Waiting Children Photolisting

Ivy is 6.

Ivy is a calm and positive 6 years old little girl, who is living in an orphanage in Eastern Europe.

She has some delays; recently she starts walking by her self. She walks slowly, climbs and goes down the stairs with help of railings.

The child can pick up a toy and to manipulate with it. Explore with the mouth. She follows moving objects with her head and eyes. Ivy pronounces loud vocal sounds. She was not diagnosed with any mental disorders or deviations.

Ivy had a successful surgery on her lip and palate. The child has delays regarding the physical and neuro-mental development.

Ivy works individually with psychologist and a pedagogue. She receives permanent rehabilitation, too. She shows interest and prefers to play with glowing toys.

Ivy eats food, cut in small peaces. She enjoys yogurt and biscuits. The child is in diappers.

O’Brien is 6. 

General physical development: 

This is a child born from a second unmonitored pregnancy and with an unknown due date. O’Brien has been diagnosed with “Moderate Mental Retardation”, a general disease “Carrier of the thalassemia trait”. The child has an Expert Decision of the Territorial Expert Medical Commission No. 91684 dated 119/24 June 2022, where a 60% type and degree of disability without assistance is determined. During the stay in the Home for M*** Care for Children, the child often suffered from upper respiratory tract infections, with bouts of bronchospasm. In physical development, the child lags behind the calendar age, differs from the typical development for the age. 

During the last examinations, O’Brien was diagnosed with a concomitant disease “Epilepsy”.

EEG epileptiform changes were established without paroxysms according to the foster parents. Due to pronounced epileptiform activity, despite the absence of seizures, regular anticonvulsant therapy was started due to the risk of seizure occurrence.

Family medical history reveals a mother who has a diagnosis of “Mild Mental Retardation, debilitas media”, with an Expert Decision of the Territorial Expert Medical Commission. The child has a sister, born on 30 November 2014 who was also diagnosed with Mild Mental Retardation. 

Motor development: 

General: the child independently stands, walks and stands up, climbs and descends stairs, not always using support. He has good coordination between his upper and lower limbs. Given the disease, the child has well-developed general motor skills, but there are tic movements of the upper and lower limbs. 

Fine: His fine motor skills are well developed. The boy is able to handle objects of different sizes and different types of writing aids. He can string, nest, assemble. The boy can move objects at long distances. 

3. Psychological status.

Perceptions and concepts: underdeveloped perceptual-conceptual sphere, due to discrepancy between calendar and mental age. 

– Attention: the child shows stability of attention when the activities arouse his interest. He does well in finding the same objects in the game “Find My Mate”. Repetitiveness of the activity in a given task is observed. 

– Memory: auditory memory is developed, the child remembers voices and names of specialists and children. Developed visual memory. The child is able to remember, store and reproduce information related to daily activities and favorite pastimes. 

– Reasoning: a deficit in reasoning processes is observed. 

– Imagination: underdeveloped 

– Intellect: the child has a delay in his intellectual development. 

– Time and space orientation: the child is well oriented in a familiar environment. 

4. Emotional development:

During his stay at the day care center, O’Brien is happy and feels well. The child is calm, smiling and radiant. He expresses his positive and negative emotions. States of anxiety, depression and aggression are not observed. Affection for the children and the team of the day care center is noticeable.  

5. Language and speech skills and socialization:

O’Brien’s active and passive vocabulary do not correspond to his age. The words have an irregular structure and part of the phonemic inventory of the language is missing. The boy forms sentences of three or more words. During a conversation, he understands the information presented to him and joins the dialogue. The child answers short questions and follows instructions.  

6. Development of personality:

O’Brien is six years old. He has formed elementary ideas about his own personality and abilities. The child differentiates his relations with close, familiar and unknown people in his environment.  

7. Relationships with others:

O’Brien adapts easily in a new environment. He has developed socially acceptable behavior in contact with specialists and other children.  

8. Playing skills:

O’Brien likes to play together with other children. He enjoys their attention and is visibly happy playing together with them. The child actively participates in outdoor games and group play activities. He likes role-playing games. He knows how to nest puzzles and name familiar objects.  

9. School activities:

O’Brien’s knowledge does not correspond to his calendar age. There is a formed idea of the surrounding reality through activities preferred by the child. He uses speech as a means of communication. The boy recognizes everyday objects and actions. He can count to five with minimal support. The child defines short-long, small-large, low-high, light-heavy. O’Brien is timid and insecure in his knowledge and actions.  

10. Hygiene and everyday life habits/skills:

O’Brien controls his needs, signals for them and stays dry during the day. The child has established self-care habits, such as dressing, undressing, putting on shoes, taking them off. O’Brien can feed himself using cutlery. 

The foster parents try to provide a safe environment for the child and meet all his needs. Every day, the child receives a variety of food tailored to the needs of the growing organism, the necessary space in the home, clothes tailored to gender, age and season.  

11. Attitude towards the adoption process:

Considering the child’s age, it is currently not possible to determine his attitude towards adoption. 

Benie is 7

General physical development: 

Somatic status (body configuration and health status): 

Benie  is a boy who has reached the age of 7 years and 2 months. Within normal limits for the age in terms of height and weight. Born prematurely, with inguinal and umbilical hernia. Subsequently, he was diagnosed with asthma, for which he currently only takes homeopathic products when needed. In the last period, the child had no asthmatic attacks. A deviation of the eyes from the visual axis was observed. After consultation with a physician, no need for vision correction was found at this stage. 

In consultation dated 26.09.2018 at the Diagnostic Therapeutic Room – “S***”, a diagnosis of “moderate mental retardation with autistic features and from Interim Discharge Summary dated 02.10.2019, also issued by the Diagnostic Therapeutic Room – “S***”, an opinion was given from the psychological research for a moderate to severe degree of underdevelopment in the spheres of development, a conclusion was made for “severe underdevelopment in most spheres of development, at the lowest indicator”. 

Motor skills: 

Gross: The boy walks independently, squats, stands up, stretches and folds his arms. Handles objects equally with both hands. It is noticed that he walks on his toes. Climbs on chairs and sofas. According to information from the foster parent at the playground, the child manages to get on and get off the appliances himself. Gross motor skills are well mastered for the age. 

Fine: Fine motor skills are not well developed for the age. Holds objects for a short time and throws them. The child does not have skills related to making coordinated movements with the fingers of his hands. Tries to play with building set for children but fails to assemble items. Under direct observation, he holds a pencil in his hand, but shows no interest in the white sheet. He leaves no traces. He can open his water bottle by himself. 

Psychological status. 

• Perceptions and ideas: The perceptions and ideas of the child Benie are hard to be accurately defined, due to the lack of developed speech. The boy responds to touch, pinching and tickling. Distinguishes the taste of food by showing what he likes and what he does not like. According to data from the foster parent, he is impressed by the lack of sound when watching TV and expresses dissatisfaction with it. Does not turn around when called by name. Avoids obstacles and manages to overcome them. When handling various toys and objects, he tries them with his mouth and salivates on them.
• Attention: Unstable attention and concentration. His attention is chaotic, there are no organized and meaningful prolonged activities. He has difficulty sharing attention. The professional foster parent informs that she observes concentration of attention when the boy is watching children’s movies. According to her information, Benie keeps his attention for about 10 minutes at such moments. When directly observing the child, he difficultly and rarely makes eye contact. Tracks a moving object in space when interested.
• Memory: According to information from the foster parent Benie knows the application of places and objects. When observed in a consulting room, there is no play with objects as intended, there is no memorization of consecutive actions. According to information from Mrs. M***, he learns certain behaviors and repeats them. He recognizes his jacket and wears it.
• Thinking: He does not play with the toys as intended. He manipulates them chaotically. It is observed during a game that he finds a hidden object. Does not follow instructions. Finds and opens the door by himself when he wants to go outside. He wears his jacket to be dressed, he recognizes it.
• Imagination: It is difficult to examine the development of the boy’s imagination given his lack of speech. The child is provided with various games and incentives for development. He does not participate in plot role-playing games. Trying to imitate animals was not observed.
• Intelligence: In the Interim Discharge Summary from a consultation at Diagnostic Therapeutic Room – “Specter” – Plovdiv, an opinion was given from a psychological research for a moderate to severe degree of intellectual retardation, a conclusion was made for “severe underdevelopment in most spheres of development, at the lowest indicator”.

