Come to the picnic

All you have to do is send us any color photo (up to 5x7) and we'll send you back a custom-made cross-stitch pattern complete with a complete list of the Anchor, DMC or J&P thread numbers required to reproduce your child into a special present for Grandparents, Aunts, Uncles, Godparents or just for yourself.

After the photo is scanned, the computer will create everything you need to transform your child into a cross-stitch work of art.

You'll receive:
1. A color pattern up to 500 x 500 stitches
2. Stitch types
3. Up to 64 colors in every pattern
4. Anchor, DMC or J&P color numbers
5. Color coding symbol explanations printed out

The Cost: Only $20.00 plus $3.00 postage and handling.
Please allow 3 to 4 weeks for delivery.
Be sure to write your name and address on the back of the photo in case it becomes separated from your order.

Fill out the information below and return today (write clearly)

Name _____________________________________________________________-

Address __________________________________________________________- _

City, State, Zip Code ____________________________________________-

Telephone ( _________) _________ Fax (_________)________________-

Photo #1: (name) ________________________________________________-

Photo #2: (name) _________________________________________________-

Photo #3: (name) _________________________________________________-

Mail with a check for $20.00 for each photo plus $3.00 shipping (for up to 3 patterns) to Help The Children, 41 W Yokuts Ave, Ste 107, Stockton CA 95207-5722.

Or charge it to your Discover Card.
Card Number ______/______/______/______
Expiration Date _____/______
________________________________________Signature

In children less than a year old, age determination is not particularly difficult. Studies indicate that experienced child care workers and parents are about 90% accurate in estimating an age for an infant, based on observation alone. Although severe malnutrition, chronic illness, prematurity or developmental delay may bias the estimate of an infant's age downward, the error is not likely to be more than 6 months wrong.

Guessing the age of an older child is significantly more complicated. Adoption workers in other countries are often accused of assigning purposely underestimated ages to make children "more adoptable. Although this probably does happen to some extent, most age determination errors are made in good faith based on the (often poor) condition of the child at admission to the institution.

I once participated in a study of physicians' perceptions of adolescents. We were asked to guess the ages, based on videotapes, of similarly dressed, healthy females rocking a baby. Experienced pediatricians' ideas ranged from 13 to 45 years; the subjects were all 16 or 17 years old. It's not hard to see how a worker in an orphanage or hospital might make a significant error in assigning an age to a child who is newly arrived and frightened, ill or starved.

Since a child must have a birth date for immigration and court hearings, all children will arrive into the adoptive home with an age, no matter how incorrect. Parents and schools have an understandable desire to know the "true" age as quickly as possible but this is not always feasible (or even desirable!)

First, there is NO test that can accurately pinpoint a child's age. Physicians and parents tend to rely on bone or dental age (based on x-rays of the wrist or teeth) or on sexual maturity. Even in children with known ages, x-ray tests have a wide variability, often indicating as much as a full year older or younger than the actual chronological age. In addition, bone and/or dental ages are commonly delayed in children with chronic illness or infection, malnutrition or deprivation (known as "psycho-social dwarfism.") Examinations done at the child's arrival into the adoptive home are likely to indicate an age much younger than the true chronological age, even in the child who appears healthy.

Studies of the growth of children following adoptive placement typically show dramatic "catch-up" in height and weight. A Danish study documented the dental development of adopted children and found that, in the first year after adoption, the dental age advanced by more than 12 months in almost all subjects. Good nutrition, elimination of chronic infection and a psychologically secure environment probably all contribute to this dramatic blossoming seen in so many children.

Second, the onset of puberty is not a good indicator of age. Even with good nutrition and medical care, there is a wide range in timing of sexual development in "normal" children. In adopted children, puberty may be delayed because of prolonged malnutrition or chronic illness. However, there is also a significant incidence of early puberty in those adopted from a background of deprivation. In a Swedish study of adopted Indian girls with known ages, the onset of puberty was much younger than in the equivalent Swedish or Indian populations. The researchers postulated that the abrupt change from deprivation to good nutrition speeded up the biological clock in the brain timing the onset of sexual maturation.

There is also a higher rate of early puberty in children with any sort of brain damage. Thus, it is not uncommon to see early sexual changes in children with mental retardation, cerebral palsy or fetal alcohol syndrome.

