Tag Archives: Adoption Resources

Considering Developmental Delays as a Special Need


“Developmental delays” is a special need commonly found in files from China. This is not a special need which has a specific diagnosis like HIV+ or albinism. Parents often have a lot of questions about what this label means. Is it a minor or more involved special need? Are these delays the sort of thing that can be overcome with the loving attention of a family and specialized therapies?

First, it’s important to note that in the early decades of international adoption, adoptive parents were often surprised to find that the babies they adopted were not meeting the normal developmental milestones. There was not a good understanding that children raised in institutions, who lack as much attention, nutrition, and stimulation as biological children, will not develop at the same rate. It was not until the late 1980’s that researchers began looking at the development of children raised in institutions. Most families beginning the process now will be probably be educated enough to know that they should expect a child raised in an institution to lose one month of development for every three months in an institution, as a very general guideline. This might look like rolling over at 6 months, sitting unassisted at 9 months, crawling at a year, and walking sometime between 18-24 months.

It is because of this that some parents have the mistaken idea that developmental delays in a file is an easy need because these are simply “orphanage delays” that the child will overcome during the first months or years home. Developmental delay in a file means the child is more delayed in development than their (already delayed) orphanage peers. I cannot stress enough that this is not a standard label slapped on to every child’s file.

Parents who are expecting minor delays which will be quickly overcome are often caught off guard when presented with a child who has delays which are much greater than anticipated. Jen writes “I had heard stories of institutionalized kids coming home to their forever family and overcoming so many of their delays. I was optimistic and ready to welcome my son into my heart and our family forever . . . Those first two weeks with him in China were confusing, stressful and scary.  Honestly, I thought my life was over. I cried every night to sleep. I even had thoughts of not bringing him home.”

Much of the information parents will encounter in process like shared family stories, or even information from agencies such as this recent blog post on an agency blog, gives the impression that this is the case for most children, maybe throwing in a short line at the end about how sometimes the delays are permanent. It is important for families to consider the full range of possibilities when deciding whether or not to adopt a child with developmental delays. 

What does it mean when China uses the “developmental delays” label? There are several possibilities.

  • The child could have the developmental delay label because they have a medical diagnosis which causes those delays. Children with serious heart conditions or children with unrepaired cleft palate who are not receiving adequate nutrition are two examples of special needs where developmental delays can be an additional label in the file.
  • The child could have an undiagnosed need which causes the delays. Cerebral palsy is one condition which is sometimes diagnosed once home in children with the developmental delay label. Genetic syndromes are not commonly diagnosed in files from China, but with chromosomal testing becoming more standard, it is not unusual for children with general developmental delays to be diagnosed with a specific chromosomal deletion or duplication once home.
  • Some children really do need more individual love and care than they get in an institution to develop, even in the “best” orphanages. They have the equivalent to ‘failure to thrive.’ These children do often overcome their delays once they are placed in a family and after receiving targeted therapies.
  • Finally, some children may have lifelong developmental delays but never receive a specific diagnosis once home, even after chromosomal testing.

488047_10151353375486943_180755832_nDevelopmental delays is such a catch-all label that you cannot generalize about an outcome. Without knowing the reason a child is nonverbal, you can’t speculate whether he or she will learn to talk after speech therapy. Even children with the same diagnosis can have different outcomes. For example, about 25% of people with cerebral palsy are nonverbal. If you are open to developmental delays as a special need, you need be open to the entire range of outcomes, including the possibility that your child will need lifelong care. It is essential to have a flexible attitude and the ability to cheer on your child’s successes without comparing him or her to their peers of the same age.

Shecki from Greatly Blessed shared how her idea of what developmental delays meant versus the reality with her son:

“When considering any special need, you should think of the worst case scenario, and determine whether your family could handle that or not.

When I considered “delays,” tacked on to the end of Luke’s primary special need (which, ironically, aside from one specialist appointment has been a non issue), I thought “worst case scenario” would be that he’d still be a little behind when he was school age, and would need an IEP to help him get through school with his peers.  Never in my wildest imaginings did I think that “delays” meant he would not walk, speak, or toilet train, and that he would not be in a regular classroom at all.

The long and the short of it is, we took a risk, never really believing, or even suspecting, things would turn out as they have.”

If you are considering developmental delays as a special need, you should ask yourself some of the same general questions you would ask about any need:

  • Can we meet the medical needs of this child?
  • What are the resources in our area for physical, occupational, speech, and/or feeding therapy?
  • What is our insurance coverage for those therapies?
  • How much time do we available for medical appointments, therapies, and working with our child at home?

On an almost daily basis, someone will ask in a forum “We are reviewing the file of a 3/4/5 year old who isn’t walking/talking. Has anyone adopted a child with similar delays who overcame them?” I have to tell you that you are asking the wrong question. It does not matter how many other children overcame their delays. It only matters if this specific child will and no one in the world can tell you that. The question you to ask yourself is if you would love and cherish this child as a part of your family as they are right now, as presented in the file, or if you really only comfortable with the potentially improved child.