At this stage, there is a lag in intellectual development. 100% disability was determined by means of a WCAC from 14.10.19 with a leading diagnosis of Atypical Autism. 

• Orientation to space and time: Orients himself in the middle of the room, opens the furniture doors. Does not recognize, does not name, does not show parts of his body. He has an orientation to the position of his body in space. He deals with obstacles by removing or bypassing them. Orientation to time is difficult to be examined given the child’s diagnoses.

Emotional development (predominant emotional states, level of anxiety; depression; aggression):

The child is smiling.

Seeks attention from others. When stimulated by the foster parent, the child reacts, hugs and seeks contact with her. He smiles when teased and gets angry when taking a toy he is interested in. There is emotional regulation. If he shows aggression or anxiety, the caregiver hugs him and he calms down. According to information from the foster parent, no depressive and aggressive states are observed. According to Ms. M***, he began to react in her absence in the room, seeking her presence. In direct observation and examination in a situation of missing foster parent, no anxiety, resistance, disapproval or joy was observed in her absence and when she appeared in the room. There is no emotional response in such a situation. In many cases, the child’s emotional reactions are not adequate. 

Orientation in interpersonal relationships: 

According to information from the foster parent, the child is actively seeking contacts with significant adults – the professional foster parent and her close entourage. Affectionate and seeking tenderness and attention from them. He takes a person by the hand to show him something he desires. According to information from the foster parent, there is no anxiety when meeting a stranger, but he does not want to be left with strangers and reacts with grumbling and crying. When directly observed in a consulting room, when the professional foster parent left the consulting room, the child did not react with crying or disapproval. He likes to be taken care of, smiles when caressed and in the case of attention from adults. 

Michael is 3 years old. 

He moves independently from position to position, climbs, bends from a lifting device. There was also a significant improvement in independent gait. Takes an active part in throwing and kicking a ball. Kinesitherapy sessions with Michael are aimed at improving balance and coordination through active exercises with football and play therapy. It was noticed an improvement in the manipulation of objects and the development of the child’s play skills. The performance of object actions with the toys is observed, i.e. as intended (e.g. talk on the phone). In terms of types of grips, progress is also reported – nests checkers and small stones in a box, strings sorters – still does not distinguish by shape and color, only the action of stringing is mastered.

Michael recognizes some of the parts of his body, such as arms, legs, head – and the idea of “body diagram” becomes more and more complete for him. He pronounces many separate words without trying to connect them into a sentence, yet. He likes to sing baby songs and to dance under the accompaniment of music.

The child recognizes his own image when placed in front of the mirror. He does not report his physiological needs and is permanently on diapers. Work is being done to teach him to assist in performing routine daily activities and his active participation in them. Michael undoes his shoelaces, attempts to take off outerwear, assists with changing, lifts his pelvis when changing a diaper, attempts self-feeding by holding a spoon, using a fist grip with the help of an adult, and the left hand partners adequately, holding the bowl.

Sandy

Sandy – Sandy turns 10 in March, 2023.

General physical development:

The child was born with low birth weight: weight 2400 grams, height 46 cm, first non-pathological pregnancy. The current physical parameters are within the normal values. She has an adequate food intake. Since her placement in the foster family, she has seizures almost every month, once or twice. Since 30 May 2017, she has been considered as an adult dependent child with disabilities by Expert Decision of the Territorial Expert Medical Committee, diagnosed with ‘Epilepsy – grand mal seizures’ and a Degree of Disability of 75%. Although she is on a permanent anti-epileptic therapy with Convulex, the seizures continue once to twice per month.

Motor development:

Gross motor development: able to control body posture, good coordination of movements and balance; good awareness of body’s position in space compared to other objects.

Fine motor development: The fine motor activity is underdeveloped. She holds a pen but her movements are chaotic and clumsy which is why she cannot draw or colour inside the lines. There is an attention deficit disorder.

Psychological status

Perceptions and concepts: No awareness of time – days, weeks, months, seasons, year, natural phenomena.

Attention span: all values below the norm. 

Memory: short and long memory values are below the norm. 

Reasoning: thought processes are underdeveloped.

Imagination: low level of complexity, rigid and highly stereotyped. 

Intellectual development: low level of development.

Time and spatial orientation: does not know what up, down, left, right, here and there means. Does not read the clock. 

Emotional development

Generally, the mood is stable. She rarely gets irritated, usually when prohibited to do or have a desired object; however, her mood quickly changes as soon as another object attracts her attention. She is constantly on a move, doing a variety of activities; she has never been seen despondent or depressive.

Language and speech skills. Communication

The child begins to build speech skills. She composes short sentences with a small number of words, which are sometimes difficult to understand. She tries to connect words in a sentence. She reports the presence of pain. The child follows simple commands, quickly losing interest in activities.

Development of personality

The maturing processes are slow. She is not self-attendant. Shows interest towards surrounding objects and therefore a permanent supervision is required in order not to get hurt while exploring them.

Relationships with others

As a result of the speech deficit, the child does not socialize with others neither seeks closer contact with them. She has some more closer rapport with her foster parents.

Playing skills

Rarely take part in the playing activities of her friends and classmates. She plays with children, but only for a short time, quickly losing interest.

Most of the time, she engages in activities on her own, but this process lacks logical predictability neither resembles a play.

School activities

The child is a student in the 2nd grade at the school in the village of S**. Due to a deficiency of speech functions, and low levels of resistance, concentration of attention, the child is on an individual form of education.

Hygiene and everyday life habits/skills

The child is already making attempts to take care of herself, such as dressing, undressing, feeding. All her other basic needs are fulfilled by her foster parents, for example, bathing, etc.

Attitude towards the adoption process

She has the ability to go from one act to another without breaking much. She quickly adapts to the new environment and people. Due to her illness, the child cannot express a personal opinion and attitude regarding the adoption process.

Sia is 5 years old.

Diagnosis – Fibrodysplasia Ossificans Progressiva or FOP.

A female child born with a low birth weight. The child was diagnosed  with a rare, progressively debilitating autosomal dominant disease – Progressive Ossifying Fibrodysplasia.

On July 8, 2022, the child undergoes a mental health diagnosis. A diagnosis was made – Generalized developmental disorder. Childhood autism.

The child is currently 3 years and 6 months old. Her health condition is monitored by a physician. All immunizations have been given to date, but the doctor’s recommendation is to stop intramuscular immunizations in the future due to the disease.

Motor skills:

Over the past three months, the team has seen no significant change in the child’s motor skills. SHE continues to move independently, but with a more rapid gait there is a risk of falling due to the inability to regain her balance once she has lost it. She cannot reach her arms, bend and stretch; cannot turn his head sideways. Movements that require flexibility of the spine are also limited due to the child’s health condition.

