Step 4: Examination and Selection

Step 4 Physical Examination of Assigned Child in China

Once a child has been selected for or by a family, some parents like additional assurance that the child matches the profile that they have developed. For those families, we offer an independent exam by licensed physicians (at Western medical clinics whenever possible).

• A complete examination of the exterior of the body and general mobility.
• Overall observation of child noting major scars, rashes, birthmarks, missing limbs, missing or extra digits, or other deformities.
• Measurements of child’s weight, length, head and chest circumference, girth, and foot length.
• Use of stethoscope to listen for normal heart and lung sounds.
• Palpation of abdomen to check for enlarged organs or sensitive areas.
• Palpation of lymph nodes for swelling or unusual masses.
• Place object or small light in child's range of vision to determine proper tracking of eyes.
• Make sounds on one side of child or other to test for hearing from both ears.
• Use of otoscope to check throat, nasal passages and ear canals.
• Manipulation of each joint to ensure proper function, including a check for hip dysplasia and/or any spinal abnormalities.
• Reflex tests to make sure that reflexes are appropriate and balanced on both sides.
• Have child grip fingers to test for strength that is appropriate and balanced on both sides.
• Measurements of heart and respiration rates.
• A visual inspection for signs/symptoms of malnutrition, including iodine deficiency hypo-thyroidism.
• Additional blood tests may be available for an additional fee.
• When available, in advance of your travel to China, discussion with caregiver to determine:
  • eating, sleeping, urination, and bowel habits,
  • general personality and developmental level,
  • examination of medical records for history of illnesses and medical treatments,
  • child's background and history of care.

Our fee for a Step 4 Physical Examination of Child is: $200 plus expenses for China. Physician examination is a routine part of services in Ukraine, for families who choose to pay for the physical exam expenses.

Note – Physician's fees vary widely within any country. Families are responsible for paying these fees directly. If the child is in a location difficult to reach from a Western medical clinic, there may be additional fees to transport the child and/or staff from the orphanage to the medical clinic. The purpose of this fee is to make arrangements with your guides in the foreign country to prepare resources for and obtain permission from the orphanage for the exam. After initially indicating that an examination would be allowed, some orphanages have subsequently not allowed a full examination of the child. While the family would not have to pay the exam expenses, the Americans Adopting Orphans fee is not refundable. Estimated exam costs in all countries are $300 including some blood work, about half that without lab tests. This service is only available to families using our Step 5 Adoption Assistance Overseas service.

Note - Americans Adopting Orphans cannot guarantee the health of any child. Medical standards and practices are very different in developing countries than in the United States. Diagnoses that can easily be made in the US may be overlooked in other countries. Under no circumstances is Americans Adopting Orphans responsible for medical conditions, or direct or indirect costs associated in diagnosing or treating any medical or psychological conditions, in any child adopted through our program, or examined by persons through Americans Adopting Orphans in other countries. Families will be asked to sign an agreement acknowledging these conditions and limitations.

Step 4 Request for a Specific Child

Some families who travel to their child's country, or who have friends or relatives there, may learn of a specific child they wish to adopt. Americans Adopting Orphans is happy to assist these families in attempting to adopt specific children. In general the adoption officials of destination countries prefer to control the matching of adopted child to family, and may refuse to honor a request for a specific child. For this reason refunds are not available if the family is assigned or chooses to adopt a different child. This service includes:

• Detailed instructions and examples of how to write an application letter to the foreign government requesting a specific child.
• If allowed, a formal Request from Americans Adopting Orphans that the foreign government assign a specific child to a family.
• When available, provide the family with information about the progress of their paperwork in the foreign country, for coordination with the orphanage where the child is located.
• Work with the foreign country in advance of your trip to have the child assigned to your family.
• If a different child is assigned to your family, advocating for you, to give you the option of declining the assignment, and asking that the child of your choice be assigned to your family.

Our fee for a Step 4 Request for a Specific Child is $300 ($315 for credit card or PayPal).

Note - Generally the China Center of Adoption Affairs only honors requests for specific children who are already in an orphanage, and are at least 3 years of age, or who have very serious medical conditions. The National Adoption Center in Ukraine requires a clear understanding of how the family came to know of the child, and be confident that it is not an attempt for a direct placement from a facilitator to the adoptive family.