The flow of children adopted from abroad continues unabated. They bring with them a variety of medical and developmental problems not normally seen by your family doctor. Who will you turn to for a specialized assessment?

The question first arises before the adoption, when you hold in your hands a referral -- a child's medical file, background information, photo and perhaps a videotape. How do you decide if this is the right child to adopt? Expert advice could help you make as informed a decision as possible.

Getting a proper pre-adoption assessment can be a problem in an intercountry adoption, given the sociocultural, language and medical differences with a foreign country.

And the problem may arise again, once your child is home. In the post-adoption period, you may be worried about possible underlying medical conditions, developmental delays, or behavioral problems, especially in children from orphanages.

For a pre- or a post-adoption assessment it's recommended to consult a pediatrician knowledgeable in the field of international adoption. Such experts are available, and below I give a selection for Canada and the U.S.

This list is compiled from various sources including Family Helper correspondents, responses from doctors and adoption web sites.

Ontario

Mark Handley-Derry, M.D., 658 Danforth Ave., Suite 210, Toronto M4J 5B9 416-461-3937, mark.handley.derry@utoronto.ca. Pre- and post-adoption assessment. Waiting list, so book ahead if possible.

International Adoption Clinic, CHEO - C1 Medical Clinic, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa K1H 8L1. Charles Hui, M.D., FRCPC, 613-737-7600, X2975, chui@cheo.on.ca.
Dr. Hui is a pediatrician and infectious diseases specialist working with children adopted internationally. The International Adoption Clinic opened Nov. 18, 2003, providing initial post-adoption assessment, investigations and referrals to other specialists. It makes recommendations to your family doctor/pediatrician who will be responsible for ongoing follow-up. Services are covered by OHIP. The clinic expects most children will come from Eastern Ontario or Western Quebec and have recently arrived in Canada. Referrals accepted for children who have been in Canada longer where there are medical issues/questions related to international adoption. To be referred for a post-adoption assessment, have your family doctor or pediatrician send a referral note, including all medical and developmental information, to Dr. Hui. The clinic recommends that the referral be made once you know your travel dates so you can arrange for your child to be seen soon after your return to Canada. --Oct 26, 2004

Sharon Marcovitch,M.D., 491 Lawrence Ave. West, Suite 405, Toronto M5M 1C7, 416-780-0909, fax 780-9490, drsharon@interlog.com. She is author of Romanian Adoptee and Family Follow-up Study. Pre- and post-adoption assessment.

Angelo Simone, M.D., Canadian Clinic for Adopted Children, 2338 Hurontario Street, #200, Mississauga, Ont. L5B 1N1. 905-848-8303, fax 848-5727, docsimone@rogers.com, web: cdnclinicadoptedchildren.homestead.com/CdnMedClinic.html.
Pre- and post-adoptive medical consultations for domestic and international adoption. Counsels parents, reviews video and medical reports. Reviews videos sent from abroad and emails or faxes back the evaluation to the parents abroad. Medical screening of children after arrival; developmental evaluations. Referrals to specialists. Most services covered by OHIP. Dr. Simone is Chief of Pediatrics at Trillium Health Centre. --Feb 21, 2010

Québec

Jean-Francois Chicoine, M.D., Pre-adoption Clinic, Quebec Travel Medicine Centre, St. Luc Hospital, 1001 St. Denis St., Montréal, Qué. H3T 1K2, 514-281-3295.
Pre-adoption consultation before accepting a child proposal. Not covered by health insurance; $75 a visit.

Family Medicine Clinic, Berger Medical Centre, 1000 chemin Ste-Foy, Suite 116, Québec, Qué., 418-688-1385, fax 688-3249. Specializing in health care for children adopted abroad.

Gaelle Vekemans, M.D., International Post-adoption Clinic, Centre Hospitalier Ambulatoire Régionale de Laval, 1515 boul. Chomedey, Laval, Qué. H7V 3Y7, 450- 978-8301, fax 978-8339. Working with Dr. Jean-Francois Chicoine. Post-adoption assessment. [From Gilles Breton, webmestre@quebecadoption.net]

Andrew Adesman, M.D., Schneider Children's Hospital, Developmental Evaluation Center for Adoptions, 1983 Marcus Ave, #130, Lake Success NY 11042, 516-802-6150, adoption@LIJ.edu, www.schneiderchildrenshospital.org/sch_dev_behav_adopt.html. Pre-adoption medical and developmental evaluation, using photographs and videotapes if available. Post-adoption evaluation.