The child cannot squat without support and cannot stand in a squatting position. She cannot extend her arms from the elbows and her forearms are usually bent at an angle. She manages, albeit limitedly, to move them back and forth relative to the torso. When she wants to pick up an object from the floor, Sia looks for the attention of those around her to hand it to her. If there is a suitable support near the object, she grasps it with one hand and manages to pick it up by leaning towards it by bending her legs. Recently, the team has observed that when she wants to pick up an object from the ground, she does not always squat, because may lose balance and kneel to achieve her goal.

Fine: Sia has limited movement of her fingers, but takes her own water bottle with a straw, as she manages to drink without help. Shows interest in doodling with a pen and can do it with both hands, but uses the left more often. She does not draw by imitation, but looks at another person’s drawing. She is able to change the videos she is watching on the phone with a sliding movement of the index finger.

Psychological status: According to the documents, the child is slightly behind in her psychomotor development and at the moment the team continues to observe that the behavior and cognitive skills of the girl do not fully correspond to her calendar age. In July 2022, Sia underwent diagnostics, where he was diagnosed with Generalized Developmental Disorder. Childhood autism. According to specialists’ observations, the emotional warmth that the child receives in the foster family and the adequate satisfaction of her basic needs have contributed to the building of attachment to the foster parents.

Emotional development: A strong attachment of the child to the foster mother is noted. Sia feels calm and good in the presence of the other members of the foster family. She also reacts positively to the meetings with the team – she smiles, looks for an emotional close, initiates play, insists that the one playing with her fulfills her wishes. She likes playing with balloons and balls. According to experts, she is not upset by the presence of strangers.

She expresses her joy through smiles and repeating inarticulate sounds. Shows urgency when wanting to achieve a certain goal or perform a certain action. If she cannot cope, she seeks help from the foster parent or another adult. The child expresses her joy at an achievement (for example, putting a ball in a basket) and at encouragement and praise from adults.

Speech-language skills and communication: According to the foster parent, Sia is vocalizing some of the shorter and easier words that are said to her. Makes attempts to selectively repeat words while listening to adult dialogue. She continues to make sounds and sometimes says syllables. Does not imitate animals. 

It is reported that in recent months the child’s vocabulary has been enriched with words, but in English. The little girl repeats some numbers in English (e.g. one, two), names objects (e.g. ball, pumpkin) and colors (pink, white, blue). She understands the general meaning of expressions and sentences that describe routine actions (e.g. give a kiss, say bye), but performs them whenever she wants.

When interacting and playing with adults, the child communicates through gestures, indicating a direction or action that she wants the other to perform. She tries to control the behavior of others and is happy if they fulfill her wishes.

Neva

Neva – is 8 years old as of February 2023.

Overall physical development:

The child is in satisfactory general condition. The child was born with polymalformative syndrome. Diagnosis: Hydrocephalus. Condition after ventriculo-peritoneal shunt placement. Spina bifida – surgically closed defect. Lower flaccid paraplegia. Neurogenic bladder-vesicostomy.

Motor skills:

General motor skills: When placed in a sitting position, she sits firmly with support, does not attempt to stand up, does not have active movements and supports her legs. Moves both arms. Can move at close range by crawling/pulling itself with arms/.

Fine motor skills: Demonstrates partially opposable thumb and tweezers grip when handling objects. Builds a tower of 5-6 cubes. Assembles and disassembles a constructor, arranges a large mosaic. Handles nesting, stringing elements on a stable basis slowly. Holds a pencil with a static or dynamic three-finger grip, basically scribbles on the sheet. After display draws dashes, closed curves.

Psychological status:

• Inceptions and imaginations:  The child registers sensory stimuli. Perceptions and ideas correspond to a satisfactory level of the environment in which it is grown.
• Attention: reduced characteristics
• Memory: unintentional, situational, transitory
• Thinking: visually effective
• Imagination: not observed
• Intellect: Demonstrates partial understanding, has built cause-and-effect relationships, consistency at the bit level.
• Space and time orientation: The child is satisfactorily oriented in the group space.

Emotional development: The general background of the mood is leveled. The child is calm, does not cry for no reason. Expresses positive and negative feelings in an appropriate way. There are no manifestations of aggression and self-aggression.

Speech-language skills and communication: The girl’s speech in most cases is relevant to the situation, semi-intelligible, with articulation and grammatical inaccuracies. Echolally repeats individual words and simple sentences heard in the middle. Neva understands counter-speech at a basic level and can enter into a short dialogue with her / sometimes she needs persistent attempts, visualization, and reformulation of the content of the question in order to understand it/. The child uses appropriate social gestures when greeting and parting.

Development of the personality: The girl explores the environment to the best of her ability. She is satisfactorily oriented in daily activities. Follows appropriate instructions. Attention is highly distracted and this affects her ability to respond, engage in an activity, and complete the activity to completion. In structured situations, Neva’s behavior needs frequent modeling, which is possible through appropriate behavioral and verbal stimuli. According to her motor abilities, she imitates through physical and verbal actions. Sometimes there is body shaking, staring into space, or teeth clenching for no apparent reason to cause such a reaction.

Orientation in interpersonal relations: The girl starts, but does not know how to independently maintain interaction. It accepts interaction and engages according to its capabilities. Easy to break up with a nice person. Knows the names of people around her. She is calm among her peers. Communication with other children is at the level of giving or taking away a toy, touching, verbally imitating adults in an attempt to communicate with them.

Play activity: The child plays with familiar toys in an appropriate manner and with guidance. The game is mainly at the level of parallel activities. During group play, is easily distracted, engages with nearby objects, and needs frequent behavior modeling. Has difficulty waiting, taking turns, and sharing toys with other children during structured play situations. The threshold of frustration at these moments is low-demonstrates dissatisfaction, wants the toys for himself, squeezes them tightly, cries when they are taken away. Shows elementary role-playing with a doll – puts drops on the baby, gives him medicine or a toy and puts him in a chair, imitates talking on the phone.

School activity: The child names familiar images in card material. It is oriented towards the use and actions of familiar objects. Does not name colors and shapes correctly. When it is concentrated, it deals with small gaps when sorting objects by color. He does not know how to group objects by any other criterion. The girl has formed concepts about parts of the body, foods, animals, vehicles, seasons, phenomena, weather, but he does not always answer questions related to them correctly. It is oriented with an emphasis on spatial relations such as above, below, on.

Every-day hygiene habits/skills for self-service: The child has no established habits, self-care skills. She tries to feed herself. She sleeps peacefully. Does not communicate or control his physiological needs.

Attitudes towards the adoption process: It is not possible to draw a conclusion at this stage.

Steve

Special Needs: Mild to moderate mental disability; Speech delays

Steve is 7 years old child, who is living in a Foster family. He walks by himself stably. He runs, jumps; there is no indication for physical disorder.

Steve is curious child, who shows interest in new games and activities. He can make a new contact quickly using non-verbal means as well as individual words. In the process of communication, he executes two-level as well as more complex instructions. The boy speaks single words; answers “yes” and “no” or gestures when is asked to answer some questions.

Steve initiates contacts and seeks communication, but often does not know how to act, especially with children and pushes them to get attention. He is usually acting as a calm, smiling and playful boy. The child plays by himself. He seeks the company of other children and seldom participates in the gaming process.

The child receives a resource help till the end of the preschool education. Since the beginning of February, the child visits Daily Center for Children with Disabilities. He eats by himself, the personal hygiene of the child is well maintained. He controls his needs and doesn’t use diapers.

There is a need for follow-up by a pediatrician and systematic work with a speech therapist, psychologist and resource teacher.

