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22.12.2016. No. 33-2-02/612

 

To all recipients attached

 

 

Information on adoptable children

 

The Ministry of Welfare (hereinafter – the Ministry) appreciating the cooperation in the field of foreign adoption, and believing that every child has the right to live in a family, in accordance with the implementation in Latvia of Article 16 of the Hague Convention on Protection of Children and Cooperation in Intercountry Adoption (hereinafter – the Convention), provides information on adoptable children for whom families are being sought abroad:

 

1.    Girl, born on January 10, 2016, resides in an out-of-family care institution since February 2016:

·      the girl has bluish-grey eyes and brown hair. She is very positive, often smiles, and always is glad when an adult talks or plays with her. She is calm, emotionally stable, cries only when there is a reason. Is able to stand on all fours, crawls on floor, during the crawling supports more on one forearm. Grasps toys, rattles them, moves toys from one hand into another during the playing. Reacts on her name, smiles, babbles, likes to imitate sounds, likes musical sounds. Reacts on her reflection in mirror – smiles. The girl enjoys to be around other children. She drinks from a cup with adult support, eats from a spoon. It is predicted that the girl will be clever, but she will not be able to walk and will need a wheelchair (she does not feel her lower part). It is not clear yet if the girl will be able to control bowel movements, probably it will be known around 3-4 years of age. Hydrocephalus is compensated, the liquid drained in time;

·      the child was born to a 33 years old mother, from her 3rd pregnancy, in the 2nd delivery, in 37th week of gestation, with weight of 3030g, 8/9 points by Apgar scale. The mother was not in doctor’s surveillance during the pregnancy;

·      child has been treated in a hospital:

–      10.01.2016. – 12.02.2016. – meningomyelocele of lumbosacral region, hydrocephalus, ventriculoperitoneal shunt (18.01.2016.);

·      the child has been consulted by:

–      neurosonography (11.01.2016.) – congenital hydrocephalus;

–      neurosonography (14.01.2016.) – period of a newborn, congenital hydrocephalus, signs of occlusion increase;

–      neurosonography (29.01.2016.) – hypoplastic c.callosum, VL dilation does not increase;

–      neurosonography (04.03.2016.) – CC hypoplasia, liquor drainage maintained, VL dilation in the dynamics compared to 08.02.2016. is progressing;

–      neurosonography (08.04.2016.) – bilateral VL dilation without negative dynamics, as compared to NSS done in March;

–      magnetic resonance imaging for head and whole length spine (15.01.2016.) – condition after congenital spina bifida surgery (from anamnesis), hydrocephalus, wide lateral ventricles and the third ventricle seems to be with occlusion, aquaeductus cerebri with adhesions. Chiari II malformation. Spinal cord fixed, placode in the level of last lumbar vertebra and the sacrum. Meningomyelocele in lumbar and sacral part. Spacious bow defect of L3 down.

–      ultrasonography for abdominal cavity (11.01.2016.) – without noticeable pathology;

–      ultrasonography for hip joints (01.02.2016.) – right hip joint corresponds to the type IIC, left –  IIA type;

–      orthopedist (08.02.2016.) – cyclically abduction in hip joints is equal, displasia in the right side, mild clubfoot. Recommended to initiate plastering after 2-3 weeks. Requires further observation of an orthopedist;

–      orthopedist (04.03.2016.) – meningomyelocele, clubfoot. Initiated coorective plastering;

–      orthopedist (11.04.2016.) – congenital foot inversion – extension deformation. Recommended gymnastics –  feet in opposite direction, to improve abduction in hips;

–      Munich Functional Development Diagnostics (MFDD) (15.02.2016.) – evaluation of the child’s psychomotor development of the following categories: crawling, sitting, walking and capturing age, the categories of comprehension, speech and social age correspond to the girl’s age.  Crawling age – turns head over the midline on either side, limbs generally in bent position. Sitting age – raises head repeatedly for 1 second in a sitting position, in the lying on the back position keeps the head on a center line for at least 10 seconds. The left side of the limb moves more actively. Walking age – legs are straightened, tense, automatic walking is not observed. Capture age – hands are mostly clenched in fists, marked capture reflex. Perception – grudgingly responds to the extreme light and sound effects. Follows by gaze to a red rattle on both sides at an angle up to 45 degrees. Speech – shouting when in discomfort. Strong sucking. Vowel "a" and wide "e" articulation, often linking them with "h" (ehe, he). Social age – calms down, if taken on hands. Focuses on  a moving face and follows it by gaze;

–      physiotherapist (15.02.2016.) – asymmetrical posture, muscle tone physiologically elevated, in legs> in arms, the amount of movement in the upper limb joints appropriate to the age. Dex hip dysplasia, a limited amount of movement, asymmetric hip folds and pelvis position. Clubfoot, a limited amount of movement in both feet. A marked asymmetric tonic neck reflex. Scars on the head (soft and moving) and the lumbar spine (solid, moveable), reddish speckle on the lumbar spine;

–      pediatrician (20.04.2016.) – physical development corresponds to the age, hydrocephalus, ventriculoperitoneal shunt (18.01.2016.), meningomyelocele of lumbosacral region, state after plastic (10.01.2016.), congenital feet deformation;

–      neurosonography and neurosurgeon consultation (23.09.2016.) – shunt valve reprogramming. The girl needs regular neurosonography and neurosurgeon control, the next visit scheduled on November 21, 2016;

–      in surveillance of an urologist due to neurogenic bladder. Remains spontaneous urination and defecation. Therapy: Driptan, cathetered twice per day. Next urologist consultation on January 25, 2017;

–      regular surveillance of an orthopedist –  ordered solid foot orthoses. Next orthopedist consultation on January 2017;

–      Munich Functional Development Diagnostics (MFDD) (30.09.2016.) – the child’s psychomotor development partially corresponds to the age in crawling.  Sitting, capturing, comprehension, speech and social age development is delayed by 1 month, walking age is delayed by 3,5 months. Crawling age – rocks on hands and knees. Turns around her axis while on stomach. Sitting age – sits alone at least for 5 seconds with frontal support. Turns from back to stomach actively. Bends easily both hands, when being seated. Good head control in a sitting position with various inclinations to all sides. Walking age – straightens legs in knees and hip joints easily, simultaneously taking over weight for at least 2 seconds. Capture age – takes blocks in each hand, is able to hold them consciously for a short time. Takes discs with fingers and straight thumb, not involving palm. Perception – tries to get an item which can be taken only by changing position. Speech – says double-syllables. Shows activity when spoken to. Makes dialogue – imitates syllables. Enjoys to make verbal communication. Laughs, giggles. Social age – enjoys the game of “hiding behind furniture”. Carefully follows actions of an adult;

·      final diagnosis (April 2016) – hydrocephalus, ventriculoperitoneal shunt (18.01.2016.), meningomyelocele of lumbosacral region, state after plastic (10.01.2016.), congenital feet deformation;

·      final diagnosis (November 2016) – hydrocephalus, compensated condition after shunt surgery, meningomyelocele of lumbosacral region, state after plastic (10.01.2016.), lower limbs flaccid paraparesis, congenital feet inversion-extension deformation, neurogenic bladder, which causes chronic urinary tract infections;

·      further necessary treatment – regular control of orthopedist, neurosonography, gymnastics. Control of neurosurgeon. Consultation of urologist. Magnetic resonance imaging of lumbar spine at the age of approximately 1 year, consultation with neurosurgeon about the results. X-ray of the spine at the beginning of active development, vertebrologist consultation, neurologist consultation, urologist consultation. Magnetic resonance imaging of brain planned on December 12, 2016;

·      the parents signed the consent to the child’s adoption in another family in February 25, 2016. The mother left the child in hospital after the birth. The parents have not shown interest in the child afterwards. In the girl’s birth certificate the mother’s husband is stated as the girl’s father, although the girl’s biological father is a different man. The mother made decision to refuse from the child already during the pregnancy. The mother does not have any dependency problems. The mother was also adopted as a child, she has problems with forming a family. There are no other relatives, who wish to take care of the child;

·      the girl has 1 older minor sister, who is in the care of the father. The decision by the Orphan’s Court on separation of the children in case of adoption has been made.

 

2.    Girl, born on June 24, 2015, resides in an out-of-family care institution since July 2015:

·      the girl has brown eyes and dark grey hair. The girl loves individual attention, seeks contact and physical embrace, she is sad, if she is not cuddled. The girl likes to play in a group with other children. Crawls quickly, stable sitting, crawls after a toy, walks by holding to something/ somebody. Enjoys to play with musical toys, imitates sounds and syllables. Shows interest about new toys and surroundings. Eats from a spoon with a help, drinks from a cup with a help;

·      the child was born to a 33 year old mother, from her 4th pregnancy, in her 3rd delivery, in the 40th week of gestation, with weight of 2990g, height – 50cm, 7/8 points by Apgar. The mother was not monitored by a doctor during the pregnancy;

·      the child has been treated in a hospital:

–      29.06.2015. – 14.07.2015. – intrauterine infection Z20.6 (risk of infection and contact with a human immunodeficiency virus HIV, syphilis prevention therapy, mother’s harmful substances impact on the fetus and the newborn);

·      child has been consulted by:

–      ultrasonography for abdominal cavity (29.06.2015.) – norm;

–      ultrasonography for abdominal cavity (30.06.2015.) – without pathology;

–      hearing test (26.06.2015.) – norm;

–      X-ray for tibial bones (04.07.2015.) –  no periosteal reaction in long tibial bones, dull contours in metaphyses,  hypodensity, which is not characteristic for lues;

–      X-ray for chest (13.07.2015.) –  mild gl.thymus hyperplasia signs;

–      neurosonoscopy (30.06.2015.) – brain differentiation satisfactory, without pathology;

