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We posed this question to Dr. Charles Nelson, Professor of Pediatrics at Harvard Medical School and one of the leading experts on attachment and th effects of childhood neglect, abuse, malnutrition, institutionalization, and prenatal environment on children. He said that most attachments to caregivers form in the first 2 (or so) years of life; thus, it is not surprising that children who spend more than the first 2 years in an institution are at an elevated risk of developing an insecure or disorganized attachment, and in some rare cases, no attachment. But, remember, this observation applies to groups of children, not individual children; thus, there may still be some children who have spent less than 2 years in an institution who still have attachment issues, and others who spend more than that who do not. Some of these individual differences may well be influenced by the kind of care a child received while in the institution. On the Creating a Family show discussing the Affect of Early Childhood Experiences on Adopted Children, he added that major attachment issues are very seldom seen in children adopted from birth.
According to Lark Cooper, Intake Coordinator for Children’s Connections, Inc., your age would not be a major issue. Many pre-adoptive families contact us in their 40’s even in their 50’s. While that is definitely true that at Creating a Family we see families where one parent is over 45, especially if that parent is the mother, wait longer to be matched with a prospective birthmother, but as Lark says, there are very few things that automatically eliminate you from adopting. Listen to the Creating a Family show on What Expectant Women Look for When Choosing Adoptive Parents and our blog on the same topic.
According to Danielle Goodman, Adoption Social Worker with Adoptions from the Heart, as a general rule single women or same sex couples do not wait a significantly longer period of time to be selected by pregnant women. The wait could be a little longer than a married couple but it is often not significantly longer. At Creating a Family we see that the adoptive parent's openness to certain risk factors, such as prenatal exposures and birth family history of mental illness, have a greater impact on waiting times.
That's a hard statistic to find. No entity keeps tract of this number and no national database on adoption failures, so we have to rely on representative samples of the adopted population. The statistic also varies based on the age of the child at adoption. In one study by Dr. Trudy Festinger, of about 200,000 children adopted from foster care, less than 1% dissolved after adoption. For more information on this study and others, listen to the Creating a Family radio show on Adoption Dissolutions: How Common, What are the Causes, How to Prevent. Also, check out this Creating a Family blog on How Common Are Adoption Dissolutions.

Each state has different laws on who can help you adopt. In most states you can use either an adoption agency or an adoption attorney. Often agencies and attorneys differ on the services they provide, such as education for pre-adoptive parents, counseling both pre and post birth for the expectant woman/first mom, and post adoption services to the family and child. They may also differ on cost and waiting time and restrictions on who they will work with. A facilitator is a person (or business) that finds expectant woman who may want to place their child for adoption. They seldom provide any type of services and are not legal in all states.

If you go the attorney route, I strongly recommend that you use an attorney that specializes in adoption. To find one, check out these Creating a Family resources on adoption attorneys.   If you go the adoption agency route, you can use our 3 step process for choosing an agency

I answered this question in a full post at the Creating a Family blog. (8/19/2012)
Creating a Family has extensive resources on how to choose an adoption agency. We set up a three step process and include all the links at our resource page. You might also want to check out our Colombian Adoption Chart with the 25 factors we think you should consider before choosing a country. (8/15/12)
 I am not a psychologist or therapist so I can only give you my opinion as a mom. First, I think today’s parents face more of an issue with our children and porn than previous generations because of the internet.  It used to be harder to access, so less of a problem. However, in your case, I too would be worried.  I think 8 is young to be interested in sexual images.  It also sounds like your daughter’s interest is beyond natural curiosity since it seems she is obsessed with finding these images despite your best effort to prevent her.

The sad reality is that sexual abuse is not uncommon in older children available for adoption because they did not have a parent to protect them from the evil that exists in this world—including pedophiles.  It is also not uncommon for pedophiles to gravitate to places where children are vulnerable, and children in orphanages are certainly the most vulnerable.  I am worried that your daughter may have been sexually abused prior to her adoption.  This is nothing to panic over, and it does not mean she is damaged beyond repair, but it does mean that you need to immediately get her help with a therapist that has experience with victims of childhood sexual abuse. Sexual abuse is so damaging and confusing for children, and if your daughter was abused in this way, she needs help understanding and processing this abuse.  Contact your local Dept. of Family Services  (or whatever the agency is called in your state that works with foster children) and ask what therapist they would recommend. (4/16/12)
The truth is that there may not be a huge difference between for profit and nonprofit adoption agencies.  The most important part is to evaluate each agency on its own merits.  Creating a Family provides a three step process for choosing an agency.  The best agencies look more like a child welfare agency rather than a child finding agency. (11/30/11)
There is no other Asian country that has embraced foster care placement for children awaiting adoption as thoroughly as Korea. Keep in mind, that most abandoned children and babies in Korea are not eligible for adoption, and are placed in orphanages rather than foster care (see our blog post on Korean adoption trends here). However, it is true that those children who are in the international adoption program are placed in foster homes.  China also places some children in foster homes, rather than child welfare institutions, especially children with special needs.  Also, the orphanages I am familiar with in Taiwan are relatively small with a good adult to child ratio.  Any agency that works in a country places all children.  They usually do not specialize in one ethnicity or mixed ethnicities.  (11/11/11)
Yes, after the subscribed period of time off antidepressants, it is my understanding that China will treat you as any other applicant. However, I would suggest thinking very hard before doing something this drastic and make sure you discuss thoroughly with his doctor. Keep in mind that the current wait for a China adoption (non Special Need) is upwards of 5 years. (11/07/11)
Answered on the Creating a Family blog: Labeling Kids — How Much To Share and With Whom.
Check with agencies with an active Bulgaria program. I would think that there would be no problem unless it is a judge driven adoption process (where the judges have a lot of discretion) and you happened upon a judge who has a personal problem. This seems unlikely.  Agencies with an active program should be able to answer this question for you. Good luck!
I don't know of any studies showing a misdiagnosis, but I can share a lot of anecdotal info. Int'l adopted kids, especially those who lived in institutions/orphanages prior to adoption, can absolutely have "symptoms" that mimic autism. Some doctors believe that early deprivation can cause a type of autism called "institutional autism". The diagnosing of autism is often more art than science, so yes, I would assume that it would be fairly east to misdiagnose. However, I would also assume that the treatment for autism would also help a child who is showing symptoms of autism regardless the cause.

Each country has different requirements on what they want in a prospective adoptive parent for children from their country.  A  few countries restrict parents who are currently on anti-depressants and a few specify the number of years they would like parents to be off antidepressants before adopting.  Many more countries have no specific requirement at all and address the issue on a case by case basis depending on what your doctor says about how your depression might interfere with your ability to parent. You should have no problem finding a country that will readily accept the short term use of antidepressants in the past.  To learn more about each countries requirements for adoptive parents, go to the Creating a Family Adoption Charts by country.

Check out the "Ask Our Expert" adoption tax credit faq page for more information, questions, and answers from our expert, Ms. Nicole Albrecht, financial adviser.
Check out the "Ask Our Expert" breastfeeding FAQ page for more information, questions, and answers from our expert, Lenore Goldfarb, Ph.D.

Hi. First, I need to make clear that I'm not a psychologist, so keep that in mind. Head banging can mean any number of things and is often a way of expressing intense frustration. It is easy as an adoptive parent to underestimate the total upheaval that adoption represents in a child's life. We are able to see the big picture and realize that this is likely the best option for this child. We know that as time goes on, our child will adjust and that his life will likely be better due to being adopted. The adoption is the fulfillment of our dream. But, it is almost certainly not your son's dream. He doesn't see the big picture. All he sees is that nothing looks like, smells like, or sounds like what he is used to. This has got to be a terrifying place for him to be. He doesn't have the language to express himself. Truth be told, even children who are proficient in their native language, or even in English, would have a hard time expressing something so profoundly confusing and scary. Banging his head is one of the few ways he has to express himself. It is one of the few things he has control over right now.

My advice is to simplify your life. Reduce your expectations of what you will get done. Create predictable routines throughout your day, so your son will be able to anticipate what is coming next. Spend time getting to know your son. Play games with him. Just be with him. Try to anticipate his needs and quickly and consistently meet them. If you don't see him improving after a few weeks, consider getting help for you to help him adjust.

Head banging is sometimes a habit formed by children in institutionalized care. Kids need stimulation. In a home environment, stimulation comes from interacting with their parents and their environment. In many orphanages, this type of stimulation isn't available and kids turn to self stimulation, like head banging.

First congratulations on your new daughter. Yes, you are right that I’ve had a lot of personal parenting experience with bed wetting. I also have done a fair amount of research on the subject and had an article on bed wetting picked up by the Associated Press.  There was a time, when a Google search of my name returned only bed wetting sites that had republished some of what I’ve written. Quite a claim to fame, eh???

Although I know it feels longer when you are up in the middle of the night for 2 weeks, you have really only just arrived home.  Your girl is adjusting to a complete and total change to everything she knows.  Regardless how she acts, she is likely reeling emotionally and barely hanging on.   Bedwetting during this adjustment time is very, very common even with much older kids who had been totally dry pre-adoption.  Jet lag and poor sleep also contribute to bed wetting.  I’ve read where it takes about a month to fully adjust to a new time zone when the difference between the time zones is as great as between China and the US.  Newly adopted kids often have erratic sleep patterns—not allowing themselves to fall into a deep sleep, frequent waking, etc.—all of which makes night wetting more common.

In your mind, pull-ups are the logical solution, but your daughter has likely never seen, nor worn them before.  They probably feel weird to her and are just another darn thing she has to adjust to.  There is nothing worse in my mind than having something weird touching me when I’m trying to go to sleep.  I think she sounds pretty resourceful.

However, I truly, truly know how exhausting it can be as the parent in this situation.  You too are getting over jet lag and are adjusting to a total change to your life.  A decent night’s sleep would really help right about now.  While I can’t promise you a totally uninterrupted night’s sleep for the near future, I do have a plan.

To put things in perspective, 40% of all children are still wetting the bed at age 4, and 20 percent at age 6.  By the age of 12, only three out of 100 are still wet at night. I don’t have any hard research, but from what I hear, I’d say that 80%+ of newly adopted 4 year olds wet the bed at night.

At the risk of way over simplifying, there are three main types of bedwetters: situational, developmental, and psychological.  Situational bedwetters wet the bed when they are sick, emotionally fried, or overly tired.   Developmental bedwetters simply have bodies that are not ready to stay dry at night until they are older—sometimes much older.  Research shows that enuresis (developmental bedwetting) is likely caused by a combination of genes, deep sleep, sluggish arousal mechanism, and smallish bladder.  And then there are the few who wet the bed (or during the day) as a way of controlling their world and parents.  These are pretty rare, and the key for parents is to avoid turning the situational and developmental bedwetter into the psychological bedwetter.

Your kiddo is clearly in the situational camp.  She doesn’t want to wet the bed any more than you want her to, regardless how she acts.  She might even be worried about it depending on how bedwetting was treated at the orphanage, and plenty of orphanages are pretty draconian about wetting the bed.  She will probably stay dry most nights pretty soon regardless what you do, but the message you need to send to her right now is that this is nothing to worry about, you will help her, and you understand her.  However, I also think it is really important that you minimize the hassle and fuss so that you both get as much sleep as possible.  I can help with my bedwetting rules learned through years of soggy experience.

The goal is to get your little one back to sleep with the minimal amount of fuss possible.  The more you do, the more awake you both become.  The added goal, especially with a developmental bedwetter, is to have them learn to get themselves back to sleep without involving you.   (This likely won’t happen with a situational bedwetter because they won’t wet the bed often enough to learn this skill.)

1.       Alter habits.  You are probably already doing this, but limit large amounts of fluids an hour or so before bedtime.  Have her go to the bathroom right before she goes to bed.  If you stay up for a couple of hours after that, it doesn’t hurt to take her to the potty before you go to bed.

2.       Simplify bedding. Put a good (read: not the cheapo brand) plastic cover over the mattress and pillow.  Use the minimal amount of bedding to keep the kid warm, but not exceed one washer load, keeping in mind that you’ll also be washing two pairs of pajamas.  We used a bottom sheet and one washable and quickly dryable warm blanket. For a while, we stopped using a fitted bottom sheet because it made remaking the bed more work.  We just threw the top sheet over the bed and didn’t even bother to tuck it in.  We didn’t use a bedspread or fluffy decorative pillows.  My kids that wet the bed weren’t big on sleeping with stuffed animals, and readily agreed to put their animals beside rather than on the bed, but you might have to play that one by ear.  If your child decides to sleep with a furry friend, just stick it in the washer and dryer with the rest of the bedding.

3.       Minimize middle of the night fuss.   First and foremost, there should be no bath until morning.   A little (or a lot) of pee will not cause a rash or harm her in any way.   If she (or you) strongly objects, let her use a few baby wipes to clean herself quickly.  She needs to change into dry PJs, and go back to sleep.

The big question is where.  I’m not a big believer in changing sheets in the middle of the night since the goal is to disrupt everyone’s sleep as little as possible.  For an occasional wet bed, I could be talked into it, but since your daughter is on a bed wetting roll, avoid the hassle of changing sheets in the middle of the night.  Here are a couple of options to consider.

a.       Have a plastic sheet spread out on the floor and a couple of blankets, so she can make a floor pallet to sleep on.  Most kids only wet once during the night, but if you have one that is the exception, then keep the floor bedding simple and easily washable as well.

b.      We brainstormed with one of ours, and he came up with this solution that worked really well.  He suggested that we keep a stack of pool towels by the bed.  If he wet the bed, he would simply lay a couple of towels on the bed then climb back in. I worried that he would still be damp and cold, but the bottom towel seemed to absorb the pee, and the top towel kept him dry.

c.       If there is another bed nearby that she could use, make sure it is ready.  I know plenty of kids who climb in bed with a sibling or parent, but you will want to make sure that bed is properly covered.

4.       Have dry jammies at the ready before they go to bed, and make sure the child knows where they are and can easily get into them on her own.  Also have a place to drop the wet pajamas.  We had an adjoining bathroom with a tiled floor, so we had them drop the wet pajamas on the floor to be picked up in the morning.  If we didn’t have that, I would put a piece of plastic (torn open garbage bag) on the floor and have them drop the soiled PJs on the plastic. You could just use a garbage bag, but getting wet pajamas into a garbage bag requires a certain amount of skill and requires being fairly awake for most little kids, so I prefer to create a situation that simply allows them to drop their clothes, but still protect the carpet from getting stinky.

5.       To use pull-ups or not—that is the BIG question.  There is a lot of debate amongst parents of developmental bedwetters and doctors about whether pull ups help or hurt the development of night time dryness.  The argument against using pull ups is that they are so absorbent that the child does not feel the first drops of urine, and therefore doesn’t rouse from her slumber enough to get to the bathroom or stop peeing.  There is some evidence that kids that use pull ups at night take longer to night time train.  The argument for pull ups is pretty obvious—ease of clean up.  In your case, your daughter objects to them, so I wouldn’t push it at all.  In my case, I was inconsistent.  In theory I agreed with the anti-pull up folks, so would go for periods of time without using them.  Then I would say “what the heck” and revert to using them again.  We always used them for travel and sleep overs.  Pull ups aren’t’ particularly useful for the situational bedwetter since you have to know in advance that the kids is going to wet the bed that night.

