Trip 1
Questions to ask when meeting a referral on day 1

Birth and Abandonment:
1. Can I get a copy of her medical file (even if it is in Russian)?
2. What is the location (name and address of hospital) and time of day she was born?
3. Was she born premature or full term?
4. What was her apgar and what were her measurements at birth. What was the opinion and observations of the attending physician?
5. How did the child come to be in the orphanage- if taken by the authorities as opposed to abandoned, why was that done- what is the family history? the social worker should have this info, and the reason for termination of parental rights is spelled out in the legal file. Was there violence, mental illness, sexual abuse in the home, how old was the child when removed from the home= all this is in the file, and must be considered in determining how emotionally intact the child will be does he or she attach to caretakers, does he or she have a concept of family, and does he or she, if old enough to know, want to be adopted. Attachment is THE MOST IMPORTANT issue.
6. Was there any history of prenatal alcohol or drug use by either parent? Did mother drink, how much and for how long, where is this child in birth order? No matter what you may be told, a maternal history of alcohol use, especially in later pregnancies, will probably mean some neurological damage.
7. Can we get any information on her parents medical history?

In the orphanage:
8. When was she transferred to the orphanage?
9. Where was she before the orphanage?
10. What was her condition when she arrived at the orphanage?
11. How long has she been in the orphanage?
12. What illnesses and diagnosis have affected her?
13. What vaccinations have been administered to her and when? If any vaccinations are missing - expect BCG (tuberculosis) at 4-6 days of life, and maybe Hepatitis B. If not - why hasn’t she received them?
14. Has she been to the hospital for any medical treatment since birth? Can we have these records?
15. Was she given any type of therapy? Can we have the reports?
16. When did the baby first roll over? Sit up? Pull up? Crawl? Babble? Say first word? Walk? Feed herself? Smile?

Now:
17. Is she on any medications? (Phenobarbital is common to sooth them)
18. What are her current measurements: Height, Weight, Head and chest Can we have records of all measurements
19. Has she done any potty training? Get clarification on what this means.
20. What is the baby home doctor’s opinion of her?
21. How does she compare to her peers physically and psychologically?
22. Does she have any allergies?
23. What is the current affect of any illnesses or allergies?
24. What is her average temperature?
25. Does she have any scars or birthmarks? What caused these? Did any shots leave marks?
26. Does she feed herself?
27. How well does she speak?
28. Does she have any relationships with caregivers (bonding)
29. Does she have a favorite toy or blanket (bonding)
30. Is she a favorite among caregivers
31. how well does she play with others
32. How does she react when left alone
33. Is she quiet and reserved or boisterous and busy?
34. Does she get scared easily?
35. Is there anything else significant about this child

Reports they have: (doctors, teachers and developmental professionals want them in order to evaluate the referral and determine poper continuity of care and services for her)
Orphanage medical chart: Monthly records for 1st year and then quarterly
Outpatient chart if she was placed after birth?
Vaccination record
Vaccinatin deferral record
Form 63
Adoptive medical
Lab reports
Consultation / evaluation reports
Transfer/discharge summary form the maternity hospital
Discharge summaries if spent time in hospital
Orphanage educational and developmental summaries (quarterly and annually)
Speech pathologist evaluation and treatment reports
School and orphanage educational and behavioral reports
Ask for as many sets of measurements as possible, including the most recent ones and re-measure yourself.


Before meeting the child to gauge if this is typical behavior
Is the baby sick right now? If so, what type of illness and what is he being medicated with?
Is the baby acting as usual today?
What is the baby’s schedule? Is now his/her time to sleep (eat, etc.)?
Has the baby recently undergone a painful procedure? What type?
Did she just wake up?
What was she doing before she visited us?
Would you bring her in with one of her favorite toys?
Would it be possible to watch a caregiver she is bonded to feed her?
If possible they would also like a picture of her being fed by her caregiver to see her swallowing development and if she maintains eye contact. Is that possible?