Five Reasons to (Still) Adopt from China

Last November for National Adoption Month, I gave five reasons to choose China to adopt from. Since then, two of those reasons are no longer part of the China program. I thought I should update it this year to let you know that despite recent program changes, the China program is *still* a great option.

November is National Adoption Month! I thought I would kick off the celebration by giving some reasons why China’s adoption program might be a good fit for your family.

1. The process is streamlined and predictable. Unlike adopting from foster care, domestic infant adoption, or programs from some (but not all) other countries, the China program has a clearly defined timeline of steps. Most families will bring home a child 12-18 months after they begin the process. Many people switch to the China program after a failed attempt at adopting through another program, so the stability is appealing.

2. You have the ability to choose your child’s age, gender, and the special needs you are comfortable with. You will not be assigned a child, nor will you be penalized for declining a file which you do not feel is a good fit for your family.

3.Travel is a single two week trip and only one parent is required to travel. Some countries require multiple trips or a lengthy stay in country to complete the adoption. While this gradual approach is undoubtedly better for the child or children being adopted, the fact is that many families could not adopt if that were a requirement. China’s travel requirement is one which most families can meet.

4. The China program still has generous eligibility guidelines. While the guidelines are now more restrictive than previously, the upper age limit is 5-10 years higher than many programs. Allowing five children in the home is more than other programs such as Thailand, South Korea, or India. China’s criteria for single parents or couples with a single divorce in their marital history are more generous than the former guidelines.

5. The China program is well established and stable. Some people have been concerned that the recent changes might indicate an upcoming closure of the program. On the contrary, China has regularly made updates to their program every 3-5 years. This is one of the aspects of the program which has helped it to continue going strong for more than 20 years. Nearly 80,000 children have been adopted to the US from China, far more than any other placing country. Of the other four top placing countries, only the Korean program remains open to American parents now that Russia, Guatemala, and Ethiopia have closed.

If you are just beginning your adoption journey and found this post helpful, you might consider buying my book which has all of this information and more, including several chapters on travel.

Updated: Evaluating agency fee schedules

I posted a version of this blog post earlier in the year. Since that time I have continued to research agency fee schedules. Since this is a very important topic, I have revised the post to include more agency information.


Although I have already written about evaluating the amount of fees a potential agency charges, I have recently run into a few situations that made me think I should take a closer look at the aspect of *when* the fees are charged. Here some situations I have discussed with people within the past few weeks:

  • A family which had paid all of the agency fees before their homestudy was completed. The agency was barred from international adoptions and the family has lost the money they paid.
  • A family which applied to a particular agency because the agency was going to receive the file of a child they wanted to adopt. The agency was upfront about the fact that the family was not guaranteed to receive the child’s file. Another family ended up with that child’s referral, but because the first family had already paid several thousand dollars in fees, they ended up staying with the agency.
  • A family which applied to an agency but decided to change to another after reading some negative reviews. Although they knew they would lose the non-refundable application fee, they were shocked to be informed that because their application had been approved they owed a $2000 “service fee” even though absolutely nothing had been done by the agency.
  • A family found a child profile they were interested in on the “shared list” section of an agency advocacy site. The agency informed them that if they applied to the agency, they would help them find the file. The file was with another agency which refused to transfer, but now that the family had committed to the first agency by paying fees they didn’t have the freedom to switch to the agency which actually held the file.
  • I am aware of two different families who applied to an agency (they used different agencies) and started a home study but through different circumstances became ineligible to adopt before the home study was completed. Both families had paid an initial agency fee of around $5000 but both agencies refused to give even a partial refund.

We all know that adoption is expensive. Families are prepared to pay the cost of the adoption, but they usually don’t have the funds to lose $3000-$6000 if they start over with another agency. The timing of WHEN you pay the fees can give you flexibility if the first agency you work with does not turn out to be the best fit for whatever reason. I looked up the fee schedules (or tried to) for over 30 different adoption agencies with China programs. Let’s look at what I learned so you can make an informed decision when choosing an agency.

IMG_0179Fee Schedules– When I gave agency red flags, not posting a fee schedule on the agency website was one of the items I listed. A full third of agencies did not have the fee schedule available on their website or required I give personal information to receive it. Many of these agencies are the ones who do not have a good reputation. Some agencies only gave a general estimate for the costs of the China program without listing individual fees or gave fees without a timeline. The good news is that 20 agencies had at least a general breakdown of fees and when to expect to pay them. I’m sticking with my suggestion that if you don’t find a fee schedule on an agency website, don’t use them. There are plenty of agencies that give you the information you need to make an informed decision.

Application fees– Application fees ranged from $200 to $800. Application fees are not refundable. If you are considering an agency because of a waiting child, very few agencies will require an application fee to view a file. Most agencies can and will locate specific files for you free of charge because they hope to gain you as a client.

Home study– It came as a surprise to me to find that some agencies are expecting fee payment before the home study is complete. Remember that the purpose of a home study is to determine that you are eligible to adopt. Certainly most families pass the home study, but I would be hesitant to work with an agency which expects payment before you have been determined eligible to adopt.