–      oculist (29.06.2015.) – Fundus oculi without pathology;

–      Munich Functional Development Diagnostics (MFDD) (16.07.2016.) –the child’s psychomotor development corresponds to the age in all categories, except social age, which corresponds to the age only partially. Gross motor – crawling age – turns head over the midline on either side, limbs generally in bent position. Reflexive crawling movements. Sitting age – the head is held to one or other side. Kicks without preference to any side. Holds up head repeatedly for 1 second from a sitting position. Walking age – reflexive foot support reaction: hip and knees straightening during verticalisation. Automatic walking motion, if the child's legs alternately touches the surface. Dexterity development - capture age - hands are mostly clenched in fists, significant capture reflex. Perception – grudgingly responds to extreme light and noise exposure. Speech – shouting when in discomfort. Strong sucking. Social age – focuses view on a face for a short moment;

–      Munich Functional Development Diagnostics (MFDD) (14.12.2015.) – the child’s psychomotor development corresponds to the age in all categories, except speech, which is delayed by 1 month. Crawling age – termination of forearm support, lifting hands (from the surface) in upturned leg straightening movements ( so called "swimming"),  sideways tilting the surface, abduction of upper leg and hand (sense of balance reaction). Sitting age – if the child is lifted into sitting position, the head is brought up on the spine extension, head control in a sitting position – if the body is bent sideways the head rises up, vertically 45 degrees as in seated position. Bends both hands easily when seated. Walking age – supports on the toes. Capture age – palms are mostly semi-open, "playing" with each other,  takes toys in mouth (hand-mouth coordination), stretches hand towards a toy and touches it. Perception age – observes toy in hand. Turns head, looking at the paper rustle place. Speech age – guttural sound articulation: articulation of blowing-type sounds (v-type sound), first syllable lines, “Rrr” lines. Social age – focuses on  a moving face and follows it by gaze, "social smile", laughs loudly if  being teased;

–      pediatrician (24.07.2015.) – perinatal hypoxia, intrauterine infection, a condition after preventive therapy course against syphilis,  increased agitation syndrome, mother’s harmful substances impact on the fetus and the newborn;

–      oculist (18.10.2016.) – hypermetropia degree II, it is possible that in the future the girl will need to wear glasses, control in August 2017;

–      Munich Functional Development Diagnostics (MFDD) (28.10.2016.) – the child’s psychomotor development corresponds to the age in categories – prestidigitation and perception. Walking and language comprehension are delayed by 1,5 months,  speech is delayed by 2 months, social age delayed by half month, independence delayed by 3 months. Walking – climbs up one step. Walks by holding with one hand to adult’s hand. Prestidigitation – the child has a "tong" grip. Leafs pages in picture book.
Throws two small discs in a container. Draws lines back and forth. Perception age – finds object under container. Puts lid on a container. Inserts smaller container into a larger container. Speech age – expresses wishes by sounds “a”, “e”, expresses double syllables “ma-ma”, “pa-pa”, some syllables expresses with a meaning. Language comprehension age – reacts on her name, reacts on praises, understands prohibition, obeys invitations “give”, “take”. Social age – gives back an item after request. Rolls a ball to an adult. Independency – drinks accurately from a cup, which is being held for her, independently takes and eats piece of food;

·      the child has not received BCG immunization, because there are contraindications of basic illness;

·      laboratory tests made for:

–      HIV ½ (29.06.2015.) – positive;

–      Anti HCV (29.06.2015.) – positive;

·      final diagnosis in July 2015 – perinatal hypoxia, intrauterine infection, a condition after preventive therapy course against syphilis,  increased agitation syndrome, mother’s harmful substances impact on the fetus and the newborn. B23.8 (HIV disease resulting in other specified conditions – obtained by vertical infection) – predicted for whole life. On the background of assigned therapy the condition is stable. The girl is prescribed following medication twice per day: 1) Lopinaviri/ Ritonaviri, 2) Abacaviri, 3) Lamivudini;

·      final diagnosis in November 2016 – HIV infection, chronic hepatitis C, atopic dermatitis, cow’s milk protein intolerance;

·      upon decision of an infectologist on August 30, 2016 a change of therapy due to resistance for previously used medication. The new therapy has reaction in a form of anemia. Hematologist’s consultation is planned on November 24, 2016. During the last 6 months (May-November 2016) ALAT indicators increase (19.07.2016. max 254 u/e, after therapy change 76 u/e, although the norm is 33 u/e);

·      further necessary treatment – consultations with infectologist, neurologist, cardiologist. Rickets prevention;

·      maternity and paternity for the girl is not stated. The biological mother arrived in a hospital without documents of personal identification, she took heroin before delivery.

 

3.   Not adoptable

Boy, born on March 22, 2013, who resides in a foster family since April 2015, previously resided in an out-of-family care institution since July 2014:

·      the boy has grey eyes and light color hair. He has peaceful nature, likes to explore the world actively. Shows features of talent in music. The boy is attached to the foster family. The foster mother does not wish to adopt the child due to her age;

·      the boy was born to a 31 year old mother, from her 6th pregnancy, in her 4th delivery, with weight of 1425 g, height 38 cm. The mother was under doctor’s surveillance during the pregnancy since 18th gestational week;

·      the boy was born in the 34th week of gestation, in spontaneous delivery in an ambulance car. It is known that the mother smoked and consumed alcohol as well as was ill with acute respiratory viral infection during the pregnancy. During the delivery the fetus had bloody amniotic fluid. After the delivery on the 4th day the baby was moved to the newborns’ intensive therapy ward with diagnosis – chronic intrauterine hypoxia, the I/Natal asphyxia, 5-7 points. Pre-term baby, grade I. Small for gestational age, respiratory distress, fast delivery. Neurosonography – leukolamacia threat. Echo cardiogram – suspected atrial septal defect (on question). Physiological jaundice – receives phototherapy, weight dynamics positive, slow.

Neonatal intensive care unit from 22.03.2013. to 26.04.2013. placed in an incubator, received parenteral nutrition for 10 days, probe feeding from the 1st – 20th day. Discharged from the hospital on the 36th day with weight of 2036g;

·      the child started to walk at the age of 16 months, to speak at the age of 2 years and 1 month;

·      the child has been treated in a hospital:

–      22.03.2013. – 26.04.2013. – moderate asphyxia in birth. Preterm baby, born in 34th gestational week. Neonatal jaundice;

–      22.03.2013. – growth hormone deficiency. Psychomotor development delay;

–      23.03.2015. – 27.03.2015. – protein energy malnutrition. Vitamin D deficiency;

–      15.09.2015. – adenoids. Bilateral secretory otitis. Bronchial asthma. Soft cleft palate;

·      the child has been consulted by:

–      ENT (15.06.2015.) – the left side recurrent purulent otitis;

–      ENT (09.07.2015.) – the left side secretory otitis. Adenoids. Language development disorders;

–      oculist (24.10.2014., 20.03.2015.) – hypermetropia;

–      neurologist (17.01.2014.) – psychomotor development delay;

–      neurologist (16.05.2014.) – psychomotor development delay and physical development delay;

–      neurosonography (17.09.2013., 07.06.2013., 17.01.2014., 16.05.2014.) – evaluation of brain development;

–      speech therapist (09.07.2015.) – language development disorder;

–      pediatrician (12.08.2014.) – protein energy malnutrition. Fe (iron) deficit;

–      cardiologist (11.03.2015.) – anatomically normal heart;

–      geneticist (02.10.2014.) – constitutionally small stature;

–      geneticist (11.03.2015.) – dysembriogenetic stigma. Small stature. Mental retardation;

–      geneticist (09.06.2015.) – small stature. Psychomotor development delay. Language development delay;

–      endocrinologist (03.02.2015.) – small stature;

–      allergist (07.01.2015.) – moderate, persistent bronchial asthma. Psychomotor development delay. Weight, height deficit;

–      allergist (31.03.2015.) – moderate, persistent bronchial asthma;

–      allergist (11.09.2015.) – moderate, persistent bronchial asthma. Possible intolerance to lactose. Physical development delay;

–      rehabilitologist (27.01.2015.) – hypostature. Left and right eyelid ptosis;

–      gastroenterologist (17.02.2015.) – physical development delay. D vitamin deficit;

–      neurologist (21.08.2014.) – psychomotor development delay;

–      neurologist (11.12.2014.) – mixed specific development delay;

–      neurologist (16.10.2014.) – psychomotor development delay;

·      laboratory test made for HBsAg (16.02.2015.) – negative;

·      final diagnosis – growth hormone deficiency. Psychomotor development delay. Protein energy malnutrition. Vitamin D deficiency. Bronchial asthma, persistent. Adenoids. Bilateral secretory otitis. Soft cleft palate;

·      further necessary treatment – D vitamin (3 drops once per day), Ventolini and Flexotide inhalations upon need. Singulair once per day from autumn till spring;

·      by a court verdict the parents were deprived of custody rights in November 2015. The child was taken out of the biological family, because the parents consumed alcohol together with some strangers at home, the mother was in such condition that she could not adequately react and ensure child care, supervision and his safety;

·      the boy has one older, minor paternal half-sister, who is in the care of her mother, one older minor maternal half-brother, who is in a guardianship, two older minor maternal half-sisters, who are in the father’s care and one younger sister, who is in the parents’ care. The decision by the Orphan’s Court on separation of the children in case of adoption has been made.