Third, there are many confounding factors in the background of older children complicating an age determination. Often there is a great discrepancy between the physical (true) age and the emotional or psychological age. Children who have suffered neglect, deprivation or severe trauma may appear and act much younger than their actual ages. Others who have lived on the streets, totally responsible for themselves at a young age, may be "old" in their knowledge of money, sex or drugs but "young" in their experience of family and school life. Children with growth retardation, whether due to malnutrition, deprivation or genetic factors, tend to be treated and to act as younger than they actually are.

What to Do When No One is Sure About the Age

What are physicians and families to do when faced with a child whose birth date is probably not accurate?

For an infant, there is little reason to change a birth date. Even an estimate that is as much as 6-12 months too young will have little effect on the child's life, especially as he approaches school age. In the rare circumstance when an infant's age is estimated as far older than his apparent development or physical size, there may be some advantage in revising the estimate downward 6 or 12 months. However, any such age revision should be delayed for as long as possible, preferably a year, to allow the child sufficient time for "catch-up."

If an infant is still significantly delayed in development or size compared to his reported age at one year after arrival in the adoptive home, it is much more likely that the child has a medical or developmental problem rather than a wrong birth date. If not already obtained, such an infant should have a thorough evaluation including neurological and medical examinations and developmental, hearing and vision testing. "Wrong birth date" should be the last diagnosis for delay in an adopted infant.

In the older child, delay choosing a permanent birth date for as long as possible. A minimum observation period should be one year; sometimes it takes several years to get a "feel" for the child's true age. The final determination should be based on a composite view of the child's development. As many as possible of the items in the following checklist should be considered in the birth date selection.

1. Review the child's paperwork for clues to age. A child who lived in an orphanage for 5 years clearly cannot be younger than five. Other dates useful in establishing a minimum age are sometimes found in immunization records.

2. Ask the child how old he thinks he is. Often no one has ever asked or the child has been told not to tell his true age. Sometimes, an approximate age can be established through an interview with the child, reviewing events such as major holidays or natural disasters. However, most children cannot produce this detailed review of their past lives because of limited English language skills. As the years go by, many tend to repress or "forget" these past events.

3. Ask the agency or orphanage who determined the child's age, when they set the age and based on what information. If the age was chosen after the child had been in care for months to years, it is likely to be fairly accurate. A birth date arbitrarily picked on the day of admission to an institution without any supporting data may be grossly in error.

4. Obtain bone and/or dental age as a minimum estimate of age. If possible, repeat these a year later to determine if there has been sign significant "catch-up" in maturation.

5. Obtain estimates of age from teachers, parents and others who have daily experience with the child. Based on school performance, experience of life, emotional maturity and social interactions, what age would these experts choose?

6. Sexual development and physical size should be considered but given low priority as too many factors can bias these to either older or younger ages. Consider these as possible minimum approximates.

Collecting all this information should optimally take one year or more. In the meantime, what age should families use to place a child in school, in sports and so on? Parents, polled on their experiences in this matter, list several suggestions:

* Use several different "informal" ages, for example, a younger age for school but an older age for sports or scouting, depending on the child's physical or social abilities.

* When asked for a birth date, give the date but not the year, explaining that the pediatrician is still gathering information.

* Use your best guess and the child's opinion in the pubertal child, erring on the side of younger to allow a lengthier school experience.

* Allow the estimated age to stand but use an appropri- ate "informal" age, redetermining this each year in consultation with the child, reviewing school and physical progress over the previous year. (of course, this may mean a child could repeat the year 15 several times over!)

Setting the Final Birth date

A final choice of birth date should be a collaborative effort between the pediatrician and parent, with input from the child old enough to appreciate the implications of different ages. The decision should be based on a composite of all the measures of the child's development over time but should also reflect the best interest of the child. Thus, an extremely immature teenager who has progressed fully through puberty might be assigned an age of 16 rather that 18 to permit another two years of high school. A mildly developmentally delayed 5 year old may receive special educational services but the same child with an age of 4 years may be deemed ineligible because she is not sufficiently delayed for her stated age.

When the final age is chosen, the pediatrician should write a summary of the factors used to determine the age. This document, printed on office letterhead, can then be used in court to support a legal birth date change. Also, should professionals in the school or elsewhere question the child's age, the parent will have a summary of the reasons the particular age was chosen. Should later events raise serious questions about the "final" birth date, again, this document can serve as a starting point for any new determination.

