and a diaper cover and it still was not holding it all in. So I did some research and ordered three Fuzzi Bunz Perfect Fit Diapers. They are q super soft diaper, water proof on the outside and micro fleece in the inside. They have a pocket that you put in the super absorbent insert that comes with the diaper. I added two Hemp inserts as well and it was seriously a miracle. No wetting and no poopy leaks in the morning. Fuzzi Bunz also makes a one-size diaper that will fit babies from 8-35 pounds but I went with the perfect fit because it runs larger and will fit him over 45 pounds if he is still bed wetting past potty training.

So if anyone wants to stock up on cloth diapers or other supplies for yourself or as a baby/adoption gift. I received a notice today from Diapers.com that they are running a Valentines special. If you enter my coupon referral code KNEU4359 when you check-out online you can save $10 off your order. That is twice the discount of their typical new customer offer. And you will also be helping me out as I will receive a $10 credit for diapers.com. I sure could use the credit to stock up on some more Fuzzi Bunz which will keep my little guy rash and leak free! We are honestly broke after this last adoption and so anything helps!
Diapers.com also carries BumGenius One Size diapers, G-Diapers, and Kushies as well as disposables and other baby accessories. The special runs through the end of February.

Friday, February 5, 2010

How to Help After Homecoming

Update: Two wise adoptive moms have left comments to this post. I first want to thank them for backing me up on this information. I have, on occasion, got the sense that some parents did not really like to hear the reality of the hard experiences, so THANK YOU for being honest with your own stories as well. I have copied their comments onto the bottom of this post.

There are nine families on their way home this weekend from Kenya with their beautiful new children from Rwanda. It has been interesting watching their travels as they had a rather different experience then us. Something I have been meaning to blog about is the often not discussed issue of homecoming. Regardless of how easy or difficult a family's time in country obtaining their child is they will experience bumps when they get home. Yes, it is easier for some then others depending on so many factors; the age of the child, the number of children adopted, gender, health, personality, prior quality of care, the children already home and the family's level of preparation prior to travel. There is something called post-adoption depression and I think it is more common then adoptive parents (mainly mothers because they usually are the primary caretakers upon arrival home), want to admit. But the reality is that after 12 months of completing paperwork and background checks and saving and fundraising that homecoming is often not the wonderful, peaceful experience that one might have hoped it to be. A good social worker will educate adoptive parents about this but often no matter how prepared they are it is still dang hard.

At minimum after arriving home the family will be exhausted and jet lagged. Often the adopted kidos may sleep unusually well and not show any problematic behaviors for the first few weeks. But after they recover their energy and get settled the most challenging period of adjustment begins. Again this varies greatly, some families may not have any issues. For sure though if they have welcomed a child over the age of 2 years into their home they are going to have to work through some behaviors and difficult adjustment at times. There are also specific medical issues that need to be dealt with when a child is adopted from Africa such as parasites, GI issues, and malnutrition. If a child has lived in a orphanage for a extended time (more then 6 months) then they probably are going to have developmental delays as well.

