What are some of the child's health and behavior issues that the social worker will be interested in at the Post-Supervision visit.

What are some of the child’s health and behavior issues that the social worker will be interested in at the Post-Supervision visit. The specific purpose of these contacts is to visit with the child and adoptive family to monitor the child’s adjustment and development and to review family life.  If this is your first meeting with the social worker, have a current medical report available as well as copy of your child’s inoculation booklet.  If you are working with a pediatrician who specializes in international adoptions you will want to have your child’s current height and weight available for comparison to the discharge medical your child received from Ethiopia.  Likewise always ask the doctor how your child rates in terms of height and weight with other children of the same age.  For instance if you child is in the 50th percentile for weight that means most children are at that weight.  If your child is above the 50th percentile in height that is a sign of being taller and if the number is in the 30th percentile in weight it may mean your child needs to gain more weight or is just simply small boned.  What is of prime importance is your child’s healthful development and the physician who is mindful of medical problems specific to Ethiopia and their course of treatment.  After all we as Americans are blessed to have some of the best pediatric care in the entire world and we are urged to use preventive and intervention services for our children. Your child’s skin is of importance to your social worker and a visual body check of an infant during diaper change is required by certain states to ascertain the skin is clear and well maintained.  This is particularly significant when a child has a history of diaper rash or fungus as I witnessed during a recent trip to an orphanage in Ethiopia. Likewise all issues pertaining to your child will be discussed including diet and favorite foods, digestion, naps, sleeping and bath time.  Too this is the time to share your exuberance over your child’s emerging personality.  Whether it is his smile; or her joy at listening to music or the welcome given to family when they step through the door all of this is important to share. For the Supervisory Visit some families like to share their child’s baby book or Life Book with the social worker because it offers so graphically your child’s progress since placement.  Here pictures of your child at home, at play or with relatives at family occasions can be displayed and perfectly document “a day in the life” of your child, in addition to being kept as forever memories of your child’s earliest experiences with you. Your social worker is just as interested as you in your child’s developmental skills.  So for young children you will be able to describe how you child is attracted to light, turns to the direction of sound, enjoys being cuddled and grasps at objects.  For slightly older children there is the excitement of the first steps and hearing their first words.  All of this brings with it the observing nature of the parent who is attuned to her child’s interests, ability to focus and motivation.  It is these observations which the family will share with the social worker and which indicate growth and maturation.  Be open to discuss bonding and attachment and how the child has responded to the new environment. Too, please discuss behaviors which you do not understand such as chronic crying even though you child is fed and dry; the hoarding of food; lying, fears and bad dreams.  You may find it helpful to maintain a diary listing the date of the event; description of what occurred and what you did to remedy the situation. Then when the social worker visits you can confer on how to deal with this predicament.  Use this likewise as a model with your pediatrician. You may want to use the Behavior Journal to clearly define your concerns. The reassuring news is the American government realizes young children, including those adopted from Ethiopia, have developmental delays which are on a continuum.  Free Early Childhood Intervention programs are thus available in your community to provide a range of in-home therapeutic services including fine motor coordination, speech therapy and bonding strategies.  All are geared to supporting the family and introducing them to ways to foster their child’s developmental milestones and cognitive abilities. For a listing of your local services you can contact your local education department.  A few words of advice:  always interview with the agencies before finalizing your decision and remember although intervention is provided till age 3 an informed parent can have these services extended with proper documentation. In concluding this discussion on the new child’s adjustment also include her/his reactions to other children in the household as well as their feelings to the newest addition.