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Adopting Again with Prenatal Alcohol Exposure in the Family, Part I

August 5, 2011

At the outset I want to be clear: I am not offering a formula here. God created families differently and I respect that we make decisions differently.

I am simply offering some of the factors that played into our decision about adopting again, as well as some new factors that have only occurred to me more recently as I’ve become better educated about FASD and have discussed with other moms the dynamics of adding another child to the family.

To recap the relevant part of our story. We brought Hope home at the age of 6 months, exactly one year after we brought home Mercy, who is 10.5 months older than Hope. We knew Hope was mildly exposed to alcohol during pregnancy. Joy came home three years later. So we did in fact adopt again with FASD in the family, although we did not formally get a FASD diagnosis until Hope was six.

I know many of you are in the process of bringing home children with known PAE (prenatal alcohol exposure) and if you are thinking of adopting (or adopting again) from Korea, you can probably hear the clock ticking. Not on the formal closure of ICA (despite the rumors Korea has not declared a date), but rather due to the changes that suggest it is not for the faint of heart and may only grow more, not less, challenging.

You’re wondering, “How can I know? We need to make our next adoption decision soon, probably before our child with PAE is old enough to guess how big an issue it will be for our family.” Here are some thoughts.

1.) If your child with PAE has ADHD or sensory integration issues, you will probably know something is up early on; you won’t be guessing. Yes: there will  be an interval right after homecoming when you can reasonably hope the challenges and neediness are due to the attachment process. If so, they will gradually improve as attachment develops. If they do not, or they grow worse (which may happen if, attachment is not developing typically), you will be in possession of some valuable information.

2.) If your child with PAE does not display any red-flag behaviors, educate your self enough about FASD that you can reasonably gauge whether or not you may be missing something. Parents with previous FASD experience pick up the more subtle signs quickly. But for some families (perhaps not most) it seems FASD is stealthy.

3.) Remember the professional recommendation that every child with PAE be screened for signs of FASD, even as young as two years of age. The most convenient way may be to use your local school district’s Birth-Three services. This will not be a formal FASD evaluation by a clinician. But the routine screening process, likely in your home with you present, will reveal sensory integration issues, speech or motor delays, attentional differences. None of these things is conclusive for FASD. But it is not likely that a child who may later be diagnosed FASD would pass a toddler screening with zero concerns.

If you don’t want to use your school district, an occupational therapy evaluation or a developmental assessment at an adoption clinic may provide similar screening. An important difference is that the district screening is paid for by your tax dollars and your report, “He was prenatally exposed to alcohol” should be all the justification you need to request screening. A formal occupational or developmental evaluation may require pre-authorization by your doctor or some known level of concern to be covered by insurance. Alternately, some private OT/PT clinics offer free developmental screening hoping to win your business if your child qualifies for therapy.

At that stage in your fact-finding process you may find your child with PAE passes with flying colors.

Or you may find you have some areas of concern to watch. If you do, know this: introducing another child into the family will almost certainly magnify those concerns. So you need to consider your resources, your support system, the strength of your marriage and to assess whether your unique family can absorb the hit. More on that in the Part II.

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One Comment leave one →
  1. August 5, 2011 11:55 am

    I am parenting a now adult with partial Fetal Alcohol Spectrum Disorder (alcohol confirmed). She was not diagnosed until she was 13 because before then we did not have confirmation of prenatal exposure. Despite the fact that she has classic facial features of FASD and she has a brain-based developmental disorder, she couldn’t be diagnosed without confirmation of exposure with also being growth impaired.

    I have always told parents to parent their children at their developmental age rather than their chronological age. That didn’t work so well once my oldest became 18 and was emancipated.

    We did adopt again, from Haiti.

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