Application approval/Contract signing– Of the agencies which had a payment that could be due before the home study was approved, most had the first payment tied to when the application was accepted or when the agency contract was signed. This fee was around $3000 with most of the agencies.  If this is the case with the agency you want to work with, consider not formally applying or signing the contract until after your home study is complete. The agency can review the home study and make changes once they have accepted you into the program. This is probably not going to work if the placing agency is also doing your home study, but it would give you the freedom to switch if you find a child at a different agency during the home study process.

Number of agency fees– It is most common for agencies to have three fees. These were typically tied to home study acceptance, referral or dossier submission, and a travel and/or post placement fee after the dossier is submitted but before travel. Here is my full tally:

  • Agencies with no fee posted: 10
  • Agencies with 1 comprehensive fee: 2
  • Agencies with 2 fees: 6
  • Agencies with 3 fees: 12
  • Agencies with 4 fees: 3
  • Agencies which required fee payment before the home study is finalized: 5

If you are not looking at an agency because you are pursuing a particular waiting child, it is beneficial to look closely at the fee schedule of potential agencies. Especially if you are anticipating submitting your dossier first to be matched with a LID child, choosing an agency which has multiple fees spaced out throughout the process will give you maximum flexibility if you end up switching agencies later. It is very common for families to begin the process intending to adopt a LID child but to find a waiting child through an advocacy group or site during the process. You might feel sure you will stay with an agency, but giving yourself flexibility is still a good idea.

Conclusion– My suggestions if you are choosing an agency:

  • Look for a detailed fee schedule to be easily available on the agency’s website.
  • Do not pay more than the application fee before your home study is approved.
  • Ask potential agencies if you can make payments on the fees or if it must be paid in full at the time it is due.
  • Ask for your agency’s refund policy. Does it vary if you voluntarily leave the agency versus if you are no longer eligible to adopt? Get the answer in writing.

If you are just beginning your adoption journey and found this post helpful, you might consider buying my book which has all of this information and more, including several chapters on travel.

10 Pieces of advice for older child adoption


Debbie is the mother of two children adopted at an older age. She posted the following in a group for those considering older child adoption. She has allowed me to share on my blog as a resource.

In light of current events in my life, I’ve engaged in a great deal of soul-searching about our older child adoptions, and the effect on our family and marriage. I thought, what would I want to share, what things do I feel we did “right” vs “wrong”, what would we have done different knowing what we know now? What did we learn (or being quite frank, mostly me through these groups, reading, research, etc) from these last five years? So here goes…

1. Adopting an older child means bringing a person into your home whose personality is SET. One must be willing to take them as they ARE, not how you hope they will be.

2. Understand with older kids, healthy physically does mean healthy emotionally.

3. Don’t make your current children or yourself “act better” than usual to make things “easier” for the new child; be natural from the start.

4. Files are meant to promote the child, so they will often embellish or even eliminate the truth. Read between the lines. Be skeptical, yet hopeful.

5. The more information you can gather, the more people who’ve met the child, the more pictures and video you can obtain, the better.

6. Before you travel, discuss and write down a plan if x, y, or z happens. Decide you are a parenting TEAM. If you have different parenting styles, discuss it, hash it out. A teen will test you, figure out if you can be “played” against one another. Older kids come from a place of survival in a harsh system, no matter how “good” the orphanage is. Think about whether your marriage can take it…or not.

7. Support each other, especially if the child prefers one over the other. Listen. Don’t “check out” of parenting.

8. Understand this may be the hardest thing you might have ever done. There will be days you are on your knees in either prayer or thankfulness, often in the same day or even hour.

9. Your other kids still need you too. They are adjusting as well to the new dynamic.

10. Have some basic rules in place from Day 1, especially in regards to electronics, the internet, and QQ (a Chinese app kind of like Facebook). Monitor communication if you can until you can be sure it is healthy communication.

I can look back now and see all the moments we could have handled better but I can also see how hard we tried as well. Our efforts were mostly rejected by our son adopted at age 13, but we and he survived (he lives on his own now and we communicate), and went on to apply all that we learned with our new daughter (adopted at age 9), who is amazing by the way! We chose not to adopt a teen again, having learned where our personal strengths and weaknesses lie.

I hope these words are helpful in some small way; I just wanted to share my thoughts.

Using the Guangzhou subway

These directions with photos were compiled by Amy, who was recently in Guangzhou. You can read more detailed directions (but without pictures) on how to take the subway from the China Hotel to Shamian Island in this post by Elizabeth at Ordinary Time. Yvette at Bringing Home Holland has a post on how to get to the Safari Park from the China Hotel which includes pictures, but is from 2011.

So from the Garden, you walk out the front door and to the right and will find a station almost directly in front of the hotel. Take the escalator down. The China Hotel also has a subway station adjacent, next to the 7-11.

Once you are in, you will come to a bank of ticket machines (look similar to an atm). There is a green button on the bottom right of the screen to change to English, if you wish.


