Choosing to adopt involves readiness to take on significant new responsibilities and transform the nature of the family. Good preparation and informed, thoughtful decisions are vital to a secure adoption. Individuals or couples struggling with the initial decision to adopt can benefit from a pre-adoption consultation. Because in most cases, little is known about a child that soon will be joining a family, "love," although necessary, will not be enough to help your new child successfully adapt to his or her family.

Some Issues to Consider Before Adopting

The degree to which a child's early institutional rearing impacts their current and future functioning depends on multiple factors. Country of origin, related socioeconomic contexts and crises, institutional characteristics (e.g., quality of institutionalization, child-caretaker ratio...etc.), duration of institutionalization, age at entry into the institution, pre/postnatal history, birth family characteristics as well as individual factors that are hard to investigate and quantify (e.g., individual resilience, temperament, biology) can all have an influence. The best strategy is to honestly assess your personal strengths and weaknesses and determine what your family can effectively manage. Sometimes this may mean saying "no" to a referral. When in doubt, consult with an adoption professional or two. Following are a few issues to consider prior to adopting:

• u Given that provided information may not always be accurate, gain as much pre and postnatal information as you can to provide you with information regarding a child's biological history. There may be aspects of your child's functioning or behavior that was determined prior to institutionalization. For example, prematurity or low birth weight can place a child at increased risk for developmental delays and impairments. Why was the child placed in the orphanage? At what age? Under what social circumstances? Generally speaking, mothers (and fathers) who cannot keep their children must experience quite distressing conditions to resort to relinquishment or abandonment. Such stressful conditions can have an impact on a child's development. The more informed you are, the better prepared you can be to provide your child with the most appropriate postadoptive environment.
  
  
• u If a child is designated as "special needs, " what qualifies him or her as special needs? Medical? Emotional or behavioral? Is your family prepared to commit to him or her and the additional services the child may require in terms of time, individual attention and financial resources both short and long-term? What special needs conditions (HIV+?, fetal alcohol syndrome or exposure? prenatal drug exposure? lead poisoning? sickle cell? cerebral palsy, heart conditions? ...etc?) can your family manage without considerable stress. Also consider if the child has a sexual abuse history, either as a victim or perpetrator, and the severity. Any identified emotional or behavioral disorder should be considered with extreme caution. Adoption is a life commitment and some children can have greater needs than can be met by any particular family.
  
  
• u What is the orphanage like? What is the child-caretaker ratio? The more children compared with adults means the less verbal stimulation and individual attention your child will receive. If you can find out , what was the child like in the orphanage and how did s/he behave? Ideally, a trip to the orphanage would provide information regarding the general conditions and living environment and provide a somewhat smoother transition then meeting your child at the airport.
  
  
• u What is the child's estimated chronological age? Has s/he had any exposure to schooling or education? What is his or her current developmental functioning? Generally, the more time spent in an institution the more delays can be expected. Particularly for children adopted at older ages, research shows that developmental catch-up can take years. If your child has difficulty adapting to school learning, are you prepared to be his or her advocate? Consider your plans for acclimating your child to a formal school environment. Do you know how to request special education services if needed?
  
  
• u What is the child's general disposition and temperament? Will the child fit in with your family's temperament or lifestyle.
  
  
• u Have a pediatrician discuss the implications of growth measurements (weight for age, height for age, weight for height, head circumference), which can provide clues regarding your child's nutritional status. Also, if you can, have pictures of him (full face, head shape, head and body front and back) to show your child's pediatrician and a neurologist or neuropsychologist who might be able to identify obvious syndromes or neurological impairments.
  
  
• u Are all members of your family ready to include another addition who will be different in so many ways? Has the family talked about the racial, cultural, and social implications of the adoption? Families that can talk about adoption openly and nondefensively promote acceptance and positive adoption identity in their children.
  
  
• u If you already have children, think about sibling order. Adopting a child who is older than existing biological children can produce some interesting but potentially challenging dynamics. Particularly, if an adopted child is developmental delayed but older than one or more of his adopted siblings who can outperform him or her, the parents will need to actively work to support a positive self-esteem and identity in all their children.
  
  
• u Our hearts often urge us to adopt more than one child at a time, especially if a referral is for a sibling group or several unrelated children who may be close. While adopting more than one child at a time can be done successfully, family dynamics and stresses will not just double or triple--they will become exponential. Families planning to adopt more than one child at a time must have accessible and plentiful resources (time, money, attention, social support, patience…etc.), be especially knowledgeable about general child development, and be well prepared for the drastic lifestyle changes they will encounter.