 

4.    Boy, born on August 22, 2012, who currently resides in a foster family since June 2016, previously resided in an out-of-family care institution since October 2012:

·      the boy has brown eyes and hair. Emotional and will sphere – refers to a contact with any adult, constitutes direct eye contact, with movements shows a desire for communication, but does so without persistence or competition with others. Welcomes the given attention, but if it is suddenly stopped or in case of contact rejection may react with sadness, disappointment, sometimes a little crying. However, mostly all of the emotions are expressed weakly, without the characteristic intensity, such as crying as grumbling, or rubbing eyes in protest. Does not request physical contact – accepts communication style as it is. Mostly characteristic joyful excitement bordering on nervousness can be noticed in movements, gestures and facial expressions. Enjoys the atmosphere of organized events with lots of people and impressions, which further reinforces the joyful excitement – loud laughs, significant movement and arbitrary contact search. Also observed radical psychic states for no apparent reason – can suddenly start to cry, followed by loud laughter, which can pass again suddenly. In these cases neither consolation nor physical contact help. Will power is unmarked – tries to do the given task, but it is more literal fulfillment of indications than internal motivation to learn. The cognitive sphere (perception, thinking, attention, interest) – thinking processes most occur at the level of mechanistic imitation –  is able to repeat what he has seen or heard recently, but after a time he is unable to reproduce it anymore. The boy knows parts of the body and can name them and show them on other people, but in doing so he needs repeated encouragement. The same applies to everyday activities such as bathing, dressing, tidying toys, etc. – an adult should always name and show the needed action – only then the boy completes it. The boy knows his name and he knows also the names of other children and teachers, but, for example, on a logical question "What is your name?"  he often responds with the last word of the question: “Name”. The boy recognizes some animals, he may show them in a book, may show signs of an object or phenomenon, for example, that the flower smells, injury hurts and need to be blown at to ease the pain. Notices minor consequences – for example, understands that pressing one button on a musical toy can start the others, but the boy lacks understanding to put together even a simple puzzle.The boy likes everything related to sound and light signals – both objects and events, he can observe or operate them enthusiastically for a long time, but by jamming in the process. Behavior, social behavior – friendly, good-natured with both children and adults. Happy with any interaction and the opportunity to gain new experiences. Understands all instructions, but the nervous agitation disturbs to perform fine motor activities accurately – eating, dressing, playing with small objects. Weak self-advocacy skills, generally does not interfere with other children's activities, but sometimes can have a sudden impulse – incomprehensible, short-term aggression. The boy likes walks, all outdoor environment and everything related to the movement possibilities – climbing, jumping, swinging, etc. Enjoys water therapy. Is able to eat independently, dress up, but does not fully comprehend, whether he has done it correctly or incorrectly. Uses toilet only with a reminder;

·      the child was born to a 32 years old mother, from her 2nd pregnancy, in her 2nd delivery, in 32nd week of gestation, with weight of 1650 g, 7/8 points by Apgar. The mother was not under doctor’s surveillance during the pregnancy;

·      the child started to sit at the age of 1 year and 3 months, to walk independently at the age of 1 year and 9 months, first teeth came out at the age of 5 months. At the age of 1 year he had 8 teeth;

·      the child has been treated in a hospital from 28.08.2012. – 19.09.2012. – premature birth (degree II), intrauterine infection (B20 – HIV, HCV), hypoxic ischemic encephalopathy I-II stage, premature children jaundice, premature children anemia;

·      the child has been consulted by:

–      ultrasonography for abdominal cavity (07.08.2012.) – without pathology;

–      oculist (10.09.2012.) – eye pupil expanding well, retina thin,  next consultation at the age of 6 months;

–      oculist (04.03.2014.) – OU astigmatism, hypermetropia. Glasses (on question);

–      oculist (20.03.2015.) – OU hypermetropia I-II degree cum astigmatism;

–      neurosonography (06.08.2012.) – without pathology;

–      neurosonography (28.01.2013.) – brain structure differentiated properly. No extended cavity systems;

–      neurologist (01.02.2013.) – consequences of neonatal central nervous system hypoxia in a form of  mild muscle hypertonia syndrome. Protein energy malnutrition;

–      neurologist (03.10.2013.) – psycho-emotional and motor development delay, monotonous, but with an interest facial expression, chaotic, stereotyped body movements;

–      neurologist (25.06.2014.) – microcephaly, psychomotor development delay, protein energy malnutrition, flat feet;

–      psychiatrist (15.07.2014.) – F83 (Mixed specific developmental disorders), mixed physical and mental development disorder, microcephaly;

–      geneticist (11.11.2014.) – microcephaly;

–      echo (07.08.2012.) – without pathology;

–      infectologist (09.11.2012.) – R75.0 (Laboratory evidence of human immunodeficiency virus [HIV]), the child has been entered in the Registry;

–      infectologist (01.03.2012.) – R75.0 (Laboratory evidence of human immunodeficiency virus [HIV]), control at the age of 1 year;

–      infectologist (06.09.2013.) – anti HIV negative, the child is taken off the Registry;

–      speech therapist (14.01.2016.) – language development delay. Comprehends verbal instructions and completes them. Marks objects and animals with their correct name;

Munich Functional Development Diagnostics (MFDD) (18.09.2015.) – walking corresponds to the age, prestidigitation is delayed by 9 months, comprehension is delayed by 6 months, speaking is delayed by 11 months, language comprehension is delayed by 10 months, social function is delayed by 3 months, and independence is delayed by 2 months. Walking – walks five steps on toes without holding. Jumps forward without falling down. Stands on one foot without holding for 2 seconds. Climbs up stairs on every second step changing feet with holding. Jumps over a piece of paper (20 cm wide) without touching it. Prestidigitation – puts 2 sticks in a box, turning them. Holds 2 blocks for 2 seconds in each hand. Turns volume knob of sound/noise instrument. Can thread a ball on a thread. Perception age – puts 3 containers one into another. Places correctly 3 out of 4 forms in a form toy. Divides discs according to size. Social age – if somebody is sad, tries to calm him. Abides by instructions of a game (one time you, and next time me). Independency – eats with a spoon, only little messing. Takes off all clothes, when requested;

–      pediatrician (12.02.2016.) – physical and mental development delay, protein energy malnutrition, microcephaly, OU astigmatism, hypermetropia;

·      laboratory tests made for:

–       Anti HCV (18.10.2012.) – positive;

–      Anti HCV (30.08.2013.) – negative;

–      HIV ½ (18.10.2012.) – positive;

–      HIV ½ (06.09.2013.) – negative;

–      TPHA (18.10.2012.) – negative;

·      final diagnosis – physical and mental development delay. Protein energy malnutrition. Microcephaly. OU astigmatism. Hypermetropia;

·      further necessary treatment – speech therapy, oculist consultation once per year, surveillance of a pediatrician;

·      by a court verdict the mother was deprived of custody rights in December 2015, the father – in November 2014, the mother deceased in May 2016. The child was taken out of the biological family because the mother could not take care of the child, she was in a friend’s house in an inadequate state;

·      the boy has one older, minor sister, who is in the care of relatives abroad. The decision by the Orphan’s Court on separation of the children in case of adoption has been made.

 

5.    Girl, born on February 2012, resides in an out-of-family care institution since February 2015:

·      the girl has brown eyes, dark brown hair. Unable to find activities independently, plays alone with selective toys (blocks etc.), does not comprehend adults’ talk, but understands activities of cuddling toys or dress etc.). The girl attends speech therapy;

·      the child was born to a 27 years old mother, from her 3rd pregnancy, in her 3rd delivery, in 42nd week of gestation, with weight of 2950g;

·      the child was treated in a hospital:

–      13.02.2016. – 15.02.2016. – seizure syndrome. Mental development delay;

–      10.11.2015. (electroencephalogram) – sleep structure altered. Dominated by slow sleep – high amplitude slow waves. Little number of sleep spindles. General changes moderate. Recommended control;

–      29.09.2015. – 01.10.2015. – functional digestive disorders;

–      27.06.2014. (magnetic resonance imaging) – changes due to undergone perinatal hypoxia. Consequences of meningoencephalitis;

–      14.03.2014. – 21.03.2014. – condition after generalized seizures, serial. Acute respiratory illness. Psychomotor development delay;

–      02.05.2012. – 15.05.2012. – bacterial infection with secondary, purulent meningitis and intram. Hypertension syndrome. Pneumonia with obstruction. Reactive hepatitis. Secondary anemia with thrombocytosis;

–      22.04.2012. – 23.04.2012. – acute respiratory viral infection. Acute enteritis. Iron deficiency anemia;

–      23.04.2012. – 28.04.2012. – unexplained etiology acute gastroenteritis. Reactive hepatitis. Bronchiolitis;

·      the child was consulted by:

–      ENT (10.07.2015.) – hearing corresponds the age;

–      oculist (17.07.2015.) – currently without correction;

–      neurologist (30.10.2015.) – psychomotor development disorder. No self-care. Moderate disorder of gait;

–      speech therapy (06.02.2015.) – language system insufficient development, level 1;

–      physical and rehabilitation medical doctor (19.03.2015.) – psychomotor development delay;

–      psychiatrist (16.03.2015.) – delayed mental development;

–      general practitioner (04.09.2015., 10.04.2015.) – psychomotor and language development and behavior disorders;

–      clinical psychologist (04.03.2016.) – significant disorder of mental processes, cognitive function and intellectual abilities on an organic background, corresponds to moderate to severe mental delay. Learning according to special pre-school programs, special educator and speech therapy lessons individually and in group. Intelligence ratio IQ currently in a relative range between 32-40 points, which corresponds to moderate to severe mental development delay. The child needs constant care and supervision;

–      psychiatrist (21.03.2016.) – F70.1 (mild mental retardation, significant impairment of behavior requiring attention or treatment). F80.1 (expressive language disorder);

·      final diagnosis – severe mental retardation with significant impairment of behavior, non-organic enuresis and encopresis. Significantly delayed social abilities’ development;

·      the child has a disability status;

·      further necessary treatment – control of an encephalogram;

·      by a court verdict the parents were deprived of custody rights in December 2015. The child was neglected. The parents visited the child in the orphanage 8 times at the beginning, since May 2015 they have stopped visits. The child is still being visited by his grandfather with his wife;

·      the girl has two older, minor paternal half-sisters, who are in the care of their mother and two older minor maternal half-brothers, who are in a guardianship. The decision by the Orphan’s Court on separation of the children in case of adoption has been made.