You choose, from the bottom, the line you wish to get off at. Then you touch the station you wish to get off (ex. We got off on Beijing Lu to walk to the Pearl River cruise).

If you have more than one person in your party, then touch the number at the right to get tickets for all (if you have a really large group you may have to make multiple transactions).

Then simply deposit your money. It does not take 1 yuan bills, only 1 yuan coins and larger bills (think small bills). For us to go to the cruise was 3 yuan each, one way. Shamian island was 4 yuan each one way.

Once your money is deposited, green coins are dispensed (like a vending machine). Collect your coins and go to the set of “gates” You simply touch your coin to a little pad thing (watch the locals), the gate opens, and you walk through.

Follow the signs to your train. Once you’ve reached the train platform, look and see which one you need. There are large signs that list each stop along the route. Find the train going your direction and wait in line.

For most destinations, you will change trains. Simply follow the signs and choose the correct train once at the platform.

Once on the trains there is a map of stops, as well as, a flashing sign that lets you know the next stop of the train.















When you reach your destination, follow the signs to exit. Just before you go through the “gates” again, look for the large sign to tell you whether you need exit a, b, c, etc.

When you exit, you will deposit your green coin and leave. When you start your journey back, you will do it all over again.

Google maps is your friend. It will show you the stop where you need to exit. Take a screen shot and you can always ask locals to help once you emerge from the subway. Ask at your hotel concierge desk for a subway map. You can also find a metro map online here, along with detailed information about the various lines. Have fun and enjoy.

June 2017 China program guideline changes

The CCCWA has released the new parent eligibility guidelines, effective immediately June 30, 2017. These guidelines were published yesterday in several locations such as Rainbow Kids, No Hands But Ours, and RedThread Advocates. I waited a day to report because I knew there would be many questions as to how to interpret the new guidelines. Agencies have now had clarification, so what is in the post reflects how agencies have been told the guidelines will be interpreted. Please note that some of these clarifications might change over the next few weeks as agencies figure out the nuances. I will update as things become more definite.

Here are the guidelines:

  • Age– Parents must be at least 30. No more than 50 years age difference between the child and the youngest parent. This is the same as the previous requirement.
  • Length of marriage– Couples need to be married for 2 years for a first marriage or only 1 divorce. If there are two divorces in the history, the couple needs to be married for 5 years. Years cohabiting can count toward the marriage. This is actually more generous than the previous guideline which required 5 years of marriage for any history of divorce and did not officially say that time cohabiting counted.
  • Health– (1) Use of medication for “mental disorder” such as anxiety or depression is still allowed under the new guidelines. It is now explicitly stated that a psychological exam is required. (2) History of cancer has again appeared in the guidelines. You must be cancer free for 3 years for skin, breast, testicular, or thyroid cancer. Other types of cancer require 5 years cancer free. (3) Adoptive parents who have dwarfism themselves can only adopt from China if they adopt a child with the same condition, making official the previously unofficial policy.
  • BMI– The BMI requirement remains under 40 in order to be eligible to adopt.
  • Financial requirements– This remains a net worth of $80,000 for families plus an income of $10,000 per household member including the adopted child. The net worth is $100,000 for single parents, plus an additional $10,000 per household member above married parents. The 12/2014 guideline included a mention of “relaxing” in the case where the family did not meet the net worth requirement but were above the “local average living standards” which has now been omitted. The new guidelines say that the requirements could be relaxed for foreigners living in China. Many families were only able to qualify because they were given a cost of living waiver, so the loss of this will have a significant impact.
  • Number of children in the home– Perhaps the most significant change is that families must not have more than 5 minors (under 18) in the home or only 2 for single parents. In addition, the youngest child in the home should be at least 3 years old at time of LID. The age of the 3 year old or a minor turning 18 is determined by what age they are at the time of LOI or LID, whichever is first.
  • Frequency of adoption– There should be a year from the adoption date of the first adoption until “current adoption application date” to begin a second adoption. The current application date is submitting LOI. This means reusing a dossier is no longer an option.
  • Adopting multiple children– Previously China allowed families to adopt two unrelated children at the same time, sometimes more depending on the circumstances. The guideline says “In principle, [parents] should adopt 1 child from China at a time.” It does make an exception for twins or siblings. Adopting two unrelated children at once was a very popular option for many families. The loss of this option will also have a significant impact.
  • Singles– Two requirements regarding singles adopting were removed from the previous guidelines. One was that the age difference between a single parent and the child they are adopting cannot be greater than 45 years. The other stated that the single parent must not have children younger than age 6 in the home. Presumably this means that the requirements are now the same as married families in those areas, so this is an improvement.
  • Expatriates– American citizens residing outside of the US must live in a country which is part of the Hague agreement or has an inter-country adoption program with China.

