Screening Protocols

Beakers

We recommend a visit to the Adoption Medicine Clinic where our team, which includes pediatric and developmental specialists, will provide a comprehensive evaluation of your child. Our areas of expertise include interpretation of lab screens and assessment of immunization status based on the child's country of origin and medical history. By doing these labs in our clinic, we can often avoid repeated needle sticks to draw the blood specimen for the tests.

Foster Care

  • Viral
    • Hepatitis B (SAg, Sab )
    • Hepatitis C Ab
    • HIV 1 and 2 Ab
  • Bacterial
    • Syphilis screening (antitreponemal Ab, RPR or VDRL)
    • Tuberculin skin test (TST) if less than 2 years old
    • QuantiFERON blood test if 2 years old or older
    • Urine GC/Chlamydia (if concern for sexual abuse)
  • General Health Screening
    • Complete blood count with differential
    • Vitamin D total
    • Iron panel including C-reactive protein and ferritin
    • Thyroid stimulating hormone (TSH) and free thyroxin (free T4)
    • Lead
  • Intellectual disability, syndromic features
    • Microarray
    • Fragile X testing- most females, especially with history of other family members with ID.  Males with ID +/or physical exam findings, FMRX testing is recommended
    • Consider MRI of the head
    • Consider referral to Neurology
    • Consider referral to Genetics
  • Abdominal pain: consider bowel cleanout
  • Short stature: Igf/BP3, celiac screening
  • Precocious Puberty: Bone age +/- High sensitivity Estradiol, LH (ICMA) and FSH, 17-OH Progesterone
  • Other consultants: 
    • Chronic snoring: consider trial of inhaled corticosteroid, ENT referral.
    • Sleep: try behavioral modifications first, then consider Melatonin 0.1-0.5 mg qhs, consider clonidine. Consider sleep study for persistent poor sleep or severe issues.
    • Pediatric GI: visit if severe, resistant constipation. Consider eosinophilic esophagitis if symptomatic.
    • Pediatric psychology and pediatric neuropsychology
    • Pediatric psychiatry   
    • Pediatric occupational therapy: visit to assess for developmental milestones and sensory processing as well as make home and school recommendations.
    • Consider referral to Pediatric Audiology and Ophthalmology.

Note: Ig, immunoglobulin; IgM, immunoglobulin M, Ab, antibody; SAg, surface antigen, SAb, surface antibody; RPR, Rapid Plasma Reagin test.

Source: Adapted from Eckerle, J. K., Howard, C. R., & John, C. C. (2013). Infections in internationally adopted children. Pediatric Clinics60(2), 487-505.

https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-foster-care-america/