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Adoption: a forgotten paediatric speciality
1Greenwich Healthcare Trust, Market Street Clinic, 16-20 Market Street, Woolwich, London SE18 6QR, UK. MaryMather@doctors.org.uk
Insights
Children needing permanent substitute care often have complex medical, emotional, and developmental needs. This highlights the importance of specialized medical assessments for adoption and fostering services.
Area of Science:
- Pediatrics
- Child Health
- Social Work
Background:
- Children in permanent substitute care, including adoption and fostering, present unique health challenges.
- Previous assessments indicate a need for comprehensive medical, emotional, and developmental evaluations for these children.
Purpose of the Study:
- To delineate the medical, emotional, and developmental profiles of children evaluated for permanent substitute care.
- To inform the development of specialized medical services supporting adoption and fostering.
Main Methods:
- Retrospective analysis of 100 adoption/permanency medical reports.
- Utilized British Agencies for Adoption and Fostering forms C (under 5) and D (over 5).
- Included physical examination, vision, hearing, emotional, behavioral, and school progress data.
Main Results:
- A significant majority of children (69%) presented with complex medical, developmental, or emotional issues.
- Only 31% of the children were assessed as unlikely to have significant problems.
Conclusions:
- Adoption medical services require specialization and standardized minimum standards for healthcare professionals.
- The medical input for adoption and fostering should be recognized and resourced as a specialist pediatric service within the NHS.
- Adequate resources and training are crucial for supporting children in permanent substitute care.
Objective:
To study the medical, emotional, and developmental profile of children being considered for permanent substitute care.
Design:
A retrospective analysis of 100 adoption/permanency medicals.
Setting:
All children considered by the adoption and permanency panel in Greenwich, south east London, between 1994 and 1998.
Outcome Measures:
Analysis of medical reports completed using the British Agencies for Adoption and Fostering form C (under 5 years) or form D (over 5 years). These include the details of a physical examination, including vision, hearing, height, and weight; emotional and behavioural concerns expressed by the foster carer and school progress.
Results:
These children have complex needs. Only 31 of the 100 children were considered unlikely to have significant medical, developmental, or emotional problems.
Conclusions:
Adoption medical work is becoming more specialised. Healthcare commissioners should establish minimum standards for the doctors involved in this work. As the NHS moves towards becoming a more primary care led organisation, this small service must not be forgotten. The NHS devotes few resources and little training to adoption. The medical input required to support adoption and fostering services should be recognised as a specialist paediatric service and adequately resourced.