What are the common health, emotional, and developmental issues common to children adopted from abroad? What should parents consider before adopting internationally? In this course, we talk with Dr. Dana Johnson, Professor of Pediatrics at the University of Minnesota where he co-founded the Adoption Medicine Program in 1986. Over the course of his career, Dr. Johnson has reviewed the medical records of over 20,000 children. 

This course covers the following topics*:

96.48 (b)(1

  • What is the general process for intercountry adoption?
  1. Choose a U.S. accredited or approved adoption service provider.  Intercountry Adoption Accreditation and Maintenance Entity 
  2. Apply to USCIS to be found eligible to adopt.
  3. Be matched with a child by authorities in country.
  4. Apply to USCIS for the child to be found eligible for immigration to the United States and receive U.S. agreement to proceed with the adoption.
  5. Adopt the child in the country of origin.
  6. Obtain a U.S. immigrant visa for your child and bring your child home.
  7. Each country has a different process.
  8. Must meet the legal requirements of the country, the US government, and your state.
  9. Go to State Dept. website to get specific info on the process for the country you are considering. Click on Country Information.
  10. You can also file complaints against your agency if you have problems-  Intercountry Adoption Accreditation and Maintenance Entity 
  • What are some of the general characteristics and needs of kids waiting for adoption abroad?  

96.38 (b)(1)

  • Generally, what factors across the world lead children to be in state care and to need adoptive families?

96.38 (b)(3),(4),(5),(7); 96.48 (b)(2),(4),(5); 96.48 (c)(2)

  1. What are the most frequent medical or psychological problems you see in children adopted internationally?
  2. What are the effects of malnutrition?
  3. What are some common environmental toxins currently seen in the primary placing countries to the US and how might they impact children? Additional info may be found at World Health Organization, World Health Statistics, World Food Program.
  4. Impact on children of maternal substance abuse (alcohol, drugs). 
  5. For the main placing countries to the US how common is:
    1. Maternal substance abuse
    2. Malnutrition
    3. Emotional issues
    4. Genetic abnormalities
    5. Developmental Delay
    6. Other known health risk factors


96.38 (b)(2); 96.48 (b)(3)

  • What is the impact on a child of leaving familiar ties and surroundings?
  • What is the experience of most children leaving their family of origin?
  • What types of behaviors are typical and how do they differ by age? 

96.38 (b)(4),(5); 96.48 (b)(4),(5)

  • How does institutional care impact children?
  • How does institutionalization affect child development?
  • What types of care are you seeing in the various countries placing children for adoption?
  • Is the degree of impact worse the longer the child is in an orphanage or child welfare institution?

96.38 (b)(3),(4),(5),(7),(8); 96.48 (b)(5) 

  • What children are at the greatest risk for attachment disorders?
  • What are the symptoms of a child with attachment disorders?
  • What is the general process for children to develop attachment and emotional ties to their adoptive family?
  • How long post-adoption should you wait until you begin to worry about disordered attachment?

96.38 (b)(3),(4),(5); 96.48 (b) (3),(4),(5) 

  • What are the psychological issues children who have experienced abuse, neglect, or trauma may face?
  • What is post-traumatic stress disorder (PTSD) and what children available for international adoption are at risk for PTSD?
  • What are the symptoms of PTSD?

96.38 (a)(3); 96.48 (b)(6)

  •  The best place to get information on the country-specific laws and the adoption process is your agency and the US State Department website on intercountry adoption, in the country information section.
  • Each year the US State Department prepares an Annual Report on Intercountry Adoption that includes the length of time and cost for adoptions from specific countries. The country-specific pages at the US State Department website also has some of this information.


96.38 (b)(9); 96.48 (b)(7) 

  • What are some of the acculturation and assimilation issues children may face post international adoption?
  • How does the age and temperament of the child impact this assimilation?
  • What can families do to help their children adjust to their new country and environment?

96.48 (b)(8)

  • Post-adoption reports are an essential part of intercountry adoption. Your adoption agency should provide information on the specific reporting requirements. You can check the US State Department Intercountry Adoption website under “Country Information.”

96.38 (b)(6),(10)

Why is it better for kids to be raised in families?

*§96.48(b)(1)(2)(4) have country-specific requirements. This course covers some countries and some regions. Agencies should confirm that it covers the specific country from which the prospective adoptive parents will adopt.

*This course includes a 1-hour conversational audio lesson, a 10-question quiz, and a certificate of completion with the successful completion of the quiz at 80%. 

Your course will remain active for 180 days from purchase date.

  • $20.00

    Health, Emotional, and Developmental Issues Common to Children Adopted Internationally

    Purchase Course

This course aligns with the following regulatory requirements.

Hague Treaty on Intercountry Adoption*

 96.38 (b)(1)

 96.38 (b)(2)

 96.38 (b)(3)

 96.38 (b)(4)

 96.38 (b)(5)

 96.38 (b)(6)

 96.38 (b)(7)

 96.38 (b)(8)

 96.38 (b)(9)

 96.38 (b)(10)

 96.48 (b)(1)

 96.48 (b)(2)

 96.48 (b)(3)

 96.48 (b)(4)

 96.48 (b)(5)

 96.48 (b)(6)

 96.48 (b)(7)

 96.48 (b)(8)

 96.48 (c)(2)

*Important Information for agencies on Hague Training Requirements 

Virginia Compliance











*Important Information for agencies on Virginia core competencies.

Illinois Licensing Standard §401.520

*Important Information for agencies on Illinois Adoption Requirements.

Nebraska Licensing Requirement








*Important Information for agencies on Nebraska Adoption Requirements.