Bobby

Special Needs: Low birth weight. Congenital CMV infection. Delays in psychomotor skills development.

Boby is 4 years old boy, who was raised by the birth family only during the first few months. He was abandoned in 2018 and was placed in the Baby Home for orphans in Eastern Europe.

The child moves through the space by rolling from back to abdomen. Put in walker he manages to stand up, but he has no good support for the legs, yet. He sits by himself in the crib, holding on to a movable or immovable support and sitting for longer and longer time.

He enjoys contact with an adult, laughs at games and jokes, makes eye contact for a short time, and sometimes for a longer time, under the influence of adults. The child utters a variety of sounds and spontaneous syllables.

He grabs a toy and performs some manipulative actions with it for a short time – he waves it and hits it on a surface, but after dropping it, he doesn’t look for it anymore. Sometimes he manages to pick up a toy placed in his immediate environment.

The child is completely dependent on the care of an adult. He falls asleep easily, both in light and in the dark, and his sleep is restful. He eats slowly and capriciously, with a feeding bottle, refuses a spoon. He is calm in changing clothes and water procedures. He uses diapers.

Boby needs a loving family.

Gabe

Gabe is a physically active 8 –years old boy, who likes to play outside. He lives in a Foster family in Eastern Europe.

Gabe finds his way in the familiar environment of the home, the kindergarten and the support center. The child moves independently, goes up and down stairs. He eats by himself with a spoon, drinks from a cup. Gabriele throws and catches a ball. He sorts 3 cubes by size. He takes off shoes, can put on slippers and shoes with patches. He needs prompting and assistance with toileting, washing and dressing.

Expresses joy with gestures. He waves “Hello” and “Bye” but when the foster mother reminds him. Although Gabriele is a child with autistic behavior, he loves physical contact and is very obedient. He is an active child and according to the foster mother, he has made great progress in many ways especially that he is much calmer than before. The child eats and sleeps well.

Gabe quickly relaxes and gets close to a new person if he likes him from the first moment; otherwise, he avoids him or ignores him.

Gabe needs systematic care from a psychologist, speech therapist and resource teacher, as well as the support of a foster parent to improve cognitive, social, emotional and communicative development.

Ethan and Noah

Ethan (10 years old) and Noah (13 years old) lived with their parents. Both parents died of cancer. The children then lived with their paternal uncle and grandmother. It was found that the relatives were not able to provide adequate living conditions for the children; therefore, they were taken out and placed in a Group home. Ethan & Noah have 2 older sisters.

Ethan is a good kid. Not an aggressive child, but sometimes imitates older children; he never initiates conflicts or fights. Regarding his speech, a speech therapist is working with the child and he is visibly progressing; his vocabulary is not poor. The child has difficulties in school. His marks are average, but he has a hard time learning his lessons. The speech therapist reports that his problem is with hissing sounds, but he has made great progress and is now reading well. Ethan is in second grade and loves going to school. He doesn’t like the online lessons, he wants to go to school to play with the other kids. Most of all, he likes to play chase and hide & seek. His favorite subject is sports, math is difficult for him, but he states that math and computers are his favorite subjects. He likes to go on trips. He really liked the trip to the mountain resort, and that they went to the pool there. Ethan loves animals, said his favorite animal is the tiger. The child wants to be in the same family with his brother. When asked what he wanted to say to the family that would eventually adopt him, he replied that he would love them, that he would help, that he would do everything at home and said: “Tell Mommy to adopt me as soon as possible! I can’t wait any more!”

Noah is a good child. He goes to school regularly and is doing well. Noah loves going to school and prefers it to online lessons. His favorite subject is sport education; he adds that he actually likes all the subjects, but math is the hardest for him. The child has many friends, but does not make friends easily; prefers to select them. Noah prefers to play outside with friends rather than be alone in his room. He likes to play sports, especially basketball and football. In his free time, he plays with his friends and his brother, and in addition to basketball and football, they play chase and hide & seek, and draw. He likes to go for walks in the mountains, but he does not like long excursions. They recently went to a mountain resort and he really liked this excursion. The child has a great desire to be adopted and prefers to be in the same family with his brother. The child does not have certain expectations or preferences for the family that would eventually adopt them, but thinks that it will be nice to have a sister. Loves animals and would be happy if the family had a pet. He likes dogs and horses the most. When asked what he would like to say to the family that would be interested in adopting them, Noah replied that he wanted to be together with his brother and not be separated.

Ethan & Noah prefer to be adopted into one family and stay together.

Mia

She is 5. 

The child has been placed in a foster family. Until 18 June 2020 she was raised in the biological family.  The child is from the mother’s 3rd pregnancy, weight – 2700 g, height – 49 cm. 

General physical development: 

The child has an impaired general condition, lagging behind in her mental development. She is psychomotorically restless and unsure of her reactions. The child has no built-in skills to perform a complex of movements following a pattern. Gross and fine motor skills are uncoordinated, underdeveloped and imprecise. 

Psychological Status: 

Mia has signs of lagging behind in the neuropsychological development. In consultation with a psychiatrist, a diagnosis was made – moderate mental delay – significant behavioural disorder which requires care or treatment. 

Mia has difficulty expressing her thoughts due to a lack of vocabulary and speech. She has age-inappropriate knowledge and skills.  

Mia does not easily accept people during her first contact with them and is a lethargic child. There are no depressive moments. She does not show aggression when defending her belongings. The child is passive. 

She is now responding to her name, but is still unresponsive to commands. She has somewhat developed a sense of satiety. She crams food quickly and then stops briefly and continues again. It is difficult to introduce her to an eating regime. 

Playing skills: 

She has no developed skills to play with toys or household objects. The girl usually grabs the toy, licks it and bites it, then throws it away. She seems to enjoy listening to music because she shows emotion. 

Learning activity 

Maria has difficulty remembering, storing and reproducing what she has learned, and her attention is sluggish without the presence of concentration. For this reason, she is insecure in her performance and does not take initiative in contact with others.

Thomas

is little boy is a real gem. Together with being a fun-loving and very alert child, he also has a gentle nature. Since being in Foster care, he has made very strong emotional attachments with those closely caring for him as well as significant developmental progress. Prior to placement in Foster care, he spent four years in a ‘family-type care home’ where he was looked after with 10 other children of a similar age to him. Since moving to Foster care he has tried so hard to make up for lost time by communicating with his Foster mother verbally. He quickly settled in with his Foster family and his joy at being looked after and given the attention of his foster family was clear for all to see.

He now has a small and ever developing vocabulary by which he can make himself understood. He also uses gestures, pointing to objects or people or animals to show what he wants to say. Using this approach, he is able to communicate effectively with his Foster mother.

He is a sociable child who enjoys the company of other children, particularly his friends with whom he loves to play. He is so full of energy, enjoying running, climbing, and riding his bike (which is fitted with stabilizers). He particularly likes to kick a ball around in the garden with his friend and play with balloons. On outings to the park and the zoo, he takes great interest in everything he sees but loves most of all anything with wheels.

His motor skills have improved recently and he is able to do more complex activities without being told how. For example, when his jacket sleeves are inside out he turns them the right way round before dressing himself. He takes great interest in many different kinds of toys. He loves the rides in the school bus every day. He is in a small class group.

He is self-caring with regard to dressing, undressing, toileting, eating and drinking.

Overall Thomas is a wonderful child who is in need of a loving permanent family who can nature his gifts and support his development.

