After speaking with numerous Adoption Agency directors, I came to the conclusion that because of the 2007 Hague accreditation process and Department of State regulations many agencies have been struggling with the educational component of the accreditation process. I had spoken with some agency directors and they informed me that they have been trying to create adoption educational manuals for parents to read, others run group classes in their agencies, while others leave it up to the parents to become educated on their own, they just provide a list of references and reading material. While this is an honorable attempt at educating the adoptive parent, it is far from adequate. The most successful post-adoption cases have consistently been the ones where the adoptive parents were properly educated with regards to the medical possibilities that could be associated with their adopted child. Because of this formal education, when a problem did arise, they were able to recognise it and bring it to the attention of their pediatrician before it was too advanced. I personally recall performing a pre-adoption medical evaluation for a young couple. They were adopting a 10-month-old infant and a 4-year-old child. They never had any children of their own, but they were determined to adopt these children in order to immediately create a family unit. They had declined any of the formal educational and parenting classes that their agency had suggested. They felt that since they were both college graduates and were too busy to take time off from their busy schedule to and that they should give it some serious thought. It is even more difficult when the children are on opposite ends of the childhood spectrum, one in diapers and one in preschool. Health wise both of these youngsters were in relatively good condition. They had some minor problems such a positive PPD, parasitic infections, a couple of specialty consultations. Along with the many visits for the early intervention program was also the grueling visit to the laboratory to take the blood for the medical screening test. The kicking and screaming that came along with this visit was more than they could handle. The infant obviously would wake up during the night to feed and have his diapers changed, while the 4 year old during the day was all too hyperactive. He would just drain his parents. He would not listen and was defiant because he could not understand English. His mother felt that he was out of control. Naturally, the adults are never at fault, it must be the child. I heard this mother say to me “ I just can not handle the older child and I would like to take him back”” There must be something wrong with him” I ask, how many of you in the adoption profession have heard of such a story? Why do you suppose that the case ended up to such extreme measures? It all lies with education of the adoptive parents. If this mother knew that the main reason why this child had been acting out with bad behavior was because he was frightened, could not understand why everything that he knew in life no longer existed. This may appear insignificant to some, but it is the world to these little children. Parents that expect to adopt a child and immediately place him in GAP clothing and anticipate him to function in our society without difficulties and a great deal of effort on their behalf are in for a rude awakening. Maybe this is why there are so many cases of adoption disruptions and child abuse reported. If you as a parent do not have the knowledge to identify when your child is having a problem, you will not be able to help him. After guiding the mother on how to handle the child, and instructing her to take some basic parenting and discipline classes, the mother was better able to care for her newly adopted children and they doing very well now. I hope that we at adoptiondoctors.com, and our new educational portal Adoptioneducationclasses.com will make a difference in the educational aspects of Adoption in general. Kind Regards George Rogu M.D.