Malnutrition and institutionalization can lead to both physical and developmental delays. For every three to four months spent in an orphanage, a child can lose up to one month of growth in weight and height, making him appear younger than he is. And medical records, particularly those for a child who was abandoned, may be imprecise to begin with.
After placement, children often "catch up" to the age stated in their medical records. For this reason, most adoption medical specialists recommend that parents refrain from medical work-ups to evaluate a child's age for at least six to twelve months after adoption, and discourage any attempt to medically evaluate age in children adopted as infants or toddlers.
Reasons to Investigate a Child's Medical Age
What about the child who continues to be significantly smaller than his peers? Or the developmentally delayed child who will soon age out of certain educational services?
Concerns such as these can lead parents to investigate and, ultimately, to petition the court to legally change a child's birth date. Both adoption and medical experts believe strongly that this is not something to be undertaken lightly. As a general guideline, the medical community argues that legal age changes should apply only to children for whom the discrepancy between legal and estimated age is greater than a year, and only for medical, educational, or psychological reasons. Adoption specialists point out that the birth date indicated in a child's records may be one of the few ties to her past and, as such, should be retained unless there are compelling reasons to change it.
Medical Tests to Determine Age
Two methods can be used to assess a child's age:
- A dental assessment seeks to pinpoint the development of a child's primary ("baby") and secondary ("grownup") teeth.
- A bone-age x-ray approximates the child's skeletal maturity by determining the number of active growth centers in the child's wrist bones.
Unfortunately, the results of either method can be inconclusive. Inaccuracies may be due to the variation of growth patterns in all children, or even to the effects of institutionalization that led to confusion in the first place. A child's dental development can be affected by malnutrition, institutionalization, and catch-up growth, and bone-age x-rays can be influenced by pubertal development and malnutrition. In most cases, a child's age can be determined only within years, not months.
How to Proceed?
Take a team approach to reevaluating your child's age. Work closely with your pediatrician and dentist to collect and properly document medical information. If your child is developmentally delayed, consult a developmental pediatrician for an evaluation. You may also wish to consult the child's school or a mental health specialist for further advice as to an appropriate peer group for your child.
If you decide to legally change your child's birth date, you'll need a lawyer. Most judges will require medical evidence that supports your claim.
You may decide not to act on the information at all. Some families decide to retain the child's original birth date, especially if changing it will not result in a more appropriate grade placement at school.
Remember, every family is unique. The decision to pursue the question of your child's legal age should be based on your child's specific needs and circumstances.
Honoring a Child's Privacy
If the court agrees to change your child's birth date, you need to be the one to tell your child what this means and why it was done as soon as he's mature enough to understand.
Given the emotional significance of birthdays in children's lives, as well as the suggested link to the child's birth family, the realization that her true birth date is not known may be sad for her. To correct the child's age, you can celebrate a "half-birthday" (or add an extra birthday celebration midway through the year). This way, the child won't feel that she's suddenly skipped (or gained) a year in her life.
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