Bobby is a 5-year-old child. He comes from a large family. After birth, the child was raised in by the birth family. Due to problems in his health, he was hospitalized several times in a hospital, after which the mother abandoned him and he was placed in a Baby Home for orphans in Eastern Europe.

Bobby has been experiencing delays in his Neuro-psychological Development. He was diagnosed with kidney issues.

Bobby is a calm and pleasant child. He is well attached to his caregivers and responds well to them. When given attention, he reacts positively and with a smile. Most of the time, the child is energetic and physically active. It is difficult for him to stay in one place, constantly moving and exploring.

Bobby responds to his name with a smile, to sounds and noise. He keeps an eye on the movement of people and objects in the room.

The child expresses his joy by erratically clapping his hands and by making noises. When held by the hand he makes several steps.

Bobby eats well with a support from an adult. His sleep is calm.

Both Leo(age of 9) & Felix(age of 12) are physically and mentally healthy kids. They are very active and energetic children who love to run, jump, kick a ball, climb etc. They are very good at riding bike and are able to make precise movements with their hands – they are dexterous and like to assemble and disassemble different toys.

Leo is 3^rd grade; his favorite subjects in school are painting, sports, technical and computer education. Felix is 6^st grade and is focused on his favorite sport soccer, but he also is good at history and math. Both children study English. They show interest and diligence in the educational activities according to their abilities and have no issues with the teachers or the discipline.

The kids play with children their own age. They have many friends in school and at the group home, where they live. They prefer games including other children. Their favorite are ball games. Soccer is very popular and Leo will be Ronaldo and Felix – Messy.  They know how to follow the rules of the game. Other thing that they like is watching cartoons. One day Leo wants to be a police officer and Felix will be definitely a soccer player!

Daily hygiene habits are established for the children. They are completely independent in practical skills. Participate in various household activities. They clean and keep tidy their room and their wardrobes. Correctly use spoon and fork; they eat clean and with great appetite.

The kids were humiliated at their home and they signed declarations that they don’t want to go back but prefer to be adopted.

Andrew

Born September, 2015.

General: Andrew does not walk independently, he takes steps, held by the adult’s hand.

Fine: The child nests, sews rings, sticks a sheet smeared with glue. Willfully grabs objects, a toy handed to him by the adult or to which he has reached by himself. He passes it from hand to hand. His motor skills are structured into increasingly precise and complex gestures with coordination, giving meaning to space and time. The child progresses towards autonomy and ease of movement. Pushes a button on a toy. Feeds independently more and more clean.

Psychological status:

• Notions and perceptions: The child has mastered the characteristics of the elements of space: color – recognizes and names the main colors and their shades – without brown and black; shape-like ball, cube, circle and square; quantity – very little; size.
• Attention: Advanced qualities of attention – there is concentration and distributability.
• Memory: His memory develops with the mastery of speech. He easily remembers what impressed him. Plays actions with objects. Learns by grass or characteristic sound. Learns individual short texts from children’s songs and performs them faithfully.
• Thinking: Count to 10. Andrew realizes cause/effect. He reaches the objects through mediation by pulling the couch rug and bringing the object closer to him. His knowledge of the surrounding world is arranged in an elementary system Compare. Classifies on the basis of color, for example balls of the same size, different in color.
• Imagination: His game breaks away from its manipulative basis. Makes a symbolic game, but doesn’t assign roles.
• Intellect:  The child was examined by Binet-Terman tеst, CoR/ Coefficient of development/ – 56%. Falls into the normative group of mild mental retardation lagging but when considering the violation of visual acuity.

Emotional development / prevailing emotional conditions, level of anxiety, depression, aggressiveness: 

Andrew expresses emotions, uses gestures to communicate. His smile is nice and social and through it he actively initiates contact. Positive emotions are dominant. Moments of discomfort are rare, they are accompanied by opposition, expressed with stereotypes, lack of response, disregard of the adult’s attempt to clarify the situation, crying and auto-aggression.

He defends his interests and desires, sometimes with negativity. Emotionally responsive to music. He sings faithfully children’s songs, dances rhythmically with the upper half of his body. Andrew is not anxious or depressed, but presents a rich and varied emotional register, which also contains negative emotions. When frustrated, it is difficult to calm down and in such moments he tends to self-harm. The psychologist continues to work with him on learning to postpone desires.

Attitude towards the adoption process:

Andrew understands the speech in its entirety and in the context of the loving, safety-creating attitude it strives for. One can talk about a certain conscious attitude and attitudes towards the adoption process in terms of growing up with a mother and father in another environment.

Ken 

Ken is a nice, well-built child of 5 years and 7 months. Once entering the room, he was slightly worried, did a few stereotypical wobbles, held on to his caregiver, whom he calls “mom”. Then his curiosity got the better of him and he relaxed to look at the objects in the room and the little treats and gifts. He liked the little red car he was given. I asked him what color the car was, he doesn’t react to colors.

Heath condition: His physical development corresponds to his age. He is in very good health, not sick.

Information about the biological family: Ken is a child raised by his biological father, but completely neglected. He often wandered the streets, he was taken out from the family by social services several times.

In April 2021, he was placed urgently in a Children Center. When he came in the center, he was severely malnourished, dirty, very hungry. The first days he wanted to eat only bread, he ate food like for two adults. Now he is able to feed himself, he likes to eat everything. Eats carefully, moderately and cleanly.

Since his placement in the orphanage, he has not been sought by parents and relatives.

Emotional development: Ken has made great progress in this 1 year and 6 months at the center. He is friendly, inquisitive, likes to look at picture books. When he plays with something that interests him, he can spend at least an hour concentrating. Loves to listen music. He is able to count to 10. He already controls his physiological needs. At night they still put him in a diaper, just in case because he sleeps deeply and long. His sleep is peaceful.

He plays with the other children, most of the children in the center are older than him. He is friendly with them and they all love him. Sleeps in a room with two other boys.

School activities: Ken attends common kindergarten together with the children from the city of Roman. He likes to attend the kindergarten. He plays with the kids, there are no complaints about his behavior from the other children, not even from their parents.

Ken understands everything from everyday life and follows verbal commands. Answers questions with yes and no.

In our meeting room, he wants to look at and touch many objects that are unfamiliar to him.

He looked carefully at a book I brought him as a gift, in which he colored with water pencil. He immediately understood how to wet the pencil and started working with the book, he was very happy and concentrated.

Kayla – Isaac’s Twin – Born 2014

Good general condition. The apparent age, corresponding to the actual. She is in normal physical and neuro-psychological development for her age. Healthy, rarely suffers from acute viral infections. There are no data on food and drug allergies.

Motor skills: General: Has good coordination of lower and upper extremities.

Fine: Well-developed fine motor skills.

Perceptions and ideas: Very well oriented to time, space and own person. Recognizes shapes, objects and figures – differentiated visual perceptions. There is good concentration, resistance to active attention. She has good memory abilities.

Attention: She has good concentration of attention. She easily concentrates on a given task.

Thinking: All logical thought processes have a good indicator.

Imagination: Possesses a developed imagination – a high level of ability to accurately reproduce an object, phenomenon, as well as the ability to independently create new images.

Intelligence: Well-developed intellectual capabilities and abilities.

Emotional development: The emotional tonus of the child is positive. Contact, emotional and inquisitive. Adequately expresses her emotional state and recognizes that of others. When a remark is made, she knows how to correct her behavior, knows how to apologize, when she realizes a mistake has been made.

Language – speaking skills and communication:

Speaks correctly, uses a vocabulary satisfactory for her age. Uses complex sentences. Demonstrates consistency and adequacy while performing a task. Has slight difficulties in pronouncing some complex words.

