Recommended Screening Tests and Evaluations

As written by Dr. Jane Aronson for Pediatric Annals, Vol. 29, No 4, April 2000

The following article describes what screening tests and evaluations your child should have when you return home.

Once the child has arrived an initial visit to the doctor should ideally occur within 10-14 days, unless the child has an acute illness and then a sick visit is obviously imperative within 24 hours. Once the family knows their travel dates, they can schedule the adoption consultation appointment long in advance since the initial visit should take at least an hour or more.

There is consensus among adoption medicine specialists about the screening tests that should be performed on every child adopted from abroad initially. For a discussion of some of these screening test recommendations, consult the 2000 Redbook of Pediatric Infectious Diseases. The list in the Redbook should be viewed as just a guideline. The list below is a more comprehensive list recommended by most adoption medicine specialists in the U.S.

Antibody titers for children over one year of age who have a credible vaccine record from the country of origin:

- diphtheria antibodies

- tetanus antibodies

- polio neutralizing antibodies for type 1,2, 3

- chicken pox antibodies (varicella antibodies)

- measles, mumps, rubella (depends on the country and reliability of these vaccines)


Hepatitis B serology (Hep B surface antibody, Hep B surface antigen, Hep B core antibody total)


Hep A total with reflex to IgM in case of acute infection

Syphilis serology (RPR, FTA-ABS)

lead level (venous)

Complete Blood count with differential and platelets

Hemoglobin electrophoresis

Thyroid screen


Free T4

Total T4

Rickets screen

Alkaline phosphatase



Liver Enzymes



Kidney Function tests

BUN, Creatinine

All toddlers from China should have audiology (hearing screen), vision screen with a pediatric ophthalmologist

Dental visit with a pediatric dentist should be done by 18 months of age

TB skin test on arrival and again 6 months from the time of arrival (If the BCG site is not healed wait until it is healed and if more than a few months is needed for healing, consider having a chest x-ray; then do the PPD (TB skin test) when the BCG scar is completely healed

Consider repeating HIV, Hep B, C 6 months after arrival (lengthy incubation periods and exposure just at the time of departure)

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