MONITORING THE DRUG-EXPOSED CHILD AFTER ADOPTION
The child with a definite or probably history of prenatal drug exposure should be monitored carefully after adoption. Like all children, growth and developmental milestones at entry to the United States should be documented. Hepatitis B, hepatitis C, and HIV serology should be obtained at entry and again 6 months later. Language skills (including articulation), behavior, and attention span should be monitored at regular visits, and neurologic examination should be performed, including assessment of "soft signs" (finger-to-nose, rapid pronation-supination, heel-to-toe walking, balance on one foot, hop). The pediatrician should assess the child's arousal, attention, recognition memory, and impulse control, with the goal of providing supportive services if needed. Although prenatal drug exposure will usually not be known with certainty, anticipatory guidance will benefit many children.