Waiting Children Photolisting

General physical development  

• Mincho is in good general health. He currently weighs 8 kg. and his is height is 78 cm, which are below the norm for the age. The child was born with a low weight of 2790 gr. after a caesarean section. He is a frequently sick child and with multiple hospitalizations in the neonatal period. Mincho lags behind in his physical and neuropsychological development. He was diagnosed with cystic fibrosis – genetically proven. The child has a family burden. The child’s mother has cognitive deficits, one of the children born in the family is diagnosed with cystic phimosis. The child also suffers from genetically proven cystic fibrosis – a mixed form with secondary lactose intolerance. Another child born to the mother was also diagnosed with cystic fibrosis. Another of the children raised in the family is visibly behind the age norms, but has no diagnosed illness.

Motor development: 

• Gross motor skills: The child has decreased muscle tone. Active and passive movements of the four limbs are preserved. Mincho is able and more and more often stands alone on a fixed support. There is no independent gait. When placed in a baby walker, he demonstrates activity and independent standing. Placed on his stomach on a flat base, the child turns, stands up, takes a four-legged stance, but does not want to crawl.
• Fine motor skills: Mincho cannot hold objects by himself. He cannot hold a bottle or spoon by himself. He reaches for an object or a given toy, but the moment he feels that he has unintentionally held it, he lets go of his hand and pulls away as if frightened. He does not know how to hold a toy, a book, a pencil and use them as intended. Sometimes when he uses a walker he shows curiosity. Opens and closes drawers and accessible cabinets.

Psychological status. The child lags behind in all indicators of his neuropsychological development. The lag in speech and cognitive development is most pronounced.

• Perceptions and representations: Mincho does not respond to his name. He turns his head towards the source of the sound and looks for it with his eyes. Recognizes the foster parent. Detects the source of sound and light. Due to his young age, Mincho is not oriented to place and time. His childhood perceptions are not clear and precise.
• General sensibility: Responds adequately to light, visual, thermal and tactile (touch) stimuli. Depending on their type and strength, he reacts positively or negatively.
• Attention: the child does not know how to distribute his attention on different objects at the same time, but there is a well-expressed general receptivity to stimuli and a manifestation of interest in new objects from his environment. Pays attention to sounds and changes in the environment. He keeps his gaze on the speaker’s face. Cognitive development lags behind norms for calendar age.
• Memory: Not able to reproduce past and acquired experience in game activity. Increasingly, with the help of an adult, he manages to perform elementary observed actions. He can’t sort objects by color and shape or recognize them.
• Thinking: The child lags behind in his neuro-psychic development. So far, characteristic knowledge and skills for his age have not been mastered.
• Imagination: not applicable.
• Intellect: His intellectual development does not correspond to the calendar age. The child

is non-verbal. He does not know how to solve situational tasks.

• Spatial and temporal orientation: Spatial and temporal orientation is not yet observed, due to a delay in neuro-psychic development.

Emotional development (prevailing emotional states, level of anxiety; depression; aggressiveness): Mincho is a calm child. Reacts distantly, sometimes crying on initial contact, but calms down quickly. The main emotions he expresses are joy and anxiety. He looks for the foster parent and feels calmer in his presence. He smiles when spoken to. The level of anxiety when walking and getting to know new places and faces is minimized. Aggressive states are not considered. Emotional discomfort is observed when in contact with water. Mincho cries a lot when he touches water, which makes bathing and maintaining his hygiene difficult.

Speech development and sociability (communication skills and dialogue skills, expression of feelings when interacting, use of non-verbal means when interacting):  The child is non-verbal. Makes inarticulate sounds. When spoken to for a long time, it is noticeable that Mincho tries to pronounce, but his abilities are reduced to the reproduction of single sounds such as “A-a-a-a”, “I-i-i-i”. The child does not know how to send or respond to a greeting, for example to wave the hand for “Bye!”

Personal development (self-assessment; characteristic features; interests): The child has a good emotional tone. After placement in a foster family and provision of individual care and attention, significant positive changes in personal development are reported, achieved at a rapid pace in a short time.

To learn more about her, please fill this out. 

Mia is 11.

Mia is a sweet 11 years old little girl. She lives in a small group home in Eastern Europe. She has several medical issues, but is showing progress in her development.

Mia can walk, run, and climb stares by her self. Her fine motor skills are in the process of developing. She could arrange cubes, put one object into another, but quickly loses interest. She could hold a pencil with three fingers and scratch within the boundaries of the sheet. She likes to hold a book and to watch at the pictures there.

Mia memorizes recurring items and activities of daily life. She could recognize familiar tunes and songs and she will hum with syllables after she heard them from an adult. She knows the rooms of the Baby home and could go and be back with out help. Now she recognizes the individual adults, with whom she has a closer contact.