If you are currently in process to adopt from China but no longer qualify, here is how this will effect you:

  • If you have LOA and are working towards travel—> Your process will continue normally
  • If you have a LID, PA, and are waiting for LOA—->Your process will continue normally
  • If you have PA but do not yet have a dossier logged in—->Your PA will be honored and you can continue the process
  • If you have a dossier logged in but do not yet have a match—–>You will still be able to be matched because you qualified at the time your dossier was logged in.
  • If you had started the process but are not matched nor have a dossier logged in—->You are no longer eligible for the China program
  • If your agency has you matched to a “pre-release” file but you do not have a dossier logged in—–>I have not heard this clarified specifically, but since you cannot send a LOI until the file has officially been released, I think you will not be allowed to adopt because this falls under no PA, no LID

Will the CCCWA start granting waivers again for the harder to place kids?

We will have to wait and see on that. We can hope that with the stricter guidelines, there will be some leeway as there was previously.

What about the partnerships? 

This document only contained adoptive parent eligibility requirements. Agencies are expecting information on the future of partnerships to be released separately, at some time in the near future.

Why did China make these changes? So many kids won’t get families now that you can’t adopt two at once, reuse your dossier, or adopt if you are a large family!

At the beginning of the document, China stated that this criteria is “in order to further promote the scientific and standardized level of inter-country adoption, and implement our working principle “everything for the children.” As far as I’m aware, adopting two at once was only an option in the US so they might see eliminating that as standardizing the level of inter-country adoption. This could also refer to bringing their requirements in alignment with those of other countries. If you look at the requirements of other country programs you will find that most say you can adopt a single child, specify a maximum number of children in the home, do not allow you to adopt with a baby or toddler in the home, and say that you must wait 1 or 2 years between adoptions.

These are common requirements because they are in alignment with what is considered best social work practices. Adopting a single child at a time and having over a year between adoptions allows the parents to focus on the physical and emotional needs of their new child. The same goes for not allowing an adoption with a child under age three in the home. The requirements state that “Parents should have enough time and energy to take care of the minors in the home, including the prospective adoptee.” Babies and toddlers require a lot of focused attention, the same as newly adopted children. A family who has six in the home who are spread out over a large age range will qualify sooner than a family with six under the age of five, which I have seen happen when families with young children adopt multiple children at once and have back to back adoptions.

It is very difficult to realize that you are no longer eligible to adopt from China. These new guidelines mean that our own family is no longer eligible. Even though we had no plans to adopt again, choosing not to adopt feels different from China saying you do not have the option. For many families it feels as if China is saying their family is no longer good enough, even though prior to this week you were good enough. People are looking at the children who would not be in their family if these policies had been in place previously and wondering why China now feels it isn’t in their child’s interest to be there. I understand all of these feeling. This is really hard for those families who love China and who love the children there who need families.

However, we have to keep in mind that China does not have to have an international adoption program at all. We do not have any entitlement to their children. The new rules are much closer to the rules they have had in place for the majority of the program. We have heard that China is very concerned about the amount of disruptions and dissolutions. Every single week, there are families who travel to China but decide not to adopt the child they were in process for. Perhaps China has concluded that the experiment in looser guidelines did not have good outcomes. That view might be oversimplified (certainly the special needs of the children now are greater than they were seven years ago), but even so, they are making this decision because they feel it is in the best interest of the children they place. I know many wonderful adoptive families who have more than six children, have young children, or who have adopted multiple unrelated children at once who disagree, but in the end, we have to choose to be thankful for the great number of children who were able to find families before China decided to restrict the parent criteria.

If you would like to consider another country’s adoption program, I would suggest you check program requirements at the US State Department website. Be sure to see how many adoptions occur from that country per year. A very low number indicates it is difficult to adopt from, even if an agency might say it is a good option. You can check program eligibility requirements and find agencies who have a program with that country at Rainbow Kids. For example, if you are no longer eligible to adopt from China because of family size, you might want to look at Poland, Hong Kong, Colombia, or Bulgaria.



Heading off problems in the early days home

You’ve been dreaming of bringing your child home for months, but those early days and weeks together are often very challenging. Your friends and family keep asking you how things are going. Somehow, admitting that your child hasn’t transitioned seamlessly into your family can feel like defeat. It is very common for families to be asking themselves “Did we just make the biggest mistake of our lives?” Here are some ways to prepare for and cope with early problems. These are all things which you hopefully learned during your required adoption education, but it can be difficult to remember when you’re in the thick of it.

*Expect your child to have more medical issues than their file indicated. Children often have minor medical diagnoses that aren’t reported, extreme dental decay, or issues which are incidental to their special need such as difficulty eating for a child with an open cleft palate. Make sure you have educated yourself about your child’s special need, are in contact with other parents who have adopted a child with the same special need for support, and have a way to contact a medical professional while you are in China in case you need a consult.

*Be prepared for your child to be immature for his age. A general rule would be to expect your child to act half of their legal age. Expect your 3 year old to act like an 18 month old or an 8 year old like a 4 year old. If you have biological children, avoid comparing your new child’s development to your children at the same age. Let him develop in his own time, and only compare him to himself. My 5 year old is so behind verbally, but when I look at his progress over the past three years I can see that he has consistently made slow and steady progress.