 

6.    Girl, born on April 13, 2008, resides in a foster family since September 2014, previously resided in an out-of-family care institution since December 2011. The girl can only be adopted by English-speaking family:

·      the girl has greyish-blue eyes and brown hair. The girl loves to sing and has a good voice, loves to play with dolls and enjoys making herself look pretty. She feels very good performing in front of an audience, and feels confident – she performed with a kindergarten ensemble in a festival of the city where she both sang and danced. She has very precise and coordinated movements and a very good voice. The girl loves being in a company of many people. She is very loud and assertive, she’ll do anything – good or bad – to get whatever she wants. During classes, if she likes the subject, she’ll do what is asked of her. If the subject doesn’t interest her or if something happens differently from how she wants it to happen, she’ll simply ignore the given tasks, will act as if she doesn’t hear when she is spoken to. The foster parents sometimes experience this when she doesn’t want to obey them – she can act as if they aren’t there. The girl is in the register of a psychiatrist. When she began to take the psychiatrist’s prescribed medicine and was regularly seeing a psychologist, she made a big progress on improving her behavior during classes. When she was residing in her previous out-of-family care institution the girl expressed heightened sexuality that could be observed when a boy or a man was around – then she’d mimic a sexual act, she’d climb into a man’s lap or pull down her own skirt. Due to this, she received rehabilitation in a crisis center and the psychologist concluded that the girl had suffered from sexual violence at a young age – but, most likely, from seeing other adults performing sexual acts, not first-hand. A criminal investigation was started to find out the responsible individuals, but, as the girl cannot remember anything from such a young age, the case will most likely be closed. Since the girl began living in a foster family in September 2014 her behavior improved and she hasn’t expressed heightened sexuality towards men of her foster family or in society. She doesn’t pay big attention to men, but their presence is still important. She wouldn’t get in the same bed with them, but she could show her stomach. Although her sexualized behavior has stopped, she has an unusual reaction towards toddlers – she kisses them a lot, touches in intimate places, stares at their genitalia. Overall, she can be unpredictable – she can sometimes be extremely familiar to strangers; her feelings and thoughts change a lot. As foster mother stated – she doesn’t really know the unwritten rules of society and has to be explained why certain things shouldn’t be done at certain times or vice versa; the girl doesn’t really understand why it is unsafe to walk on the lane where cars drive, she doesn’t know what the point of being responsible is and, although she wishes to have a family from her whole heart and talks a lot about it, doesn’t really understand what constitutes it. The girl had issues with being picky with food, she didn’t want to wash herself and she wouldn’t admit her mistakes. Foster mother said, that after patient and careful explaining the girl overcame these things, although she still has a hard time admitting her fault;

·      the girl’s characterization from her school (02.11.2015.) – in September 2015 the girl started the 1st grade at boarding school. The girl stays at school during working days and returns in the foster family for weekends. The girl wishes to be a leader among peers, finds it difficult to make friendly relationships. Sometimes feels nervous, which can lead to destructive actions or aggression. Sometimes shrinks into herself and does not communicate with others for long period. The girl has good marks at school, she writes neatly, but still has problems with reading. If gets stuck during the learning process, may stop learning even for whole day. During games and other activities takes part gladly, but needs to be supervised as her behavior may become unpredictable. May organize an activity for other children. During sports classes the girl does actively what she likes and wants, but is not keen to complete a teacher’s proposed activities. If she does something incorrectly, she stops participating in further activities. In emotional situations (for example, foreign visitors at school) the girl can show obtrusive behavior, may be exaggeratedly joyful or on the contrary – destructive. She has a tendency to show off, which does not correspond to the age. She needs adult’s presence to fall asleep, she sleeps well when asleep;

·      in November 2015 the foster mother confirmed that the girl has had episodes of significant aggression – she has injured infant with scissors (cut nipples), has kicked cats, has attacked an adult with a stick from the back. The girl has very poor hygiene skills;

·      the girl was born to the 20 years old mother. There is no information about the pregnancy and the early development of the child;

·      the girl has been treated in a hospital:

–      18.03.2009. – 27.03.2009 – ARVI (Acute Respiratory Viral Infection), acute tracheitis, acute rhinosinusitis, Rotavirus – in the form of gastroenteritis. Lack of protein energy;

–      14.04.2012. – 18.04.2012. – acute respiratory viral illness. Herpes labialis infection. Sec. limfodenopatia. Hernia umbilical;

–      19.05.2012. – 23.05.2012. – functional gastrointestinal tract disorder. Acute bronchitis;

–      11.06.2012. – 15.06.2012. – furunculosis. Lymphadenitis of underjaw. Acute rhinosinusitis;

–      19.06.2012. – 25.06.2012. – ARVI (Acute Respiratory Viral Infection). Post-acute lymphadenitis state. Sec. lymphadenopathy;

–      02.12.2012. – 07.12.2012. – ARVI (Acute Respiratory Viral Infection) with exanthemas. Sec. limfadenopatia;

–      13.09.2013. – 16.09.2013. – poisoning with medicaments;

·      the girl has been consulted by:

–      ENT (25.03.2009.) – rhinitis;

–      ophthalmologist (13.12.2012.) – H52.2. (astigmatism);

–      speech therapist (2012.) – check-up;

–      surgeon (20.06.2012.) – lymphadenitis;

–      psychiatrist (2012.) – F80.0 (speech pronunciation issues). Social and pedagogical neglect;

–      psychiatrist (March 2013) – F98.8 (other behavioral and emotional disorders, that usually begin in childhood or teenage years), neurosis (nail biting);

–      clinical psychologist (27.11.2015.) – intellectual sphere results correspond to mild mental development delay (PS-IQ= 62). Verbal abilities correspond to mild mental development delay (IQ=57). Non-verbal/ practical abilities correspond to a delay close to mild mental developmental delay (IQ=72);

–      speech therapist (19.01.2016.) – F80.1 (expressive language disorder). F81.1 (specific spelling disorder). F81.3 (mixed disorder of scholastic skills);

–      neurologist (10.07.2015.) – emotional disorders;

–      gynecologist (10.07.2015.) – no gynecologic pathologies. Recommended to acquire more hygiene skills;

–      psychiatrist (08.02.2016.) – mixed disorder of scholastic skills. Behavior disorder;

–      electroencephalogram (19.01.2016.) – EEG basic rhythm partly consistent with the child's age, little alpha waves (irregular), slow activity dominates. Focal epileptiform activity in PO zones. Recommended EEG control in dynamics;

·      the girl has a disability status;

·      further necessary treatment – included in the Registry of a psychiatrist. Esprico vitamins 2 tablets twice per day;

·      in December 2014 an adoption process with a Latvian adopter was stopped. During the first visits, the girl grew more and more irritated, loud and disobedient, but the adopter hoped that she’d find a common ground with the girl and continued the process. Very soon after the pre-adoption care started, the adopter understood that she is unable to take care of the girl, because she was afraid that the girl would hurt herself or other children in the household. The girl would cry or laugh hysterically, scream that she hates the adopter, that she (the girl) will kill her. She’d throw the toys that the adopter bought her and would not eat the food that adopter gave her. The adopter said, that the girl rejected her when she wanted to calm her down with a hug or talk about what’s making the girl feel uneasy, as the girl clearly was feeling bad. In the end, adopter decided to stop the pre-adoption care, as she couldn’t take care of the girl against her will. The foster mother states, that such a behavior from the girl has never been seen. Once she was back together with her foster family, she was completely normal and wouldn’t even talk about the time spent in the pre-adoption care. The foster mother is sure that this reaction of a girl was a way of testing the boundaries of the adopter and probably the adopter should’ve been more patient. The foster mother stated, that the girl is ready for new adopters, but the adopters must know that the girl’s behavior can change completely until she gets used to her new family and surroundings – the process of adaptation can take some time;

·      in July 2015 the girl had unsuccessful pre-adoption care in Italian family. The girl’s attitude towards adopters was negative, the girl showed high level of stress and despite the consultations with a psychotherapist, there were no improvements in relationship. The Orphan’s court concluded that the girl feels stressed to hear unknown language, therefore it is recommended that the adopters should speak English as it is the language the girls starts to study and may react less stressfully;

·      the mother and father were deprived of custody rights by the court verdict in September 2013. The parents consumed alcohol and the girl lived in conditions that were dangerous to her health and life. She suffered from emotional violence and negligence of her parents, and suffered from sexual violence by having seen sexual acts performed in her presence. None of the parents or other relatives have taken any interest in her, they’ve never visited her in the institution. The girl acts in a quite reserved manner towards her foster family, she doesn’t show excitement of seeing them too often. The foster family hasn’t expressed a wish to adopt the girl;

·      the girl has three younger half-brothers, two of which are adopted and the middle half-brother is under guardianship. The decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

7.    Girl, born on February 9, 2006, resides in an out-of-family care institution since May 2013:

·      the girl has light grey eyes and brown hair. The girl attends specialized boarding school for children with mental development disorder. The girl has significant self-regulation disorder, periodically she has aggressive behavior towards others, when being angry, she may break things or damage them, for example, she may tear off wallpaper or tear bed clothes. The child has difficulties in a study process, she has difficulties to concentrate for work, and she requires individual approach and calm teacher’s manner. The girl has special needs, she has mental development disorder and behavior disorder, which require patience, peace and compassion, as well as possibility to pay individual attention to her. The girl is unable to formulate her attitude towards adoption due to her state of health, besides she has periodic contact with her biological mother, and hope that her mother will be able to fulfil her promises to take her back home;