She is comfortable with unfamiliar people and is not afraid to initiate contact, vocalizing specific sounds. She likes to cuddle and has consistently positive affect.

Mia is still unable to vocalize combination of syllables or single words, but the caregivers report that the sounds that child expresses very depending on her state, needs and desires and eventually one can recognize what the child is saying and can establish a contact with her.

Mia can eat by herself. She has selectivity for food by its type and taste.  She is in the process of forming habits of using the bathroom by herself. 

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Elon is 8 years old.

His diagnosis is Arthrogryposis. However, this doesn’t seem to affect him much. Even though he has restricted movement in his knees (they do not bend much) he finds a way to go up and down stairs and slopes without any problem. Elon wears orthopaedic shoes and splints on his lower legs. However, he is excellent at putting them on and taking them off independently.

Elon is independent with toileting, dressing, undressing, feeding and drinking. He can make his own sandwiches with very little guidance.

Elon enjoys helping others. He is very good-natured.  He is schooled in the care home with other children who do not learn as fast as he does.

Elon enjoys the company of others together with going out to playgrounds, parks, zoo, indoor soft play areas, shopping Malls etc. He takes in every new experience with great interest, looking carefully to see how things work.

In public places, he is observant and makes quick decisions on what he wants to do and not to do.

Elon is desperately trying to communicate verbally but unable to speak at present. He understands everything. He is now trying to make sounds in an attempt to speak. He has lived in the care homes for nearly 2 years.

He is a very smart boy who has a lot of potential and would do very well in a family setting.

I am not convinced that special education is necessary for him, although he is obviously behind in his educational milestones simply because he has lived in a residential institution and again he is a child who has not had adequate speech therapy. So although his understanding is good he has no good effective means of communication at the present time.

ELon has a beautiful smile. He interacts with adults with gestures showing them what he wants.

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Motor skills:

General: Does not turn from back to stomach. Tracks moving objects and turns its head in the direction of sound.

Fine: Reaches for hanging toys, holding them briefly, placed in

his hand.

Fine motor skills are slightly improved. On his own picks up toys placed around him, manipulates them.

Psychological status:

– Perceptions and representations: not constructed

-Warning: cannot be surveyed

-Intelligence: lagging behind in psychomotor development in all indicators

– Spatial and temporal orientation: not formed

Emotional development:

Laughs out loud at teasing. The child’s emotional reactions are directed at the adult. They are related to satisfying basic life needs. Crying around feeding times.

Emotional development:

Laughs out loud at teasing. Calm while awake, plays briefly. The child’s emotional reactions are directed at the adult. They are related to satisfying basic life needs. Crying around feeding times.

Language and communication skills:

Make sounds

Personal development:

There is a lack of awareness of one’s own personality /young age/.

Orientation in interpersonal relations:

None. A privileged connection is being established.

Gaming activity:

Reaches for hanging toys and briefly holds a toy placed in the hand.

Educational activity:

Individual classes with a psychologist, pedagogue and rehabilitator.

Household hygiene habits:

It is fed through a gastrostomy. He sleeps in a crib. The sleep is peaceful. He is tearful when bathing. Completely dependent on the care of the staff – feeding, bathing, changing.

Attitudes towards the adoption process:

Still at a young age.

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Nancy is 3.5 years old! 

Motor skills 

General: After carried out regular rehabilitation, Nancy has started to hold her head upright. There is support at the feet for a short time, held by an adult or next to a stationary support. She turns independently from the back to the abdomen. Stays in a sitting position on her own. Does not walk. 

Fine: Poor fine motor skills – reaches out to a toy from a supine position, tries to catch it. She holds herself with her hands for stationary support for a short time in her crib. Makes attempts to grab a small toy and holds it for a short time. She doesn’t hold a spoon during meals, she doesn’t drink water on her own, shares the foster parent. 

From July 2020 the girl uses the social service “Part-time rehabilitation” in Day center for children and youth with disabilities – kindergarten to “Unique Children of V***” Foundation the town of V***. The girl needs regular rehabilitation procedures in order to strengthen the muscles of the torso, lower and upper extremities. 

Emotional development: 

Psychomotor apparently calm. In case of side noises, she becomes irritable, hard to calm down. She finds it difficult to adapt to new places and people. Strongly attached to foster parents. Good emotional ties in the foster parent’s family. 

Play activities: 

Due to the impossibility of fine grip in full volume and manipulation of play objects with the upper limbs, actual play activity is lacking. According to the foster parent, the beginnings of curiosity and interest in certain toys from her environment are noticeable. When resting in the crib and playing children’s songs as a background, the girl shows interest by trying to get up and turn her head in the direction of the sound. She also tries to make guttural sounds accompanying the music. Recently, she has been looking at a smart phone, according to the foster parent, she non-verbally shows preferences for a certain children’s movie. When it is played she watches it. 

