Children's Hospital Colorado

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



The International Adoption Clinic (IAC) at Children's Hospital Colorado offers families a wide range of services before, during and after adoption.

We know the adoption process can be overwhelming and stressful, which is why we're here to help prepare parents and ease the transition for the whole family.

What is an international pre-adoption assessment?

Our specialized outpatient referral clinic considers your prospective child and family as a whole. We take into account the needs of the parents, the child and any siblings who are awaiting the arrival of a new brother or sister. Our team carefully considers the prospective child's country of origin, background and medical history to help parents make an informed decision and find the right fit for their family. Plus, we'll help families with any anticipated needs the child may have upon adoption.

Our team is also here to educate parents about common medical and psychological issues in international adoption. We work to prepare families for some of the challenges that children who have been institutionalized face when transitioning to a new home environment.

How much do pre-adoption assessments cost?

Pre-adoption assessments are an out-of-pocket expense. The cost depends on how quickly the family needs the review completed and whether they have previously had us review a pre-adoption file for another child. For a cost estimate, please call us at 720-777-4963 or email

Why is it important to have a pre-adoption assessment?

There are several benefits to the pre-adoption assessment. Some families are trying to decide if a child is the right fit for them, while other families know they are going to adopt a child but want to know what needs the child will have once they come home.

Many internationally adopted children have complex medical needs, and we can help the families get a more complete and accurate picture of what future services a child may require. This may include surgeries, subspecialty clinic referrals, developmental services and school placement services.

We may also see indications of conditions such as autism or severe developmental delays of which the family may not have been aware. We can connect families to subspecialty clinics, when needed, before the child comes home. For example, we can refer families for audiology counseling to discuss possible cochlear implants for a child with deafness, hematology to talk about chronic blood transfusions for a child with thalassemia, or urology to learn how to use a catheter to help drain urine for a child with spina bifida.

How does a pre-adoption assessment work?

Pre-adoption assessments do not require an appointment and can be completed within a 24-hour turnaround time upon request. As part of this pre-assessment, we examine the medical records of prospective adoptees, including medical information, photographs, videos and any other information provided by the adoption agency.

A medical provider will review the files and then discuss the findings over the phone with the prospective parents. We look specifically at the child's medical needs, growth and development. We are also able to review medical records with other subspecialists at Children's Colorado, as needed.

We aim to make the prospective parents aware of any concerns or areas where they might want more information from the adoption agency. We strive to give the family a realistic picture of what needs the child will have, so they can make an informed decision about adoption.

Support along your adoption journey

After the initial pre-adoption review, we are available to review any future information and updates that come between the pre-adoption review and the actual adoption, as well as while the family is traveling abroad. This service is included in the initial cost of the pre-adoption assessment.

Many adoption agencies send periodic updates (some as often as monthly) between when the family accepts the child's file and when the adoption is processed. Updates typically include any relevant medical changes, developmental milestones, growth measurements, photos and videos.

Because this process can take up to several years, it's important for families to know that we're here every step of the way to review updates and information.

Going to meet your child: travel support

Flying to a foreign country to meet your child for the first time can feel like a rollercoaster of emotions, so we're here with medical and emotional support to ease your anxieties. Parents who have completed a pre-adoption assessment with our clinic can count on us to answer questions and offer insight while they're traveling to bring their child home.

Families let us know when they are traveling, and if they have any questions or concerns during the trip, we can respond via email. Sometimes this includes sending us photos or videos of the child if they are worried about something they want us to review.

After you're home: post-adoption evaluations

The post-adoption evaluation is a comprehensive 90-minute clinic visit in the weeks following adoption. Our team members include a general pediatrician, pediatric nurse practitioner, clinical neuropsychologist, occupational therapist and physical therapist. Each therapist will perform a developmental assessment, and the medical providers will perform a full medical examination.

Learn more about our care team and what they do.

Many children adopted internationally are developmentally delayed at the time of their adoption. A baseline assessment helps determine what services the child needs, such as speech therapy, physical therapy, or occupational therapy, and what activities the parents can do at home to help the child gain important developmental skills. Our assessments often help parents with school placement concerns, and occasionally, we can help a family change the record for a child's birthdate and age when evidence indicates this is incorrect in the child's original records.

We generally do blood tests at the end of the post-adoption visit and will provide vaccine recommendations once we have tested for disease immunity. We also test for different environmental, nutritional, genetic and infectious disease risks that can be medically screened at the time of adoption.

Our team will share feedback at the end of the visit and send an in-depth report to your family and your child's primary care doctor with our recommendations. We'll also provide recommendations for any needed subspecialty referrals at Children's Colorado.

Specialty medical consultations and follow-up

We offer additional consultation visits for medical, developmental or behavioral concerns as needed or as requested by parents or healthcare providers.

If we are concerned about a child at their initial visit, we will occasionally recommend they come back several months later for a follow-up evaluation after they have had more time to adjust and develop.

Sometimes we see children who have been home for many years but are having new issues, usually related to behavioral or developmental concerns. In most of these cases, the child did not establish care with us immediately following their adoption, and is having symptoms or issues several years later with concerns that have never resolved.

These follow-up visits are also 90 minutes with our full care team, just like our post-adoption evaluations.

Other pre-adoption topics

See our list of helpful resources for more information on travel, nutrition, attachment and behavior. We provide guidance on questions such as what to bring while traveling, how to approach feeding concerns and how to begin building a bond with your newly adopted child.

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 International Adoption Clinic.