6.       Involve the child in the cleanup.  This rule is really more for the developmental bedwetter than the situational bedwetter.  If your kid occasionally wets the bed after skipping his nap or having a huge glass of water after dinner, it really doesn’t matter if he helps with the cleanup since it happens so infrequently.  If however it happens a lot, it is good for the child to take on some of the responsibility.  The key, and this is the most important part, is that this is in no way punitive.  You must NOT think of this as punishing your child by having her cleanup.  Your child is simply helping take care of herself.  We teach our children to button up their shirts by themselves and to take care of wet sheets for the same reason.  It builds confidence and, in the case of bedwetting, it restores dignity.  Bedwetting can make a kid feel inferior and immature, so everything we can do to build their competence is a good thing. Across the board, your attitude with bedwetting should be one of working together to solve the problem.

A four year old can help carry the pillow case and pajamas to the washer the next morning, while you carry the sheet and blanket.  Most four year olds would love to spray the mild cleaner on the plastic sheet cover and floor where the jammies sat while you wipe it down.  They will feel competent and proud to be able to help.   Make sure you notice how capable they are, and thank them as well.  They should also help make the bed up the following night.

Eventually and gradually, if your child does not develop night time dryness, she will grow into pulling the sheets off the bed in the morning and putting them in the washing machine.  Whoever is around when the washer stops should put them in the dryer.  My kids would usually empty the dryer and take the sheets up to their beds, but almost always I was around to help them remake the bed before bedtime.  We just incorporated this ritual into our bedtime routine.

7.       Reassure your child.  I have never heard of a child over the age of four or five who didn’t worry that something was wrong with them.  You are at a big disadvantage here since your daughter doesn’t have the language to understand reassuring words.  That is why your actions of treating this as just a normal part of adjustment is so crucial.  She will draw her reassurance from how you respond.  But for kids who do have language, they need to know that everyone occasionally wets the bed.  It helps for them to know that drinking that big drink right before bed or skipping that nap, make it more likely.

Developmental bedwetters need to know that plenty of kids their age wet the bed.   Even though the cause of bedwetting past the age of 4 or 5 is multifactorial, my kids latched on to the idea of small bladder size.  I used two different size balloons and showed them how the large balloon could hold so much more than the small balloon.  One time, one of my children had a friend sleep over.  I overheard him explain matter-of-factly to his friend that his bladder was still growing and wasn’t big enough yet to hold an evening’s worth of pee.  His friend responded, “Yeah, I understand. My nose is bigger than yours, so it I guess my bladder is too.”  Huh?!?  No need to correct faulty logic.  Bottom line is that my child accepted his bladder size, and his friend accepted his nose size.

My children gradually outgrew night time accidents when they were between 6 and 8.  There are medications and bed alarm systems, but we never needed to use them.  When I was writing the article on bedwetting, one of my former bedwetters was 12 years old.  When I told him in passing that I had been asked to write an article on bedwetting because of my “expertise”, he was genuinely confused about where I would get such expertise.  He had no memory of wetting the bed until I jogged his memory.  He was young when he stopped (6 ½  to 7) and he had not suffered from the sleep over or camp anxiety caused by bedwetting, but still his lack of memory surprised me.  Now mind you, this same kid can remember every time I have screwed up as a parent and unjustly accused him or lost my temper too quick, but couldn’t remember the times when I think I did something right, like how we handled bedwetting.  However, I suppose that is the goal—to treat bedwetting as just a natural and normal part of life that it doesn’t warrant remembering 6 years later.

No, I haven’t heard of this specific orphanage, so I can’t give you specific information, but can give you general advice.  If you are hearing “Hurry up. Send us your money so you can save a child” be cautious!  Go to our Adoption Chart for Ethiopia,  and if you are hearing something significantly different from the information there, be even more cautious.  You will need to use a reputable licensed adoption agency to adopt from Ethiopia.  You mentioned the orphanage, but not the adoption agency you would be using.  We have extensive resources for selecting an adoption agency.  Do NOT skip this step because of the perceived urgency of saving a child.  You will want to get with a good solid agency with a long standing program in Ethiopia.  Bottom line: If it sounds too easy or too fast or the children too healthy or too young, then be suspicious. 

Dear Dawn, I am a mother of nine children born to me (ages 20 months to 18 years), all homeschooled, and have adopted my husband's second cousin as of 2 months ago. We did not know her prior to this and the adoption moved very quickly once the state determined that her mother would not get her act together. She is 3.5 years old. I think she would have an easier time overcoming her attachment issues if I could overcome mine. Everywhere I read, no one has a problem with loving and sympathizing with their adopted child, but I do. I feel like a complete beast. I am civil to her, often affectionate, and try to be fair about her rights in the family. I am unable to fake expressions of love and do not like how the integration has to be so sudden and total. I feel like if I was joining a family I would be quiet and shy and try not to make waves and let people get used to me. Instead I have to treat her like the sister to my children from minute #1 and everyone has to act like she has always been here. I don't want to bore you with the details, especially of how awful I am. She is a normal little girl, but I am choking on what is required of me. I listened to about 24 of your podcasts preparing for the adoption, especially anything about attachment and parenting. I thought there was one with a mother/author who had trouble forming the attachment to her child and cannot figure out, especially with the present set of demands on my time, which podcast it was and who the author was. I am also interested in the resource, if any, about kinship adoption and how to help adoptive families form the bond.
I am so glad you reached out to me and to our Creating a Family community for help. You are wise to realize that attachment is a two way street. Yes, we talk a lot about the child attaching to us, but parents also have to attach to their child. The first thing you should know is that you are absolutely not alone. The second thing you should know is that there is help.

This whole adoption happened very fast and wasn't necessarily your choosing. It sounds like there was a need and you stepped in, but you wouldn't have gone out to seek this opportunity. You're struggling with two issues: the rapidity of change and the lack of a real choice. Both are hard to stomach. And let's face it, you are also adjusting to life with 10 kids, which is no small feat.

My first piece of advice is to give yourself time. With a pregnancy, you have 9 months to adjust to the idea of a new child and to fall in love with this child. Even after the birth for many people the process is more growing in love rather than falling in love. It sounds like you are putting a lot of pressure on yourself to love this child immediately. Change your expectations to allowing time for you to grow in love with her.

Adopting a 3.5 year old is more like the process of dating than the process of giving birth. When you give birth, the child is helpless and unformed (more or less). A toddler is neither helpless nor unformed. You need to get to know this person just like you got to know your husband when you were first dating. That takes time and effort. It also takes scheduling one on one time with her, which I suspect is hard to do with your schedule.

You need to take very good care of yourself during this initial adjustment period. Think in terms of 9 months rather than 2 months. Be kind to yourself. If there is any way you could get extra help for the next 6 -8 months, I would strongly recommend it. Also, lower your expectations during this adjustment period for your house keeping and even your homeschooling. One of the blessings of homeschooling is that you have the flexibility to slack off just a bit and then pick up when things settle down.

While you are growing in love, fake it till you make it. Continue to care and nurture this little being. The very act of caring and nurturing helps with bonding. Get Deborah Gray's book Attaching in Adoption and work through some of the activities with your new daughter. You can involve your other kids to. Also read Toddler Adoption by Mary Hopkins-Best.

Although what you are experiencing is not terribly uncommon and you are not a beast, I strongly recommend that you find a good adoption therapist to help you through this adjustment period. Call you local DSS office and ask who they have worked with. If a therapist knowledgeable about adoption issues is not available, then just go to a good counselor who can support you through this huge life transition.

You may be tempted to say that you don't have the time to spend doing all this stuff with 10 kids, homeschooling, and life in general. I can't stress enough how important it is for you, your family, and this child. The time spent now will pay off in spades as she ages.  For more advice from those who have been there and felt that, check out the discussion we had about your question on the Facebook Creating a Family Group.

Yes, all states require a homestudy before you can adopt regardless whether you adopt through an agency or privately.  If you are adopting privately, you will need to use an attorney.  I strongly recommend using an attorney with lots of experience with adoptions.  Try finding one through the American Academy of Adoption Attorneys  If there is not a member attorney in your city, choose one in your state for you and your local attorney to consult with.  Ask your attorney to recommend a homestudy provider. It usually takes a couple of months to complete, so you'll want to get started soon. 


You will likely be asked about your conception plans during the homestudy.  Some agencies specifically require that you not be actively trying to conceive, but with private adoptions, it is up to the expectant parents to decide if this is a relevant factor.  However, even though it may be possible to adopt while actively trying to get pregnant, it is not necessarily advisable.  You need to seriously consider whether it is in this child’s best interest for you to try to have another child within the first couple of years.  It takes time to adjust to parenting, working out the work/life/childcare balance, etc.  This child deserves your undivided time and attention at the beginning.  If you were successful in your conception plans you could end up with two kids very close in age.  Some people can pull this off, but in my opinion, it takes lots of support, help, and money.  If the thought of not conceiving a biological child within the next several years is too difficult, you may want to reconsider whether you should adopt at this time.

Unfortunately, China does not look at each case individually and your diagnosis of cancer and the antidepressants rules China out for you. Other countries would look at the circumstances of each case specifically and might rule in favor of accepting your family. Sorry to be the bearer of bad news.

Friends and family are a HUGE resource in spreading the word that you are interested in adopting and helping find an expectant woman who may be considering making an adoption plan for her child.  Yes, you'll need a homestudy. It will have to be done by an agency in your state.


Yes, it can be completed in 2-3 months. You need to be very clear with whomever you use to do the homestudy about the time frame and make certain they can give you that turnaround. If you're starting to spread the word about adoption, it's a good idea to have your homestudy ready. The only downside is that they do expire. In most states they expire in 12 months, although they last a little longer in a few states. Renewing a homestudy is usually less expensive and less time consuming.

Each country establishes the restrictions that they think will best insure qualified parents.  I don’t k now why a country would choose to only allows adoptions by families who have no children, but I can speculate. There have been rumors for years that wealthy families “adopt” children for to become servants or to harvest body parts. I suppose it seems more likely to cultures unfamiliar with adoption of a unrelated child that someone who already has children would be more likely to want a slave or a kidney. For countries which place few children, the best place to find current information on adoption is the State Department Adoption website/ Country Page.

I know of families of color adopting from China, but have not heard of a black or biracial person or couple successfully adopting from Russia.  The judges in Russia have quite a bit of leeway in approving adoptive families. I've checked with a few agencies that have told me that they doubt a Russian judge would approve such an adoption. There is not, however, an official prohibition, but before you proceed with adopting from Russia, make sure to question the agency about whether they have successfully completed an adoption where the adoptive mom is black or bi-racial.
We have addressed this issue specifically in two Creating a Family shows:
My experience with Korean, and I assume it would be the same with other Asian languages, is that the spelling differs greatly depending on who is translating.  Translating requires trying to match the Korean sounds to English letters, and that is more an art than a science.  Korean is a totally phonetic (beautifully phonetic actually) language, while English is anything but.  How about keeping the pronunciation, which after all is the heritage part rather than the English translation, and changing the spelling to reflect it?  “Heah” or “He-Ah” or “HeAh”looks like it sounds and is easy to fill into forms without the space.  

Also, I wouldn’t worry too much about middle names being the source of embarrassment.  After he’s been home for a short time, most people won’t even know his middle name.  Teachers don’t usually call out a child’s full name.  For the most part, the only one who says my kids' full names is me.  

I’ll add this question as a discussion topic over at the Creating a Family Facebook page to see what others have to say. You may get a lot better suggestions from them.
I am not an expert on adoptions in the UK, but we have done many many shows on all types of adoption, and much of the information would be relevant.  The best approach is to look at the show descriptions and highlights on the Big Lists for 2007, 2008, 2009, and 2010 at the radio page. We have also had shows specific to the LGBT Community,
  • Adoption and the LGBT Community- Oct. 21, 2009
  • Family Building and the LGBT Community May 5, 2010
You can listen to all shows on our radio page or you can download them to an iPod or MP3 palyer.

Learning disabilities are not necessarily an impediment to adoption unless they would impact your ability to parent. In the US, all prospective adoptive parents have a homestudy prepared that serves to educate them on adoption and to assess their ability to be an adoptive parent.
Please check out my April 2010 blog on this topic where I answer this question. The Status of Haitian Adoptions.
Please check out my April 2010 blog on this topic where I answer this question. The Status of Haitian Adoptions. It may be possible in the future, but the pending new law only allows for families with no more than 2 children already in the home to adopt. It is very likely that if the new law is ever passed, they will not be making exceptions to circumvent it in the foreseeable future. If you still want to adopt, there are many countries, including the US foster system and US private domestic adoptions, that will accept families of your size. Check out our Country Adoption Charts to understand more about the adoption process for the top placing countries, including domestic adoptions. Save

Several Creating a Family shows have covered this topic in depth. I suggest you listen to the following shows:


China does not usually waive age requirements. Also, it is very difficult to adopt a preselected child from China. Their system is not set up for this type of adoption. It is highly unlikely that your friend will be able to adopt this specific child. Sorry to be the bearer of bad news. To get a second opinion, I'd recommend contacting an agency that has a long standing program in China and see what they say.

First, thank you for your kind words. It truly is nice to hear that the blog makes a difference.  The funny thing about writing a blog is that once it’s released into the ether world of the internet, you wonder what impact it has.  Now, to your question.

The psychological evaluation is common in many countries and becoming more so.  Countries want to make sure that the people adopting their children are not “nuts” and are capable of parenting.  I’m not really convinced that the psychological evaluation is all that effective at determining this and doubt that it is more effective than the home study, but I understand the desire of the country.  Also, quite frankly, the psychological evaluation allows blame sharing when things go wrong.  “Hey, even the psychologist couldn’t tell that this would happen.” or “We did all we could to make sure that pedophiles or child abusers didn’t adopt. It’s not our fault one slipped through.”

The evaluation is usually fairly standard and is nothing to worry about.  Adoption agencies and foreign countries are not looking for perfection.  They are simply trying to weed out obviously inappropriate families.  We all have idiosyncrasies and quirks that we worry about, but these seldom interfere with parenting.

If you are working with a local agency they will usually have a psychologist or therapist they recommend and who is familiar with what is required.  If not, you need to find out from your agency as much information as possible about what type of evaluation is required and what the country is looking for.  This is important information for the psychologist to have before the evaluation.
You can ask this question on any adoption forum, but some forums require that all responses be through direct message rather than on the forum, which significantly limits the usefulness of the forum. The two best forums for researching agencies are the yahoo groups  Adoption Agency Research Group - Domestic and Adoption Agency Research Group- International. The international group is more active than the domestic group. The great thing about these two groups is that they encourage the discussion of agencies rather than prohibit it. You can search through the messages to find old discussions about the agency in question as well.
You are absolutely not alone in struggling with this. I think for a lot of us, the joy at having these wonderful little beings in our lives is tinged with the sorrow (guilt?) of knowing that we have them because someone else lost them.  It’s hard to know that our happiness is at the expense of someone’s sorrow.  I suspect you are also dealing with what I call the "claiming" issue--on some level struggling with feeling like you are their real mom.  Although not at all unusual, you’re having a double whammy because you don’t feel like your feelings are logical.  Their first mom wasn’t even close to “being up for the job” and without a doubt should not be in the mothering position now; therefore, feeling guilty doesn't feel totally rational.

You and your husband are 100% your sons’ parents, but they also have another set of parents.  You didn’t take them from their first mother; in many ways, she “gave” them to you by her actions.  I think your compassion for the first parents will serve you and your sons well in the long run, so long as it doesn’t interfere with your being completely and totally their forever and right-now mom.