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General information

At the moment of the evaluation Genghis is 12 years old.

He was born on June 30, 2011 from a second caesarean section, premature with a weight of 1700 g and a height of 40 cm. Immediately after birth, he was admitted to the HMSSC – Ruse.

After an assessment, it was found that it is suitable for the child to be brought up in a family environment and in 2013 he was placed in a professional foster family.

Since March 2014 he is with expert decision 100% need of outside help with leading diagnose “Generalized disorder in the development”. 

Motor skills

Gross motor skills: Genghis has an independent gait. Gross motor skills are well developed, but there is difficulty in bending when trying to pick up an object from the ground.

Fine motor skills: The child has a correct grip on a pencil/painting brush. There is already a developed sense of pressure on a sheet, when drawing/writing. The boy claps his hands, unzips, scribbles within the sheet, arranges a wooden puzzle with the support of an adult, tries to color correctly and nest a mosaic. He still struggles with buttons – buttoning, unbuttoning. Cutlery is gripped with a fist.

Psychological Status: Psychomotor agitated, does not make eye contact, does not respond to name calling, does not follow verbal instructions. Expressive is poorly developed. Memory and intelligence – significant lag.

Personal development

The child’s personality continues to be built in parallel with the development of his cognitive skills, so he also develops his self-concept, the ways of interacting with others and his attitudes towards the world. Given the age, life experience and diagnosis of Genghis, his personal development is still in the initial stages, in which the child with the help of the foster parent develops basic trust and his independence is stimulated /however difficult it may be given his diagnosis/.

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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.

The child is 2 years and 1 month old. According to data from the medical epicrisis, the child has a diagnosis: “Microcephaly”. At the age of 8 months, she was hospitalized in the P** Diagnostic Center, where a delay in neuro-psychic development and mainly in motor development was found. The child was also diagnosed with a genetic disease due to which she cannot absorb glucose — “Disorder in the exchange of pyruvate and gluconeogenesis – PDHC deficiency”. When the child is 1 year and 3 months old, is an established need for a ketogenic diet with the specialized food “KetoCal”. She needs special care and dietary nutrition. 

On 08 of Nov 2022, the child is re-examined at the “S*** General Hospital – to check the results of the 6-month treatment with the ketogenic diet and to find out how the child’s body is absorbing KetoCal. The child was discharged from the hospital on November 10, 2022 with a conclusion: the specialized food is well received by the body, the general condition has improved and a recommendation to continue the ketogenic diet. 

Gross motor development: The motor activity of the child is still low. The child does not hold the head straight. She tries to walk, but on his toes and with the help of an adult. She holds her hands into fists. She has developed grasping reflexes but does not hold objects. The girl responds to color stimuli, in the form of moving toys, but does not follow them with eyes. 

The child cannot sit up on his own; it must be supported on both sides. A wheelchair with devices to keep the child’s head and back upright is to be purchased. 

Fine motor development: Fine motor skills are underdeveloped – the child tries to grasp objects, but quickly drops them.  

Psychological Status: 

• Perceptions and concepts: The child’s sensory perceptions and concepts are in a developmental stage. The child reacts to auditory stimuli and makes sounds.
• Attention: Active attention is still unstable.
• Memory: In the stage of pending development.
• Reasoning: In the stage of pending development.
• Imagination: In the stage of pending development.
• Time and space orientation: In the stage of pending development.

Emotional development: 

The child’s emotional state is stable. The child continues to be attached to the foster mother. The child can imitate: repeats the laughter of the foster mother. Reactions of anxiety have not been observed. Tanya feels safe both with the foster mother and in the extended circle of the family in which she is raised. The child reacts emotionally and with a smile to the people she knows. 

Language and communication skills: The child does not have developed speech: she makes sounds and imitates laughter. 

Personal Development: In the stage of pending development. 

Relationships with others: 

According to the foster parent – K***, the child has adapted well to their family. Tanya reacts to strangers, and this is expressed through the child’s emotions, depending on the tone of the voice spoken to her, as well as the height of the person. 

Playing skills: 

The child reacts to toys. Upon observation by a specialist, it was found that the child likes bright toys, especially those that are red in colour. The child listens to the sounds made by the musical toys. 

Hygiene and everyday life habits/skills: Not applicable to the child’s age. The child is cared for entirely by the foster mother. 

Attitude towards the adoption process: Not applicable to the child’s age.  

 Morris – 4 Year Old Boy!

General physical development

– Somatic state (body configuration and state of health): Normal body configuration.  

