Dr. Sharon McKee knew she had big shoes to fill when she accepted the job as pediatrician in Akron Children’s Oak Adoptive Health Center in 2014. Founded in 2004, the center recently celebrated its 10th anniversary and also said goodbye to its long-time medical director, Dr. Ellen Kempf, who retired in late 2014.
“Oak Adoptive Health Center was started back in 2004 when international adoptions were at their peak,” said Dr. McKee. “Families would return home and have difficulty finding care for the unique issues these children presented.”
The number of international adoptions has decreased over the years as a result of political and economic influences. Countries like Russia are now completely closed to adoption.
“Ninety-five percent of the children we see in the center are from China,” she said. “The majority of them have special medical or developmental needs.”
Dr. McKee spends about 20 hours a week at the center doing pre-adoption consults and developmental and medical assessments. On Monday and Thursdays evenings she sees patients at Akron Children’s pediatrician office (ACHP) in Green.
Today begins with a pre-adoption consult with a couple from Hudson. The couple, who already has 3 biological children under the age of 8, met with Dr. McKee last September regarding a 5-year-old Chinese boy they have committed to adopt.
Recently another child has become available and they are meeting with Dr. McKee today to assess the scope of his medical needs.
“This couple has always known they wanted to adopt 2 children, and they wanted the kids to be relatively close in age so they can bond and communicate with each other,” said Dr. McKee. “When this 4-year-old boy, also from China, became available, they asked me to look over his medical records.”
Depending on the orphanage or adoption agency, medical records, lab work, X-rays, CT scans and even video may be available to the adoptive family. This information allows Dr. McKee to assess the scope of a child’s medical needs and whether he is a good fit for the family.
“My assessment is only as good as the records I receive and how they are translated,” she said. “I always tell parents there could be some surprises when they get the child home, but I do my best with the information I’m given.”
Dr. McKee also consults with other medical specialists when a child’s condition is outside her realm of expertise. In today’s case she has already consulted with urology, cardiology and ophthalmology.
She explains that the little boy looks to have had a surgical repair to a genital abnormality called hypospadias. More concerning is the boy’s left-sided ptosis, or droopy eye, which could indicate vision problems.
“You always wonder what caused the ptosis,” she said. “It could be nerve damage or trauma from birth. He also appears to have a crossed eye. His visual acuity could affect his learning down the road.”
Dr. McKee finishes reviewing his medical record from a year ago and advises the couple to ask their agency if they can get any up-to-date information on the health of the boy.
“All I can do is offer my medical opinion based off what I know and give them a realistic picture of what to expect,” she said.
Her next patient is 4-year-old Noah from China. Noah has only been in the U.S. for about 6 weeks. He suffers from muscle weakness and spinal atrophy and is wheelchair bound.
Noah’s 3-hour appointment is referred to as a triad assessment because it involves 3 different components – an assessment by developmental specialist Liz Rebadow, a medical exam by Dr. McKee and a behavioral evaluation by psychologist Vince deGeorge.
Dr. McKee peeks in on Liz and Noah as they get started. She makes note of how he holds his head, when he gets tired and when he starts to slump to one side.
Liz is performing a battelle test, which looks at Noah’s receptive, expressive and cognitive abilities.
She gives Noah 2 pictures. “Which one do you drink coffee out of?” she asks.
“I don’t drink coffee,” he responds in fluent English. The room erupts in laughter.
“Noah is a charmer,” said Kelsey, Noah’s mom. “Everywhere we go people gravitate toward him.”
She explains that because of Noah’s advanced medical needs he was fortunate to be placed in a group foster home in China where he attended school, went on outings and received medical care.
Noah aces pretty much every task Liz gives him.
“With Noah approaching school age these tests help us know if he needs interventions or an IEP (individualized education program),” said Dr. McKee.
Kelsey and her husband, who had seen photos and video before adopting Noah, knew what they were getting into.
“We knew he was cognitively on the ball,” she said. “Once we knew that, we felt we could handle his physical limitations. We just fell in love with him.”
Noah recites his alphabet, plays with an airplane, writes his Chinese name down on a piece of paper, and stacks blocks.
While Liz and Noah continue their session, Dr. McKee asks Kelsey about what tasks Noah can do for himself.
“Noah can brush his own teeth, feed himself, drink from a cup, blow his nose and wash his hands,” she said. “He needs my help getting dressed.”
Once Liz completes her assessment, Dr. McKee takes Noah and Kelsey next door to the patient exam room where she checks him over and asks mom more questions about bathroom habits, sleep routines, swallowing and respiratory function. She reviews his blood titers and antibodies, which indicate any vaccines he may still need.
Dr. McKee explains to Kelsey that she will likely repeat some tests to ensure accuracy.
Noah lies on the table so Dr. McKee can listen to his heart and lungs and check his eyes, ears, nose and throat. She gives Noah the stethoscope so he can hear his own heartbeat.
“Do you hear it?” she asks.
“Yes. Boom, boom, boom,” he answers.
She straightens out his legs to check his reflexes.
“Hey Noah, does anything hurt?” she asks.
Noah complains that his feet hurt when he has to point or flex them.
Dr. McKee tickles the bottom of his foot which sends him into a fit of giggles.
Kelsey explains that they just ordered a power chair for Noah, which will give him more freedom in his mobility.
Noah will soon start physical and occupational therapy to work on maintaining what mobility he has and stretching and strengthening his muscles.
Dr. McKee tells Kelsey that their final appointment today will be with Dr. deGeorge, who will discuss any concerns she has over attachment issues.
“If I’m very concerned about a family’s ability to bond I will usually sit in on this session, but I don’t see a need for that today,” she said.
When Noah enters Dr. deGeorge’s office he immediately gravitates to a table with toys in the corner. While he plays with a set of toy dinosaurs, Dr. deGeorge asks Kelsey if she has any concerns about anything.
“Things have been very smooth,” said Kelsey. “With 2 other adopted children at home I feel like I know what to watch for.”
“What do you hope to get out of our session?” he asks.
“To learn about all of the services available to us to help Noah reach his full potential,” she responds.
Dr. deGeorge offers information about finding support groups, camps and getting in contact with Noah’s future school district.
Kelsey and Noah will be back to see the team at the center in 6 months to see where things are – physically, emotionally and developmentally.
“Generally we follow a patient for at least a year and longer if we deem necessary,” said Dr. McKee. “Dr. deGeorge has a little more continuity with these kids because oftentimes they go through stages where they experience different emotional and behavioral issues as they age.”
“We’ve been so pleased with the services here,” said Kelsey. “We are very grateful this place exists.”
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