Is it possible to have any form of communication with the first parents?  Even if not, you can have an imaginary conversation with them.  What do you think they would want for their sons?  Do you think their birth mom feels like you stole her children or do you think on some level when she's not stoned she is thankful that you stepped in when she couldn’t?  It is tempting with foster care adoption to demonize the first parents, but seldom is this best for the children.  You can and should find ways to honor birth parents, without condoning their actions.  For some parents, this honoring relieves the feelings of guilt.

Knowing that it is a common feeling doesn’t really help a lot, I know.  There aren’t many resources that I can recommend, but there are a few.  
  • We did a Creating a Family show on Feb. 20, 2008  on Transitioning to Parenthood where we talked about some of this.  
  • We’ve done a number of shows where we talk about how to honor first parents even when their actions are not particularly honorable.  Go through the Big Lists for 2007, 2008, and 2009 to listen to some of these.
  • A wonderful article by Dawn Friedman in Salon titled Open Adoption, Broken Heart might be a huge help. Her circumstances were different, but her feeling very similar.
  • The book The Post-Adoption Blues by Foli and Thompson may be of some help, but it isn’t directly on point to what you’re feeling.
  • I am in the process of looking for an adoption therapist to talk for a show to be titled Happily Ever After? Unexpected Feeling of Adoptive Parenthood. I wish I already had it booked so I could tell you when it would be.  Sign up for the updates and I’ll let you know when we have it schedules.
  • Play around on The Center for Adoption Support and Education (C.A.S.E.) website  and sign up for their newsletter. They are a terrific organization with all types of support for adoptive parents.
  • Check out Pat Johnston’s book Adopting: Sound Choices, Strong Families. I don’t think she directly addresses this issue, but in her first chapter she talks about issues that can interfere with our whole hearted acceptance of adoptive parenting, and in the last chapter she talks about adjusting to parenthood. All in all, she’s one wise woman.
  • If you are concerned that your feelings are interfering with your attachment to your sons or with your ability to parent them, then find a counselor that understands adoption issues.  You can get past these feelings with a little help.
There isn’t anything exactly like what you are looking for.  First, make sure you check out our resources on adopting older kids.  The classes you will be required to take will cover some of this. A great resource is Brothers and Sisters in Adoption by Arleta James.  Parenting Your Older Adopted Child by Brenda McCreight provides a pretty good overview. Deborah Gray’s two books (Attaching in Adoption and Nurturing Adoptions) cover the attachment aspect, but probably won’t answer all your other practical questions.  There are many books that address problem areas, such as Dr. Gregory Keck’s Parenting the Hurt Child, but you are looking for help with more typical adjustment issues with older kids.  The last chapter in my book, The Complete Book of International Adoption covers a lot of issues that may come up within the first 6 to 12 months home. Although specifically geared to international adoption, most of the issues are the same since most internationally adopted kids are over the age of one.  You can probably find it at your library or they will be willing to get it for you either by buying or through interlibrary loan.
The answer is somewhat dependent on the country, but usually if you have sufficient savings to support your family, then temporarily having no income shouldn’t be a problem.  Talk with an agency that has a longstanding program in Ethiopia and ask if this could be a problem in Ethiopia.  Things like this are seldom found specifically addressed in a country’s regulations, but an agency working in the country should know the subtleties of that country’s adoption regulations.  Stress that you are both in school so that you can get an even better job when finished and that you both have a track record of working (assuming these statements are true :-)).
To understand my answer, you will need to look at the Haiti adoption chart. It is not clear how a couple with one biological child will be treated under the pending revision to the Haiti adoption law.  It is also not clear whether you would be treated differently under the existing law since you have “good reason” for wanting to adopt.  You would still need a Presidential Waiver under the existing sytem, but might be more likely to get one than another couple. Anytime you enter the wait for a Waiver, you increase the time and uncertainty of adopting from Haiti. In the past, little was clear or easy about adopting from Haiti and the earthquake has done nothing to improve the situation.  

I believe adoptions will resume in Haiti, and I am hoping it will happen this year (2010).  I am also hoping very much that Haiti will take this “opportunity” to revise their adoption laws, by either passing the pending law, or completely revamping the system.  I have no feel for if this might happen. I know several Non-Governmental Organizations (NGOs) and adoption agencies have been trying to make this happen for some time.  There are other NGOs that are opposed to most international adoptions or are so fearful of the possibility of child trafficking that they will argue for a more restrictive law.  Right now (end of January 2010), any form of adoption reform is the farthest thing from anyone’s mind in Haiti.  They have so much bigger issues to deal with.  

If you are anxious to begin the adoption process this year, I would suggest not applying to Haiti.  Many agencies are not even accepting applications right now.  Have you thought about adopting domestically either through birth mother relinquishment or through the foster care system?  Or, have you thought about a different country such as China (Special Needs program) or Ethiopia?  Depending on when your birthday falls, you may have to wait a few months before applying to China.
Agencies are divided right now (Jan. 21, 2010) about whether to accept applications for a Haiti adoption. The problem is that no one knows how long it will be before Haiti can start making referrals.  On our Jan. 20 Creating a Family show the representatives of both the Dept. of State and Citizenship and Immigration Services indicated that it could be a long time. I am very hopeful that the legal infrastructure that would allow adoptions to resume will be reconstructed at least sometime in 2010, but quite frankly that is just a guess.  There is some ground work that you can begin now, but it may be risky to complete your home study too soon because home studies do expire. It is not too costly to do an update, but it make make better financial sense to wait until more is known. I would be cautious about paying money to an agency until we see when Haitian adoptions will resume.  Check out our Adoption Chart for Haiti.  Note that there is a new adoption law that has been pending for some time that will change the adoption process and requirements if is passed.
We have done a number of Creating a Family shows that may be of help to you.  You can listen to these shows by clicking on the 2009 Big Lists on the Radio Page
  • How to evaluate an Adoption Referral or Domestic Adoption Match Dec. 30, 2009
  • Nature vs. Nurture Dec. 9, 2009
  • Evaluating Adoption Referrals Feb. 4, 2009

We also have a Creating a Family video on Evaluating Adoption Referrals or Domestic Adoption Match. You can watch this video on our Adoption Video Page.

I would suggest you discuss this potential match and your concerns with your adoption agency. It may be possible to have this woman evaluated by a doctor to help her manage her behavior and to provide you with additional information. Unless you are a doctor with training in this area, it is not a good idea to try to diagnose something as serious as bi-polar disease. Impulsivity is also common with Attention Deficit Disorder.
No, I don’t have a child with FASD. We have many varying degrees of learning disabilities in our house, so that may be what you heard. Creating a Family has, however, done a number of shows that will be of help to you.  The shows can be listened to from The Big Lists at our radio page.  The Resources are available on our Special Needs Page. You are correct that FASD is a spectrum disorder meaning that it will present in many different degrees making it hard to tell you exactly what living with a child with FASD looks like.  However, there are ways to reduce your risk of adopting a child with severe fetal alcohol syndrome.
  • April 14, 2010- Upcoming show on Living with a FASD Child
  • Oct. 1, 2008- FASD and Adoption
  • Feb. 4, 2009- How to Evaluate an Adoption Referral for Significant Health Issues
  • Dec. 30, 2009- Evaluating an Adoption Referral or Domestic Adoption Match
I’m so glad everyone is focused on helping the first mom’s older children understand adoption and what is happening.  It is confusing for the children not being placed for adoption, but with all the adults focused on their best interest, it need not be devastating.  Unfortunately, there is a dearth of resources to help children in first families understand adoption.  The one really good resource is the book Sam's Sister by Juliet Bond.  The story is told by 5-year-old Rosa, whose newborn brother is placed in an open adoption. The entire book can be read online at Perspective Press to see if you want to buy it. It would be a very thoughtful gift to give the mother.

We list a lot of books that are designed to explain adoption to children.  Many of these books can also be used to explain adoption to a birth mother’s other children.  There are many many good one.  We give a good review and age ranges, so pick the ones you think would work best.  

I also heard of a first mother who used the Discovery Channel series Adoption Stories to explain adoption to the children she was not placing.  Since it is geared for adults, and primarily for adults that want to adopt, I was skeptical, but she thought it was very helpful.  I would recommend that the mother watch it first to make sure that it is sending the message that she wants and that it is something that a four year old could understand.
Absolutely you can adopt out of state. You will need to comply with The Interstate Compact on the Placement of Children, (ICPC).  The ICPC is not a Federal law, but a reciprocal State law which has been enacted in the 50 states, the District of Columbia and the Virgin Islands.  As a result, adopting out of state is a bit more complicated, but it’s done all the time. Hire an attorney in Georgia that is very knowledgeable on adoption and the ICPC.  I strongly suggest you consult with an attorney that is affiliated with the American Academy of Adoption Attorneys .  She or he will let you know if you will need another attorney in your home state. Good luck.
Take a look at the comparison country charts under Adoption Resources on our site. The info you are looking for is under Additional Information.  If it is a firm rule prohibiting parents that take antidepressants, then it is included.  Most often it is more of a gray area, with the answer depending on factors such as how long you’ve been controlled, what your doctor says, if there was a definitive temporary cause, etc. If the chart says nothing, you can assume that it is a gray area and that country is a possibility.  

My suggestion is to first look through the country charts and see what countries are not options for you based on all the parental requirements (length of marriage, # of divorces, etc.) including your history of depression.  Select a few agencies that have active and fairly large programs in these countries. You want them to place quite a few kiddos because you want them to be able to give you an educated opinion on whether your specific history of depression (controlled, long term, etc.) will be a problem. Ask specifically how many families have received a referral in t he last two years with your history of depression.
Well, thanks for the vote of confidence, but my crystal ball is decidedly cloudy on this one. This is what we know.  As you know, Guatemala shut down to international adoptions to the US on Jan. 1, 2008 due to concerns about corruption and fraud.  It is important to note that it was the US Department of State that stopped processing inter-country adoptions from Guatemala, not Guatemala that decided on their own to stop sending children abroad for adoption.  The US DOS concluded that Guatemala was not in compliance with the Hague Treaty on Intercountry Adoption.  The US became a member of the Hague Treaty on April 1, 2008 and all adoptions between 2 member countries (Guatemala is a member) must be in compliance with the Hague standards.  

In the last 2 years Guatemala has been working on becoming compliant with the standards of the Hague Treaty.  They have established a new governmental entity, the National Council of Adoptions, to process all international adoptions.  However, a representative of the State Department expressed that they had a long way to go on a Creating a Family radio show in May 13, 2009.

On Nov. 19, the Guatemala National Council of Adoptions announced that they would begin a 2-year pilot international adoption program.  This pilot program would seek to place children who are older than 5, sibling groups, or “children with health, mental or emotional issues."  They anticipate placing no more than 200 children a year through this program.  They have stated that they would like to work with no more than four countries to place children through this pilot program and have asked for countries to contact them no later than Dec. 3, 2009 if they are interested in being a part of this program.  From a practical standpoint, what this means is for the US to be a part of this program, the US State Department must apply.  They will not accept applications from adoption agencies.

We don’t know yet whether the State Department has applied to be a part of this pilot program.  To hear what the State Department had to say about the future of adoptions from Guatemala, listen to the May 13, 2009 Creating a Family show.
First, I should tell you that I’m not an expert on British adoption law or Portuguese law both of which will likely be involved.  I can however help you think through what some of your potential issues.  Yes, China requires couples to be married.  I don’t think they care whether you go through a marriage ceremony or go through a legal proceeding declaring that you are married by common law, but you will need to submit some form of documentation proving you are married.  Whatever documentation you submit will need to show that you have been “married” for two years if neither of you has been divorced, or five years if either of you has been divorced.  You will need to see what the procedure is in Portugal for granting common law marriages and granting them to foreign citizens.

Your second issue is how the adoption will work as a British citizen living abroad.  Again, I’m not knowledgeable about British or Portuguese adoption and immigration law, but it is likely that you will have to adopt the child following British adoption and immigration law in order to be able to grant the child British citizenship.  Portugal may well not let you immigrate the child into Portugal unless you have done this.  I would strongly suggest that you contact an immigration attorney that is knowledgeable about adoption or an adoption attorney that is knowledgeable about immigration.

There isn’t an easy yes or no answer to your question.  My answer will depend on a number of factors.  The standard we are supposed to use when deciding on placing children in a home is the following: “Is this placement in the best interest of the child?”  The hurdle you will have to overcome is showing that having a dad that is only present on the weekend is in the best interest of the children.  


Is this arrangement permanent or do you anticipate a change sometime in the future?  If you anticipate that this is a temporary arrangement, make this clear to the social worker doing your home study.  If you are able to afford household help that frees you both up to spend time on the weekend with the children, make that clear.  Focus on your weekly support network that can help you cope with being a new :mostly single”mom to two kids.  If you don’t have this support network, develop one because you’ll need it.  You don’t say whether you want to adopt from US foster care or from abroad.  Some countries may ask for additional information to be included in your homestudy, given your living arrangements. 

I have a 9 month old son who has been with me for 3 months. This is a private domestic adoption. Before me, he had a lot of moves, including his last one being in the middle of the night. He went to sleep in one home and woke up in another. There was also a lot of chaos in his first home, where he lived for his first 4 months, including domestic violence and birth mom's depression. When I got him at 6 months, he had regressed himself to a newborn. Although we are going through a regression right now, overall, we have made good progress on attachment and bonding. But even when he was feeling more secure, we have had sleep issues. Our main issue, which has been present for at least 2 months, is that at least once a week, he wakes up anywhere between 3-5 AM and can't fall back asleep. He is tired and not doing things that usually keep babies up, such as practicing new milestones. He will just lie there, staring at the ceiling and sucking his fingers. If I pick him up, he tries hard to fall asleep, again putting his head on my shoulder, closing his eyes, sucking on his fingers and security blanket. He is clearly not enjoying it but can't fall back asleep. It usually takes him a full hour before he falls back asleep. I have eliminated all the usual causes - hungry, wet, teething, etc - and I am fairly certain it is trauma related. I am just not sure how to go about dealing with it. Nothing I do seems to help him fall back asleep. I pushed his bedtime back, bought a sleep machine, have a perfectly consistent bedtime routine. I can't see any difference in the day leading up to it.
I agree with you that his sleep issues are probably trauma related. I know it seems like an eternity when you’re the one missing the sleep, but 3 months is a very short period of time to work through this issue. It sounds like he is doing wonderful on the really important issues of bonding and attaching and healing from the traumas in his early life.  I truly think you have to give him more time on this sleep issues.

I do have a couple of suggestions. Is he content to just lay there and stare and suck on his fingers without you actively trying to get him back to sleep? If so, fantastic!  The ability to self sooth back to sleep is exactly what we are shooting with all of our kids. For some people and at sometimes in life, it simply takes longer to “catch the window” of sleepiness.  If he is not quite able to do that without you nearby, could you put a mattress on the floor of his room and try to sleep there without actively engaging in getting him back to sleep?  

If none of these suggestions will work, I’d recommend still being present with him which means that you’ll have to lose sleep on those nights. I can’t stress enough how important it is to take care of yourself so you will continue to be able to take such great care of him. This means you need to nap or rest the next day. Can you get someone on backup who can pitch at a moments notice on the following day to allow you a 2 hour nap? It really won’t be forever that you need this and it would give Grandma or good friends or little old church lady or hubby a chance to feel like they are helping you. Now is also the time to let some of the “shoulds” in life slide.  You know, the “I really should be _____ (decorating, cleaning, cooking exciting meals, helping out at church, etc.)”.  I hope some of this helps and that your little fellow and you are both soon sleeping better.