·      there is no data available on the child’s birth and early development;

·      the child has been treated in a hospital:

–      23.07.2013. – 19.08.2013. – F70.1(Mild mental retardation, with significant impairment of behaviour requiring attention or treatment), F98.0 (Nonorganic enuresis);

–      01.07.2014. – 28.07.2014. – F70.1(Mild mental retardation, with significant impairment of behaviour requiring attention or treatment), F98.0 (Nonorganic enuresis), Z62.2 (Institutional upbringing);

–      06.10.2014. – 29.12.2014.  – F70.1(Mild mental retardation, with significant impairment of behaviour requiring attention or treatment), Z62.2 (Institutional upbringing);

–      02.03.2015. – 14.04.2016. – F70.1(Mild mental retardation, with significant impairment of behaviour requiring attention or treatment), Z62.2 (Institutional upbringing);

·      the child has been consulted by:

–      ENT (14.06.2016.) – organs without pathology, in norm;

–      surgeon (14.06.2016.) – surgically healthy;

–      dermatovenereologist (14.06.2016.) – without pathology;

–      pediatrician (14.06.2016.) – no somatic illnesses at the moment;

–      psychiatrist (02.06.2016.) – F70.1(Mild mental retardation, with significant impairment of behaviour requiring attention or treatment);

·      laboratory tests on HbsAg, HIV1/2, SED (01.06.2016.) are all negative;

·      final diagnosis – F70.1 (Mild mental retardation, with significant impairment of behaviour requiring attention or treatment);

·      further necessary treatment – to continue psychiatrist’s assigned therapy, to receive treatment in a psycho-neurological hospital;

·      by a court verdict the mother was deprived of custody rights in April 2016, the father – in July 2014. The girl was taken out of the family due to negligence, insufficient medical care, emotional and possibly sexual violence. The child received help in a crisis center. The mother has visited and telephoned her daughter, but her interest in the child is irregular and inconsistent. The girl had aggressive relationship with her siblings, they do not keep in touch currently. The other relatives are not interested in the girl;

·      the girl has 7 half-siblings: 1 older minor paternal half-sister and 1 older minor paternal half-brother, who reside in a different out-of-family care institution. She has also 1 older major maternal half-sister, who lives abroad, 2 younger maternal half-sisters, who reside in a different out-of-family care institution, and 2 younger maternal half-siblings (boy and girl), who are still in the mother’s care. The decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

8.     2 siblings: half-sister, born on June 20, 2002, and half-brother, born on February 8, 2006, who reside in a foster family since September 2014:

·      the half-sister has dark brown eyes and dark color hair. The girl has excellent marks at school, she reads a lot and attends dance group at school. Sometimes the girl has behavior problems. Since placement in a foster family, the child has become more open;

·      the girl was born to a 23 years old mother, from her 2nd pregnancy, in her 2nd delivery, with weight of 3160g, and height 53cm, 8/9 points by Apgar. Umbilical cord once around the neck. Newborn adaptation period. The mother was under doctor’s surveillance during the pregnancy;

·      the girl started to walk at the age of 14 months, to talk- at the age of 1 year and 5 months, her first teeth came out at the age of 8 months. At the age of 2 months she had allergic dermatitis. At the age of 9 months she had obstructive bronchitis;

·      the child has been consulted by:

–      oculist (28.05.2003.) – acute conjunctivitis. Acute rhinitis;

–      dermatovenereologist (28.10.2013. – 04.11.2013.)  – scabies;

·      final diagnosis – therapeutically healthy;

·      the half-brother has blue eyes and blonde hair. The boy has average marks at school, has problems with reading. He is very helpful and gladly helps the foster family with household chores inside and outside. The foster family characterizes him as a good boy, although sometimes he has temper tantrums and angriness. He enjoys team work and entertainment. The foster family does not wish to adopt siblings;

·      there is no medical data available on his birth and early development;

·      the child has been treated in a hospital:

–      13.08.2007. – 14.08.2007. – state after drowning;

–      11.11.2008. – 13.11.2008. – hernia inguinalis dextra, surgical therapy;

–      31.03.2009. – 06.04.2009. – acute bronchitis. Iron deficit anemia;

–      11.05.2010. – 21.05.2010. – acute right side lower lobe pneumonia;

·      the child has been consulted by:

–      ENT (22.05.2013.) – healthy;

–      oculist (22.05.2013.) – without pathology;

–      surgeon (19.10.2008.) – hernia inguinalis dextra;

–      dermatovenereologist (21.10.2013. – 04.11.2013.) – scabies;

·      final diagnosis – therapeutically healthy;

·      by a court verdict the mother was deprived of custody rights in March 2016, the paternity for the girl was not stated, the father of the boy deceased in January 2006 (before the boy’s birth). The children were taken out of the family, because during the inspection of an Orphans’ court the mother was under strong influence of alcohol, there were two unrelated people in the flat, also under strong influence of alcohol, the whole flat was full of cigarette smoke, there were neither products at home nor money to buy them, as the consequences the children’s health and life were in danger. The children suffered from negligence and emotional violence due to mother’s dependency on alcohol. Currently the biological mother almost never visits her children in the foster family, on very rare occasions she calls. The foster family has good relationship with the children, they do not plan to adopt the children;

·      the children have one older minor maternal half-sister, who resides in a different foster family. The boy has also one older minor paternal half-sister, who resides in a crisis center, and two older minor paternal half-brothers, who are in the care of their mother. The decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

9.     6 siblings: 1st child – a boy, born on July 23, 2006, 2nd child – a girl, born on August 22, 2008, 3rd child – a boy, born on August 28, 2009, 4th child – a boy, born on March 10, 2011, 5th child – a boy, born on April 12, 2012, 6th child – a girl, born on November 5, 2013. Children reside in an out-of-family care institution since January 2016:

·       1st child – a boyhas blue eyes and light color hair. The boy attends 3rd grade at a boarding school for children with speech problems. His results at school are average. The boy is closed, sensitive and he gets offended easily. He is helpful in everyday chores. He expresses his view like an adult. He has problems in relationship with other classmates. Sometimes he can be hysteric. Since the boy has suffered from physical and emotional violence, he is in chronic state of stress. It is necessary to boost his self-esteem, to create an appropriate environment around him in order to lessen his alertness, insecurity and to teach him to build trust in others. It is advisable to organize contests periodically, in which the boy could win, as well as give him jobs which he can complete easily;

·      the boy was born to a mother from her 2nd pregnancy, in her 1st delivery with weight of 3140 g and height 51 cm;

·      the child has been treated in a hospital:

–      07.04.2012. – 12.04.2012. – rotavirus infection. Acute pharyngo-tonsillitis;

–       15.04.2012. – 18.04.2012. – acute respiratory viral infection, moderate pace;

–      29.01.2013. – 01.03.2013.  – influenza, moderate pace;

·      the child has been consulted by:

–      ENT (16.04.2012.) – healthy;

–      oculist (31.03.2015.) – healthy;

–      neurologist (31.03.2015.) – healthy;

–      speech therapist (28.06.2013.) – dyslalia;

–      surgeon (31.03.2015.) – healthy;

–      dermatovenereologist (31.03.2015.) – skin is clean;

–      pediatrician (01.07.2016.) – healthy;

·      final diagnosis – dyslalia, encopresis, enuresis;

·      2nd child – a girlhas blue eyes and blond hair. The girl attends 2nd grade at a boarding school for children with speech problems. The girl is active and communicative. Her intellectual abilities correspond her age. It is recommended to develop her creative potential. She is friendly with other children. The girl is obedient, she defends her point of view and she blames others in her failures. Due to experienced violence at home, the girl has sudden emotional swing. An unsatisfied need may lead to hysteric reactions, which can be easily modified and stopped fast. The girl needs periodic help of a psychotherapist due to nightmares;

·      the girl was born to a mother from her 3rd pregnancy, in her 2nd delivery with weight of 3420 g and height 54 cm;

·      the child has been treated in a hospital:

–      29.07.2007. – 02.08.2007. – stomatitis. Rachitis;

–       23.09.2007. – 28.09.2007. – acute respiratory viral infection. Allergic dermatitis;

–      27.05.2011. – 02.06.2011. – acute pansinuitis;

–      03.04.2012. – 10.04.2012. – acute respiratory viral infection;

–      28.01.2013. – 01.02.2013. – influenza;

–      12.01.2013. – 21.01.2013. – chicken pox;

–      20.01.2015. – 26.01.2015. – influenza, moderate pace;

·      the child has been consulted by:

–      ENT (07.05.2014.) – healthy;

–      oculist (27.11.2012.) – healthy;

–      neurologist (13.12.2012.) – neurotic ticks;

–      speech therapist (07.05.2014.) – language system insufficient development with functional language disorder;

–      surgeon (07.05.2014.) – healthy;

–      dermatovenereologist (19.10.2014.) – atopic dermatitis;

–      pediatrician (26.01.2015.) – healthy;

·      final diagnosis – dermatitis, neurotic ticks;

·      3rd child – a boyhas grey eyes and light color hair. The boy is sporty and mobile, he finds it difficult to control his temper. Requires supervision. The boy is talkative and open. The boy has speech problems. The boy needs help in socialization process. It is advisable to create friendly environment, to integrate him in common children activities, to help him in a process of building positive relationship with peers. It is necessary to pay attention to the correction of learning disorder;

·      the boy was born to a mother from her 4th pregnancy, in her 3rd delivery with weight of 3330 g and height 51 cm. The mother was not under doctor’s supervision during the pregnancy;

·      the child has been treated in a hospital:

–      24.01.2012. – 31.01.2012. – acute respiratory viral infection. Left side lower lobe pneumonia;

–       30.07.2012. – 03.08.2012. – acute respiratory viral infection;

–      04.01.2013. – 07.01.2013.  – head soft tissue contusion;

–      16.01.2013. – 30.01.2013. – secondary cardiopathy. Chicken pox. Acute respiratory viral infection;

–      17.04.2013. – 02.05.2013. – acute respiratory viral infection. Mutual haimoritis (inflammation of the sinuses);

·      the child has been consulted by:

–      ENT (07.03.2016.) – throm lens cerumen;

–      oculist (12.11.2012.) – hypermetropia I;

–      neurologist (12.11.2012.) – healthy;

–      speech therapist (23.02.2016.) – dyslalia with elements of language system underdevelopment;

–      surgeon (12.11.2012.) – healthy;

–      dermatovenereologist (07.03.2016.) – skin is clean;

–      pediatrician (07.03.2016.) – cardiopathy with heart rhythm disorder;

·      final diagnosis – dyslalia, hypermetropia I;

·      4th child – a boyhas grey eyes and light color hair. The boy strives for emotional contact, undivided attention and support. He is socially developed, active, disobedient, does not wish to complete the given tasks. The boy is significantly traumatized from the experienced physical and emotional violence in the biological family, the boy has distorted image of the world, in his play the boy imitates the experienced violence, he is aggressive and hits his toys. He will need time and support to improve his psycho-emotional state;

·      there is no data about the pregnancy and the child’s birth available;

·      the child has been treated in a hospital:

–      08.01.2016. – 22.01.2016. – Polytrauma: skull vault fracture. Brain contusion. The right large tibia diaphyseal chipped fracture. The right funny-bonediaphyseal chipped fracture with dislocation. The right radius bone head wrench. Contused wound in head (hair part).  Left tarsal joints subcutaneous hematoma. Anemia. Physical development delay;

–       30.01.2016. – 03.02.2016. – acute viral enteritis, moderate pace;

·      the child has been consulted by:

–      neurologist (13.06.2016.) – central nervous system astenization. Cephalalgia. Digestive system disorder in anamnesis;

–      pediatrician (22.06.2016.) – cephalalgia. Central nervous system astenization. State after polytrauma. Right elbow fracture. Health group II;

–      pulmonologist (22.03.2013.) – bronchial asthma (mild);

·      final diagnosis – cephalalgia. Central nervous system astenization. State after polytrauma. Mild bronchial asthma;

·      further necessary treatment – classes with a psychologist, electroencephalogram and neurologist control after it, medicine treatment (Noofen, Magne B6);

·      5th child – a boyhas blue eyes and light color hair. The boy is inquisitive, insistent, hyperactive, and spiteful. The boy requires constant attention. He finds it difficult to abide by behavioral borders. He does not react on reprimands and requests, he does not concentrate attention. The boy needs to acquire new positive methods on how to obtain what he wants, without doing injustice to others. It is necessary to integrate the child gradually into children’s group, to help him to improve interaction skills and pay special attention to his communication with peers;

·      the boy was born to a mother from her 6th pregnancy, in home  delivery, with weight of 2860 g and height 50 cm. The mother was not under doctor’s supervision during the pregnancy;

·      the child has been treated in a hospital from 31.01.2016. – 04.02.2016. – influenza, moderate pace;

·      the child has been consulted by:

–      audio speech therapist (23.02.2016.) – insignificant expressive language disorder;

–      oculist (12.11.2012.) – hypermetropia I;

–      surgeon (22.01.2016.) – pes planus (physiological);

–      pediatrician (21.01.2016.) – language development delay;

·      the child has not received all vaccinations according to age;

·      final diagnosis – expressive language disorder. Posture disorder. Health group II;

·      further necessary treatment – speech correction, remedial gymnastics, massage, appropriate foot-wear, balanced nourishment, course of vitamins;

·      6th child – a girlhas blue eyes and blond hair. The girl is obedient, alerted, periodically secluded, builds contact gradually. She is friendly with other children. In the biological family the child did not receive wholesome emotional support and calm, organized, comfortable and secure environment. It is necessary to work with her intellectual development;

·      there is no data about the pregnancy and the child’s birth available;

·      the child has been treated in a hospital:

–      01.02.2016. – 11.02.2016. – influenza, moderate pace;

–      23.02.2016. – 29.02.2016. – acute respiratory viral infection, moderate pace. Bronchitis;

·      the child has been consulted by:

–      neurologist (13.06.2016.) – emotional lability;

–      surgeon (22.01.2016.) – pes planus II;

–      pediatrician (22.01.2016.) –pes planus II, health group II;

·      the child has not received all vaccinations corresponding her age;

·      final diagnosis – emotional lability, pes planus II, health group II;

·      further necessary treatment – psychologist classes, remedial gymnastics, massage, appropriate foot-wear, balanced nourishment, vitamin complex;

·      according to the evaluation of a psychologist of the orphanage in September 2016, the five older children are all open for contact, they have well developed cognitive skills. They have good comprehension level and ability to answer the questions. They still have mixed feelings towards adoption. They wish to live all together, they strive for love and wish to live in a family. The children remember that they had hard times in a biological family, but they hope that the parents will change. At the same time the children wish to live in a good family, to find parents abroad, and wish to have a good future. The youngest sister is unable to express herself due to her small age;

·      by a court verdict the parents were deprived of custody rights in June 2016. The children were taken out of the family, because during the inspection of an Orphans’ court the children were in dangerous conditions and their further stay in parents’ care endangered their health, life and wholesome development. The parents had ruthless attitude towards the children, especially the 4th child. The parents consumed alcohol, especially mother. The mother smoked. The children suffered from emotional and physical violence, and also negligence. They received rehabilitation course for 2 months in a psychological help center. The children require stable, secure and predictable environment and emotionally warm relationship with their caregivers. It is recommended to continue acquired skills to practice self-regulation, attend classes with a psychologist for further emotional stabilization and repeat rehabilitation course after 6 months. With the Orphans’ court decision the parents are not allowed to meet children, the parents are not interested in their children;

·      the children have one younger minor brother, who resides in a different out-of-family care institution. They also have 3 older major paternal siblings – 2 half-sisters and 1 half-brother. The decision of Orphans’ Court on separation of the children from the youngest brother in case of adoption has been made.

 

10. In the process of adoption  

Boy, born on January 19, 2009, who resides in a foster family since December 2013:

·      he has light brown hair and blue eyes;

·      information provided by his foster mother in December 2015 – when the boy was placed in the foster family he didn`t talk, only shouted, and was aggressive. In psychiatrist`s consultations the boy chose to draw only in black color. In the foster family there was another child of similar age and the boy gradually started to learn from him, imitated his actions, started to play with Lego. The boy has not acquired reading and writing yet, he is in the process of learning letters slowly. Psychologist suggests not to impose to do anything by force, finding ways to help the boy to grow interest in learning. His behavior has improved, he isn`t so aggressive anymore, he can communicate normally. The boy is very gentle, learns and tries to behave well, observes the decencies, prepares gifts for the foster mother. Both biological parents of the child are in registration of a psychiatrist with diagnoses mental retardation and psychosis. Mental retardation isn`t diagnosed for the boy, he doesn`t need to take any medicine but he is in the psychiatrist`s surveillance because of behavior problems at the time when the boy was placed in the foster family. The boy is not yet ready for school;

·      information provided by the foster mother in June 2016 – the boy`s behavior has improved considerably. It is possible to reach an agreement with the boy, he helps with household chores, he is communicative, wishes to be caressed by the foster parents, strives for attention. The boy still can yell and hit if someone takes away his toy. The foster mother limits the time the boy can spend on the computer because computer games may make him aggressive. It is decided that the boy needs to study extra year in a kindergarten in order to prepare better for a school – the boy has difficulties with reading – mixes up letters and cannot connect words;

·      information provided by the foster mother in September 2016 – the boy is sociable and sweet. The boy still does not like to study, he is spiteful and tends to sulk during the learning and declares that he is not going to do the given task. The foster mother usually achieves his obedience in learning by offering something that he might want in return (desired walk, sweets etc.). The boy does not hold writing and eating utensils correctly, he holds them by all fingers. For writing he currently uses notebooks with letters written in dots and he draws over them to acquire learning skills better. The boy befriends other children well, if everything is fine, but if not, he may become angry and even hit the other child. After anger episodes he is good at expressing his feelings and explaining his version of a conflict. Good results can be achieved by a positive, encouraging attitude. The boy wishes to be adopted, he understands the adoption well and looks forward to meeting his future family;

·      there is no information on the pregnancy and perinatal development of the child;

·      the child has been treated in a hospital:

–      06.08.2015. – phimosis;

·      the boy has been consulted by:

–      psychologist (30.06.2015.) – the child takes part in all assigned tasks, controls his behavior. His emotional condition is stable and consistent. For complex tasks the boy needs to take frequent breaks. His conversational level is limited, observed difficulties to speak out and justify his opinion;

–      dermatovenerologist – healthy;

–      surgeon (31.07.2015.) – flatfoot. Phimosis;

–      neurologist (27.08.2015.) – no neurological pathology;

–      oculist (29.09.2015.) – healthy;

–      ENT (31.08.2015.) – healthy;

–      pediatrician (21.10.2015.) – practically healthy. Height – 116 cm, weight – 22 kg;

–      psychiatrist (18.01.2016.) – mixed disorder of scholastic skills (F81.3). Expressive language disorder (F80.1). Recommended dynamical psychiatrist`s surveillance;

