A child with a history of early institutional rearing may have special needs and concerns regarding development and overall functioning may surface. While evidence from research has shown that many children adopted from overseas show initial developmental delays with rapid catch-up growth postadoption, parents may wonder about their individual child's current and future developmental status and capabilities. An initial assessment of a child upon his or her arrival to the U.S. can help parents gain an accurate early understanding of their new child, the child's needs, and provide information regarding the most appropriate stimulation and environment. Follow-up assessments can document progress and changes in the child's needs when they occur, and maximize the nurturant support that the family can offer.

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Despite a loving and enriching home, some infants and children do not show as rapid developmental and physical progress as other children. In particular, those with histories of prematurity or other pre or perinatal medical conditions, prolonged institutional rearing, negligent or abusive care, notably depressed physical growth measurements, and/or "special needs" designations will need close and consistent monitoring of their medical and developmental status. Referrals can be made to local and national health care professionals (e.g., pediatricians) familiar with the issues related to international adoption and other developmental specialists and support networks.

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Infant and toddler evaluations are game-like and enjoyable consisting of assessment of general problem solving (cognition), use of language and sound, gross and fine motor skills, and neurodevelopmental reflexes. Standardized assessment measures together with detailed conversation with parents about their child, rating scales, previous reports and evaluations, and clinician observation, an overall developmental picture of a child can be obtained to guide parental expectations and facilitate a child's optimal functioning.