Great questions.  The answer is to be totally up front with the social worker that is performing the home study.  You are right that it is possible for “expunged” records to come back to haunt you.  I have been told that this is particularly a problem if you were fingerprinted by the police, but in this computer age with everything on computer files, I predict it could be a problem even without fingerprints. 


It is highly unlikely that either of these arrests will pose a problem for you.  They were more than 10 years ago, and they are not part of a pattern of recurring behavior.  Before your homestudy, spend some time thinking about what you learned from these “indiscretions”, and make sure to present this information when you bring up your arrests.  Also, be prepared to answer some questions from your social worker on the place of alcohol in your life now.  He/she will probably want to make sure that excessive drinking is not still a problem. 

I have a section in my book that talks about the effects of institutionalization (p. 47-49 and Chapter 8). If you are interested, it is available at most libraries. At the time it was written (2006) I had read most of the research that was out there. I can't say the same for the last year or so, but I try to keep up. The research is interesting and not necessarily consistent on the linear link between time in the institution and later problems. Humans are such amazing creatures and so very different. That makes it hard to generalize and say that if your child spent his first two years in an orphanage then you can expect to see A, B, and C. Also, orphanage care differs by country, by region, and even within the orphanage itself. And truth be told, we parents differ in our temperaments and preparation and this affects our kiddos as well.


However, having said all that, the research does show some patterns that support what you are seeing. Motor skill delays are usually the first to improve once a child is placed in a loving home, while language and social skills may lag behind. Research shows that many kids who spent time in an institution pre-adoption have some lingering language issues once school age.

I have a section on language development in adopted kids on my website. Also, I just added a fact sheet on how post institutionalized kids develop social skills and friendships to my school issues section on the Adoption Resources page.

On a personal level, I started one of my sons a year late in school and I never regretted it. It is so common that he doesn’t stand out or feel particularly different, although he does complain some about it when an older grade gets privileges that his grade doesn’t.

Well, you are right that now is a tumultuous time in international adoptions. This is not unprecedented historically, but who knows if it will rebound as it has before. The ratification of the Hague Treaty by the US alters the landscape. I suggest you go back to the beginning and rethink your options. First, analyze whether you would be a good family to adopt from US foster care. There are not many options for children under two who are already free for adoption, but it does happen with the foster-to-adopt on occasion, especially if you are open to sibling groups or children with special needs. The problem is that you might have to go through a few failed adoption placements because the child is able to go back to his family of birth or an extended family member steps forward to adopt the child. This is more likely to happen with younger children.


Second, I would suggest that you reconsider domestic adoption. It is true that fewer pregnant woman that are considering an adoption plan for their baby choose older couples, but you increase your odds if you will accept a child with more risk factors (for example, prenatal substance abuse or alcohol use or prematurity) or an African American boy.

OK, now to international adoption. The following countries are still possibilities for you: Russia, Kazakhstan, Ethiopia, Haiti (probably), and Taiwan, Look up the country charts for these countries on this website to see the specifics. Kazakhstan did not close down, and although there are rumors, there are always rumors, and they don’t seem very credible to me. Processing of dossiers is moving slower for Kazakhstan especially if the dossiers are being processed through the Kazakhstan consulate in Washington DC. Unfortunately, I don’t see international adoptions from Cambodia opening back up any time soon since Cambodia lacks the infrastructure to ensure that there will be little fraud. Also keep in mind that if you are open to children with special needs, many countries are more flexible on the age requirements. The radio show, Creating a Family covered the status of international adoptions around the world on the June 18, 2008 show.

First of all, I need to add the disclaimer that the following answer is not intended to be legal advice.
To adopt internationally through the US government (State Department and US Citizenship and Immigration Service (USCIS), one member of the couple must be a US citizen. The problem you face is not so much with the adoption, but with the immigration of that child. To immigrate a child to the US, and thus to gain US citizenship, you must be a US citizen, which is logical when viewed from the immigration standpoint. Your child must be given citizenship, and the only citizenship you can confer is British. Therefore, you must work through the UK adoption and citizenship laws. Try contacting the DES (Department for Education & Skills) for information. Their website is: Once your child has British citizenship you can apply to the USCIS to allow the child to live in the US.
There are several ways to find basic information about adopting from a specific country. For starters, I have adoption charts for the top countries that send children for international adoption in the United States. I include information on the 25 factors I think parents should consider when choosing a country from which to adopt. But what if you are considering a country that does not place many children to the US? Where do you go to get reliable information?


The first place to look for information on the process and advisability of adopting from any country is the US State Department web page on country specific information. This is by far the most reliable and complete source of basic information. Be wary of commercial sites as a source of information if they are trying to sell you something (e.g. pay an application fee). Pay particular attention to the section on the number of adoption to the US. If there are very few international adoptions to the US, you need to be aware that you are stepping off the well trod path, and you should expect a bumpy ride. If you have additional questions that aren’t answered by the US State Department country specific information, you can also contact the Consular Section at the US Embassy in that country. You can find contact information at the List of US Embassies.

I see this dilemma fairly frequently when I work with families on deciding on a country. When we dig a little deeper usually the parents find that they answered the parental preference worksheet as they thought they should, not as they truly felt. Perhaps you underrated your preference for a Caucasian child because you thought it somehow “looked bad” to prefer a child of your race. Also, it is possible that you have strongly competing preferences. You want a stable, quick, inexpensive country that places young Caucasian children. Remember, your preferences are what they are and shouldn’t be lightly dismissed, but sometimes you can’t have it all, and you have to honestly (read ruthlessly?) decide on your priorities. It often helps if you can attend gatherings with adoptive families of all hues to get a better feel for transracial adoption. Check with a local international adoption agency about playgroups or family gatherings where prospective parents are welcome. I strongly encourage you not to rush through this step in the process. (Oct. 2006)
First of all, I need to add the disclaimer that the following answer is not intended to be legal advice. The problem you face is not so much with the adoption, but with the immigration of that child. To immigrate a child to the US, and thus to gain US citizenship, you must be a US citizen, which is logical when viewed from the immigration standpoint. Your child must be given citizenship, and the only citizenship you can confer is Canadian. Therefore, you must work through the Canadian adoption and citizenship laws. The US system allows for US citizens living abroad to adopt and I can only imagine that the Canadian system would have similar provisions. Once your child has Canadian citizenship you can apply to the USCIS to allow the child to live in the US.
US law requires only that one of the prospective adoptive parents be a US citizen and it is possible for US citizens to adopt while living abroad. The main hassle is the home study. First, you have to find someone where you are living who meets the qualifications required by the placing country and the qualifications required by the US government. Not all countries specify the qualifications of the home study provider, but some do. Second, you need to find an agency that will work with families living abroad. Because of the liability requirements in the new Hague Treaty regulations, this may be a bit of a problem. This may sound like a bit of legal mumbo jumbo, but the main point is that it is indeed possible and the first step is to call a couple of reputable agencies and ask if they work with US citizens living abroad. The Child Welfare Information Gateway publishes a list of agencies that place children with U.S. Citizens living abroad. One business that provides home studies for expats is Adopt Abroad. First check with your placing adoption agency to make sure that they will accept a home study by this agency. Also, there is a yahoo group that may help: adoptionforamericansabroad . (Dec 2007)
No, adoption of Native American children is not considered a form of international adoption. Adoption of Native American children is governed by the Indian Child Welfare Act, initially passed in 1978. Adoption by non Native American families has a long and controversial history. Some estimates are that one quarter of all Indian kids were removed from their families for adoption or institutionalized care between 1958 and 1967. The Indian Child Welfare Act greatly limits this practice and states a strong preference for placement with Native American families. For more information on the Act go to
It may be possible, but it is certainly not easy. The following is a good summary of the issues.
The first place to look for information on the process and advisability of adopting from any country is the US State Department web page on country specific information. This is by far the most reliable and complete source of basic information. Be wary of commercial sites as a source of information if they are trying to sell you something (e.g. pay an application fee). Prospective adoptive parents must reside in Italy. I am often asked about adopting from a country that is not often associated with international adoption, such as a European country. There is a logical reason that most adoptions to the US come from only a few countries—availability of children in need of homes. Most developed countries (yes, I know that there are exceptions such as China and Korea) do not have a surplus of young children in need of homes. Women in developed countries often postpone child bearing, and infertility is increasingly becoming a problem. Domestic adoptions increase with infertility. Also, the social stigma against single motherhood is crumbling everywhere. In other words, the domestic adoption situation in most developed countries is remarkably similar to the US.
Most countries have older children who have been removed from their parents and are in need of homes, but only a very few allow these children to be placed outside of their country. If you are considering older children, don’t forget that the US has plenty of foster children in need of homes. To learn about these kids, go to
So much depends on you and the child, but generally the benefits to adopting an older child/toddler include:


  • You will have more information about the child’s personality and interests and can choose a child that will fit well with your family.
  • You will probably have more medical and developmental information on the child enabling an IA doctor to give you a more realistic picture of her health risks.
  • The child will be able to take care of herself better than a younger child.
  • No diapers and bottles.
  • Fewer years of daycare expenses.
  • The child will be able to fit into your lifestyle sooner. (Go skiing, go to movies, garden, and help with chores.)
  • You still get to experience lots of first: first taste of ice cream, first Christmas with presents, and first bike ride.
  • Your child may be able to share his past with you—the good, the bad, and the ugly—allowing you to help him integrate his past into his present.
  • Your daughter may be able to relate more quickly to a pre-schooler who can play and talk (or least will be able to talk as soon as he learns English)

The disadvantages are that your child has a past and comes to you with the baggage of her past. You have no control over the quality of her prior care and often have little knowledge of her past unless she is able to tell you. She will have habits and behaviors already established, some good, and some not so good. Also, if you are adopting a child from another country, the child will have already established fluency in another language and will have to learn English. This transition time when you and the child are not able to communicate can be frustrating to both parent and child since you are both used to being able to communicate.

I interviewed Mary Hopkins-Best, author of Toddler Adoption, for my radio show, "Creating a Family". To hear this interview go to the Radio Page and click on the Jan.23, 2008 show.

Let me put in a plug for adopting a child from the US foster system. There are likely not a lot of healthy preschool age children outside of sibling groups, but it is still possible to find a 3-4 year old especially if you can accept certain special needs. The adoption is free and monthly adoption assistance may even be available to help with living expenses until the child is 18. To see some of the US children in foster care go to

See the Resource Guide at the back of my book for resources for adopting a preschooler or older child.

That’s a really interesting question. As you know, the law in Colombia just changed in September 2007 and one aspect of the law is that agencies can not charge for adoptions to Colombian or Colombian-American families. There is some uncertainty on what this means exactly. For example, does this mean that only the agency fee must be waived? Can you be charged for a home study? What about the immigration fees? I suspect your case is being caught up in the agency’s uncertainty of how they are supposed to proceed.


I have a couple of thoughts. Is this child at a private orphanage that only works with one agency? At this stage, it may be hard to find the answer to that question, so it may be helpful at this point to consider whether you are open to another child. If you only want to adopt this child and this is the only agency that can place this child, then you are in for a rougher, or at least longer, road. The first step would be to call the US Embassy in Colombia to ask their advice.

If you are open to working with another agency and another child, I would spread your net wide and call or email quite a few adoption agencies that place from Colombia. I suspect you will find an agency that is willing to move forward with you now even though they don’t have all the answers to how this “no charge” business is supposed to work. The best way to find these agencies is found on page 72 of the book, but I’ll summarize it here for those people who so foolishly (:-)) don’t have the book. The following websites can help you find an agency that places in a particular country.

  • The Joint Council on International Children’s Services is a membership organization of agencies that agree to abide by a set of ethical practices in international adoption. Their website lists member agencies under all the major placing countries. This is a great place to start.
  • Adoptive Families Magazine has a database searchable by country. To access the database, look under search tools and click on Adoption Program. I like this database because it allows you to specify certain search criteria such as number of years the agency has been licensed, the number of annual adoptions, and the largest country program for that agency. But at this stage it is most helpful to just include your state and the country as the search criteria.
  • Rainbow Kids lists all agencies in their database that place from a country. They have a nice feature that allows you to email all listed agencies to request information.
Many families choose to have their referral information evaluated by a doctor to help them assess the health risks of this child. Although general pediatricians may be able to help, increasingly families are turning to doctors specializing in international adoption medicine (IA doctors). The American Academy of Pediatrics has a directory of members of their Section on Adoption and Foster Care. Members of this section specialize in health issues for children adopted from abroad and keep up with new developments. Another list of IA doctors, although not necessarily member of the AAP Adoption Section, can be found at the University of Minnesota International Adoption Clinic website (click on Other Adoption Medicine Professionals). It is not necessary that the doctor be located nearby, but some families want to be able to talk with someone in person or want to be able to take their child for a post adoption evaluation to the same doctor who reviewed the referral.

I know of no IA doctor that specializes in a specific country. You do want a doctor that has evaluated quite a few kiddos from your country so make sure you include that question in your interview. Different doctors have different personalities so talk with them first to see if there is a good fit. When interviewing an IA doctor consider the following questions.
• How many adoption referrals have you evaluated? In the last year?
• How many adoption referrals have you evaluated from my country?
• How long does it usually take to have a referral evaluated if we have medical information before we travel?
• How do you arrange to review data if we receive medical information when we are in country?
• How comfortable do you feel with diagnosing FAS in a child of ___age and ______ ethnicity?
• How much do you charge and what is included? Are phone calls after the initial review included or an extra charge?
Yes, it is common to get varied reports on an agency. As with all communication over the Internet, there is no way to verify who you are communicating with or the truth of what is said. It may be a glowing post by someone working for the agency or a slanderous post by an irrational adoptive parent. Be wise and try to critically assess what you are hearing. Did the reference adopt from your country recently? Is this person being reasonable. Not all are. Are they basing their opinion on personal experience or what they’ve heard from others? Do they seem to have a vendetta? As hard as this is, it is important to not overreact to one bad reference. It would be hard to find any agency that has been in business for a while that bats 1000 all the time or hasn’t had the misfortune of a hard to please client.


I know that on some level this answer isn’t what you are looking for. You want assurance that you are making the right decision. I wish I could give you that guarantee, but my guarantee would be worthless. I can commend you on doing the research and can tell you that most people who have bad experiences didn’t do much research until after they started having trouble. (2/2008)

First, I strongly recommend that you listen to the Creating a Family show on foster care adoption. To listen, go to the Radio Page, and click on the May 14, 2008 show.


There are two basic ways to adopt from foster care. You can adopt a child who is currently available for adoption because his parent’s rights have already been terminated. There are about 115,000 children in this boat, about evenly divided between black and white, and boys and girls. Their average age is 8.6 years, but about 31 percent are under five. Many of the younger kids are part of a sibling group.

The second way to adopt from the foster care system is through what is often called the foster-adopt program. Different states call is different things, but it is usually a variation on that label. In this program, you first go through the training to become a foster parent (usually a 10-12 week course is required). The child that is placed in your home is not legally free for adoption (meaning that the parental rights have not yet been terminated) and may not become legally free for adoption since the goal is to reunite birth families where possible, or place children with extended family. The child will be available for you to adopt only when these options are not available. Usually, case workers have a feel for which children will become available for adoption and they try to place these kids in foster-adopt home, but there are no guarantees. Most of the younger children that are adopted from foster care are placed through the foster-adopt system.