Can identify herself by gender and age. Calm and cheerful child. She is always smiling, radiant, does not cry for no reason. Like any child, she likes to be the center of attention.

Oksana – Born 2015

Good general condition. The apparent age, corresponding to the actual age. She is in normal physical and neuro-psychological development for her age. Healthy, rarely suffers from acute viral infections. There are no data on food and drug allergies.

Motor skills: General: Has good coordination of lower and upper extremities.

Fine: Well developed fine motor skills.

Perceptions and ideas: Very well oriented to time, space and own person. Recognizes shapes, objects and figures – differentiated visual perceptions. There is good concentration, resistance to active attention. She has good memory abilities.

Attention: She has good concentration of attention. She easily concentrates on a given task.

Memory: the main parameters of memory – memorization, retention, reproduction correspond to the age of the child.

Thinking: All logical thought processes have a good indicator.

Imagination: Possesses a developed imagination – a high level of ability to accurately reproduce an object, phenomenon, as well as the ability to independently create new images.

Intelligence: Well-developed intellectual capabilities and abilities.

Emotional development: The emotional tonus of the child is positive. Contact, emotional and inquisitive. Adequately expresses her emotional state and recognizes that of others. When a remark is made, she knows how to correct her behavior, knows how to apologize, when she realizes a mistake has been made.

Language – speaking skills and communication: Speaks correctly, uses a vocabulary satisfactory for her age. Uses complex sentences. Demonstrates consistency and adequacy while performing a task. Has slight difficulties in pronouncing complex words.

Isaac – Kayla’s Twin – Born 2014

The apparent age does not correspond to the actual. There is a slight lag in physical and neuro-psychic development for the age. The child is healthy, rarely suffers from acute viral infections. There are no food or drug allergies.

Since his admission, developmental delay has been noticed and the necessary consultations have been made with a general practitioner, endocrinologist, pulmonologist and neurologist. After the user’s dispensary stay at the Specialized Hospital for Active Treatment of Children’s Diseases a diagnosis has been made: Duchenne spinal muscular dystrophy. On 13.09.2021 he was admitted for prophylactic medical examination.

Motor skills: General: Has good coordination of upper extremities. Clumsy gait. Fine: Fine motor skills are not well developed given the disease.

Psychological status:

Perceptions and ideas: Oriented autopsychically (i.e., oriented in relation to itself) and alopsychically (i.e., oriented in relation to the world), oriented in space (spatial orientation), partially temporarily disoriented (temporal orientation). Recognizes shapes, objects and figures – differentiated visual perceptions. He has difficulty concentrating, instability of active attention is observed. Memory abilities are not well developed.

Attention: Significantly reduced concentration, switchability and distribution of attention. Easily distracted when completing a set task.

Memory: The main parameters of memory – memorization, retention, reproduction are reduced to the minimum for the age of the child.

Thinking: All logical thought processes have a low indicator. There is a poor vocabulary, poor in form and means of expression. It is difficult to establish cause-and-effect relationships. Concrete-figurative thinking is leading.

Imagination: Weakly developed imagination – a low level of ability to accurately reproduce an object, phenomenon, as well as the ability to independently create new images.

Intelligence: Poorly developed intellectual capabilities and abilities. Due to the disease, the user has a delay in intellectual development. Has difficulty pronouncing four-, five- and more-syllable words. Falling behind in learning the study material.

Orientation to place and time: Poor orientation to time and place,

Emotional development: The emotional tonus of the child is positive. Contact, emotional. Expresses his emotional state and recognizes that of others. When a remark is made to him, he corrects himself, knows how to apologize.

Sam is 3.  He is a handsome child with expressive eyes. He is a well-proportioned and well-built child. He enters the room walking alone, accompanied by the pedagogue of his group.

His physical development corresponds to his age. He currently weighs 12 kg and is 91 cm tall.

Due to the delay in neuropsychological development and some manifestations of the autistic spectrum, on November 2, 2022 Sam will enter the Pediatric Clinic for an examination, consultation with a child neurologist and a diagnostic examination for atypical autism by a child psychiatrist.

He didn’t show much concern at my presence as a stranger, but he immediately began to look for the pedagogue, and when she stood next to him, he seemed to feel more secure.

He looked carefully at the little toys and book I brought him as a present. He touched all the new items, flipped through the pet picture book, but continued with the other gifts. We opened the little cubes, which he looked at for a moment, and then took the clear plastic packaging. Sam concentrated on using his fingers to peel off a small piece of what was left of the label stuck on it. At first he didn’t succeed, but he didn’t give up and with care and concentration managed to peel it off. The next new and interesting item for him turned out to be my document folder. He reached to pick it up and leaf through it, but was verbally instructed by the teacher not to touch it. He looked into the eyes of the pedagogue  and obeyed the prohibition, refusing to look at and take my folder.

He started playing with the plastic packaging again. He was sitting quietly on the bed until he was allowed to get off and walk around the room. Moves and climbs into bed and chair without problems.

Right now, he immediately went around seeing what was there. Sam likes to open and close windows and doors. He went to the window, saw that it was tightly closed, knocked a few times on the glass and went to touch the television in the room.

He was brought a musical toy with keys, he pressed them with one hand, but his attention was drawn to another staff person in the room who was copying a document onto the printer. The sound of the printer impressed him and Sam listened very carefully and at the same time watched as the copied sheet came out.

In conclusion, Sam is an attractive child. Born a second degree of prematurity, he developed more slowly, but in the last month he began to make progress in some of the important areas of his neuropsychological development. If he is adopted by a family that has experience with children with special needs, and in which he receives special attention, love and care, I think he will be able to integrate, be happy and develop his potential.

Boy, Age: 6

Region: Eastern Europe

Primary Diagnosis: Severe mental disability; Cerebral palsy; Asthma

Gayson is a 6 years old boy who leaves in a Group home in Eastern Europe.

He was diagnosed with severe mental disability, Cerebral palsy and Asthma for which he took medicines and received care from different specialist.

Grayson stands up on his own, even without support. Walks on its own for short distances but is unsteady. Picks up toys of different sizes and shapes by himself and transfers them from one hand to the other or hands them to a person nearby. Recognizes different types of toys and uses them as intended. He is trying to manipulate with scissors and a pencil, recently he has been successful, he is learning to cut along a line. He tries to draw and manages to keep his attention on this activity for a long time. He likes to have other children around him.

Grayson shows interest in what is going on around him. He understands simple instructions requiring 2-3 steps given to him. His vocabulary is increasing with every passing week – he understands most of what is asked of him, but has difficulty pronouncing the words. The child’s speech development is at the level of pronouncing random sound combinations and syllables. He tries to say the words “grandma”, “mom” and “come”.

Grayson is emotional and sociable. He recognizes the voice of a familiar person, he himself seeks contact with the people around him. Shows interest in musical toys and toys that make different sounds. He is calm and smiley most of the time. Grayson seeks contact with other children in the group. Shows interest in various activities. Imitates the actions of older children.

Grayson needs a loving family to love him, to take care about him and to make his life much better then it is in the Group home.

Paul is 7 years old boy, who was raised by his  birth family unti 2016. He was abandoned and in 2016 and was placed in the Baby Home for orphans in Eastern Europe.

Paul is a boy born full-term, with normal physical and motor development. He has been experiencing moderate mental disability and behavioral disorders. Early infantile autism is being discussed, but there is no evidence of a diagnosis in this regard.

Paul is a calm and pleasant child. He is physically very well developed – walks and run by him self, climb stairs an trees and has a sense of self-preservation.

