Association/or Ambulatory Atlantic City, May 9, 1962 Pediatric Services, Adoption practices: An operational and evaluative stu@ in an outpatient department Morris Green, M.D., and Carolyn Godfrey, M.A. T I-I E last decade has witnessed a greatly increased interest in adoptions. Recent experiences in the Outpatient Department of the Riley Hospital have repeatedly demonstrated both the opportunities and the need for pediatric research in this area. The present study was designed to evaluate certain problems in adoption practice in the community and to determine the possible contributions that a diagnostic center could make to their solution. The study was conducted in the period From the Department o] Pediatrics, Indiana University School of Medicine, and the James Whiteomb Riley Hospital for Children, Indianapolis, Ind. eAddress, Dr. Richard W. Olmsted, ehalrman, Department o[ Pediatrics, University of Oregon Medical School, 3181 S.W. Sam Jackson Park Road, Portland I, Ore. 276 from September, 1960, through December, 1961, and involved the collection of data on 40 children referred to the pediatric diagnostic clinic for evaluation in relation to adoption. In 12 of the 40 cases the authors judged that previous utilization of professional services by the responsible agency had been inadequate. Previous professional advice was judged to have been inadequate or incorrect in 20 per Cent of the cases. Five such instances were the result of undue reliance on infant developmental tests. An attempt was also made to assess the previous total planning for each child by the agency concerned. A rating of good, fair, or adequate was assigned to 35 per cent of the cases and a rating of poor or very poor was given in 65 per cent of the cases. Volume 62 Number 2 Abstracts--A. Ambulatory Pedlar. Services 2 7 7 The data document the presence Of serious deficiencies in adoptive practices and help define a new role for an outpatient department in relation to (1) diagnostic services, (2) preventive services, (3) professional education, (4) research, and (5) social action. In regard to diagnostic services, the outpatient department appears to be in the most advantageous position to provide consultative services to agencies in the case of children with multiple handicaps where a variety of medical consultations, infant developmental tests, genetic counseling, or psychiatric appraisal are indicated. These special examinations are not readily available in many communities. The preventive services supplied by the clinic chiefly involve counseling with agencies to help eliminate unwarranted delays in permanent planning and placement. The provision of services to adoption agencies also provides an uncontrived opportunity for medical students and pediatric residents to gain realistic experience in the important area of adoptions as well as some knowledge of the functioning of community social agencies. This investigation also represents a type of operational and evaluative research in the field of child welfare services, a type of research that may have a wider application in communityoriented outpatient departments. Finally, the paper demonstrates how the staff of a children's hospital can join with others to help gain the increased support necessary for the provision of adequate services to children through investigation and publication of the facts in relation to deficiencies in child welfare practices. This activity would appear consonant with the role of the university in research and social action.
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