Keep in mind that most states not only place foster children for adoption from the county department of social services, many also have contracts with adoption agencies to find homes for these children. To increase your odds of finding a child, it helps to check with both public and private agencies. Also, you do not have to adopt a child from your state or region. Most agencies try to keep children in the foster-adopt program nearby because parental rights are not yet terminated, but children who are currently free for adoption are often placed across state line. A wonderful resource for seeing what children are currently free for adoption throughout the country is

My rules for control battles of any sort are make them infrequent, choose very carefully, and make darn sure you win the ones you pick. Your child has control of what goes in and out of his body, so if you make potty training a power struggle, he will win and ultimately you will both lose. But, there are things you can do to help him decide that using the toilet is a good idea.


  • Don’t use pull-ups during the day. I know, I know, it’s a hassle, but a child wearing pull-ups is seldom uncomfortable when wet or dirty so has less incentive to use the potty. It helps to pick a time when you can stay at home during the first week or so that you try this. You shouldn't necessarily wait for warm weather, but boy, it sure is easier to have them outside in just their underpants when you are going through this stage.
  • Buy some special big-boy underpants and let him pick them out. They usually will pick ones with action figures or cartoon characters on them. I encouraged my kids to try to keep that character dry and clean.
  • This point is key: Don’t fuss or make a big deal when he has an accident, but matter of factly have him be the one to take off the wet underwear and wash them out. If there is a puddle on the floor get him a rag to wipe it up. He may need a little help with the poopy pants, just so he doesn’t get the mess all over the floor, and so you can make sure he has cleaned himself well.
  • Have him train a doll or stuffed animal to use the pretend toilet. Give him the words to help encourage his toy: "you'r a big boy now, so I know you want to use the potty like a big boy", "I know you will do it when you are ready", etc.
  • Make sure to use a child size potty chair. Some kids are afraid of the flushing sound, so don't worry about having him flush anything if he seems afraid.
  • Use incentives (bribes?) for when he is successful. Use whatever works for your kid: stickers, candy, etc.
  • If he seems particularly stubborn, pick a place that your child likes to go and tell him that he will need to be potty trained before he goes there. This is easier once he is out of pull-ups because he already knows he can go anywhere in pull ups. For example, tell your child that he can't go to the pool until he is using the potty because the pool doesn't want pee and poop in the water or around the pool. Do not say this in a punitive manner, just state it in a matter of fact sort of way, and let him know that you are sure he will soon be able to go to the pool.
  • With my sons, I dropped Cheerios in the potty and had them aim to sink them. They loved this. Too bad this won’t work for little girls.
  • The main idea is to stop all fussing or reminding about potty training. Turn the responsibility over to your son. In other words, remove yourself from the battle and the only one he has left to fight is himself. But also turn as much of the clean up over to him as well. If he puddles, let him wipe it up, change his clothes, and put the wet clothes in the in the laundry room. Remember, this is not as a punishment, but it is simply what needs to be done. Don't worry if he doesn't do it perfectly.
  • Relax, very few children enter kindergarten wearing diaper during the day. Nighttime wetting is a totally different matter and you'll just have to wait until his bladder matures.
  • Here are some other free resources;
Whether they are Hague accredited does not matter since Vietnam is not a Hague country, so I wouldn’t let the fact that they are not accredited worry you. There must be a Memorandum of Agreement between the US and Vietnam for adoptions between these two countries to continue.

On Jan. 28, 2008, the Department of State issued a warning to potential adoptive parents of the risk of beginning new adoptions from Vietnam at this time. The 2005 Memorandum of Agreement, required by Vietnamese law to authorize adoptions between the United States and Vietnam, expires on September 1, 2008. Negotiations on renewing this MOA are ongoing, but there is no certainty a new Agreement will be in place on September 1. The State Department indicates that they expect changes in the new MOA due to concerns about baby trafficking. “In view of the processing time required in Vietnam from placement to the Giving and Receiving Ceremony, an adoption process begun now cannot be completed before the current Agreement expires. We do not know whether the Government of Vietnam will continue to process pending cases if the current Agreement expires before a new Agreement takes effect.” To read the full warning, go to

A separate State Department FAQ on the current status of international adoptions from Vietnam can be found at, I understand that you are asking me my opinion of what will happen. I have no crystal ball, but historically the US government has tried very hard to finish adoptions of families that are “in process” when an agreement ends. If I were adopting a healthy baby, I would recommend not choosing Vietnam right now. However, you are not in that boat, and the child you are considering may well have few to no other options. It sounds like you also have few other options. If you decide to go forward, I have a few words of caution.

  • Do the same research I recommend in my book before you agree to this agency.
  • Get in writing what their refund policy is if adoptions stop.
  • Pay as you go for services provided. In other words, don’t agree to pay much money up front considering the volatile nature of Vietnamese adoptions right now.
The answer depends on a couple of things. The requirement that an agency be accredited by the State Department applies to agencies that are placing children from other countries that are also a member of the Hague Treaty on Intercountry Adoption. (Being a member basically that they have signed and ratified the treaty.) The US, in this case the receiving country, will officially be a member on April 1, 2008. The easiest way to find out if your country is a Hague member is to look at the country charts on this website. If there is not a country chart for your country, go to The chart is a little confusing to read, so focus on the "EIF" column since that will help you sift through those countries that have signed but not yet ratified. So, if your country is not a member of the Hague Treaty, then your agency does not need to be accredited and their absence from the list means nothing, other than that the Hague Treaty doesn’t apply to your adoption.


If your country is a member of the Hague Treaty, then the requirements of the Hague Treaty apply to all cases begun after April 1, 2008. It does not apply if you have filed your I-600A (Application for Advance Processing of an Orphan Petition) or I-600 (Petition to Classify an Orphan as an Immediate Relative) before April 1. Chances are good that you have already filed your I-600A, so again, you need not worry.

But if you are adopting from a Hague Treaty country, and if you have not and will not file your I-600A before April 1, 2008, and if your agency was not on the accredited list, then you will not be able to use that agency. If this agency is only providing your home study, it may be possible to continue to have them do the home study so long as the placing agency is accredited.

There is not much info in the book on independent adoption because as a general rule, I don’t recommend them. The one time I think it may make sense is in a case similar to yours when you speak the language and have good contacts with local attorneys and government officials that can help you maneuver through the system legally. Most people are not in that boat. Keep in mind that you need to be very careful that you have good ethical help and be smart about how much the total process will cost. I would strongly recommend not paying money up front. I’m sorry that I can’t be of much help to you since I really don’t know which countries allow independent adoptions.
First let me make the standard qualifier: I’m not an accountant so you will need to verify this answer with your accountant, but it is my understanding that the tax credit can either be taken:


•In the taxable year in which the competent authority enters a decree of adoption; or

•In the taxable year in which a home state enters a decree of re-adoption or otherwise recognizes the decree of the foreign-sending country, if that taxable year is one of the next two taxable years after the taxable year in which the competent authority enters the decree.

I get this information from Internal Revenue Bulletin: 2005-26 , issued June 27, 2005 (also known as Announcement 2005-45 Finality of Foreign Adoptions)
You can find this bulletin at

Your son's decree of adoption was complete in Guatemala before he came home in October 2007, therefore, the way I read the IRS bulletin, you should be able to get the tax credit of Qualified Adoption Expenses in 2007. If any accountants out there read this differently, please let me know.

I'm so sorry you are going through this. There is no simple answer. I think you have to look at what is best for you and your family first. It's kind of like the airline instruction to take care of yourself before you put the oxygen mask on your child. If you have reached the point of despondency and exhaustion then it seems like it would be time. One thought would be to take a break and just see what develops. Don't push, don't spend more money. Just let what will happen happen. But here's the important point, don't blame yourself or feel guilty. Not every adoption situation is meant to be and you are not at fault that this one isn't working out. Good luck, and know that you aren't alone.
It has always surprised me that there is not an official, comprehensive source for what agencies place kids from Korea with specific states. Korean adoption is one of the oldest international adoption programs and although, in my opinion, it is one of the best programs in the world, it grew in a hodge podge manner, and the problem you are facing is a result.


For the uninitiated, Korean international adoptions are sponsored through four independent Korean adoption agencies, rather than the Korean government. (This is one reason why Korea is not a member of the Hague Treaty on Intercountry Adoption.) Each of these Korean agencies works with specific agencies in the US. They only allow their US partner agencies to place in specific states. There is actually a logical reason for this since Korean children are placed with families under a guardianship arrangement with the US agency. The adoption is finalized in the US under the law of the state where the family is living, rather than in Korea. I list the Korean agencies and their US partner agencies under my Adoption Resources page .


Unfortunately, it is little bit more complicated, as you found out. The US agency may have a contract with another agency to place children in that state. For example, it is possible that Catholic Charities in Baltimore might facilitate the placements in Louisiana under an agreement with Catholic Charities in Louisiana, so I would suggest checking with Catholic Charities in Baltimore.

In addition, many agencies can place children with special needs in all states so if you are open to a child with special needs, contact several of the US agencies listed on my Resources page and ask what SN children they are currently trying to find homes for.

Without a doubt, the costs for Russian adoptions are soaring now, in large part because of the havoc the weak dollar is playing with the extensive travel requirements of Russia. However, of the countries you are looking at, I would still think it is the most stable. I have an adoption chart for Russia, Ukraine, and Kyrgyzstan on this website that you can look at.


From my discussions with IA doctors, most think the risk of FASD is about the same in all countries of the former Soviet Union, which of course would include Uzbekistan and Kyrgyzstan. Listen to the Creating a Family radio show on Oct. 1, which will be on FASD. My guest will be Dr. Julian Davies, one of the leading authorities on FAS and adoption. I will ask him about the prevalence of FAS or FASD in children adopted from this region. I would caution that they see far fewer kids from these countries, so a general statement like that might be less useful. I would go to the yahoo groups for adoptions from these countries and ask what parents are seeing in their referrals and hearing from IA doctors that are reviewing their referrals. Listen to the Oct. 1 Creating a Family show which will be on the risk of FAS in adoption.

Adoptions from Uzbekistan and Kyrgyzstan are still very new and you should expect a lot of unknowns and changes while in process. If you have little tolerance for uncertainty and unpredictability, I wouldn’t go with a new program.

I don’t have specific information on the prevalence of FASD in Kyrgyzstan, but based on my knowledge of other Eastern European and Central Asian countries, I would assume that it is similar to what is found in Russia. (Go to the Russia adoption chart under Country Charts). The Oct. 1 Creating a Family radio show will be on FASD and my guest will be Dr. Julian Davies, one of the leading authorities on FAS and adoption. I will ask him about the prevalence of FAS or FASD in children adopted from Kyrgyzstan.


As much as I am a huge supporter of online support groups, I would not use them as my primary source of information. I would contact several agencies that have programs in Kyrgyzstan and ask them pointed questions about the health of the children they have placed in the last year. To find an agency that works in Kyrgyzstan, I would suggest these resources.

Parent support groups: Other parents are your best source of information on selecting an agency, and support groups are the best place to find these parents. Support groups exist for each of the major placing countries. You can either attend meetings or go online. Although I’m a big believer in actual human to human contact, for finding agencies that handle adoptions from a country, online forums are just as good.

US Department of State: For countries that require agencies to be licensed or authorized, the State Department website is a good place to start. (See the Country Chart Appendix for which countries require licensing.) To access the State Department information, go to, click on Children & Family Services, under International Adoption click on Country-Specific Information and select the country. Licensed agencies are usually listed in the discussion section. This site is not always current.

Internet: Adoption websites can also help you find agencies that place children from a specific country.

  • The Joint Council on International Children’s Services is a membership organization of agencies that agree to abide by a set of ethical practices in international adoption. See discussion later in this chapter. Their website lists member agencies under all the major placing countries. This is a great place to start.
  • Adoptive Families Magazine has a searchable database by country. To access the database, look under search tools and click on Adoption Program. I like this database because it allows you to specify certain search criteria such as number of years the agency has been licensed, the number of annual adoptions, and the largest country program for that agency. But at this stage it is most helpful to just include your state and the country as the search criteria.
  • Rainbow Kids lists all agencies in their database that place from a country. They have a nice feature that allows you to email all listed agencies to request information.
Taiwan is probably not a good choice for you. You can check out the requirements on the Taiwan adoption chart under Adoption Resources. At least on the books, some orphanages may allow single women, but in practice single women are seldom allowed to adopt a healthy infant. Some orphanages may consider singles for a child with special needs or over the age of 7or 8.
I don’t know the details for international adoptions from Hong Kong or if there are specific health requirements for prospective adoptive parents. From what I understand, Hong Kong has their own international adoption laws separate from the adoption laws of China. The governmental agency that handles adoptions from Hong Kong is Adoption Unit of the Social Welfare Department. You can get some information from the US State Department website page for Hong Kong. Keep in mind that Hong Kong does not place many children for international adoption. To get more detailed information on parental health requirements, your best bet would be to contact the Hong Kong branch of International Social Service. There email address is \n This e-mail address is being protected from spambots. You need JavaScript enabled to view it


Taiwan is not a part of China, and has their own laws, including laws governing international adoption. International adoptions from Taiwan are not centralized under one government agency, and the requirements vary by orphanage. I don’t know of any specific parental health requirements. If the child is relinquished by the birth mother, she is usually given the choice to select or help select the adoptive family. This often results in excluding families with less than stellar health histories, but it is hard to predict what qualities a birth mother might be looking for in an adoptive family.

This is such a personal decision that I hesitate to voice an opinion. I can however give you some food for thought. As you say, it is very likely that your children would be only a few months apart. You didn’t say, but it is also likely that your referral will be for a girl, so the children would be the same age and same gender.


There are both short and long-term consequences to consider. In the short term, your biggest issue will be time and energy. Your adopted child will need a lot of one on one attention at the beginning to help her attach to you, and help you attach to her. You need time to stare into each other’s eyes and marvel at her perfection without interruption or worrying that you are neglecting another child. The results are rewarding, but this much attention takes time and energy. Sleep issues are very common with newly adopted children, and often continue past the first year. Your biological daughter will also be facing a huge adjustment having to share her parents. If you don’t adopt right now she would have your undivided attention. Add to all this, the usually energy and time requirements of toddlers. This will be much more work than “just” having twins.

In the long term, you need to think about how each child will be able to develop as an individual, and how you will be able to establish a separate relationship with each daughter. This is always something to think about whenever you add another child to the family, but it is exacerbated when you have two children the same age and same gender. Inevitably, one child will be “easier” for you to establish a relationship with because you may share similar strengths, interests, or temperament. The hard part is making sure you work to establish a relationship with each child regardless of ease, and I think this is easier when they aren’t the same age. Keep in mind, your adopted daughter will likely not be as easy to parent at first since you don’t know her and she doesn’t know you.

Comparisons are also a potential problem with two children the same age. Teachers, relatives, strangers, parents and the girls themselves can compare. We all go into parenting saying we would never compare our children, but the reality is that it is almost impossible not to. Comparing doesn’t mean preferring, but it can still be destructive. Your adopted daughter will probably arrive with developmental delays, and these can last for years. Even if you work hard not to compare your children, they will compare themselves. All children do. An age gap of a couple of years usually takes some of the sting out of the comparison.

And yet, even with all these complications, people are able to do it successfully. The question is whether there is any real advantage to you, your husband, and both of your daughters to do it this time. I wish you the best of luck with this decision. If you decide to postpone the referral, try to get a promise from your agency that you would be able to fit back into the queue without losing much waiting time when you decide the time is right.