Jane Aronson, M.D., International Adoption Medical Consultation Services, 151 East 62nd St., #1A, New York NY 10021, 212-207-6666, fax 207-6665, orphandoctor@aol.com, www.orphandoctor.com. Dr. Aronson specializes in the medical issues of children adopted internationally. --14 May 2002

Julia Bledsoe, M.D., Center for Adoption Medicine, Pediatric Care Center, University of Washington, 4245 Roosevelt Way NE, Seattle WA 98105, 206-598-3006, fax 598-3040, adoption@u.washington.edu, www.adoptmed.org. Seattle pediatrician, expert on intercountry medical issues, mother of two internationally-adopted children, runs an intercountry medical clinic at the University of Washington, with Julian Davies, MD and Cynthia Kertesz, MD. --Dec. 19, 2007

Debbi Borchers, M.D., Eastgate Pediatric Center, 4357 Ferguson Dr., Suite 150, Cincinnati OH 45245. Office 513-753-2820; res. 606-331-7026; fax 513-753-2824; debbiborch@juno.com. Reviews written and video referrals; pretravel counselling; post-adoption consultations. Takes calls from abroad.

Cedars-Sinai Medical Center, Pediatric Infectious Diseases, 8700 Beverly Blvd., Suite 4221, Los Angeles CA 90048, 800-233-2771, 310-855-4431, fax 310-423-4131, www.csmc.edu/2275.html. --Dec. 18, 2007

Boris Gindis, Ph.D., BG Center for Cognitive-Developmental Assessment, Rehabilitation, and Training, 13 South Van Dyke Ave., Suffern NY 10901, 845-357-2512, fax 369-6830, gindis@bgcenter.com, www.bgcenter.com. BG Center professionals speak English and Russian: child psychiatrist, pediatric neurologist, psychologist, NY-State-certified speech/ language pathologists, educational evaluators and social workers. --11 Mar 2002

International Adoption Clinic, Children's Hospital and Research Center at Oakland, 5275 Claremont Ave., Oakland CA 94618 (mailing address: 747 52nd St., Oakland 94609). 510-428-3010, fax 510-45-5878, ncurtis@mail.cho.org, www.internationaladoptionclinic.org. Medical Director: Nancy Curtis, MD. Carina Grandison, Ph.D., Developmental Neuropsychologist. Resource for adoptive children, their families, medical practitioners and adoption professionals on the west coast and throughout the U.S. --Dec. 18, 2007

International Adoption Clinic, Riley Hospital for Children, ROC RI 4380, 702 Barnhill Dr., Indianapolis, IN 46202, 317-274-7260, fax 317-278-0860, washinge@iupui.edu, www.rileyhospital.org/parents-and-patients/programs-and-services/iac.jsp. Comprehensive evaluations with special emphasis on infection, immunization, nutrition, birth defects and psychosocial development. --Dec. 18, 2007

International Adoption Clinic, University of Alabama at Birmingham, 1600 7th Ave. South, MTC 201, Birmingham AL 35233-1711, 205-939-6964, adoption@peds.uab.edu, http://adoption.chsys.org. Jennifer Chambers, Director. Pre- and post-adoption services and long-term follow-up. Medical evaluation and screening. Evaluations of developmental and emotional issues. --Feb 18, 2005

International Adoption Clinic, University of Chicago, Comer Children's Hospital, 5721 S. Maryland Ave., Chicago IL 60637, 773834-8925, adoption@uchospitals.edu, www.uchicagokidshospital.org/specialties/adoption. Larry Gray, MD, Lag@uchicago.edu. John C. Kim, MD, johnkim2@uchicago.edu. Pre-adoption assessments. Post-adoption medical evaluations. Developmental evaluations. -- Dec. 1, 2004

International Adoption Medical Consultation Services, Winthrop University Hospital, 120 Mineola Blvd, #210, Mineola NY 11501. Leonard Krilov, MD, 516-663-9570, malonso@winthrop.org, www.winthrop.org/departments/specialtycenters/?id=18. Medical guidance to adoptive parents before, during and after adopting a baby overseas. Medical evaluation, infectious disease consultation, travel preparation. Post-adoption medical and developmental evaluations. --Aug. 3, 2006

Nataniel James, M.D., Maine Medical Center, 22 Bramhal St., Portland ME 04101, 207-871-0111.