–      psychologist (24.03.2016.) – boy`s memory is below average, memorizing is slow. He gets tired quickly, his attention and concentration skills are low, time of fixity is insufficient, skill to switch over is slow. Indicators of logical thinking are below average, he has difficulties to answer questions. His skill to discuss is weak, knowledge does not correspond to his age. Cognitive skills are below the norm which allows to predict serious difficulties in the learning process, it is necessary to prolong learning in the pre-school educational institution for one year;

–      pediatrician (29.09.2016.) – practically healthy. Current weight 23 kg, height 121 cm;

·      laboratory tests on Anti HIV1/2, HIV1 Ag, Anti HAV IgM, HBsAg, Anti HCV, RPR, TPHA  (15.09.2016.) are all negative;

·      final diagnosis – mixed disorder of scholastic skills (F81.3). Expressive language disorder (F80.1). Flatfoot. State after phimosis surgery;

·      further necessary treatment – dynamical psychiatrist`s surveillance;

·      the father has given consent to the child`s adoption in December 2013, parents were deprived of custody rights by the court verdict in July 2015. The boy suffered from emotional violence and was neglected, parents left him in the kindergarten. The parents or other relatives haven`t been interested in the child. The boy has emotional bond with the foster mother but foster parents do not plan to adopt the boy;

·      the boy has 1 older maternal half-sister who is under guardianship. Children have no emotional bond. A decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

11. Boy, born on May 18, 2003, who has been in a foster care and guardianship since January 2013 and currently resides in an out-of-family care institution since April 2015:

·      the boy has grey eyes and blond hair. The boy has developmental delays, he is impulsive and has self-regulation and behavior problems. He is rather reserved, he does not trust adults and the contact with him needs to be built gradually. The boy has learning and concentration difficulties, he has been absent from school, and he needs support in the learning process. The boy needs emotional support and clearly set boundaries. Hehas conflicts with peers and succumbs to the bad influence of other children. The boy gladly takes part in various spare time activities. He also enjoys to spend time at the computer, but the usage of computer should be controlled. The boy previously resided in a foster family and also with a guardian, he had aggressive attitude towards his youngest siblings. The boy wishes to be adopted and to live in a family;

·      the boy has been treated in a hospital:

–      09.10.2014. – 06.11.2014. – F92.8 (Other mixed disorders of conduct and emotions), Z61.1 (Removal from home in childhood);

·      the boy has been consulted by:

–      ENT – nasal septum deviation;

–      oculist (20.11.2015.) – H52.1 (Myopia). Needs to wear glasses;

–      neurologist (20.11.2015.) – check-up;

–      surgeon (10.05.2016.) – surgically healthy;

–      dermatovenereologist (10.05.2016.) – without pathologies;

–      pediatrician (10.05.2016.) – no chronical somatic illnesses;

·      laboratory tests on HBsAg, HIV ½, SED  (22.02.2016.) are all negative;

·      final diagnosis – F92.8 (Other mixed disorders of conduct and emotions), H52.1 (Myopia), J34.2 (Deviated nasal septum);

·      further necessary treatment – no need to take any medicine, needs to wear glasses;

·      by a court verdict the mother was deprived of custody rights in October 2015, the father – in April 2014. The child was taken out of the biological family because there were grounded suspicions that the boy suffered from emotional and physical violence and negligence and his further stay in the biological family endangered his wholesome development. The boy has received psychological help in a crisis center in individual consultations on several occasions, he has been treated in a psycho-neurological hospital and has received consultations from a children’s psychiatrist. Since the child’s removal from the biological family, the parents have not been interested in their son, his education, health and development anymore, they have not visited him;

·      the boy has two younger siblings – half-brother and half-sister, who are in adoption process with a foreign family. The decision by the Orphan’s Court on separation of the children in case of adoption has been made.

 

12. Boy, born on July 15, 2003, resides in an out-of-family care institution since December 2012:

·      the boy has brown eyes and hair. The boy attends specialized boarding school, program for children with severe mental development disorders or multiple severe development disorders. According to the evaluation of the child’s self-care abilities and needs, the boy is in 4th level (significant insufficiency of self-care and needs, all care activities are provided by a care-taker). The boy is able to eat and dress individually. During the day-time he goes to toilet with reminder. The boy has cognitive, mental and emotional development disorder and it does not correspond his age. The boy’s adaptation skills are very low, his functioning is lower than almost all children in his age-group. The boy needs to be cared for and supervised day and night;

·      there is no information on the pregnancy and perinatal development of the child;

·      the boy has been treated in a hospital:

–      14.12.2012. – 17.12.2012. – atypical autism. Moderate mental retardation, with significant impairment of behavior requiring attention or treatment;

–      01.01.2013. – 11.01.2013. – acute viral bacterial infection. Acute rhino-pharyngitis. Dehydration syndrome. Eating disorder. Atypical autism. Moderate mental retardation, with significant impairment of behavior requiring attention or treatment;

·      the child has been consulted by:

–      ENT (31.10.2013.) – adenoids. Palatine tonsil hyperplasia;

–      ENT (30.10.2014.) – impacted cerumen (sulfuric cork);

–      oculist (30.10.2014.) – hypermetropia;

–      neurologist (31.10.2013.) – atypical autism. Moderate mental retardation, with significant impairment of behavior requiring attention or treatment. Weak posture;

–      pediatrician (15.01.2015.) – unspecified acute upper respiratory tract infection;

–      psychiatrist (17.02.2015.) – moderate mental retardation, with significant impairment of behavior requiring attention or treatment.Atypical autism;

–      dentist (08.05.2014.) – dental rehabilitation under general anesthesia. Repaired all affected teeth;

·      laboratory tests made for (17.03.2015.):

–      erythrocytes 3.65 (10x12L);

–      hemoglobin 112 (g/L);

–      trombocitis 151 (10x9L);

–      other indicators without deviations;

·      final diagnosis – atypical autism. Moderate mental retardation, with significant impairment of behavior requiring attention or treatment. Unspecified chronic tonsil and adenoids illnesses. Posture abnormalities;

·      the child has a disability status;

·      further necessary treatment – to be in constant supervision of a psychiatrist and pediatrician.  To take medication: tab. Depakine chr. 300 mg x2, tab. Rispolept 1 mg x2. Periodically massage and physiotherapy. Assistance with self-care;

·      by a court verdict the parents were deprived of custody rights in February 2015. The parents were not motivated to provide enhanced care and supervision for a child with special needs. Due to negligence of parents the child’s further stay in the family endangered his health and life. There is no information available on parents’ addictions. The child’s relationship with relatives is neutral. It is characteristic for a child to seek support from adults, simultaneously he is uncritical in building contact and is ready to go with any adult from the staff, which most likely means that he has low attachment to any definite person. The father’s mother is interested in the child and she has submitted application in Orphans’ court with request to take the child for visits in her home. The mother is interested in the child only episodically;

·      the boy has no siblings.

 

13. Girl, born on August 20, 2003, who has been in out-of-family care since August 2010 (foster care for 6 months and guardianship for 2 years and 11 months) and who currently resides in an out-of-family care institution since March 2015:

·      the girl has greyish-blue eyes and dark brown hair. The girl is hard-working, conscientious, she has good results at school. She likes to read, draw colorful drawings and she likes handicrafts. The girl is active, helpful, friendly, good at organizing games or other activities. She also has good communication skills, she is a good listener. The girl likes to make hairdos and to use accessories. She is positive and joyful, takes part in orphanage activities. The girl has good appetite, she hasn’t been ill, she swims, her teeth are in good state, she has no vision problems. The girl dances folk dances and sings in a choir. The girl is at the age when friends’ opinion is the most important, sometimes she succumbs to the influence of friends. Sometimes she has some conflicts with peers, which are usually resolved easily. The girl starts to like boys. She also tried to smoke, but the social worker of the orphanage believes that after she was caught, she no longer has tried it;

·      the girl was born to the 34 years old mother. There is no information about the pregnancy and the early development of the child;

·      there is no information on the child having been treated in a hospital or consulted by any specialists, except psychiatrist (due to traumatic conflicts with half-sister previously and also movement to the orphanage);

·      the girl has experienced one unsuccessful adoption process with a family from the USA in 2015. The girl exposed jealousy towards the adoptive mother, she tried to sow discord between the adopters. It is concluded that the girl needs undivided attention and she needs to be the only child in a family;

·      by a court verdict the mother was deprived of custody rights in January 2012, paternity for the girl has not been stated. The reason for taking the child out of the family – the mother did not take care of the girl and could not provide the child’s basic needs. The child suffered from negligence. The mother has visited the girl in the orphanage accompanied by a worker of the child’s Orphans’ court once in this year. The mother has telephoned to the orphanage several times when under the influence of an alcohol;

·      the girl has 4 major siblings – 2 half-sisters and 2 half-brothers. She also has 1 older half-sister, who resides in a different orphanage. She also has 1 half-brother, who has been adopted to the USA. A decision of the Orphans’ Court on separation of the girl from her half-sister in case of adoption has been made.

