Adoption children's health 'neglected'

November 30, 1999 / BBC News

Children being considered for adoption are let down by a system which does not spot their medical problems, says research.

As many as six in ten have a serious medical, developmental or emotional problem - many of which are not picked up until their pre-adoption medical.

The problems identified in children at their "adoption medical" were investigated by paediatric specialist, Dr Mary Mathers.

Her research - published in the Archives of Disease in Childhood on Tuesday - indicates that 64% of children examined were identified as having serious problems.

Cerebral palsy was diagnosed in one child at his adoption medical - which is carried out at some point after the decision to find adoptive parents for the child has been made - while for another, the medical was the first time a congenital lung condition was identified.

The research was conducted on 100 adoption medicals carried out in the London borough of Greenwich from 1994-1998. She said that for many reasons - including the availability of contraception and abortion services, the social acceptability of single parenthood, and the fact that many women now chose not to have children at all - the number of babies available for adoption had fallen steadily since the early 1970s.

It found that most of the children had behavioural difficulties including high levels of aggression, anger, temper tantrums, attention seeking, mood swings, feat of change, separation anxiety, inappropriate friendliness and sexualised behaviour, immaturity and difficulty sustaining relationships with other children.

Dr Mather told BBC News Online that children in care are sometimes moved around with such frequency that their medical records can be "permanently in transit".

'Problems can go unrecognised'

She said: "Children in care don't have that all-powerful advocate of a parent, who will recognise that something is wrong, and who even if they don't get satisfaction, will press on and on until they get the help that their child needs.

"Their problems can go unrecognised for much longer than is at all necessary - especially if foster parents have no idea of their medical history."

She said that the general public and the medical profession needed to "bring themselves up to date" with what adoption now means.

She said: "Adoption is no longer about healthy babies being found for couples who cannot have children."

She said: "The children for whom substitute parents are now sought are likely to have complex physical, developmental, emotional and education needs. They are likely to have been damaged by inadequate parenting, abuse and neglect."

And she said that it was no longer sufficient to give children in care the kind of medical that was once appropriate.

Currently, a child is examined for vision, hearing, height and weight - and emotional and behavioural concerns raised by foster parents and schools are considered.

Comprehensive assessment

She said: "There needs to be a recognition of the complex problems experienced by children in care, and the impact that has on the medical care they need.

"Children like this need to have a comprehensive assessment of their health carried out. That will take time - approximately seven hours per child - and resources.

"It is a small speciality - but resources are provided for rare diseases and disorders.

"Adoption does offer a good second chance for many children - but we are now in a situation where we do not find children for parents, we have to find parents who are suitable for children with very complex needs."