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Most families carefully evaluate the referral information about their child prior to travel. They have some general idea of the child's health, as well as specific questions for the caregivers. The degree of growth delay may also be anticipated, especially if updated measurements are provided close to the time of travel. If a video has been reviewed, the parents may have some sense of the degree of developmental delay to expect, as well as some preconceptions about the child's personality and behavior ("she's smiley and sociable," or "he's a serious child"). Because the videos are brief snippets of a child's day and may be months out-of-date by the time the family travels, these expectations may be incorrect. Furthermore, the stress of the transition may alter the child's demeanor and behavior. Major questions about the child's health development, and behavior should be addressed prior to travel if possible, as analysis and interpretation of this sensitive and important information is difficult at the last minute.

The quality of the initial encounters of the parents and child depends on various factors. Parents have usually been well prepared by their adoption agencies about what to expect when they travel to receive their child; they must remember that the child often has had no preparation. Although little may be done to prepare young infants, older children have surprising ability to understand some of what happens with an adoption. In orphanages where children are frequently adopted, children may recognize that the appearance of strangers is followed by disappearance of one of their group. This may create a great deal of anxiety. If the transition is gradual, children may see that the child being adopted gets special attention as she comes and goes from the group. When the child returns from outings with her parents, she may have new clothes and toys. Jealousy, anxiety, and fear may create misbehaviors and emotional upset in the entire group of children.


From THE HANDBOOK OF INTERNATIONAL ADOPTION MEDICINE by Laurie C. Miller. © 2004 by Oxford University Press, Inc. Used by Permission.


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