Children's Hospital Colorado

How We Work at the International Adoption Clinic

At Children’s Hospital Colorado, we treat the big things, the small things and everything in between.



International adoption and orphanage life create unique challenges to children that can affect their health, growth, behavior and development. Our International Adoption Clinic (IAC) team has professional expertise in global health issues, infectious diseases and the unique developmental and behavioral challenges faced by children who are adopted from abroad. In short, we understand how international adoption works and we want to help you adjust to life as a family back home.

The International Adoption Clinic care team

Pediatrician and pediatric nurse practitioner

A general pediatrician and pediatric nurse practitioner will review any medical records that you have and discuss your child's growth and overall health. They will also address questions about nutrition, infectious illnesses, immunizations or any other health concerns. They will perform a physical exam during the visit.

Their assessment works to identify the specific environmental, nutritional and infectious risks that many internationally adopted children face, as well as to determine what immunizations your child needs and whether they require any additional referrals to other subspecialty clinics.

Occupational therapist

Our occupational therapist (OT) helps children develop and improve skills needed for daily living and working. The OT will check your child's fine motor skills to assess how your child is using their hands in play and for other tasks. The OT will also do a screening for feeding and oral motor skills and evaluate how well your child is able to use their senses.

OT screening is important for several reasons. First, feeding can be a challenge when internationally adopted children first come home. Their former feeding techniques conformed to cultural and orphanage norms, which can lead to difficulties with oral motor skills such as chewing and swallowing. For example, babies are often fed through large nipples with big holes, preventing them from learning to suck or swallow correctly, and toddlers are often encouraged to eat quickly. There can be anxiety around feeding, resulting in hoarding, pocketing or overeating. We help parents learn to offer reassurance and avoid stress around feeding, because feeding is an attachment behavior.

Internationally adopted children are also at high risk for sensory difficulties, which can result in attention problems, impulsivity, irritability and excitability. All of our providers work together with families to address these issues if they arise, but our OT is especially focused on these concerns.

Physical therapist

Our physical therapist (PT) will spend time with your child looking at how they move. The PT will check your child's muscle strength, quality of movement and level of development in gross motor skills like rolling, crawling, sitting, walking, running and climbing.

The PT can then recommend whether your child needs ongoing physical therapy for gross motor delays, and whether there are particular skills or activities your family can work on at home. Many internationally adopted children are delayed in their gross motor skills because they may have been kept in cribs for prolonged periods, or may not have been exposed to structures like stairs and playgrounds. Our PT can help assess where your child's gross motor skills currently stand, and what additional services or activities your child needs to continue to gain these important skills.


Our clinical neuropsychologist will focus on cognitive development, social and emotional development (including the child-parent bond), and language skills. The neuropsychologist will use standardized testing to get a sense of your child's current development and will make suggestions on the next steps for learning, school and activities for play.

Because children adopted from abroad are at high risk for both developmental and behavioral problems, our neuropsychologist helps address these issues and makes recommendations for needed therapies. For example, many children show indiscriminate social behaviors immediately after their adoption, such as offering equal affection to adults whether they are caregivers or strangers. We make recommendations about helping children appropriately focus affection on the parents, and limiting the number of caregivers at places like daycare so as not to replicate the orphanage environment. Many children also have difficulties with dysregulated sleep, and we make recommendations about evening routines and the bedtime environment.

Understanding your child's cognitive, social and emotional development is also important for school placement. It helps determine the most appropriate grade level and any needed services or therapies through a school's individualized education plan (IEP).

Subspecialists at Children's Hospital Colorado

We refer children to other subspecialty clinics at Children's Colorado when needed. This is very dependent on each child, as some children don't need any referrals and others with complex needs require several.

Working with your child's pediatrician

To optimize your child's care and health, we work closely with your family's pediatrician. We send a comprehensive letter after your visit with our findings and recommendations for treatment and follow-up care.

Contact our international adoption experts

For more questions about adoption medicine or our international adoption services, please contact us via phone at 720-777-4963 or by email at

Learn more about your visit to our adoption medicine clinic.