Telling the Child

How does one tell a child who is old enough to understand that he is now a different age? One innovative approach is to use an altered birthday schedule. For the child who is suddenly "older," birthdays can be held at 6 month intervals with a year advance in age each time until the correct age is reached. The extra birthdays can be explained as "making up for the birthdays you missed before you came to live with us." For the child who is now "younger," the annual birthday can celebrate half-years. For example, the child will be six, one year later he will be 6 1/2, and so on until the correct age is reached. Again, the explanation of making up for missed birthdays seems to be acceptable to children.

We're on the World Wide Web Now

Check out the facts, policies and fees.

Links to foreign language dictionaries, medical sites, INS and other government sites, laws, etc.

Links to adoption related materials.

Photolistings of waiting children.

Lots more to come as we complete the pages.

Thousands of babies in this country do not have the food to grow and develop properly. Without this food, development and intellec- tual problems will occur which will affect him for the rest of his life. A third-world child will become blind because there is no medication available. Another may die for lack of a respirator.

Help The Children was founded to save and improve the lives of both U.S. and third-world children. Your donation will buy baby food for a U.S. child or it can allow us to assist underdeveloped countries to improve medical conditions for all of their children.

HTC supports foods banks and family shelters in the U.S. with donations of baby food, formula, diapers, clothing and hygiene products for the care of the children needing their services.

Medical equipment and supplies have been sent to the Baptist Medical Center, Nigeria; Hospital Menino Jesus, Brasil; Clinica San Rafael, Mexico; Assistencia Ao Menor Enfermo, Brasil; and Clinica San Juan de Dios, Peru and many others. New projects are being considered.

Benefactor
$41.67 per month________
$500.00 per year_________

Patron
$20.00 Per Month________
$240.00 Per Year________

Sponsor
$10.00 Per Month________
$120.00 Per Year_________

One time gift of $________

Please mail this coupon and your check to:
Help The Children
41 West Yokuts Avenue
Suite 107
Stockton, CA 95207-5722
(209) 478-5585
FAX (209) 478-5586

All donations are tax deductible to the extent allowed by law.

Please print or type:

Name _____________________________________________________________-
Address __________________________________________________________-
Apt. or P. O. Box ________________________________________________- ___
City ______________________________________________________________
State_________________________________________Zip Code ___________- ____
Telephone (________________)______________________________________-

You may designate us at work through the following payroll deductions: United Way, CFC, or CA State Employees Campaign

The mother is a mental patient with a diagnosis of right-side hemiparalysis, dementia, psycho-organic syndrome. There is no information about the father. Nothing is known about Oleg's early development.

His official diagnosis is oligophrenia of mild debility of unclear genesis. Slow in psycho development and speech.

Because the mother abused alcohol, she was deprived of her parental rights. There is no information available about the pregnancy, delivery or birth weight.

He has had whooping cough, spasmodic cough with acute bronchitis, bronchial pneumonia, and anemia.

The official diagnosis is muscular hypnotic syndrome, hydrocephal- ic syndrome and is slow in speech and psycho development.

This beautiful little boy has light brown skin and wavy black hair. He was abandoned in the hospital at birth. He had a respiratory problem and underwent treatment for it. Except for colds (aller- gies?), he is healthy. He's had some undernutrition and is small for his age.

He does have a severe bilateral hearing loss and uses hearing aids. Because of his limited hearing, his development in other areas is delayed but he is intelligent and capable of catching up when he acquires good communication skills. His present conduct shows some signs of hyperactivity and attention deficit but this may be due to the lack of communication skills. He gets frustrated easily because he can't understand or make himself understood.

We are seeking a family who is already familiar with deaf culture and ASL.

Lena was a full term pregnancy with a weight of 3000 gms. She was slow in psychomotor development. She sat at 10 months and walked at 1 year 7 months.

She has been in protective care since she was 7 months old. The parental rights were legally terminated.

Although the official diagnosis is Oligophrenia and Intellectual Insufficiency, her condition is satisfactory. She's healthy and active. Medical examination do not reveal any problems.

YOU are the most important part of Help The Children...... Without YOU, we cannot exist.