The child expresses his joy by erratically clapping his hands and by making noises. When he is very close to the caregiver, who has lifted him up to the level of her face he takes note of her – he laughs and slaps her with his hand to express his joy and in order to study her face.

Nick is clumsy when walking with slightly bent knees stepping on toes. Climbs stairs without looking for support, moves independently, but clumsily.

During the observations conducted in the office, impaired development of the limbs was observed. The boy can run, jump and stand on one leg. According to foster family information, he rides a bicycle. Does not fully flex and extend arms. He is stiff in his movements. He reports pulling and pain when stretching the limbs. Climbs on chairs and sofas. Handles objects equally with both hands, but has difficulty with movements.

Fine: It is difficult for the boy to extend his fingers and palms. There is a violation in the development of fine motor skills as a result of an illness. The child grasps and holds objects. He holds a pencil in his hand, tries to draw. Builds a tower of cubes. Handles a constructor and successfully nests its elements. Coordinates hand movements, leaves one object to pick up another. Manipulates toys and objects as intended. Writes some letters and numbers. He colors trying not to go outside the contour. Uses spoon and fork when eating, but clumsily.

Psychological status. 

Perceptions and perceptions: Visual and auditory perceptions are normal. The tactility is normal. Partially constructed representations of time and space. Aware of imminent danger. He doesn’t know the seasons. Knows most of the colors. He can’t draw a human figure. He finds it difficult to depict images through drawing. 

Attention: Volitional attention and resilience are observed. Able to independently allocate and switch attention from one activity to another. Selective focus depending on interests and the nature of emotional attitudes, which is characteristic of age. Share common activities and play. —

Memory: It is observed that the child uses past experience during play, remembers, stores and reproduces incoming information. Knows what different tools and objects are used for. Memorizes songs and poems and demonstrates them. 

Thinking: Separates the important from the unimportant, can summarize what he remembers, look for connections and dependencies. Can form judgments and inferences. Effectively uses mental operations – comparing, evaluating. 

Imagination: Adequate development of imagination for the age period is observed. Participates in story role-playing games. The games provided to him are varied.

Intelligence: The ability to reason, analyze and synthesize information is observed. Make cause and effect connections. Uses coping strategies in different situations. 

Spatial and temporal orientation: Nick orients himself adequately in the environment. He has an orientation to the position of its body in space. The boy has partially formed ideas about the seasons and the days of the week.

Emotional development (predominant emotional states, level of anxiety; depression; aggressiveness): The child is observed with a good emotional tone. He is emotionally attached to foster family. Looking for closeness and support in difficult times. According to information from foster family, he enters into communication with peers and adults, but at the beginning he is a little more cautious and distrustful. Shows interest in new things. He is curious. He does not show aggression towards others. He is benevolent in his contact with others. Able to identify and express basic emotions and feelings.

Language and communication skills (skills for communication and dialogue, expression of feelings in communication, use of non-verbal means in communication): Active and passive vocabulary at a satisfactory level, confuses genders. When meeting with strangers a little shy, but soon he relaxes and enters into a dialogue. Ask questions. He can recite and sing poems and songs.

Personal development Nick is defined by gender as a boy. He defines himself as a good child. He remembers his biological parents. He identifies himself with his origin. Enjoys joint activities with the foster parent. He has an understanding of the family he lives in as a foster family. Responds to a positive and benevolent tone with a smile. Expresses joy and displeasure. He delights in praise. Understands scolding for unacceptable behavior and feels shame.

Orientation in interpersonal relations (with peers; with adults):

The boy does not attend daycare. He is benevolent in his relationships with others. Initiates common activities when interacting with peers.

Attachment to the foster parent is observed. He tries to help her with housework and daily activities according to her. He is responsive and sympathetic to the feelings of others.

Some stranger anxiety is observed, but it is not long before he relaxes into contact and engages in interaction. Reacts calmly in contact with a stranger, smiles. He is happy when he is the object of attention, he likes it. According to information from foster family, in cases where he has to be left in the care of another adult, Nick does not react with alarm.

Play activity: The child pays attention to all toys and tools around him, does not bother to manipulate them. Shows interest in different types of toys and objects, gets involved in new activities and games. Participates in general plot role-playing games. Likes puzzles. 

Learning activity: Holds attention and shows interest. Assists with request and instructions. At the moment, training activities are carried out by foster family in a home environment. The foster parent stimulates and offers a variety of games and activities to the child supporting his general knowledge and intellectual development. Nick has learned most of the letters, but he confuses the numbers. Shows interest in puzzles and likes to arrange them.

Boy, Age: 6

Primary Diagnosis: Severe mental disability; Absence epilepsy

Michael is a 6 years old boy who leaves in a Foster family in Eastern Europe.

He was diagnosed with severe mental disability and epilepsy for which he took medicines and had no seizures any more.

Michael attends kindergarten. In the social service, he does not play or contact with the other children, he prefers independent activities.

 The child shows interest in children’s music videos, films and commercials by clapping, jumping, stepping from one foot to another and doing all this with great enthusiasm, making cheerful sounds and with a big smile on his face. He repeats these actions several times during the day during his visits to the kindergarten.

Michaels has delays and is receiving supports and interventions from specialists in the local community.

QUESTIONS FOR CLARIFICATION ABOUT THE CHILD:

1. On what date was she accommodated in HMSCC – January 2019
2. Diseases or complications of the child’s condition in the period after June 2022 /date of the last Medical certificate- NO
3. New consultations after June 2022 conclusions: NO
4. Hospitalizations after June 2022 – where, dates, diagnoses: NO
5. New immunizations: NO
6. Recent blood and urine tests: NO
7. Is there a change in the motor development of the child, if so, what is it:

Can he walk with someone else’s help and alone –  NO The child cannot walk independently. He moves by pushing when placed in a walker. Stands up on his own and stands on his feet when in his crib. He can get out of bed by himself. The child does not occupy an independent seat.

Does he play with toys, how – Avram likes musical toys. He manages to hold them in his left hand and manipulate them.

8. Speech –

– Does he pronounce combinations of sounds – random sounds

– Does he pronounce syllables – does she make meaningful combinations of syllables? – pronounces combinations of syllables, but does not make sense in them; 

– Does he say words like “mom”, “grandma”, “aunt”, “poop”, etc., does it make sense in them? / “yes”, “no”, “give”? – sometimes

– can he imitate syllables and words or the sounds that animals make “meow”, “baw”, “pa-pa”, etc. – NO

9. Therapies – speech therapist, occupational therapy, physical therapy? – The child has daily therapy with a kinesitherapist and pedagogue. He is followed by a neurosurgeon.

10. Psychological status at the moment, emotional development:

– Is he responsible when she is called by name? – Yes, when he hears a familiar voice.

– What instructions does he follow? – He takes a toy handed to him, throws a ball, wants to hold everything by himself

– Is there a person from the staff of the center to whom she is especially attached? – He is attached to 2-3 of the educators

– Did he quickly adapt to the new situation? – YES

“Does he like to be carried?” Does he let them hug her? When he is upset, how do they calm her down? – He likes to be carried in arms and hugged. 

11. Nutrition?

– Is he learning to drink from a glass?– He drinks from a glass. 

– Does he eat only pureed food? Yes, he eats pureed common food. 5 times a day.

– Is he trying to feed herself – YES

12. Daily habits, daily routine – do you sleep during the day? Is she sleeping well or is her sleep restless? Does she cry when she is put to sleep? Are they teaching her to use a potty? Does she like to be bathed?