I’m hearing the same rumblings and I’m also hopeful that international adoptions from Cambodia will be able to reopen soon with an ethical, well-regulated program. The latest information that I have heard was when I specifically asked Michele Bond from the Department of State’s International Adoption section about what was happening with Cambodia on the June 18, 2008 Creating a Family show. You can listen to the show on the radio page of this website. She was more optimistic about Cambodia than I thought she would be. The program closed for much of the same reasons international adoptions from Vietnam will soon close down, so the key is if the international adoption authorities in Cambodia will be able to establish the infrastructure to support and enforce ethical adoptions.
The Ministry of Women, Children and Social Welfare (WCS), the ministry in charge of international adoptions in Nepal, suspended all intercountry adoptions on May 8, 2007, pending approval of reforms of the adoption process by the Nepali Cabinet. All cases that were in process when international adoptions from Nepal closed have now been processed. On May 2, 2008, the Nepali Cabinet approved new terms and conditions to govern the intercountry adoption process, but as of yet, Nepal has not reopened to international adoption. Some of the changes include:


· Centralizing the adoption referral process under the WCS, rather than the individual orphanages.

· Increase efforts to find biological parents of abandoned children.

· Increase efforts to promote domestic adoption.

· Foreign adoption agencies must now be registered by Nepal in order to place children from Nepal.

As far as I know the following parental requirements have not been changed.

· The age difference between prospective parents and the adoptive child must be at least 30 years;

· The couple must have been married for at least 4 years prior to filing an application and be "infertile;"

· Single women between the age of 35 and 55 may also adopt. Single men may not adopt Nepalese children

Although Nepal has not reopened yet, it looks like it will, but we don’t know when. As you heard on the June 18 Creating a Family radio show, the State Department thinks it will be relatively soon, although I don’t remember the exact wording they used. You can get your dossier in line, but the problem you may have is finding an agency that is licensed by Nepal since they likely are in the process of doing this. To find an agency that has placed children from Nepal in the past and may be registering for a Nepalese license, you can look to the following resources. Make sure you specifically ask the status of their license with Nepal. In addition to working with a US adoption agency, I think prospective adoptive parents may still be able to adopt through Nepal Children’s Organization (Bal Mandir), but I don’t have any specific information on how to do this. By the way, I have much more detailed information on selecting an agency in Chapter 3 of The Complete Book of International Adoption, which should be available at your library. If you want to buy it, all you need to do is click on the copy of the book on this website. (How’s that for a soft plug?)

The following websites can help you find an agency that places in a particular country.

  • The Joint Council on International Children’s Services is a membership organization of agencies that agree to abide by a set of ethical practices in international adoption. Their website lists member agencies under all the major placing countries. This is a great place to start.
  • Adoptive Families Magazine has a database searchable by country. To access the database, look under search tools and click on Adoption Program. I like this database because it allows you to specify certain search criteria such as number of years the agency has been licensed, the number of annual adoptions, and the largest country program for that agency. But at this stage it is most helpful to just include your state and the country as the search criteria.
  • Rainbow Kids lists all agencies in their database that place from a country. They have a nice feature that allows you to email all listed agencies to request information.

For more information on adopting from Nepal, check out the following:

· The US State Dept. has information on their Nepal page. You can also email them directly at: \n This e-mail address is being protected from spambots. You need JavaScript enabled to view it

· The US Embassy in Nepal has an adoption page.

· It is possible to contact the Ministry of Women, Children and Social Welfare directly at \n This e-mail address is being protected from spambots. You need JavaScript enabled to view it , but I would suggest that you work through an agency or the State Department.

I have a list of countries that place with singles under my Adoption Resources. In this list, I tried to reflect not just whether they would consider placing with singles, but whether they are single friendly.


Try not to be discouraged: singles adopt all the time. Also, don’t let your discouragement keep you from starting the process. The only way to shorten the wait is to begin. And last, but not least, you didn’t indicate what age child you were looking for, but don’t overlook adopting from the US foster care system. I have lots of resources on that option under the Adoption Resources.

To adopt internationally and bring you child to live in the US, one parent (or in your case, the only parent) must be a US citizen. As a Canadian citizen, you would have to adopt following the Canadian immigration laws for internationally adopted children. It is an interesting fact that as an Canadian citizen, you could adopt domestically in the US either through a birth mother placement program or through our foster care system.
There is no legal mechanism to process international adoptions between the US and Vietnam right now, and that would apply to special needs adoptions as well. The bilateral agreement that governed international adoptions between the US and Vietnam has expired, and no new adoptions can take place until a new agreement has been signed. It is not up to Dr. Long, it is up to both governments to negotiate and sign a new agreement. According to the JCICS, Vietnam has just appointed a lead negotiator for this agreement.


I have also heard the rumors of a special agreement just for special needs adoptions, but in my opinion, that is unlikely. You might want to listen to the June 18 Creating a Family show with Michele Bond from the Department of State’s International Adoption section. We spent a lot of time talking about Vietnam. I join you in your prayers. There are kids who need families and families who would love to adopt them. (Sept. 24, 2008)

I think that the cause of your daughter's problems, whether alcohol related or not, is far less important now than treating the symptoms. The treatment would be the same regardless what caused the problems.


I would have her evaluated by an International Adoption doctor that sees lots of kids before you rule out a physical problem. I give resources for finding an IA doctor near where you live at my Adoption Resources page. I would ask specifically about a sensory integration type of disorder. Second, I would immediately get her in a early childhood development program, which are usually free through your county or school district.

I would also strongly consider seeing a specialist in attachment. In the meantime, I would recommend reading the following two books, both of which I have reviewed at my suggested books page under “Attachment”: The Connected Child by Dr. Karyn Purvis and Attaching in Adoption by Deborah Gray. I have interviewed both of these authors on the Creating a Family show and you can listen to those interviews at the radio page or by podcast.

I wish you luck. I firmly believe your daughter can be helped.

You raise a good point. The stereotypical “face of FAS” is easy to confuse with racial features. However, an International Adoption doctor that is trained to evaluate referral pictures for FAS features should be able to distinguish racial features from FAS features. Regardless of your child's race, this is not a diagnosis you should try to make on your own. Keep in mind, of course, that a child can be affected by maternal alcohol consumption without having the facial features. I would suggest finding an international adoption doctor that sees a lot of referrals. I list resources for finding IA doctors on my Adoption Resources page. Also, listen to the Creating a Family radio show/podcast on Oct. 1, 2008 when I interviewed Dr. Julian Davies on FAS and Adoption. He was terrific.
According to Dr. Julian Davies, a pediatrician with both the University of Washington’s Center for Adoption Medicine and their FAS Clinic, on the Oct. 1, 2008 Creating a Family radio show/podcast, the greatest damage is caused by a rapid rise in the alcohol blood levels. In other words, binge drinking is the most harmful. The timing during the pregnancy is not as clear, but research suggests that the greatest risk of brain damage occurs with binge drinking during the first trimester and the classic “face of FAS” is caused by excessive drinking on Days 19, 20, and 21.
Oh, if only it were so easy. Unfortunately, although looking for the distinctive “face of FAS” (the relatively minor facial abnormalities used to diagnosis FAS) is still the best way to help pre-adoptive parents determine the risk that their referred child will have FAS, it is not the definitive diagnosis. Doctors would love to have a record of maternal alcohol consumption in order to diagnosis this complex syndrome, but that is almost never available in any form of adoption. In international adoption, it is seldom asked and in domestic adoption, according to Dr. Julian Davies, drinking during pregnancy is grossly underreported. On the Oct. 1, 2008 Creating a Family radio show/podcast, Dr. Davies said that the facial features result from excessive alcohol consumption on Day 19, 20, and 21 of a pregnancy. If the mother did not drink during those days, it is possible for the baby to not show the stereotypical facial features, but to still be impacted. After adoption look for evidence of growth impairment and brain damage to help with a diagnosis.
Well, no doubt about it, a recent DUI or DWI certainly limits your adoption options. Your husband’s alcohol possession as a minor is likely not as much of a concern. You have several factors to consider. First, with international adoption, certain countries have specific limitations with criminal history. Other countries are more forgiving so long as they think that his drinking is not a current problem. In addition, adoption agencies may have their own prohibitions against placing with a couple with a fairly recent DUI in their past. With birth mother placement programs such as US domestic newborn adoption, birth mothers may be hesitant to place with a couple with a DUI.


This information will come out during the adoption process so you need to address it up front, and preferably before you spend any money. Call the agencies you are thinking about and specifically ask if his DUI or DWI will be a problem. Also tell them about anything that he has done since then that may be relevant, such as stopping drinking, limiting his consumption of alcohol, going to rehab or counseling, etc.

Yes, my opinion on stability increases with each passing month. We won't know for sure until more new children are referred and those adoptions finalized. No one would be happier than me for that program to flourish. There is a huge need. (Nov. 2008) 
I’m so sorry you are stuck on this merry go round. You seem to have had more than your share of bad luck. I have a couple of thoughts on your situation. First, I would not get out of the queue for China, but I think you do have good reason to worry. I don’t know all the details, but if seems to me your agency should have warned you when you applied last February that you may run into a timing problem, since the upper age for adoptive parents to adopt an non special needs child is 49. Even as of last February, I estimate 30+ months on my adoption chart for China .


The truth is that no one really knows what will happen to the waiting times for adopting from China in the future. There is some thought that once the Chinese government catches up with the backlog of dossiers that were in line before the changes to parental restrictions in May 2007, the waiting times will decrease. On the other hand, the Chinese government has indicated that they are seeing fewer baby girls abandoned, perhaps because they have various campaigns to encourage parents to keep their female infants. China is also making a push to increase domestic adoption. So, it’s anyone’s guess what will happen to Chinese adoptions in the future. We did a Creating a Family show on this topic on August 6, 2008 and you can learn more about what some experts think will happen.

Have you considered switching to the special needs (a.k.a. waiting child) program for China. Special needs can include medically correctable conditions, such as cleft palette or clubfoot. It can also include more life altering illnesses, but you can choose which conditions to consider. The waiting time for adopting a child with special needs is considerably shorter. I hope you agency has a special needs program for China so that you don’t have to change your place in line.

It is hard to guess what will happen with Bulgarian international adoptions. I still rate adoptions from Bulgaria as unstable. Although I certainly wouldn’t withdraw your dossier from China, most agencies will allow you to do a concurrent adoption from another country while your dossier continues to wind its way up the wait for China. Check out the adoption charts to see which countries would be best for you and your husband.

I suppose you have considered and ruled out adopting from the US foster care system. If not, it is certainly worth considering. The cost is minimal or free, and the waiting times vary greatly depending on what you are looking for.

You might also want to look into embryo donation/adoption. If you are in good health, you age is not necessarily a factor. However, some agencies and donating couples do restrict older moms., has the largest collection of resources for those considering embryo donation/adoption. Look under either Adoption Resources or Infertility Resources . (The information is the same on both pages.)

Well, I agree that four years with little action is asking too much--the patience of Job comes to mind. As you know, in most states you can adopt domestically through an agency or independently, often through an attorney or, in some states, a facilitator. There are several differences between an independent adoption and an agency adoption, and one of them is that usually with independent adoptions you will be required to actively seek an expectant woman that is considering making an adoption plan. Whomever you adopt through will give you specific ideas on how to “advertise” for expectant mothers, but it will probably include networking through your friends, family, church, and doctors, and advertising in local newspaper and the internet. Because of these finding expenses, independent adoptions are often more expensive.

Usually when I consult with people who have been waiting a long time with little action for a domestic adoption, I suggest that they look at what they’ve told their agency or attorney as far as risk factors, gender, or race. Often the couple is requesting a child that there is a low probability of finding. Sometimes they are correct that they should stick with these restrictions, but sometimes they are just not well informed about what the risk factors mean. Another suggestion is to look at the information you have prepared to be shown to prospective birth mothers. It could be that you need to rework it to better show yourselves off.

Since you’ve likely already spent money with this agency that you would lose if you withdrew your application, I would suggest that you ask them specifically how many children they’ve placed each year in the last four years that meet the criteria you’ve requested. How many of these women were shown your profile? What they would suggest on improving your profile. Also, read over your contract. Many do not prohibit you from proceeding concurrently with an independent adoption. You do need to think through what you would do if two birth mothers selected you.
Let’s start with international adoption. I suggest you look at the country adoption charts at (Go to adoption on the horizontal menu, and click on Adoption Charts). In your case, you will have to do a bit of reading between the lines on these charts. Usually, I tell people to start with their limiting factors such as age or marital status, but many countries will make exceptions to their stated requirements for families looking for a child with special needs. For you, the greatest limitations will be your inability for at least one of you to travel, and your strong preference to not adopt a child exposed to alcohol or drug prenatally. The countries that do not require families to travel are Korea, India, and Ethiopia. Of these three, Korea and India are less flexible on parental age, so I’d suggest looking into Ethiopia.

Of course, you should also consider domestic adoption. Since you have already adopted from the US, you are probably familiar with the process. It is possible to adopt a child with special medical needs from a private adoption, but most of these medical needs will be more severe since minor medical needs does not usually make a baby hard to place in the US. Children with medical special needs are also available from the US foster care system. As a general rule, you are not limited to your own state when adopting from foster care. I list various photolistings for children available from foster care at the Adoption Resources page of Make sure that you let the social workers know that you are adamant about not adopting a child that may be been exposed to alcohol or drugs, since this may significantly limit the children that are available to you. Good luck with this journey.
I imagine that your friend heard this story from the Creating a Family radio show. I have had several shows on attachment including:


Although it is impossible to make a diagnosis from a brief description, it sounds like your daughter is exhibiting some of the classic symptoms of a severe attachment disorder. I strongly recommend that you listen to the above mentioned shows and read over some of the free resources I list on the Attachment page under Adoption Resources. And absolutely find a therapist that is trained in adoption and attachment issues. I can tell your heart is in the right place, and I pray that you and your daughter will flourish with counseling.

Boy, this is such a hard question to answer. I feel for you! I don’t think waiting times should be the first consideration when choosing an agency. I encourage families to choose an agency that is well established in the country from which they are adopting and provides good adoption education and post adoption services. In short, I’m looking for an agency that is more focused on child welfare than child finding. However, it is possible to find a great deal of fluctuation in waiting times even amongst these type of agencies, and realistically waiting times should be a factor, if not the factor. Keep in mind that if you change agencies, you will be out the money you have already spent. Do your research on the agency with the shorter waiting times. Ask specific questions about the longest, shortest, and average wait in the last year for the age, gender and special needs you are looking for. Sometimes, the shorter wait is only an optimistic guess, and you don’t want to switch agencies for a guesstimate.
What I’m hearing is that it is slow going. Vietnam has postponed a couple of joint negotiating meetings. The process is complicated because some want Vietnam to join the Hague Treaty for Intercountry Adoptions and others think that is unrealistic in the short term. If Vietnam joins the Hague rather than negotiate a separate Memorandum of Understanding on International Adoptions with the US, then it could be years before adoptions resume because Vietnam does not have the infrastructure in place to comply with this treaty. Creating this infrastructure would likely be a good thing for the long term sustainability of international adoptions from Vietnam, but it takes time. Many of us would like to see a new bilateral agreement with many of the Hague Treaty safeguards in place, while Vietnam works toward implementing the Hague Treaty.



The Joint Council for International Children’s Services (JCICS) and U.S. Senators Mary Landrieu and Norm Coleman will send a letter to the Prime Minister of Vietnam urging Vietnam's continued participation in negotiations related to a new bilateral agreement on intercountry adoption and emphasizes the importance of Vietnam's transition to a Hague-compliant system. To support these efforts go to the Vietnam page of the JCICS website.