Calendar age: 4 years and 4 months; height: 105 cm; weight: 12.800 kg.; chest circumference – 57 cm; head circumference – 51 cm 

– Motor development:  

– Gross motor skills: He can walk on his own. 

– Fine motor skills: He takes toys of various sizes and shape on his own initiative and manipulates with them; his left hand is leading. 

Psychological state:

– Perceptions and notions: He is interested in what is going on around him and in playing activities such as musicals, speech and manipulations with toys.  

– Attention: Short-term attention to impacts and to activities with him.  

– Memory: Not developed; he has memorized separate moments from the daily routine for feeding, staying awake and sleeping. 

– Thinking: Not developed; thinking in images and actions. 

– Imagination: Cannot be assessed due to his young age.  

– Intellect: The boy is lagging the indicators for neuro-psychic development of children of his age.  

– Orientation in space and time: He easily transitions from one known space to another one; he reacts with satisfaction by producing sounds and combinations of sounds; he is oriented at a low level in the daily routine moments relating to feeding and sleeping.  

This is a child at the age of 4 years and 4 months with considerable discrepancy between calendar and mental age. 

Emotional development (prevailing emotional states, level of anxiety; depression; aggressiveness): When adults speak to him and tease him, he smiles, reacts vividly, and produces lengthy combinations of sounds and syllables. The boy recognizes the tone and voice of a familiar adult. Uses non-verbal means of communication. He cries when feeling uncomfortable when he needs to be changed or when he is tired. 

 Speech development and sociability (communication skills and dialogue skills, expression of feelings when interacting, use of non-verbal means when interacting): Morris produces combinations of sounds and syllables; he screams; he is unable to express himself in words and this is why he throws toys from time to time.

Personal development (self-assessment; characteristic features; interests): He is interested in what is going on around him and depends completely on the care provided by the staff. 

Orientation in human relationships (with peers; with adults): Morris is happy when a known to him adult appears; he smiles and produces lengthy combinations of sounds. He shows when he wants to be taken by adults. 

Play (play skills, preferences to play on his/her own or with peers, involvement in role-playing games and in symbolic play): Morris takes independently toys of various shape and size, he persistently reaches them and plays with them for a long time. He prefers new toys producing sounds and musical toys that he hits with his left hand. He can imitate actions with the toys as shown to him; when he fails to do so he gets frustrated and throws the toy away.

Education (knowledge, skills and competence of the child/the schoolboy/girl); preferred subjects and activities at school; difficulties in the educational process): Pedagogues works with him individually to stimulate the development of his speech and the manipulations with toys. He gets involved for a while in group activities with a pedagogue; the boy looks stares at videos with children’s songs. A physical therapist, a pedagogue, a psychologist, and caregivers work with him.

Everyday habits and hygienic habits /skills to take care of himself/herself (including sleep, eating, etc.): Diapers are used. He is serviced by adults from the staff according to a daily routine schedule. He is fed 4 times a day by adults with a spoon; he eats general food and building foods. He sleeps in the day and at night.

 Attitude towards the adoption process: Young age.

Nina is 8.

Basic data: Nina was born towards the end of 2014.  Since 2018, the child is being raised in a professional foster family in the village of S***.

General physical development: the general physical development of the child is well developed at the moment the child is 138 cm tall and weighs 32 kg. Nina is a mobile and energetic child, with well-developed motor function.

Motor skills: – Motor skills such as running, jumping, climbing, kicking a ball and throwing are well developed. She lacks agility, dexterity characteristic of her calendar age. Delayed movements are observed in coordinated movements and walking on a limited surface.

Fine motor skills: outlines letters and numbers on a dotted line. Does not associate sound with letters, studies them mechanically.

Psychological status: The child was re-examined with the ER of TELK from 7/27/2020  60% without foreign aid, leading diagnosis: Mild mental disability for a period of 3 years. The doctor’s conclusion is that the child needs special care during upbringing. Perceptions and ideas – A deficit in the perceptual-imaginative activity is reported, similar passage through the individual cognitive stages.

-Attention-Insufficient sustained attention. Concentrates on a given activity, but for

short periods of time;

-Memory– Remembering is involuntary, perceptually influenced, and during play. Attracts the attention of peers appropriately. At a slower pace, skills for full contact with other children in the class and adequate expression of emotions are formed.

-Thinking– Thinking is clearly active, and understanding of causal relationships is in the process of development.

-Imagination – the child has a well-developed imagination, with opportunities to apply elements of imagination in a game;

-Intellect – Intellectual development does not meet the norm of the child’s calendar age.

-Spatial and temporal orientation – Lack of experience and thinking based on expanded speech, determine inaccuracy of ideas and rough orientation in space.

