U of M clinic helps adoptive families

Oliver is an adorable, dark-haired toddler with an easy smile. He and his parents, Briana and Matt Begansky, are in an exam room playing with a ball and eating animal crackers. They're waiting for a nurse from the International Adoption Clinic.

Oliver spent the first 18 months of his life in a Chinese orphanage. It's rare that a male Chinese child is put up for adoption. In fact, statistics show that 95 percent of Chinese children adopted in the U.S. are female.

Oliver is missing part of his left foot. His mother Briana says the clinic founder, Dr. Dana Johnson, thinks that could be the reason Oliver's birth family felt they couldn't care for him.

"Our son is missing the toes on one of his feet. (Dr. Johnson) said this child will be probably running and playing just like any other child," says Begansky. "He may just need a little insert in his shoe. And we were thrilled to have that information so quickly, and we were able to move forward."

The Beganskys traveled to China and brought Oliver home to Minnesota on Dec. 21, 2005.

Oliver's father, Matt Begansky, says he has concerns similar to any other new father, but the clinic helps him to be aware of some special issues his son might have.

"Just generally what to expect in terms of attachment, and tips on setting boundaries and being sensitive to how he was brought up," says Matt Begansky. "Instead of having a timeout, it's a sensitive timeout -- holding him in my lap. Instead of putting him in a room and closing the door, because that's what the first year and a half was like for him. Just being understanding of what his experience has been."

Oliver Begansky's medical file was one of nearly 2,000 pre-adoption files Dr. Johnson evaluated last year. He says he spends hours looking for medical clues to make sure he can get an accurate picture of the child's well-being.

Johnson says setting expectations is critical when you're developing a lifelong relationship between parent and child.

"What we like to do is to make sure that families adopt children that they feel capable of parenting. That's what our advice is directed towards -- do you have what is needed to take care of this child?" says Johnson. "If they don't, then they have the opportunity to say, 'You know, we're not the parents for this child.' We want to place that child in the best possible environment so that child can reach their maximum potential."

Dr. Johnson knows what it's like to be a new parent, trying to glean information from the medical records of a child born in a foreign country. He and his wife adopted their son, Gabriel, 20 years ago from an orphanage in Calcutta. That experience prompted Johnson, a neonatologist, to create the International Adoption Clinic in 1986.

Seeing how children blossom when they get into an adoptive home just as been an extraordinary experience for me.

Johnson says 20 years ago the clinic was unique, because it took a multi-disciplinary approach to treating children. The clinic is a sort of one-stop shop for parents, utilizing the expertise of physical therapists, audiologists, pediatricians, psychiatrists and any other specialists an adoptive child may require.

When the clinic was founded in 1986 it was focused on caring for the physical health of children. But that began to change in the 1990s, as Americans began adopting children from Romanian orphanages.

Experts say those children were emotionally and mentally mistreated. Babies were left alone, without any stimulation, for long periods of time, and were often tied to their cribs.

"So these kids are often sensory-seeking --they'll throw themselves into a wall, they'll spin around in chairs, they'll look hyperactive," says Dr. Johnson. "As soon as you get them to an occupational therapist who has experience in this area, and starts on therapy and aids that might increase sensory stimuli for these kids -- wearing tight clothing, having a period of time before a test to go out and exercise, spinning on a little platform -- suddenly, they're a new child."

Natalie and Zachary Girard, two active 4-year-olds, are drawing on a chalkboard in an examination room. Their parents, Mary and Steven Girard, adopted them in 2003 from a Russian orphanage. The family is back at the International Adoption Clinic for a routine followup visit.

Mary Girard says Dr. Johnson reviewed Natalie and Zachary's medical evaluations while she was in Russia finalizing the adoptions. She says Dr. Johnson's practical advice made a big difference during her initial meeting with Zachary in a Russian orphanage.

Mary Girard says Zachary was very quiet, and she was unsure if he could even walk.

"We explained that to Dr. Johnson and he said, 'You might want to consider getting him into an environment where he's comfortable.' It turns out the room where we always met him was a room where they brought him for a medical review or an immunization. So he was petrified in the room," says Mary Girard. "He suggested we see him in the room where he sleeps and eats, and the orphanage was absolutely fine in doing that. As soon as we got him in the room he took off across the floor running after a ball."

"It was simple things like that -- when you're in a foreign country you don't know what to do --what should we do to make a good decision here. That was wonderful," says Girard.

Dr. Johnson says helping to strengthen the bonds in new families is a rewarding part of his job, and the main mission of the International Adoption Clinic.

"As a pediatrician, intellectually I know that a family is a great place for a child to be. But I don't think I really realized how critical a nurturing environment is in a child until I saw what happened to kids who weren't in that situation," says Johnson. "Just seeing how children blossom when they get into an adoptive home just as been an extraordinary experience for me."

The International Adoption Clinic is advising doctors who are following Minnesota's model and starting similar clinics around the nation. The specialty has been recognized by the American Academy of Pediatrics, and more than 200 doctors are now adoption specialists. In the U.S. this year, 20,000 international adoptions will take place.

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