
Post Placement Supervision
The following is a list of the type of questions asked during the post placement interview, but this is only generalized. Specific issues will be focused on depending on the needs of the children and family. In addition to the visits, we also recommend that the adopting parents phone either Dr. Brown or Andy every week or whenever any clinical issue may arise. We will assist you in creating a treatment or education plan for your child(ren) and assist you in linking up with the medical, educational, counseling and social services in your area.
Coming to see you with your new child(ren) to help you forge strong family bonds is our joy and great privilege!
POST PLACEMENT REPORT QUESTIONAIRE
What is the Post Placement Number 1 2 3 4 Please advise
Adoptive Parents Names:
Child’s New Name after Adoption:
Child’s Name before Adoption:
Child’s Gender:
Child’s Date of Birth:
Place of Birth and hospital name if known:
Birth Mother’s Name if known:
Birth Father’s Name if known:
PLEASE ANSWER ANY THAT ARE APPLICABLE AND AGE RELATED…THANKS!
Health: Describe the child’s new weight and length.
Describe the child’s feeding habits including the types of food, the types of drinks including brand of formula if applicable, and the amount of ounces per time and the amount of times per day listing the feeding schedule.
Name and address of pediatrician:
Describe the date of the most recent doctor’s visit with the results, and date of next scheduled visit with the intended purpose.
Describe the current health of the child stating any concerns.
Education: Describe the activities that your child is doing and the steps you are currently taking to take to educate your child.
Appearance and Adjustment to Social Standards: Describe your child’s appearance, growth, personality and social interaction.
Child’s Acquired Skills: Describe the new things that your child can do, or say, or understand, including specific words or commands etc.
Basic Care: Describe how you are taking care of your child including bath, changing, toilet training, sleeping and feeding schedule.
Safety: Describe the safety measures you are using to protect your child.
Emotional Bond: Describe the bond that you have with your child and the response of the child to you.
Fostering the Child’s Abilities: Describe what activities you intend to enroll the child when the child is older.
Setting Behavioral Patterns and Discipline: Discuss any difficulties in the feeding, bathing or sleeping routine, and describe the child’s response to the structure or rules.
Child’s Accommodations: Describe the child’s room.
Family’s Work Routine: Describe the work routine of the parents and day care arrangement for the child.
Family’s Social Ties: Describe the bond of the child with the extended family, siblings or friends.
Transition: Describe any difficulties in the recent month or any concerns you have about the child.
- Development, Health, Adjustment:
- Physical Development
- Illness
- Immunizations
- Eating
- Sleeping
- Personality
- Language Development
- Social Interaction/Observations
- Favorite Activities, foods, toys, books, songs etc
- Least favorites
- Adjustments to parents and surrounding
- Opportunities for Cultural Experiencs/Interchanges
- Parent/Family Adjustments:
- Response of Siblings to Adopted Child
- Changes/Stresses in marriage of adoptive parents
- Child’s acceptance by extended family members/community
- Adoption Issues:
- Post-Adoption issues needing to be addressed
- Post Placement reports filed
- Assessment and Recommendations
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