Emotional development: Understands and accepts emotions, feelings and hidden mechanisms, but fails to respond adequately in one way or another, reciprocally to the situation. She has not yet developed the ability to manage her own emotional state and balance, inner feelings and priorities have not been clarified. Low resistance to frustration, general immaturity, weak or absent criticality, pronounced dependence on physical aggression. Lack of control over impulsive socially undesirable emotional reactions.

The child speaks and understands Bulgarian. Says most words with slurs or mispronounced sounds, vocabulary relatively poor for age. Uses mostly simple sentences or poorly structured complex sentences.

Personal development– Shows no interest in extracurricular activities. In situations where she is not given enough attention or does not get what she wants, she begins to shout, get angry, cry, remaining in this state for a long period of time. However, her outbursts are relatively rare, and as the child grows, a change in behavior is observed.

Orientation in interpersonal relations– Shows no interest in extracurricular activities. In situations when she is not given enough attention or does not get what she wants, she starts to shout, get angry, cry, staying in this state for a long period of time. However, her outbursts are relatively rare, and as the child grows, a change in behavior is observed.

Play activity – In the company of other children, the child wants to be active and join in common games and activities, but does not have the skills to attract the attention of his peers in an appropriate way. At a slower pace, skills for full contact with other children in the class and adequate expression of emotions are formed.

Educational activity – Nina is in the 2nd grade. Due to difficulties in learning the academic material, she was assessed as a child with Special Educational Needs. A resource teacher, a speech therapist and a psychologist at the school work with her individually. She attends classes regularly and willingly.

Household hygiene habits – Nina has developed self-care habits, being able to use the toilet by herself. Feeds independently and handles utensils properly. She has developed hygienic habits – she washes his hands before eating and dries them with a towel. Brushes teeth before bed after reminder. She dresses herself and knows how to fold and arrange

the clothes.

Attitudes/attitudes towards the adoption process – the child cannot realize the adoption process due to the neglect in his development.

Rio is 10.

Diagnosis: Mild mental disability, no disorder or minimal behavioral disorder.

It concerns a male child with normal physical and disability in neuropsychological development. Poorly developed speech. With affective reactions to frustration, aggressive acts. Active attention deficit and poor impulse control. Memory and intelligence – delay in cognitive development.

The child has a congenital metatarsus varus deformity of both feet; surgical correction of the right foot in infancy with a very good result. There is no data on the treatment of the left foot.

Low birth weight.

Medical history. Medical history.

Pregnancy and childbirth:

Another pregnancy: second

mechanism of birth: by normal mechanism, born at home, hospitalized in the 1st hour after birth.

birth weight: 2350 g.

length at birth: 49 cm.

general clinical assessment: APGAR – at 60 min. – 9.

Family burden: no data.

Allergy to food and medicines: no data.

Vaccinations: Immunizations against tuberculosis, hepatitis B, diphtheria, tetanus, whooping cough, poliomyelitis, hemophilus infl., pneumococci, measles, rubella and mumps have been carried out. Completed for age immunization status.

Pre-existing common childhood diseases such as whooping cough, chicken pox, measles, rubella, mumps, etc.: no data.

Past other diseases and complications related to them: Acute infections of the upper respiratory tract.

Acute bronchiolitis.

Varus of the metatarsal bones (metatarsus varus), bilateral, congenital.

Tuberculosis – no.

Convulsions – no.

Ashton is 12.

General physical development: The child has normal physical development for his age – at the moment Atanas is 146 cm tall and weighs 34 kg.

– Motor skills: – The child is 11 years old, with normal physical development. The child has a correct posture and coordinated body movements. He runs, jumps, climbs, being able to keep his balance.

Fine motor skills – with well-developed motor skills. The child has good hand-eye coordination, which is necessary for writing and drawing. Can draw, applique and model with

plasticine.

Psychological status:

-Perceptions and representations:– the child’s visual perceptions are impaired. With decision No. 91088/4/7/21, the child was re-examined with the ER of TELK with a 60% degree and type of disability with a diagnosis of “Traumatic cataract of the left eye” for a period of three years. Athanasius can recreate and recount past events. The auditory analyzer is normal,

perceived as normal.

-Attention- Has sustained attention, concentrates in a given activity;

– Memory – Remembering is intentional, perceptually influenced and during play. Has a good memory for past and present events;

-Thinking – thinking is clearly effective, and the understanding of causal relationships is developed according to the norms of age development;

-Imagination – The child has a well-developed imagination, with the ability to apply elements of imagination in a game;

– Intellect– Intellectual development corresponds to the norm of the calendar age, of

who is the child;

-Spatial and temporal orientation: According to his experience of age and thinking based on expanded speech, determine accuracy of representations and orientation in space. It has a correctly built left-right orientation of its own body.