Jerri Ann Jenista, M.D., 551 Second St., Ann Arbor MI 48103, 313-668-0419, fax 668-9492. Dr. Jenista is also editor of Adoption/Medical News (Adoption Advocates Press, 1921 Ohio St. NE, Palm Bay, FL 32907).

Dana Johnson, M.D., Ph.D. International Adoption Medicine Program and Clinic, University of Minnesota, 717 Delaware St. SE, Mail Code 1932, Minneapolis MN 55414, 612-624-1164, fax 612-625-2920, iac@umn.edu, www.med.umn.edu/peds/iac. Provides pre-adoption medical reviews of child referrals for prospective adoptive families, both international and domestic. Post-adoption specialty clinic services include initial health screens and developmental assessments. Part of the University of Minnesota Children's Hospital, Fairview. Web site has 44 topics in adoption medicine issues.

Edward M. Kolb, M.D., F.A.A.P., International Adoption Medical Consultants, 13110 Birch Dr., #148, Box 366, Omaha NE 68164, 402-680-3269, fax 496-7126, adoptmedconsultants@cox.net and ekolb@chsomaha.org. Expertise in international adoption medicine. --30 Aug 2002

Patrick Mason, M.D., International Adoption Evaluation Center, Hughes Spalding Children's Hospital, 35 Butler St. S.E., Box 26020, Atlanta GA 30335-3801, 404-616-0650 fax 616-1982, adopt@oz.ped.emory.edu.

Laurie C. Miller, M.D., Director, International Adoption Clinic, Floating Hospital For Children at Tufts-New England Medical Center, 750 Washington St., Boston MA 02111, 617-636-8100, fax 617-636-8388, lmiller1@tufts-nemc.org, www.floatinghospitalkids.org/OurServices/SpecialServices/InternationalAdoption. Founded in 1988. Specializing in medical, developmental and nutritional problems of internationally adopted children. Pre- and post-adoption evaluations. Dr. Miller is chairperson of the American Academy of Pediatrics' task force on institutionalized children.

Oak Adoptive Health Center, Akron Children's Hospital, One Perkins Square, Akron, Ohio 44308-1062, 330-543-1000, www.akronchildrens.org/cms/subsite/b0c78ff0c81191e3. Ellen Kempf, M.D., F.A.A.P., Medical Director, 800-262-0333 ext. 33550, ekempf@chmca.org. Pre-Adoption and Post-Adoption Evaluations, Psychological Assessments. Founded June 2004. --Dec. 19, 2007

Julie Rathbun, M.D., University of Washington Medical Center, Seattle WA.

Heidi L. Schwarzwald, M.D., Clinic Chief, Texas Children's Health Center for International Adoption Texas Children's Hospital, 17th floor, Clinical Care Center, 6701 Fannin St., Houston TX 77030, 832-822-1038, 1-877-824-5437, fax 832-825-1281, hlschwar@TexasChildrensHospital.org, www.texaschildrenshospital.org/CareCenters/InternationalAdoption/Default.aspx. Child health care for families adopting internationally. Reviews medical information and tapes; provides developmental, physical, and laboratory examinations when the child returns. --Dec. 19, 2007

Nina Scribanu, M.D., International Adoptions Health Resource Center, Georgetown University School of Medicine, 3307 M St. NW, Washington DC, 202-687-8635, fax 687-8899

Stramski International Adoption Program, Stramski Center of Miller Children's Hospital, 2801 Atlantic Ave., Long Beach CA 90806, 562-424-4815, www.memorialcare.com/miller. Gary Feldman, M.D., Medical Director. --May 16, 2005

Carol Weitzman, M.D., Director, Yale University International Adoption Clinic, 464 Congress Ave., New Haven CT 06520, 203-737-1623. Dr. Weitzman is a developmental and behavioral pediatrician. The clinic is multidisciplinary. --19 Nov 2003

International Association for Medical Assistance to Travellers, 40 Regal Rd., Guelph, Ont. N1K 1B5, 519-836-0102, fax 519-836-3412, iamat@sentex.net, web www.iamat.org. Also: 1287 St. Clair Ave. West, Toronto, Ont. M6E 1B8, 416-652-0137. Directory of 125 countries with the location of English-speaking doctors, trained in North America or Europe, who make house calls.

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First published in Adoption Helper No. 34, then Family Helper No. 51, Health Issues in Intercountry Adoption, and updated since.

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