The homestudy is done before the adoption to evaluate your ability to parent. What exactly has to be covered in the homestudy varies by state, and can even vary by counties within a state. If you are adopting internationally, most sending countries also specify items they want addressed in the home study. For example, some states have specific bedroom size requirements for the child, some countries require that you own your own home, some counties require that you have your well water tested for EPA drinking water standards, etc.

Regardless what state you live in, the social worker will evaluate your living situation. If where you are living is unsafe for a child, then you would probably have to move before the homestudy because the social worker would have no way to make sure that you will move to some place safe before your child is born or referred. However, if your apartment is just small and not the ideal place that you would like to have, but isn’t unsafe or totally inappropriate for a baby, then you do not need to move before the homestudy, unless of course your state or sending country has a specific requirement that your current apartment doesn’t meet. You should tell the social worker that you are planning on moving to a bigger place in the same neighborhood, but he or she will be evaluating your current resident for the homestudy. You do not need to have the child’s bedroom or nursery ready for the child before the homestudy.

I am assuming you are renting your apartment. This is seldom a problem for state or county homestudy requirements, but some sending countries specify that adoptive families own their own home. I list these requirements in the country adoption charts at Before you panic, check with your agency to see if there is some way around this requirement. I have heard of countries waiving this requirement if the adoptive parents have a letter from their parents saying that they will inherit the “family house”.

I think the biggest mistake people make in anticipation of the homestudy is focusing on the evaluating aspect. Ideally, a homestudy is as much about educating you and answering your questions as it is about judging your worthiness to adopt. Remember, they aren’t looking for perfection. If they were, I would never have been allowed to adopt.
There are several ways to find basic information about adopting from a specific country. For starters, I have adoption charts for the top countries that send children for international adoption in the United States. I include information on the 25 factors I think parents should consider when choosing a country from which to adopt. I only have charts for the 18 top placing countries, so likely you won’t find a chart for your smaller sending country. I strongly encourage you to read through a couple of the adoption charts to see what type of factors you need to think about and ask questions about before you settle on a country.

The first place to look for information on the process and advisability of adopting from any country is the US State Department web page on country specific information. This is by far the most reliable and complete source of basic information. Be wary of commercial sites as a source of information if they are trying to sell you something (e.g. pay an application fee).



At the State Department site, a couple of items are of particular interest. First, pay particular attention to the section on the number of adoption to the US. If there are very few international adoptions to the US, you need to be aware that you are stepping off the well-trod path, and you should expect a bumpy ride. Second, look at the requirements for adoptive parents and make sure that you qualify. In addition, I would suggest that you contact via email the Consular Section at the US Embassy in that country. You can find contact information at the List of US Embassies. Ask questions about the length of the process, any recent road blocks that you should be aware of.

Adoption agencies don’t often have programs in the countries that send very few kids to the US. If the country is a member of the Hague Treaty on Intercountry Adoption, you will need to use an accredited US agency. If not, you may need to hire an attorney in that country to process the adoption. First, make sure that independent adoptions are legal in that country. This information should be on the US State Department page, but if you aren’t sure, ask the Consular office.


Unless you speak the language of the country, communication will be a big problem. I cannot stress enough how important it is to find an attorney that knows what she is doing. I hear a lot of horror stories from where I sit, and you must protect yourself, your heart, and your money. Ask the US Consulate Office is they know of any agencies that place from that country or any attorney in the country that do adoptions. When hiring an attorney ask specifically how many adoptions they have completed in the last year, last two years, the total cost, and the time from start to finish. Ask for references.

It will be hard to find a support group, even online, if the country places very few children for international adoption. You can always try our friends at yahoo to see if they happen to have a group. Type the word “adoption” and the country you are interested in the search window, and maybe you will get lucky. Or, if the country is near another country that has an active international adoption program, join the support group for that country. For example, many of the support groups for Guatemalan adoptions also offer information and support for other Central American countries.

Have you thought about adopting from the Philippines? I don't know how stringent they are about health of the adoptive parents, but they do give preference to families of Filipino heritage. Check out the country chart on the Philippines at Usually they do not allow gender requests, but you can always ask. I would also suggest considering the US Foster-to-Adopt program.
Yes, it is possible and it is done. The usual way this comes up is if there are not many embryos from one couple or if there is concern that not many will survive the thaw. In this case, the doctor or adoption agency may choose to thaw embryos from a different couple so that the receiving couple will have enough to transfer.
Assuming the health of the intended mom (the woman receiving the embryos) is not a factor, it is the age of the genetic mom that is used to determine the likelihood of successful implantation. In the case where the embryos were created through egg donation, it is the age of the egg donor. This question was discussed to some extent on the Jan. 28, 2009 Creating a Family show.
Well, it is possible, but I don’t generally think of the Philippines as the best place for a single woman to adopt from. I would not suggest trying to adopt from the Philippines unless you are interested in either an older child or a child with a special need.
I find that many prospective adoptive parents have concerns about open adoption. I think in some ways the term "open" is to blame. It is so very vague. "Open" can mean anything from sending an update letter once a year through your attorney or agency to actually meeting on a regular basis. The degree of openness varies and is negotiated between the birth parents and the adoptive parents.

 It is true, that almost all domestic adoptions have some degree of openness and it is also true that the more willing you are to discuss the degree of openness, the more likely that you will be chosen by a birth mother. We had a Creating a Family show on open adoption on November 12, 2008. ( I strongly suggest that you listen to this show to get a feel for how open adoption can work from the adoptive parents perspective and from a birth mother's perspective. I will tell you that most adoptive parents are far more accepting of open adoption after they have done it. Also, the research shows that openness in adoption is good for kids.

If after getting more informed about open adoption, you are still adamant that you don’t want any degree of openness, I would suggest that you consider international adoption. With most, although not all, international adoptions, there is no contact between the birth and adoptive parents. It is possible that your child will be able to connect with their birth family when they are an adult.
On the adoption charts at this website (look under the Adoption menu), I have a section on “Adequacy of Medical Reports” for each country, including China. The medical reports for China tend to be brief, but are usually more detailed for children with special needs, although the increased detail is usually limited to medical and developmental information on the specific special need. I would strongly encourage you to have this report reviewed by an International Adoption doctor that has a lot of experience looking at medical reports from China. I include information on how to find such a doctor under the Adoption Resources. You can ask your agency for more information, but in my experience when adopting from China, they may not be able to get more detail for you.
Yes, there is a way to adopt that child. The specifics might change depending on the state involved, but the basic process is usually the same. First, the county child welfare office (DSS, DYFS, or whatever it is called where you live) would take guardianship of the child. Likely, the child would be placed in a foster home while the mother’s identity is determined. Once the mother is identified (leaving out whether the police might be involved for child endangerment, attempted homicide, etc.) DYFS must first determine if it is in the best interest of the child to go back to the mother. They might decide that they need to work with the mother to help her get her act together before a decision can be made. At the same time, they would usually also try to identify the birth father and determine if it is in the best interest of the child for the birth father to have custody. If not, DYFS will almost always look to extended family members that might want to have guardianship or adopt this child. If that is not possible, then they will seek an adoptive family for the child. If the child was placed in a “foster to adopt” foster home (a family that has expressed an interest in adopting their foster children) then that family is usually considered first.
I know it sounds self serving, but the first place I’d go is to my book, The Complete Book of International Adoption: A Step-by-Step Guide to Finding Your Child. I have a complete chapter that details specifically how to go about choosing an agency. I spent a lot of time developing a step by step approach to agency selection, and it is still the best thing I've seen. The best forum I know of for asking advice from the Been There Done That crowd is the Adoption Agency Research Yahoo group. If you want to talk with someone directly or have me work through the selection process with you, schedule a consulting time with me.
First, congratulations on being cancer free for 13 years! China has very strict medical requirements, but the wording is a little strange to our Western ears. I’m sure our medical jargon would seem equally strange to them. The Chinese regulations don’t use the word “cancer”, but they imply that they will forbid placement with prospective parents that have or have ever had a cancer diagnosis, and in practice they do just that. I imagine that’s why the agency said it was an unwritten regulation.


Each country’s international adoption policy and practice are unique, and yes, other’s do have policies and restrictions that aren’t necessarily spelled out in writing. This is especially the case in countries where judges have latitude on approving adoptive parents, such as Russia. This is why I strongly urge prospective adoptive parents to choose adoption agencies that have a lot of experience placing children from their country of choice. It’s a waste of money and precious time to submit your dossier to a country that is likely to not refer a child to you. I think the agency did you a favor of steering you away from China before you spent this time and money.

Other countries have less strict health restrictions for adoptive parents, including US domestic adoption programs. No country would likely place with a parent with a “bad prognosis”, but it sounds like your prognosis is excellent and your doctor would state that in writing. Check out the country charts under Adoption at I mention when the health restrictions are strict and where judges have a lot of latitude.

Oh man, does this bring back memories. I can proudly say that they are now just memories, and that all four of my kids do their business in the potty. (Not much to be proud of since 3 of them are teens, but hey, with teens I don't get much to brag about, so humor me.) I actually wrote an article on bedwetting that got picked up by the AP and for a while, when you googled my name you would get a bunch of stuff on bed wetting. (Again, not much to brag about, but...)


Advice is worth what you pay for it, but here goes. Keep in mind that there is no perfect solution. Daytime and nighttime wetting are usually two entirely different things and should be handled differently. I’ll start with daytime wetting. First, I assume you’ve had your daughter checked by a pediatrician to make sure there is no physical problem. I know exactly what you mean about being concerned about your daughter using it as an attention getting device. It can also be used as a way of saying "I'm in charge here, not you." I give a lot of suggestions, some of which might help in your situation, at the adoption resources page under Potty Training.

Since it looks like there is a possibility of using it as an attention getting tactic, I think I'd go the pull-up route until she was dry for a week. In no way would I make it punitive, just matter of fact. “We wear pull ups until we can be dry. Don’t worry, I’m sure you’ll be ready soon.” Also, try some of the “incentivizers” I suggest under potty training on the Adoption Resources page. She should be completely responsible for any of the hassles of wetting herself (change clothes, put wet clothes in washing machine, wipe up puddle on the floor, etc.). Make sure you don’t make too big of a deal out of it and don’t be punitive

As for nighttime wetting, I am convinced after all my research that the only logical and sanity preserving approach is to let nature take its course. There is no research to show that the bed alarms work, and there is plenty of anecdotal evidence that they disrupt not only the child's sleep, but the rest of the house as well. I had two bed-wetters, and both stopped on their own when their bladder had matured and sleep patterns changed.

At 5 ½ your daughter should be taking care of herself and getting herself back to sleep in the middle of the night without waking you. We made sure we had good mattress protection (I bought the cheap ones and made sure I had an extra because we wore out a few), a pile of old large towels, and an extra blanket in their room. In the middle of the night if they woke up wet, they could put a few towels on the bed and go back to sleep or they could choose to sleep on the floor. (For whatever reason, most of my kids like to sleep on the floor so this was fine with them.) If they were prone to pee twice in the night, which most kids aren't, I would make sure that there was plastic for them to spread under them if they chose the floor. The key is that you shouldn't be awaken in the night to help. Let them brainstorm on what they need in the middle of the night to get back to sleep. (One of my kids came up with the towel idea.)

Simplify your bedding. We used a bottom fitted sheet, a washable blanket, and no bedspread. This made clean up easier in the morning and remaking the bed easier at night. In the morning, if the bed was wet, the child was responsible for stripping the bed, wiping off the mattress pad, and putting everything in the washing machine. If I was upstairs, I might help them, but not always.

I must say that we would vacillate between using pull-ups at night. I think most of the time we opted to not use them as they got older, but then I would start worrying and we would go back to them. Also, even though there is no evidence to say that it works, I would always take them to the bathroom before I went to sleep at 11:00 or so. I couldn't help feeling that it would help to get give them a fighting chance if we got every little bit out. It didn't work, but I still did it. Isn’t that the classic sign of stupidity—continuing to do what you know doesn’t work?!?

We never made a big deal out of bedwetting and we assured them that this was natural for some kids, and that they would eventually outgrow it when their bladder got bigger. They always had pull-ups and a plastic bag to put the wet pull up in for sleepovers. A friend of mine, who told me that she wet the bed until she was 13, told me that when she was almost 13, her mother told her that she could have new sheets and bed spread when she stopped wetting the bed. Apparently, that incentive helped her, because she got the bedspread within six months. When you are sure that you are not dealing with a power struggle, you might want to suggest a reward. I’d be careful with this approach though and wouldn’t suggest it anytime soon.

If you go back with your son, he will be a US citizen traveling on a US passport. The likelihood that Vietnam would try to “take him back” is so remote that it is truly not worth thinking about. The number of laws that would be broken are too numerous to mention.
For the record, I personally think that the best age for a birth country visit is somewhere around 11 and 12 years old. They are old enough to remember the trip, but still young enough to enjoy traveling with the family. Usually this age has not reached the teen angst stage, or the fairly typical adoption identity issues stage. I also think visiting their birth country might help firm up his identity as a Vietnamese-American before he enters his teen years. I’m not suggesting that this is the only age or that a homeland visit is essential to transculturally adopted kids, but if it is something you can do, it is a wonderful experience for the whole family.
We did a Creating a Family show on April 22, 2009 Sensory Processing Disorders with Carol Kranowitz, author of The Out-of-Sync Child: Recognizing and Coping with Sensory Processing. Also, I have lots of resources about SPD under Adoption Resources.


First, I would take the information from the OT evaluation back to your county/state Early Intervention program and ask for a reconsideration of getting services. Second, I would fight your insurance company arguing that SPD is a neurological problem, not a devleopmental problem, assuming neurological problems are covered by your insurance policy.

If you lose on both of these, can you afford one visit to an Occupational Therapist to get help in setting up a program that you can implement at home? The suggested therapies, especially for preschoolers, can relatively easily be incorporated into play, but it helps to be more intentional with time and specific activities. Also, read some of the books I list to add additional activities that you can incorporate easily into your day. If possible, go back to the OT every few months to see how you are doing.