Avram does not take an afternoon nap, he eats everything. He is very stubborn and when he decides that he wants to pick up an object, no matter how heavy and large, he does his best.

The child actively uses his left hand.

He still uses a diaper, potty several times a day.

His sleep at night is peaceful.

13. Personal impressions: The child spends a large part of the time in his bed. He gets out of there for meals and general activities with the other children when he is put in a walker. In my opinion, the child needs active work with an occupational therapist, physical therapy and individual work to stimulate his speech skills.

It is in the child’s best interest to be adopted as soon as possible and to receive all the individual care and attention he needs for his development.

• Somatic state (body configuration and state of health):

During the last six months there is no data of the child to have suffered from virus diseases or to have suffered incidents. Rey usually passes through an illnesses because he refuses to take any kind of medications. The only chance for him to take a medication is in the hospital with infusions. He had a bronchial asthma, but with the time it has subsided. He had Varicella in March 2020. At the present moment his condition is stable. He doesn’t have any chronic diseases. His physical development is delayed according to his calendar age. He had suffered from Covid-19 in March 2022. He went through it relatively easily.

• Motor development:

At the present moment there is observed motor delay that is behind the norm with the child. It corresponds to a child on the age of 3,5-4 years old. He tries new activities carefully, he is curious. He catches, touches and sometimes smells the objects that he sees around him. He tries to jump. He has difficulties with climbing and going down on stairs – he walks on them stair by stair and leading is one of the legs. He seeks support around him to feel more confident. He establishes short eye contact. There is observed a period of time when he is able to perform a set task or to answer a question. There are moments when he plays independently. He has delay in relation to the spatial orientation of the norm for his age.

Fine motor skills: There is observed delay in the fine motor skills. The child is able to catch and squeeze objects, toys. He can’t hold correctly pen or pencil. He knows the letters and the numbers, he names them in English and in Bulgarian. He knows the fruits and the vegetables and names them. He has developed passive vocabulary for all objects and names them. He also names the animals. He makes attempts to color in an outline, but he has difficulties. For him it’s easier to scribble and usually he does it in the shape of a circles, holding two pens in both of his hands. He is trying to do puzzles from 16 parts. He can hold a spoon and a fork, also a cup and to drink correctly. He eats independently – often just using his hands. He can undress himself, but he has difficulties with dressing himself and putting his shoes on.

2. Psychological state:
   • Perceptions and ideas: Rey knows and distinguishes the colors, he names them always clearly and knows them in English. He can say the numbers up to 10 in English and Bulgarian. He knows the Bulgarian and English alphabet.
   • Attention: The attention is unstable. There are moments when he does something for short time – playing with a constructor, building a house. He decides when to stop with the game.
   • Memory: mechanical memory
   • Thinking: visual-active. He can count, to add single digit numbers and single digit with double digit numbers. Counting calms him down. He doesn’t show interest in books.
   • Imagination: there is missing recreational imagination. He enters in roles in the game, he imitates dolls and situations. He names and imitates also animals.
   • Intelligence: There is delay from the norm for his age.
   • Spatial and time orientation: He has established ideas of spatial orientation. For time relationships still doesn’t have ideas.
3. Emotional development (prevailing emotional states, level of anxiety; depression; aggressiveness): He is very emotional. Sometimes he is more agitated. With moderate level of anxiety. He establishes eye contact. There is observed delay in his cognitive development for his age. Indications for autism. There is an emotional bonding between the child and the foster parent. He likes to walk barefooted and this is how he gets to know the environment – it is observed that he has stronger sense of the feet then the hands.
4. Speech development and sociability (communication skills and dialogue skills, expression of feelings when interacting, use of non-verbal means when interacting):

The child has developed passive vocabulary. The speech is not clear when he says certain words. He doesn’t know all the animals. He likes small animals. At the present moment he makes two simple sentences from 2 words. He has some vocabulary with English words. He learns quickly poems that somebody reads to him.

5. Personal development (self-assessment; characteristic features; interests):

Rey doesn’t have formed self-image. He used to be scared of the mirror before, but now he looks himself in the mirror. He tends to interact with adults. He is not distant with an unknown person, but he lets the person “into his world” when he decides to. He doesn’t go to preschool at the present moment since March 2022 when he had suffered from Covid-19.

6. Orientation in human relationships (with peers; with adults): From the observation made for the child and the foster parent it wasn’t found any kind of problematics. The foster parent tries to incorporate the child to her and to the society.
7. Play (play skills, preferences to play on his/her own or with peers, involvement in role-playing games and in symbolic play): Rey tries to play symbolic or story games alone or with peers, adults. He plays independently with stuffed toys, constructors, Lego. He loves to build houses. He plays with other children. He is very musical and tries to imitate melodies. He catches and throws a ball with both hands. He rides a balance bike.
8. Education (knowledge, skills and competence of the child/the school boy/girl); preferred subjects and activities at school; difficulties in the educational process): He is enrolled in a preschool. He has stopped going for two months during the summer break and after that he went back. He has stopped going since March 2022.
9. Every day habits and hygienic habits /skills to take care of himself/herself (including sleep, eating, etc.): Rey tries to eat by himself. He usually smells first the food before eating it. He has periods when he choses what to eat, like there was a period of time when he wanted to eat only red food. He tries to dress himself independently, but still needs assistance with that. He has removed the diaper by himself at the age of 5 years and 4 months and at the present moment he has good self-regulation. He goes by himself to the restroom. He needs assistance with the shoes and with the bath time.
10. Attitude towards the adoption process: He doesn’t understand the concept due to the deficits that he has.

General physical development: is significantly behind in his physical and nervous mental development. The physical development does not correspond to the calendar age – height and weight below the age norm. According to the child’s medical certificate, he has “Congenital microcephaly”, “Hydrocephalus” 1 degree, “Atrophy of the optic nerve – blindness of both eyes”, “Cryptorchidism” and “Congenital inguinal hernia-dextra” with a diagnosis of “Background retinopathy”. The child is on constant drug therapy. No allergies to food and drugs have been established. The child does not fall ill very often.

Motor development: general: The child cannot walk independently, but takes a few steps with support. He stands up independently by holding on to available support. He moves by turning from back to stomach and vice versa. The boy can sit up unassisted.

Fine: In the process of development (significantly behind the age norm).

Emotional development:  The child is emotionally unstable — anxious and acting impulsively.

His behavior is unstructured and his mood is unpredictable. A rapid change of emotional states is observed. He does not show liveliness or pronounced positive emotion when in contact with an adult.

Interaction with adults and peers: The child is not oriented in interpersonal relations, but calmly accepts body care and responds with a smile to speech or teasing by an adult. He does not show interest in peers.

Special Needs: “Spastic cerebral palsy” – quadriparesis, moderate degree. Symptomatic epilepsy. Lumbar spina bifida with hydrocephalus..

Gross motor development: Significantly limited — the child changes direction /turns in bed/, turns from back to stomach and sideways, turns his head in the direction of sound. The child stands independently next to a stationary support and sits independently. During the day, he is placed in a stationary cradle and walker

Emotional development (general mood; anxiety level; depression; aggressiveness):

He expresses his emotional state by laughing, crying and making sounds. The child is calm, loves the company of an adult, likes to be sung to, smiles when teased.

Personality (self-assessment, features; interests): The child is calm, holding hands smiles, making eye contact.

Interaction with adults and peers: The presence and interaction with staff and users is equally well received, but he prefers the company of an adult.

Playing (skills for playing; preferences (individually or with peers), participation in role plays and symbolic games): The child shows interest in musical toys, and during group music therapy, reading of stories and teasing from an adult