Emotional development – the child understands and accepts emotions, feelings and hidden mechanisms, manages to react adequately in one way or another, reciprocally to the situation. He has developed the ability to manage his own emotional state and balance, inner feelings and priorities are not clarified. There is resistance to frustration, general maturity. There is built-in criticality, there is no pronounced dependence of behavior on external stimuli and marked impulsivity. Does not show verbal or physical aggression. Demonstrates control over impulsive socially undesirable emotional reactions.

Language and communication skills – The child speaks and understands Bulgarian. Says most words clearly with correctly pronounced sounds. Vocabulary is relatively good for the age. Uses simple and complex sentences and correctly structured complex ones

sentences.

Personal development– Shows interest in extracurricular activities. He is actively involved in extracurricular activities. Inquisitive and curious about the surrounding world. Shows interest in films and clips of a scientific and entertainment nature.

Orientation in interpersonal relations – normal behavior is observed with Atanas. Does not enter into conflicts with older fathers in the foster family. He communicates with the children in the class, and has no evidence of showing aggression towards them. He has friends with whom he communicates between classes. Relations with aunt and uncle are good. He helps them with the housework. Shows concern and respect in dealing with them.

Play activity – In the company of other children, the child is active and gets involved in general play and activities. Has developed skills to attract the attention of peers in an appropriate way. Skills for full contact with other children in the class and adequate expression of emotions are well formed.

Educational activity – Atanas is in the 5th grade this year. Does not show difficulties in learning the learning material. Shows an increase in success in all subjects. Prepares independently for school. He prefers mathematics and the Bulgarian language, as well as man and nature.

Household – hygiene habits – Before placement in the foster family, the child did not have permanent hygiene habits. He gradually acquired hygienic habits and began to wash his hands, teeth and maintain his personal hygiene. Tidying up his room. He sleeps and eats independently, he has no preferences for certain food. He chooses his own clothes. After coming home from school, he changes into the clothes he wears to play outside.

Attitude/attitudes towards the adoption process: during the last conversations with the child, he is hesitant about the adoption, since the certain candidate adopters, with whom there were familiarization meetings, subsequently refused to adopt him. Ashton is familiar with the procedure itself and the possibility of finding him a suitable family to be his. The child is referred to a social service in the Center for Social Welfare and Development in S*** to change attitudes and hesitations to be adopted.

Geri is 12.

The girl’s body configuration is visibly correct, with Geri being visually smaller than children in her age group. The skin color is dark, the eyes are brown, and the hair isdark brown. At this time, it is not known that Geri suffers from any chronic or hereditarydiseases or that she needs to follow a specialdiet. General health is good. Geri doesn’t get sick often. 

Geri’s motor activity is appropriate for her calendar age. Running, climbing, kicking, throwing a ball, spinning a hoop, jumping rope during play activities are welldeveloped and continue to improve. Motor coordination is well developed. Shows physical activitytypical for the age period.Fine motor skills:

Fine motor skills are developed. Geri does well with cutting and dotcoloring, handlesglue independently, colors without going out of outline. She cannot read or write, having only learned to spell her first name. 

Chis is 9.

The general health of the child is normal for the age, correctbody configurationwith light skin, brown hair and light eyes. The boy doesn’t get sick often. There is no data on chronic and hereditary diseases.–

Motor skills:General motor skills: Chris’ motor activityis normal, compared to the age group. There are nodata on manifestations of hyperactivity or delayed actions. The child actively and willingly participates in sports games and activities–running, kicking and throwing a ball during playactivities.

Finemotor skills: The boy’s fine motor skills are well developed. He fulfills the norms necessaryfor his age. The child is diligent and attentive during the performance of exercises related todeveloping fine motor skills. A positive process of creativity and individuality is observed duringactivities related to fine motor skills.

Psychological condition – Perceptions and ideas: The boy’s perceptions are normal for his age. The child has realistic ideas,recognizes and names objects from the world around him. The child’s sensory experience isdeveloped and continues to be enriched. The boy has knowledge of basic shapes, colors and sizes. Chris correctly recognizes and groups figures by shape, color and size and characteristic features.

Sarah is 12. 

General physical development

At the present moment, the child is in good general health, within the norm for the calendar age. She eats and sleeps well. The foster parent provides the child with regular preventive examinations by a personal doctor, as well as access to specialists when necessary. All necessary vaccinations for age have been given.

On July 9, 2020, the child was issued an expert decision for 75% need for outside assistance with a leading diagnosis: other mixed behavioral and emotional disorders.

General illness: other mixed disorder of behavior and emotions with underdeveloped expressive speech, articulation disorders, hyperactivity, emotional static, dysphoric reactions, agitation crises, behavioral deviations with attachment disorder, disinhibited type, hypomnesia, non-independence, mild cognitive deficit mental retardation, significant difficulties in social adaptation and integration in the school environment.

