Be Honest with Yourself
Go in knowing that children from other countries often have health and developmental delays, probably due to a lack of toys and stimulation, minimal time with their caretakers or even trouble connecting emotionally with staff members who wear surgical masks to prevent the spread of disease. That said, I remind parents that the likelihood of a child having learning disabilities or other health issues is similar whether adopting abroad or in the United States.
Learn the Lingo
I've seen the language vary from state to state and by country. A baby described as having "developmental delays" may have mild to moderate mental retardation. A child described as "active and needs a lot of attention" may have Attention Deficit Hyperactivity Disorder (ADHD). "Specials needs" may mean there are serious health issues or that the child has an older sibling and they must be adopted together.
Ask Everyone Questions
Not just the agency head. Hang around and ask the everyday foster care or orphanage workers if they've noticed any differences between the child you're hoping for and others who are waiting to be adopted. Do they know anything about the mother or her family? Ask whether the mother had any history of alcohol abuse, which could cause fetal alcohol syndrome? Get a photo so your doctor can detect subtle features that may signal problems.
Insist that the baby you plan to adopt at least has a simple newborn screen of blood tests, which spot 40 inherited rare diseases and everything from anemia to hepatitis to syphilis and tuberculosis. This is a requirement in the United States.
Bring an Expert
This can be especially helpful in deciphering medical terms in foreign adoptions. The American Academy of Pediatricians (AAP) has a directory of pediatricians who have a special interest in adoption. Many of them perform pre-adoption and post-adoption exams.
Embrace the Positive
Realize that most adopted children develop beautifully and make amazing progress once they get good nutrition, medical care and (of course) your attention and love.
Can adoptive parents get the "baby blues" too?