Families who adopt often find their children have complex medical, emotional and developmental needs, due in large part to significant transitions other children haven't faced. For nearly 20 years, Children's South, the Children's of Alabama location near Acton Road, has hosted The Adoption Clinic to address those needs.
For instance, a birth mother may not have had prenatal care or may have abused substances during her pregnancy. The children may have been in orphanage care or foster care. Many children have experienced emotionally difficult transitions.
"We assess our patients in three areas - medical, emotional and developmental - to make sure they are able to meet their greatest potential and overcome any difficulties they may have experienced," said Jennifer Chambers, MD, MPH & TM.
The team of professionals at the clinic distinguishes between multidisciplinary care and interdisciplinary care. "That is an important distinction for us," Chambers said. "In the case of multidisciplinary clinics, patients usually show up in one location to see specialists in different disciplines as a way to make it easier on the patient's schedule. Interdisciplinary means we work together. One of our specialists will go into the patient's room and gather information, then we conference about that information and the next specialist goes in. We have three specialists and our nurse, who knows our patients well. Together, we come up with a plan to help the child.
"The three areas of medical, emotional and developmental are very integrated in a child, and it's hard to pull out what's most important, and what is impacting the child most. You need to look at it from all three angles, so you can know what to prioritize.
"Take, for example, a case when parents suspect their child has ADHD. The clinic will check labs to make sure medical issues are not the cause of attention deficit. A family therapist will assess whether anxiety is playing a role, and an occupational therapist will test to see if sensory issues are distracting the child.
"That's an example of a case where the child has been adopted for a while. On the other hand, if they are newly adopted, they may have a myriad of difficulties. Let's say a child is newly adopted from India. The child may be malnourished; they may be developmentally delayed and they could have no attachment to their parents. We could give those parents hours and hours of homework every day, but no parent can do that. So we look at the child's list of difficulties together and prioritize what's do-able for the parents for the next three months, until we see them again."
Originally named the International Adoption Clinic, the clinic's name was changed a couple of years ago as more calls came from domestic adoptions and foster parents requesting services. The clinic works with the child's pediatrician to support their care. "If you are doing primary care, you don't have time to dive into all the issues related to adoptive care," Chambers said. "I was trying to do it as a primary care physician when I first started, and it was difficult to get everything done. That's when we decided to start the clinic."
The clinic team brings a personal perspective to their work, since several of them are adoptive parents themselves. "We aren't just treating our patients, but we are also learning how to parent our own kids effectively," Chambers said. "There is a better doctor-patient relationship when you are going through the same things as your patient. It doesn't have to be that way to offer good care, but it's a benefit we enjoy."
The clinic staff includes two pediatricians, an occupational therapist and a family therapist. "Because it takes so long to train people, we try to see everyone ourselves rather than expanding our staff. We do use specialists all over the Children's and UAB, and they know our kids well. We collaborate with plastic surgery, neurosurgery, cardiology, orthopedics, ophthalmology, ENT, neurology and others," Chambers said.
The clinic starts working with families even before they adopt by providing educational seminars. Once a family is matched with a child, the clinic also provides pre-adoption services, going over the medical files for the child to help families make a more informed final decision about adopting a particular child. Once the child is adopted, the clinic begins post-adoption services.
"It's never too late to come to clinic," Chambers said. "Even if a teen was adopted at the age of three, if they are struggling, we will do an interdisciplinary consult to figure out what's going on. There are a lot of kids struggling now because of the pandemic school changes, or maybe parents are starting to notice the difficulties more now that they are spending more alone time with their child."
Many of the clinic's original patients are now adults, allowing the team to see the difference they've been able to make in their lives. "It's very fulfilling," Chambers said.a