In 2022, the child was consulted several times with a child psychiatrist. It was established that the girl quickly shortens the distance in the contact, talks about things that excite her, does not always understand the question asked, is roughly oriented to her own personality, not oriented to time and place. Emotionally labile, volitionally unstable, impulsive, functioning at the level of mild mental retardation. The child was prescribed medication according to a scheme.

Final diagnosis: Mild mental retardation, significant behavioral disturbance requiring care or treatment.

Motor development:

• Gross motor skills: Motor skills – running, jumping and climbing – are in a low norm for the age. The child goes down and up stairs, runs, climbs, has purposeful catching and throwing of a ball.
• Fine motor skills: The child uses both hands equally successfully, but the right hand is leading. The development of fine motor skills does not correspond to age. She experiences difficulty in redrawing, she finds it difficult to nest elements, contour drawing is improved, with the support of an adult she manages.

Psychological state: 

• Perceptions and notions: Specific, objective, nonsensical, out of the norm for the age. She responds adequately to auditory, visual and tactile stimuli. The child has poor spatial orientation, perceptions and ideas. She has no established concepts of qualitative and quantitative relationships.
• Attention: Directing attention is relatively difficult – reduced active. Active attention is relatively easily attracted, but very difficult to retain – low resistance. The volume and distributability of attention are in the lower limit of the norm for the age. The girl experiences difficulty to the point of inability to concentrate attention and to filter the essential from the non-essential stimuli – the strongest stimulus is leading. Attention span is also below normal for age, but improvements are reported.
• Memory: Memory and intelligence – at the level of mild to moderate mental retardation. The girl functions more like a 6-7 year old child. Visual-mechanical memory and long-term memory are at a low level. The volume of memory is in the low limit for the age.
• Thinking: When examining logical thinking, the child demonstrated a thought process in the lower limit for the age. Thinking is – fragmented, broken. Experiences difficulties in finding regularities and dealing with logical tasks of this type. Cannot handle words with abstract meaning.
• Imagination: Unproductive, at the lower limit for age. The girl cannot reconstruct, typify, schematize images by memory or by signs.
• Intellect: The deficits in cognitive development that the child had when placed in the foster family are difficult to compensate given the mild degree of mental retardation. Intelligence development is at the lower limit for age. The child still experiences difficulties in recognizing and naming colors (knows red and yellow), geometric figures. She has serious difficulty if she has to redraw them or follow an outline; to group by a given feature, to compare. Associative thinking is slower. Lacks understanding of abstract concepts.

Orientation in space and time: Regarding time ideas, the child does not recognize the specifics of different seasons. She has an idea of the parts of the day, but not of the days of the week and their sequence.

Emotional development (prevailing emotional states, level of anxiety; depression; aggressiveness): Sarah’s emotional functioning is typical of a younger child. The girl has a slight mental retardation, does not recognize the basic emotional register and its nuances, has difficulty determining her own emotions and those of others. Her adaptation to the foster family’s home has been successful, but she still rarely follows the rules, often due to a lack of understanding of what is required of her. She hardly respects authority, does not follow instructions. She still uses a diaper at night. The child is very lively and mobile – with hyperactive behavior, is curious about the environment. She has a hard time staying in one place. Due to this fact, the girl is receiving medical treatment. The girl loves mobile games. The foster mother reports that the girl often loses things, sometimes falls into extreme emotional states in frustration and fights if she doesn’t get what she wants. She does not structure her sharing well and does not know how to express her inner experience. Due to entering puberty, increased manifestations of oppositional behavior, changes in pressure and impulsivity are reported.

Speech development and sociability (communication skills and dialogue skills, expression of feelings when interacting, use of non-verbal means when interacting: Sarah has echolalic speech. The reason for this is poor language skills and comprehension problems. Language abilities are far below the norm for the respective age. She has a poor vocabulary, does not express herself grammatically correctly, has difficulty composing a simple sentence with visual support and guiding thoughts. Articulation is sometimes unclear, pronunciation indistinct. Impressive, expressive speech and ideas are below the age norm. the child does not have abstract thinking. There are deficits in the development of phonemic hearing and auditory attention, letter and number gnosis. Due to poor attention span and deficit in memory and thinking processes, the child has difficulty memorizing graphemes and numbers. Work is done on enriching the speech on topics and on the appropriate use of prepositions, using visual materials in order to facilitate the process and create interrelationships between the words and the content.