*Before you travel, refresh your memory on typical orphanage behaviors and the common reactions children have to being handed over to new parents without warning. I suggest the following resources:

*Have a plan for aggressive behaviors towards yourself or other children in your home. I think the biggest thing for people who bring home a new child with other children in the home is that we are hardwired to be very protective of the other children. If your new child pushes your toddler down the stairs, Mama bears says “That kid needs to be gone NOW!” Have a plan in mind for mild to moderate aggression, like biting, kicking, or shoving, towards your other children. Be prepared for an extended time period of jealousy or conflict between your newly adopted child and another child in your home, especially if they are close in age. They might be thick as thieves, but be prepared for the worst case scenario.

Even if your child is not physically aggressive, they can still have very challenging behavior. Defiance and testing boundaries are completely normal. This behavior can be because your child is trying to exert control at a time when she has no control over her life or an attempt to push you away. A child who has lost all of his previously caregivers will not have any idea you will be permanent. Unconsciously, he feels it’s better to chase you away to get the inevitable abandonment over sooner rather than later when he feels attached to you.

*Finally, what wears people down is an extended period of high stress.

  • Have a support system in place. Now is the time to lean on others who offer to help with food, cleaning, transporting children to activities, or whatever makes life easier.
  • Do not hesitate to avoid seeing or talking to people who are causing you stress. This is a time when emotions are running high all around. You can smooth over family relationships once things are more settled at home.
  • Your social worker is one of your best resources. Don’t wait too long to call her up to ask for suggestions.
  • Don’t neglect yourself during this time where you are focused on your new child, her behaviors or medical issues.
  • Stay on top of self care. Don’t say “We have to cocoon” when you really need to get out of the house or lose your sanity.
  • Keep an eye out for depression and address it as soon as possible.
  • Marital conflict is common, too. Don’t be afraid to have a few counseling sessions.


If you are in country or newly home, please try not to panic about these things. You are not alone. These are normal and expected, but that does not make it easy. Get some help, make a plan, and keep putting one foot in front of the other. Things will look very different six months from now and even more different a year from now.

Post Adoption Documents

Following up on the post placement reports post, this post is an overview of all of the documents you will receive after the adoption and how to obtain important US documents. This post was co-written with my friend Judy, who wrote up the original version available in the China Adoption Questions group. This and more information is included in the Mine in China book.

In China
In province, you will receive the:

  • Chinese Birth Certificate (white folder, in Chinese, with translation)
  • Abandonment Decree (white folder, in Chinese, with translation)
  • Adoption Decree (pretty red folder, in Chinese and English)

You will often receive multiple copies of the birth certificate and abandonment decree. They are sometimes marked with an A and B on the front to make it easier for you to know which is which since the white folders are identical on the outside.

You will also receive your child’s Chinese passport in their Chinese name, usually on your last day in province, although sometimes it will be forwarded to you in Guangzhou. After the medical in Guangzhou, a US immigration entry visa will be added to the Chinese passport. Consider the Chinese passport a single use passport only. It can not be used again once the child has passed through immigration onto US soil. However, keep the passport in a safe place when you get home, more on that later.

On your way home, before you get on the plane, you will receive a sealed brown folder. Do not lose it, do not open it. Put it in your carry on and hand it to the immigration officer at your port of entry. It contains copies of all the USCIS paperwork and copies of the birth certificate, abandonment decree and adoption decree. You can receive these documents back at a later date if you file form G-884, Request For Return of Original Documents.

You will also receive a Hague Adoption Certificate. This certifies that your adoption has been completed in accordance with the Hague convention governing adoption.

Social Security Card
After you return home, you MAY receive a social security card with your child’s Chinese name on it in the mail about 2 weeks after arriving home. Do not be alarmed if you do not receive one, even if you checked the magic box on your paperwork. The arrival of the social security card is entirely dependent on factors outside of any rational understanding and the mystery, like adoption gremlins, is something best accepted as part of the wonders of adoption.

If you receive a social security card (with the Chinese name on it) in the mail, feel blessed and use it in good faith. This is your child’s social security number and will never change. You will sit tight until the Certificate of Citizenship (CoC) arrives. If you DON’T receive a social security card in the mail in a couple of weeks, again, do not be alarmed. You can sit tight and wait for the Certificate of Citizenship to arrive or if you need a social security number right away, you can go to your local Social Security office to get a card in the Chinese name. It’s your choice, based on your medical insurance and tax needs.

If you go to the Social Security office before the Certificate of Citizenship arrives, take with you the Chinese birth certificate, adoption decree, child’s Chinese passport, and your ID. The Chinese passport can serve as a second proof of the child’s birthdate and theoretically the IR-4/IH-4 visa will serve as proof of citizenship. If you do this, you will need to make a second trip after the Certificate of Citizenship arrives to change the name and register your child as an American citizen if they don’t accept the IR-3/IH-3 visa.