I wrote about this topic and the philosophy behind it in the last chapter of The Complete Book of International Adoption: A Step-by-Step Guide to Finding Your Child, so I would first recommend that you get a copy from the library or (better yet) buy one. (smile) But I can also try to help you a bit here. It seems to me that you have what at first blush look like competing goals: helping your child attach to you and helping your child and your parents attach, but in fact may not be at odds with each other. Both parental and grandparental relationships are important. It seems from your question that your daughter is attaching well to you and your husband. By the time your parents arrive, she will have been home for over two months. If she seems to be adjusting and attaching well, I don’t think I would set too many boundaries for grandparent interactions with her, unless your parents are the overbearing type. Follow your daughter’s lead in how much she wants to warm up to her grandparents. It is important that your parents start to view your new daughter as their grandchild and that usually requires a certain amount of cuddling and care. There is nothing like a child seeking you out to tug at the heartstrings, so if it were me, I’d let them cuddle and spoil to their hearts content. I would probably let them do some of the baby/child care as well if they are eager and if your daughter is willing. You, of course, should still be the primary one to care for her, but a diaper change or bath with you nearby seems fine. You will likely see if this is confusing to your daughter by her behavior and can always scale back and explain to your parents at the time. If your parents are the “take over” type and you need to tone them down, I would explain the typical attachment cycle as it occurs in newborn (child cries, needs are met by parent, child is satified, new need arises, child cries, etc. and eventually child learns to trust parent). Tell them that with adopted kids, this cycle is disrupted, so it is important to reestablish the cycle as soon as possible. Reestablishing takes proactive and deliberate actions rather than the “natural” reactions that happen with a newborn. The child needs to form the bond with her parents first then it can be transferred to grandparents later. Stress how important their role is in her life, but that they need to wait just a bit until she is more firmly attached.
I am an adoption educator and consultant, not an agency. The Creating a Family website strives to be an independent unbiased resource for information and support. No gender specification is the new rule for Kazakhstan. I am hearing that if you have a "good" reason for wanting a specific gender (such as we have 2 sons and want a daughter), Kazakhstani officials are often receptive. The problem is that there is no guarantee so you have to go in willing to accept either gender.
I'm so sorry you are caught up in this mess. At this time no agency should be making or even promising a referral from Guatemala of a healthy baby or an older child or a child with special needs! The country is closed and no agency should be encouraging families by telling them that they will soon get a referral of any sort. It is my prayer that the country will open again, but in my opinion, this will not happen soon. I am hoping that somehow the US and Guatemala will find a way to allow the international adoption of older children or children with special needs in the interim, but this is also not likely to happen soon. The legal framework in both the US and Guatemala simply doesn't exist for this to happen and since both countries are members of the Hague Treaty on Intercountry Adoption, both countries are waiting until Guatemala can set up the infrastructure to comply with the Hague standards. It's all very frustrating, but if you want to adopt soon, I suggest that you switch countries. Many agencies that have more than one country program will allow families to switch programs without charging them the full price. Some agencies will allow the family to be placed "higher on the list" for the new country than if they were starting at the beginning, if this is applicable to the country you are considering. By the way, the homestudy cost for an update and renewal should be less than a brand new homestudy if you use the same home study preparing agency. Good luck. (May 2009)
You should absolutely do something nice for her such as bringing a small gift of appreciation. Sometimes just thinking about the enormity of what she is giving you can overwhelm you because you can think of nothing big enough or special enough to symbolize your thanks. You are right; you can never fully express your gratitude in a gift of any sort, so you have to shift your thinking. The gift will be only a small token of your thanks and is meant to help her through this next transition period in her life. The most meaningful thing you can give is the assurance that you will love her child with all your heart, and that you will do your best to raise him to become a healthy and happy adult. A letter to that affect is exactly the right gesture. I assume from your question that this will not be a very open adoption, but if it is appropriate to your past communication, you can promise to send pictures on a set schedule (once a year on his birthday, twice a year, etc.) You could also enclose a picture of you and maybe a picture of the nursery if you haven’t already shared that.


It would also be kind to bring a small gift, but not something very expensive or ostentatious. You probably know her a little, so think of something that she would like. I recommend something that will last, rather than something like clothes or perfume…perhaps a really nice picture frame, or a necklace of a heart or something else to represent love. Of course, flowers or candy can accompany the small gift. Congratulations.

I contact anywhere from 2 to 5 agencies, and sometimes support groups, to get the information for each chart. Ethiopia information varies from agency to agency. Some agencies hold fast to the two year requirement, but others tell me that Ethiopia accepts applicants that have been married one year. This may be due to the decentralized nature of the adoption process in Ethiopia. I believe two years is the more common requirement, so I will amend the chart to reflect this variance.
India never shut down, but they did implement the Hague Treaty on Intercountry Adoption. Once the US finally joined this treaty in April 2008, all adoptions between India and the US must follow the Hague Treaty requirments. The philosophy of this treaty is that all effort should be made to find adoptive parents in the child’s birth country before international adoption is considered. Therefore, India seeks first to find adoptive families living in India, then adopted families of Indian descent that have immigrated abroad. Only if adoptive parents meeting these criteria can not be found, will a child be placed with a family of non Indian heritage. Practically speaking, what this means is that most adoption agencies that place from India work primarily with adoptive families where at least one of the couple is of Indian descent or has Overseas Citizen of India (“OCI”) status. OCI families usually get younger children as a result. However, it is possible for non OCI families to adopt from India if they are open to older toddlers (2-4 years) and a longer wait.
Unemployment with substantial assets would be treated differently be different countries and would of course depend on how substantial your assets. The one word of caution I would have would be to ask a lot of questions to the agency before you spend any money towards the adoption. You need to know for sure that they have faced this situation or know the country well enough to say that being single and unemployed will not disqualify you or decrease your odds to the degree that you aren’t willing to risk the time and money. I wish you the best of luck on the job search and the adoption.
India never shut down, but they did implement the Hague Treaty on Intercountry Adoption. Once the US finally joined this treaty in April 2008, all adoptions between India and the US must follow the Hague Treaty requirments. The philosophy of this treaty is that all effort should be made to find adoptive parents in the child’s birth country before international adoption is considered. Therefore, India seeks first to find adoptive families living in India, then adopted families of Indian descent that have immigrated abroad. Only if adoptive parents meeting these criteria can not be found, will a child be placed with a family of non Indian heritage. Practically speaking, what this means is that most adoption agencies that place from India work primarily with adoptive families where at least one of the couple is of Indian descent or has Overseas Citizen of India (“OCI”) status. OCI families usually get younger children as a result. However, it is possible for non OCI families to adopt from India if they are open to older toddlers (2-4 years) and a longer wait.
Unemployment with substantial assets would be treated differently be different countries and would of course depend on how substantial your assets. The one word of caution I would have would be to ask a lot of questions to the agency before you spend any money towards the adoption. You need to know for sure that they have faced this situation or know the country well enough to say that being single and unemployed will not disqualify you or decrease your odds to the degree that you aren’t willing to risk the time and money. I wish you the best of luck on the job search and the adoption.
As you have found out, the CCAA does make exceptions to their strict family requirements for harder to place children. If CCAA has approved you, you should have absolutely no problem finding a SW to perform your homestudy. To adopt from China, you need to work with a Hague accredited agency, and this agency should be able to help you find a homestudy provider in your area. If not, go to the yahoo state adoption lists that I include under my Adoption Resources and post this question on the Virginia list. You could also contact the nearest Families with Children from China group and ask them to ask their member who performed their home study. Time is of the essence for you and this child, so make sure you are up front on the time deadlines with the home study provider at the very beginning. Good luck.
I'd like to hear your thoughts on how to be conversationally sensitive to couples that are adopting after dealing with infertility, as well as introducing my kids to others. I have the greatest respect for what they have faced, and I want to show kindness when talking to them about their adoption(s). My husband and I chose to adopt first and wanted to have bio kids as well (and adopt more!), but we did not have to deal with infertility. We adopted our oldest daughter, and became pregnant (unplanned/unexpectedly) with our son during the adoption process. So, they are 2 months apart, which conspicuously begs questions of all passers-by and total strangers, as our daughter is biracial. We are prepared and unbothered (mostly!) by those questions, but... I am constantly annoyed with people assuming we were 'unable to have kids' and 'so blessed to have "our own"' and 'oh, that always happens that you get pregnant once you decide to adopt.' Nope, we were just irresponsible during the adoption and now we have 2 wonderful "twins." I feel the need to 'pre-answer' that question of "Are they twins" or "So what's the deal here?" sometimes (in defensiveness of adoption as a FIRST choice for starting families) by saying, "NO we were not unable to have kids, we chose to adopt our daughter and then had our son 2 months after she was born." My husband thinks this comes across as very hurtful to people to may have struggled with infertility. I think he is absolutely right, and feel terrible for having said it to anyone at all, as they may never have shared their personal situations with me, I could have unknowingly stung them, perhaps even deeply hurt them. What would you say/use as an introduction of your children in this case? I want to drop the 'oh she was adopted' lingo altogether before she's old enough to hear and understand and be made to feel defined by her adoption. I also don't want to unknowingly be hurtful to anyone. Would love to hear your perspective and any advice. You do such wonderful work on your site and blog and podcast! I think you are an invaluable asset to many, many people in the adoption world. Thanks for all you do!
I am impressed and thankful that you want to be sensitive to your infertile friends. I think it helps to think through the issues/questions that may potentially come up. Because your kids are so close in age, you have a couple of asked, and unasked, questions that you are trying to "answer". First, is the question of how you have two children almost the same age that obviously don't look alike. Second, why did you adopt?

The answer to the first question is the one I would spend more time thinking about and being sure I "got right" since it affects your children and how they feel, which in my opinion needs to be your first priority. You need to be answering this question in a way that will help your children answer the question because they will be getting this question much sooner than most parents realize. Most parents of virtual twins say their children face this question on their own by kindergarten.

How you answer depends on who you are talking to and the circumstances of the conversation. A short and sweet, "We were blessed to be able to have kids both by birth and adoption; they are two moths apart" may be all that is necessary. If you need or want to go further, I see nothing wrong with saying, "We chose to adopt first, but always planned to try to have a child by birth--maybe not quite so soon. We are very lucky, as you can see."

It is really important to help your kids answer some version of “how come you have a sister/brother in the same grade but you don’t look alike and you’re not twins?” Practice with your kids by reading books (I give my suggestions at the suggested book page) and talking with them in kid appropriate language. Something along the lines that families can be made by birth and adoption, and both ways are real and normal and great. Socializing with other families that have both adopted and birth children is amazingly helpful in normalizing this idea. I once overheard my daughter talking with a friend who was the only birth child in her family. The girls were giggling and saying wouldn’t it be weird to be in a family that didn’t have both. Who would want that???

I don't think that it is necessarily hurtful to an infertile couple to realize that for some, adoption is the first choice, so long as it is not said in a manner which implies that it should be their first, second, or any choice. If they have already decided to adopt, then you can share the excitement of your adoption which in no way minimizes the agony they went through to get to this place of excitement. I share your irritation with the assumption that people only turn to adoption as a last resort when all other options have failed. I think it is OK to say “we wanted to experience the excitement, joy, and wonder of both adoption and birth, and we realize how lucky we are to have experienced both.”
One of the best is the yahoo group Adoption Agency Research. Tell them I said "Hi".
Check out the May 13, 2009 Creating a Family radio show. Nothing has improved since then, unfortunately. I don’t see Guatemala opening up any time soon, even for older or kids with special needs. I don't have a crystal ball, but I do anticipate that Guatemala will eventually reopen for international adoption, but the scale will probably remain fairly small.
There are two good sources of info on whether your wait is out of the ordinary. First, your agency should be well versed in what is typical for your region, and if your wait is not typical, they should help you determine why. Second, as you know, I'm a big believer in networking with other adoptive parents. Get on and start posting. Ues, the internet is fraught with rumors, but on the more active forums the basic truth usually comes out. Good luck.
Sure. We have done a couple of shows specifically on FAS, but they weren’t the ones Dr. Aronson was on. She was on the Jan. 30, 2008 show. The FAS show with Dr. Davies was Oct. 1, 2008, and the show on how to evaluate a referral, which discussed FAS, with Dr. Dana Johnson, was on Feb. 4, 2009. To access all these shows, Go to the radio page, then click on The Big List for the year, then click on that show.
The decision of whether to add another child to your family is intensely personal and involves mostly you, your husband, your existing children, and the potential new child. Whether we want to admit it or not, age is more than just a number. On the other hand, our concept of age is not static. I can suggest a few resources to use in helping you make this decision. The April 8, 2009 Creating a Family show was on “How old is too Old to Become a Parent”. We wrestled with some of the issues to consider. You can listen to it at the radio page of, click on the 2009 Big List or download it to you iPod from iTunes. I have also written a couple of blogs that may help, espeically the one titled "How old Is Too Old to Become a Mom". Also, we had an interesting discussion on age and parenthood last week on my wall at Facebook. Friend me (dawndavenport1) and check it out. One thought to consider: if you adopt an older child, the issues of your age would be less relevant. There are many older kids in the US foster care system and in orphanages around the world that need parents and especially could benefit from your previous parenting experience.
Being a mixed race couple will absolutely not be an obstacle to domestic or international adoption, and in fact may be an advantage, especially with domestic adoption. Although it is difficult to predict what characteristics an expectant mother might be seeking in a family to adopt her child, she might prefer a mixed race couple if her child is also mixed race. The same could be said for adopting children from foster care. Good luck.
Domestic adoption is governed by state laws and each state has different laws, but no state has a law restricting Caucasian families with a child by birth from adopting a child of any race domestically. This sounds like it is an agency policy, and not a good one at that. If you feel like you and your wife are best equipped to parent a Caucasian child, then by all means, that is the type of child you should adopt. Most agencies do not have this policy and most adoption attorneys do not have this policy. With almost all domestic infant adoptions in the US, the pregnant woman (and sometimes the biological father) decides who she wants to adopt her child. She may well want a Caucasian family and may well want her child to have an older brother. It is true that you may have a longer wait since more families are also looking for a healthy Caucasian baby. We have done a number of Creating a Family shows on domestic adoption that I think would be helpful to you. Check them out at the radio page on the Big Lists.
You ask a great question and one without an easy answer. Some countries have specific restrictions on health and others have vague restrictions and others approach it on a case by case basis. Where countries have specific restrictions, I list them in the adoption country charts on this website. These are more common in countries with a highly centralized international adoption program. It is harder to find out a specific problem will exclude you in countries that either don’t have specific restrictions or handle them on a case by case/judge by judge basis. Kazakhstan falls into this category. Your best bet is to call several agencies that have placed a large number of kids from that country and preferable work in several regions of the country and ask if your husband’s condition will be a problem and if they have worked with couples that have had similar or worse health issues.

If your husband’s condition will not interfere with his life expectancy or parenting ability and if his doctor will state this, you will likely not have a problem finding a country to adopt from. Don’t forget about domestic private adoptions and adopting from foster care. For the record, my husband also walks with a limp and had a significant length discrepancy resulting from a motorcycle accident and it was never an issue at all in our adoption.
In an ideal world you start telling your child the day she arrives. When you are blowing bubbles on her belly, you say, “I’m so glad we adopted you.” You read books on adoption to him when he’s a baby in arms and continue on up until he says he would rather read them himself. You also read books about all the different types of families there are in this world, and you share your amazement in how wonderful it is that families are families regardless how they are formed. Of course, these aren’t the only books you read to him, but in and amongst the books you own, should be a healthy assortment of adoption and family formation books.

Now, the truth is that your beloved won’t get too much out of these early talks, but you will get practice at saying the words and telling the story. There is no one time that you tell, it is a continuous telling. As your child ages, you look for opportunities to fill in pieces of the story and to elaborate on things that you glossed over. You want to send the message, that no question is off limits and that you aren’t threatened by his wanting to ask them or wanting more information on his birthparents. All of the information that you know should be shared with her, even if it is hard for you to tell. You share in a very simple terms when she is younger, but gradually fill it what you know.

Now, don’t panic, all is not lost that you haven’t begun. You simply need to start now. I list some of my favorite books and video explaining adoption to kids on the Suggested Books page under Adoption at The main disadvantage is that you are probably going to feel awkward at first, and it would have been nice to have that awkwardness when they were younger, but it’s not the end of the world.

You raise an interesting point about having different degrees of information for your children. Those of us who have combined children by birth and adoption also have this issue. I wrote a blog entry on this, rather crudely titled "Tales from a Blended Family: Swimming in Mom's Pee." There is nothing you can do but be honest. I don't know the details of your situation or even how old your children are, but one way to broach the subject is by talking about the different types of adoptions. Sometimes mommies know that they aren’t ready to be a mommy, and they make an adoption plan and pick out the family. Sometimes mommy’s and daddy’s aren’t ready, but they don’t know it. Other people cared about the children and stepped in to make sure that they had a mommy and daddy to adopt them and raise them and love them forever and ever and ever. There are books listed in suggested books for helping you share difficult information, such as drug abuse and neglect, with your child. We have also done quite a few Creating a Family radio show on how to talk with your kids about adoption. Check these two out:


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