Personal development (self-assessment; characteristic features; interests): Sarah does not demonstrate adequate self-esteem for herself. According to data from the foster parent, it is difficult for her to follow the rules at school, she often does not respect authority figures and when she is reprimanded, she does not respect and follow the established order. In a family environment, she avoids or rarely participates in common activities and tasks. She cannot help with household tasks and activities, and if she does it is according to her momentary mood, being able to perform elementary actions specifically oriented with the help of another.

Orientation in human relationships (with peers; with adults): with peers: The child has difficulty fitting into the company of other children. She prefers to play with younger children, 6-8 years old. She has difficulty sharing food, objects and toys and does so only with familiar and close children. She often takes other children’s toys, mistaking them for her own. In case of frustration, she can react slightly aggressively towards another child, quickly controlling the impulse without falling into extreme emotional states.

With adults: When meeting a stranger, the girl reacts timidly, but after a while quickly closes the distance. Hardly respects authority and rules. Acts more impulsively (primarily) and emotionally. When she sees something that attracts her active attention, she forgets about any guidelines, limits and prohibitions and fails to restrain the impulse.

Play (play skills, preferences to play on his/her own or with peers, involvement in role-playing games and in symbolic play): The girl has a hard time fitting into the company of other children. She prefers to play with younger children. There are no built-in skills for participating in general games, she is not cooperative. Does not take initiative in general games.

Education (knowledge, skills and competence of the child/the school boy/girl); preferred subjects and activities at school; difficulties in the educational process): The girl is currently in the fourth grade. She has a hard time dealing with the material. She seeks help from the teacher when needed.

Everyday habits and hygienic habits /skills to take care of himself/herself (including sleep, eating, etc.):  At the moment, the child does not have household hygiene habits, she does not know how to take care of herself and maintain her personal hygiene independently. She gets dressed with help from her foster parent and cannot choose her own clothes. The acquisition of self-care habits and motor skills also lag behind. She has recently started brushing her teeth on her own.

Attitude towards the adoption process: Given her cognitive deficit, the child is not familiar with the adoption procedure. She shows no resistance or attitude to the adoption process and expresses a strong desire to have a new family.

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.

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.

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.

1. Place where the child is being raised: center for placement for children and youths with disabilities
2. General physical development

• Somatic state (body configuration and state of health):
• Motor development:
  • He is delayed in the development of his motor skills. Sunny is with weak motor activity, he is able to hold up his head, when picked up, to roll over is tummy and roll over his back and he already has stable support in his legs. He is trying to sit and he makes small attempts to crawl. He is being placed in a walker but he still does not move with it but he sits and plays with the toys which are on it.

3. Psychological state:
   • Perceptions and notions: limited
   • Attention: unstable
   • Memory: it cannot be evaluated.
   • Thinking: limited.
   • Imagination: not developed.
   • Intellect:
   • Orientation in space and time: not developed.
4. Emotional development (prevailing emotional states, level of anxiety; depression; aggressiveness): The emotional development of the child does not correspond to his calendar age and it is below for his age. The emotional development is also delayed. The child demonstrates sensitivity towards specific stimulation from the outside world and towards some changes in his personal status/ He demonstrates irritation when feeling discomfort. He does not demonstrate preferences towards specific people or toys. The individual communication with the child calms him down – caresses, hugs, listening to peaceful music, gentle speech. There is no aggressive or auto-aggressive behavior. The anxiety level is low.
5. Speech development and sociability (communication skills and dialogue skills, expression of feelings when interacting, use of non-verbal means when interacting): All nervous processes are not regulated and they are going uncoordinated. The child trembles and listens in a loud sound and follows with eyes people and objects which are moving. He makes difference in the tone with which somebody speaks to him and he pronounces undefined sounds. When somebody talks to him, the child smiles or he laughs with voice.
6. Personal development (self-assessment; characteristic features; interests): At this moment of his development the child does not have personal speficis and interests.
7. Orientation in human relationships (with peers; with adults): The caregiver reacts adequately when the child needs comfort and consolation, while hugging him, caressing him and talking him gently. There is direct physical and emotional contact with the child with more smiles, hugs, caresses in order the child to feel closeness and to build sense of safeness and trust.
8. Play (play skills, preferences to play on his/her own or with peers, involvement in role-playing games and in symbolic play): The child has access to variety of toys to play with, which are adequate for his age – rattles, rubber toys and toys with lights and sounds. The child manages to spend more time on object, placed in his hand or to take an object, which is close to him.
9. Education (knowledge, skills and competence of the child/the school boy/girl); preferred subjects and activities at school; difficulties in the educational process): The child is not in a school age.
10. Every day habits and hygienic habits /skills to take care of himself/herself (including sleep, eating, etc.): The child does not have self-serving skills, he relies on his caregivers.
11. Attitude towards the adoption process: The child is of young age and is unable to express an opinion about the adoption process.

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.

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.

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.

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