If you choose to wait for the Certificate of Citizenship to go to the Social Security office for a social security card in your child’s new legal name, you will need to take the following:
 Chinese birth certificate, adoption decree, Certificate of Citizenship, and your ID. You don’t need to take your child, although some offices will tell you otherwise. You also only need one parent to go. It is not uncommon for the person at the Social Security office to have no idea what they are doing. Print off the criteria from the Social Security website to show the person if they object to your documents. Ask to speak with a manager if you continue to have problems.

Certificate of Citizenship (CoC)
Your Certificate of Citizenship will arrive 6 – 12 weeks after you arrive home. Keep it on your radar – they can get lost in the mail, and I understand now someone needs to sign for it, so keep an eye out for missed delivery slips.

According to USCIS, if it has been 50 days since you entered the US with your child but your Certificate of Citizenship has not arrived, you can use the following contact information to check on the status:

U.S. Citizenship and Immigration Services
Buffalo District Office (NER, D02)
306 Delaware Avenue
Buffalo, NY  14202

or Child-Citizenship-Act@uscis.dhs.gov

You may also call 1-800-375-5283. You have to provide them with your reference number (listed on the child’s passport) and other simple identifying info. However, they will probably simply say that they are behind on processing so you should continue to wait. If you need the Certificate of Citizenship sooner, don’t hesitate to get your Congressperson or Senator involved. That’s their job, to help constituents navigate government officialdom.

If you have lost your child’s Certificate of Citizenship, form N-565 and $555 will get you a new copy.

Note: When I did an image search for Certificate of Citizenship there were many images of actual CoCs from adoptive parent blogs including birthdates and addresses clearly visible. I know this sounds obvious, but do not post photos of your child’s legal documents online without covering personal information.

US Birth Certificate and/or Delayed Registration of Foreign Birth and/or Re-Adoption
Once you get the Certificate of Citizenship, you will need to get a US birth certificate or equivalent (which in most states is called a Delayed Registration of Foreign Birth or Foreign Birth Registration). Whatever it is called in your state, you will want to get this. In case of loss or damage, it’s a lot easier and faster to replace the US birth certificate than it is to replace the Chinese birth certificate. Also, you’ll get less hassle when you go to register your child for school or he/she applies for a driver’s license or college or job or any other circumstance where a birth certificate is required. Just trust me on this. Every state has different rules about getting the US birth certificate, some states it’s as easy as submitting a form, some document copies, and a check for $25 to juvenile court, and some states require you to re-adopt. You will need to look up your state’s rules, or check with your homestudy social worker for more details. Childwelfare.gov has a listing of state statutes, but it is from 2014 so it might be outdated.

US Passport
At some point, you will want to get a US passport for your child. This serves as an important additional proof of citizenship. Passports are more portable than the Certificate of Citizenship and far cheaper to replace. Information on obtaining a passport is found on this State Department page on the US Child Citizenship Act of 2000. Note that you will have to send original documents when you file for a passport. This includes your child’s Chinese birth certificate and Certificate of Citizenship. If you need the passport before you receive your child’s Certificate of Citizenship you can send your child’s Chinese passport because the the IR-4/IH-4 visa serves as proof of citizenship. The documents you send will be mailed back separately from the passport. You will typically receive them 1 to 7 days after the passport, so don’t panic when only the passport shows up in your mailbox. 

For passport renewals, you no longer need to send the Chinese birth certificate and Certificate of Citizenship. I was able to renew my adoptee’s passport in 2022 with a state issued birth certificate and state issued adoption document so you can now use these if you have completed the process for these in your state. 

Nullifying the Chinese Passport

Upon your child’s first application for a tourist visa for a visit back to China, you will need to send both your child’s US passport AND your child’s Chinese passport. You will receive both back. When the embassy affixes the Chinese tourist visa to your child’s US passport, they will also stamp and puncture the Chinese passport to nullify it. Don’t worry if you misplace the Chinese passport. You can still get your child a visa to go back to China, but it may take longer and you might have to provide more documentation.

DO NOT, under any circumstances, leave the US on the child’s Chinese passport once they have entered through US immigration. Your child will not be allowed back into the US without a lot of hoop jumping and questions. If anything involving the police or hospitals or other officials were to happen during your travel abroad, the situation for your child would be handled according to the treaties and laws applying to Chinese citizens. The US embassy would not be contacted, and would not be able to intervene on your child’s behalf, even if they were contacted. If you know that you will be traveling abroad, it is imperative that you obtain a US passport for your child.

China Post Placement Reports

You might think that once you’re home, the paperwork is over. Sadly, that is not the case although it will not reach dossier levels of paperwork. Besides obtaining vital documents for your child such as a Social Security card, US passport, and state issued birth certificate, you also have an obligation to send post placement reports to China at required times for the next few years. MLJ Adoptions has a good post giving a general explanation of post placement reports, but this post will address reports for China specifically.

It is important to complete the post placement reports for a few different reasons. Firstly, you agreed to do so when you adopted from China. Secondly, it reflects on your agency and on other adoptive parents. You might have seen agencies advertise that they are ranked #1 or #2 by China. One of the criteria China uses to rank agencies the percentage of the agency’s families which submit post placement reports. Finally, China will not approve you to adopt again if you are missing any post placement reports.