So basically what I am saying is that the first few months home are a critical period for the new family and they will need the support and understanding of their family, friends, coworkers and community. At this same time parents will need time to focus on what is called "attachment parenting". If extended family and friends do not understand what that means their can be tension during visits and the relationship between the adoptive family and child can be compromised. Here are some basic recommendations that I am providing to family, friends, coworkers, church members, neighbors, anyone who wants to help a family who has just arrived home with a internationally adopted child (I think it is a bit different for domestic or foster/adopt but you may be able to relate). Some of these we have received and others I wish we would have. I will say though, that it was interesting to me the differences in how people responded to the birth of our son, versus the adoption of our daughter, and then the adoption of our second son. I will let you decide what I might mean by that.
  • First and foremost treat everything about the adoption as you would have if the family had given birth. Hold a baby shower, make welcome signs, send them balloons (avoid latex as they are serious choking hazards) or flowers. If you send a gift, wrap it in baby paper or appropriate paper for a older child. This is a time to celebrate the same that you would if the child was a newborn birth child. This may vary by age of the adopted child, but I think that ALL children deserve to be celebrated and I know that the parents would really appreciate the thought. It is a once in a lifetime experience.
  • Also really important is to ask them what they need help with, you might be surprised.
  • Offer to drop off or pick them up at the airport (airport parking is very expensive)
  • Stock their fridge and cupboards just before they get home, you have no idea how good a diet coke (no diet pop their) and fresh vegetables (can't eat fresh vegetables) taste after being in Africa.
  • Bring them a hot meal the first night home, even better deliver a hot meal every night for the first week home.
  • Clean their house for them or hire someone to do it just before they come home, have it done again a few weeks later (when things really start to get tough).
  • Offer to babysit any other children in the home so that they can get some much needed attention and parents can have some one on one with the new one/s.
  • Offer to give rides to older children who may need to get to activities.
  • If it is winter go shovel their driveway and sidewalks.
  • Offer to run errands for the family or to go to the store (Having to take my screaming toddler to the store, and having everyone stare at me has been one of my worst post adoption experiences)
  • Simply lend a open ear, encourage the new mom to be open and honest about her feelings and needs. Take her out for a break, a cup of coffee or a nice lunch.
  • This one is REALLY important so I am leaving it for last: During any visits that happen in the first few months be respectful of the adoptive parents wishes regarding feeding, holding, and comforting the child. A child who has lived in a orphanage has passed through the hands of MANY caregivers and it is crucial that they learn to go to their new parents as the sole primary caregivers in the beginning. It would not have been normal for our oldest son to jump on the lap of a complete stranger at the age of 2 years and as hard as it is to understand you are a stranger to this child. So just ask the parents what the "rules" are. It may vary by household and how involved you are with the family. My personal preference for this issue is fairly conservative, I did not want anyone else holding, comforting or feeding my adopted kids for the first two months home. Especially for my son since we went through a period of him rejecting having a mommy. For a toddler in particular, if the parent has taken something away from the kido and they start screaming it would not be o.k. for a different person to then confuse the child by comforting him or her. You see what I mean, this can be complicated so if you are not sure just ask.
That certainly is not a extensive list of how to help but I think this got long enough. Any questions? Feel free to leave a comment and I will do my best to answer.
Comments:
Kari,
I'm a new reader to your blog. Congratulations on your family. You hit the nail on the head with this post. The adopted child has to learn to love and trust their new parents. The experience isn't a Hallmark card. It's hard. Very hard.
We adopted our son from Guatemala three years ago. The first few months home, we limited visitors and outings outside the home. We kept his world small. We also held him all the time. All. The. Freakin. Time. Skin-to-skin contact is so important. So is fostering eye contact.
Our "rules" upset a lot of people, including grandparents. But it had to be done and I kept myself from letting guilt beat down my resolve.
Moms and dad, especially moms, expect angels singing on high. We've grown to love this child in our hearts and it's so hard when the child rejects his new mommy and displays typical, normal, totally appropriate adjustment behaviors. Add illnesses and jet lag on top of it all and the entire family is in for a ride.
What I had to learn was that this was not about me. This was not about me not being a good mom or my son rejecting me as his caregiver.
The child is scared out of his wits. Everything changed in a blink of an eye and he or she can't communicate. Smell, taste, language, everything is different. Of course he's going to freak. I would, too.
I hope all perspective adoptive parents educate themselves about what the first three months home will be like. I hope they tell their families the rules for attachment. And I hope they have support. Sometimes a new mom needs to call another mom who's been there for a hug, a good cry or the chance to get out of the house.
Thank you!


Thanks for the helpful suggestions on how to support parents post adoption. I wish I had the list and given it to my friends and family before bringing our children home! Though people were for the most part very supportive, there was a marked difference between how my bio son was welcomed and how his adopted siblings were. I would like to give the benefit of doubt and believe it was because it was not my first child, the novelty had worn off, but I think I have a suspicion people would have been more helpful if I was adding three bio infants within three months of each other. I certainly needed more support then, than when I had my first, but I certainly got more support with my first. I think it is so hard for non-adoptive friends and family to really get that for an adoptive parent, the adopted child is just as longed for, wanted and loved as bio children. I am more sensitive now to the needs of adoptive parents and I am always looking for opportunities to be a support in the first few weeks home.

Tuesday, February 2, 2010

Little Leo Turns 3

Our little Leo turned 3 today. February 2nd was his estimated birth date from the orphanage and on his Rwanda medical records. We kept the celebration simple, a GI friendly dinner of chicken and rice, cake, and presents at home with just the five of us. He is not yet interested in a lot of toys but I found a small and durable remote control car for toddlers that he just pushed one button on the remote and it makes it work (New toys at Target in the "special toys" section). He was fascinated that the car moved and chased it around the living room then dad taught him how to drive it which was even more amusing because he screamed every time it moved.

The day was a little bittersweet however. I wish I knew his birth story, I wish I knew what he looked like when he was born and how much he weighed. I wish I could have seen all his firsts. I wish I had a baby picture of him. These things we will never have answers to but I will do my best to tell him his story when he is ready. My daughter likes to tease my eldest son about being a fat baby and then she asks me what she looked like when she was born. I tell her what I do not know but what was probably true, that she was so tiny and so beautiful. I then explain that while she did not grow in my tummy like her big brother did, she grew in a even more special way, she grew in my heart. And that is where Leo entered my life. The emotions that I went through and are still going through with him are very much like pregnancy and childbirth. And so today I can only imagine what we do not know.