If a large number of families do not submit reports, it could even affect the future of the China program. The State Department found that not submitting post placement reports was a factor in the programs of Kazakhstan and Guatemala, both of which are closed to Americans. Many feel that the changes China made in the post placement report schedule two years ago were a direct result of the Reuters “re-homing” investigation. China wants to know that the children they place with American families are being well cared for.

Because agencies want families to submit the post placement reports, many now require that families pay the costs upfront. Requiring a deposit which will be returned after all of the reports have been submitted is also common. Some still have the option of paying as you go, although this makes it tempting to skip in order to save money. Often a homestudy agency will charge $300-$500. You might have to pay mileage for the social worker, too. If your homestudy agency has closed or you have moved, you still have the responsibility to find a new agency to conduct and write up the post placement visit. If your placing agency has shut down, you should find a new placing agency to submit the report for you.

There are two different timelines for the required post placement reports. If your travel approval was issued before January 1, 2015, your schedule is:

  • 1 month
  • 6 month
  • 1 year
  • 2 years*
  • 3 years*
  • 5 years*

If your travel approval was issued after January 1, 2015, your schedule is:

  • 6 month
  • 1 year
  • 2 years
  • 3 years*
  • 4 years*
  • 5 years*

Although the 1 month report is no longer required by China, many agencies require it so they can check in on families sooner to find problems early. Report times marked by an asterisk are ones which the parents may self-report, so no meeting with a social worker is required. If you have adopted both before and after January 1, 2015, you will be using both schedules so you have to keep track of which child is on which schedule. Post placement reports typically include an update on the child’s health and development, current photos, and if the child is over the age of ten, an essay written by the child. It is best to contact your placing agency directly for their requirements. They should be able to provide you with a template.

As of April 1, 2021 parents will be required to submit five photos/video directly to the CCCWA annually until their child turns 18. A written report is optional.

I hope this post has cleared up any confusion. Post placement reports are an important part of the adoption process even though your child is home.

Understanding Waivers in the China Program

As I wrote in A new year . . . a new China program? there were several changes in December 2016–some official and others unofficial. Although these changes have been in place for a couple of months now, people still find them confusing. Waivers seem to be the aspect that people have the most questions about.

A waiver is when a family or person who does not meet all of China’s criteria is granted permission to adopt. For example, China used to say that anyone on medication for depression or anxiety was not eligible to adopt. However, many people in that situation adopted through the China program anyway because China granted them a waiver. It sometimes came with stipulations, such as adopting a special focus child rather than a LID designated child, or that the person have a psychological exam to make sure their mental health was sufficient to parent.

According to my understanding, a waiver is not a formal part of the adoption process. You do not draft a letter, sign and notarize it, and send it to China. Rather, agency personnel will inquire at the CCCWA about individual cases to see if it is likely they would be granted permission to adopt. For this reason, some people are interested in adopting again, but they don’t really know if they had a waiver the first time they adopted.

In December 2014, China changed their requirements to make official many of the situations where waivers were commonly granted. Among these new guidelines changes included:

  • Instead of setting an upper age limit of 50, the requirement is now that there should not be more than 50 years difference between the younger spouse and the child. For single parents, the age difference is capped at 45 years.
  • Instead of limiting the family size to 5 children under age 18 in the home, the number of children cap was eliminated entirely. However, as of December 2016 no families with more than 10 children under 18 in the home have been approved.
  • While the guidelines still state that adoptive parents should not have “mental disorder,” the following statement was added: “In the adoption by a couple, if they have such illness with minor symptom (sic) and are under good control by taking a small dose of medicine, they will be exempt from this limitation.”
  • Similarly, serious health conditions which affect one spouse now have the caveat: “In the adoption by a couple, if one party is completely healthy and the other suffers any of such diseases but is under good control after treatment, they will be exempt from this limitation.”
  • Finally, regarding the income and new worth requirements, China stated that “For PAPs whose family per capita annual income and family net worth does not meet the requirements . . . but is above the local average living standards, the limitation can be relaxed accordingly if they can provide valid certification.

What this means is that if you take a low does of medication for anxiety or depression, you do not need a waiver and are eligible to adopt from China. If a married couple is 62 and 60 years of age, they do not need a waiver as long as they are adopting a child between 10-13 years of age. If one spouse has a condition such as epilepsy or has cancer in their medical history, you do not need a waiver if your spouse is in good health and you are therefore eligible to adopt from China. Unfortunately, a BMI of over 40 does not fall under this “healthy spouse” category, even if the other spouse has a BMI under 40. At this time, both the marriage length and BMI requirements remain unchanged. If you do not meet these requirements, there is really nothing to do but wait to see if waivers begin to be granted again in a few months.

Red Thread Advocates, in conjunction with WACAP, has compiled this information in a great chart. You can see what the guideline is, whether a waiver is necessary, and in come cases whether waivers were likely or unlikely to be granted in the past. I have been given permission to post the charts below.