 

14. In the process of adoption

2 brothers: older brother, born on February 25, 2006, and younger brother, born on March 13, 2007, who reside in a foster family since December 2015, previously were in a guardianship since May 2008.  The brothers are adoptable together:

·      the oldest brother – one of his eyes is brown, other one – blue, and his hair is grey. The boy attends 4th grade, his results at school are good. The boyis quick-witted, he comprehends tasks quickly, fits in new collective very fast, can react in unexpected situations. The boyrealizes his personality and skills, draws beautifully, reads well, he likes sports. Boy is sweet, he needs individual attention and love. If he receives it, his behavior is good;

·      the boy was born to a 26 years old mother from her 3rd pregnancy, in her 2nd delivery, with weight of 2640g and height 46cm. The mother wasn`t under doctor’s surveillance during the pregnancy. The child started to sit at the age of 7 months;

·      the boy has been consulted by:

–      oculist (13.10.2011., 31.08.2012.) – healthy;

–      surgeon (22.03.2011.) – good posture;

–      orthopedist (31.08.2012.) – good posture;

–      ENT (18.04.2013.) – earwax buildup;

–      pediatrician (01.08.2013.) – healthy;

–      dermatovenerologist (12.04.2016.) – no acute pathology;

–      speech therapist (13.04.2016.) – no speech and language disorder;

–      neurologist (21.04.2016.) – neurologically healthy;

·      laboratory tests made for:

–      SED (25.02.2006.) – negative;

–      HBsAg (12.04.2016.) – negative;

–      HIV ½ (12.04.2016.) – negative;

·      the youngest brother has blue eyes and grey hair. The boyattends 3rd grade, his results at school are average. The boyis hard-working and helpful, wants to be a leader. He likes sports and has talent for visual arts. The boyis sweet, he also needs individual attention and love. If he receives it, his behavior is good;

·      the boy was born to a 27 year old mother from her 5th pregnancy, in her 3rd delivery, with weight of 3280g and height 50cm. The mother wasn`t under doctor’s surveillance during the pregnancy. The child started to walk independently at the age of 1 year and 1 week;

·      the boy has been treated in a hospital:

–      22.05.2007. – 25.05.2007. – acute bronchitis;

–      02.05.2008. – 15.05.2008. – acute obstructive bronchitis. Residuals of rachitis;

–      01.06.2015. – 05.06.2015. – otitis media chronica sinistra;

–      31.08.2015. – 02.09.2015. – otitis media chronica sinistra. Adenoidectomy;

–      06.11.2015. – 09.11.2015. – otitis media chronica sinistra;

·      the boy has been consulted by:

–      oculist (13.10.2011., 31.08.2012.) – healthy;

–      surgeon (31.08.2012.) – good posture;

–      orthopedist (20.08.2013.) – good posture;

–      ENT (27.04.2015.) – purulent tympanitis;

–      ENT (09.11.2015.) – chronic otitis of left ear;

–      pediatrician (03.12.2015.) – healthy;

–      dermatovenereologist (12.04.2016.) – atopic dermatitis, acute condition;

–      speech therapist (13.04.2016.) – no speech and language disorder;

–      neurologist (21.04.2016.) – nonorganic nocturnal enuresis (F98.0);

·      laboratory tests made for:

–      SED (12.04.2016.) – negative;

–      HBsAg (12.04.2016.) – negative;

–      HIV ½ (12.04.2016.) – negative;

·      medical information from the foster mother – the boy has nocturnal enuresis almost every night. Because of enuresis he also has cutaneous inflammation of the genital area, he has to use powder Advantan prescribed by dermatovenerologist. The boy periodically has tympanitis, when he catches cold, runs without scarf (last winter he didn`t have it, but at the moment the ear is a little bit inflamed, the boy uses ear drops). Approximately every 3 months the boy attends ENT to remove earwax buildup. Neurologist has indicated that the boy has attention deficit syndrome and the boy needed to take Esprico and Memotropil for 3 months. At the moment the boy takes only homeopathic medication Nervoheel and powder Advantan;

·      the foster mother tells that the boys tend to conflict and compete with each other, but they don`t want to be separated anyway, only each of them needs individual attention and love;

·      by a court verdict the mother was deprived of custody rights in November 2009, the father – in July 2011. The father was in custody, but the mother couldn`t provide safe environment for the children, their health, development and life, she had no income and place of residence. The children were neglected. They were placed in a crisis center and after that – in a guardianship, the guardian was their grandmother. In December 2015 Orphans` Court made a decision to suspend the guardian from her duties because she failed to fulfill them;

·      the boys have been in a hosting program in the USA once, but the host family hasn`t expressed a wish to start adoption process. The boys liked abroad, the foster mother has discussed with them that they are in the foster family only temporarily;

·      the brothers have one older brother, who resides in an out-of-family institution and two younger sisters, who reside in another foster family. The brothers don`t have contact and close relations with siblings. The decision of the Orphans' Court on separation of the children in case of adoption has been made.

 

15.  2 brothers: older brother, born on June 26, 2004, and younger brother, born on August 15, 2007, who reside in a foster family since October 2013. The brothers are adoptable together:

·      the oldest brother has light brown eyes and light brown hair. The boy attends 5th grade, his results are good. At the end of 4th grade he even received diploma because of good grades. He can settle into a new environment quickly. The boy has good communication with peers, sometimes he disobeys adults. In school he likes to experiment, draw, work with paper, is interested in woodworking and engineering. The boy is very lovable, athletic, he likes to play floorball and basketball. He can also be very careless, spiteful, gentle, lazy, can take advantage of the situations, sometimes he lies. In the last year his foster mother noticed that the boy comes home from school with unknown things, for example, stationery. She told him to bring them back to the owners. But once he stole from a shop, was caught and got into serious trouble – was called to consultations and meetings with school specialists, the foster mother believes that it was a good lesson for him. The boy has told that he just wanted to try how it is to take something, what happens in such cases. There haven`t been any stealing episodes since then;

·      the boy was born to a 18 years old mother from her 1st pregnancy, in her 1st delivery, with weight of 2698g and height 47cm. The mother was under doctor’s surveillance during the pregnancy, but there is no information on the pregnancy and perinatal care of the child;

·      the child started to sit at the age of 7 months, to crawl at the age of 7 months, to walk independently at the age of 12 months, and to speak indistinctly at the age of 1 year and 6 months, his first teeth came out at the age of 8 months;

·      the boy has been treated in a hospital:

–      02.02.2006. – 10.02.2006. – acute respiratory viral infection. Acute abstructive bronchitis;

–      04.04.2014. – 04.04.2014. – rhinitis chronica hyperplastica. Adenotonia. Caustica conchae nasales inferiores bilateralis;

·      the boy has been consulted by:

–      oculist (20.11.2013.) – norm;

–      ENT (05.03.2014., 14.08.2014.) – adenoids II;

·      final diagnosis – practically healthy;

·      the youngest brother has light brown eyes and light brown hair. The boy is very sweet, draws beautifully, plays checkers, dances folk dances, is athletic (the boy`s left leg is shorter than the right, but it doesn`t disturb him to do sports because of orthopedic footwear). The boy likes to work with natural materials and paper. He attends 3rd grade, results at school are average. He doesn`t like to stay in new environment for a long time, is quite stubborn, testy, impatient, very principled and quick-witted. He also has good contact with peers and sometimes he disobeys adults;

·      the boy was born to a 21 year old mother in her 2nd delivery, with weight of 3132g and height 48cm. The mother was under doctor’s surveillance during the pregnancy, but there is no information on the pregnancy and perinatal care of the child;

·      the child started to sit at the age of 7 months, to crawl at the age of 6 months, to walk independently at the age of 12 months, his first teeth came out at the age of 6 months;

·      the boy has been treated in a hospital:

–      20.01.2012. – 24.01.2012. – streptococcal tonsillitis. Streptodermia of the right side. Atopic dermatitis;

–      24.03.2012. – 25.03.2012. – acute gastroenteritis;

–      25.05.2012. – 26.05.2012. – contused wound in the head;

·      the boy has been consulted by:

–      surgeon (14.12.2013., 14.02.2014.) – pathological gait. Shorter left leg (2cm). Needs to wear orthopedic footwear;

–      ENT (05.03.2014.) – adenoids II;

–      oculist (14.08.2014.) – OU Hypermetropia II. Vod 4,5/ Vos 5,0 (wears glasses);

–      USG (04.10.2016.) – norm. The boy has nocturnal enuresis, but all the organs are in norm. Doctor considers that enuresis could express because of the boy`s deep sleep, recommended consultation with urologist;

·      final diagnosis – shorter left leg. Weakness of muscle and ligaments. Hypermetropia II. Nocturnal enuresis;

·      further necessary treatment – regular consultations of oculist and orthopedist. The boy needs to wear glasses and orthopedic footwear every day. Recommended consultation of urologist due to nocturnal enuresis;

·      by a court verdict the mother was deprived of custody rights in October 2015, the father – in May 2015. The parents used alcohol, didn`t take care of the children, they were neglected. Parents couldn`t dispose of the money, were indebted, children were left alone in the candlelight. Parents were not able to provide all the necessary for school, that`s why children still didn`t go to the school in the middle of September. The parents didn`t provide medical care for the children. The father`s partner often looked after the children, shouted at them and called them names, was emotionally violent towards the children. The parents haven`t been interested in the children;

·      the children have 4 siblings: one older paternal half-brother and three younger paternal half-sisters, who reside in different foster families. The children don`t have contact with other siblings. The decision of the Orphans' Court on separation of the children in case of adoption has been made.

 

16.  Girl, born on April 25, 2003, who resides in a foster family since December 2015. From March 2005 till December 2015 the girl was in a guardianship:

·      the girl has blue eyes and light hair. She studies in the 6th grade at boarding school, in program for children with mental development disorders (level AB). Her results at school in general are good, she likes manual training class and music, but has problems with mathematics and sports. The girl attends folk dances and sings in a choir. She is friendly and warmhearted, emotional, helpful, timorous. She often needs cheering up, may be tearful. On the street or in unfamiliar places she may become insecure or childish, it`s necessary to encourage her. She has difficulties to operate with cash, to understand the quantity. The girl reads a lot and quickly, but afterwards she can’t retell what she has read. The foster mother tells that she is a healthy child, she doesn`t have to take any medicine or follow any diet;

·      the girl was born to a 25 years old mother from her 3rd pregnancy, in her 3rd delivery, with weight of 3390g and height 51cm. The mother was under doctor’s surveillance during the pregnancy. Delivery was normal, with Apgar score of 7/8. Breast feeding starting from placental period;

·      the child started to sit at the age of 7 months, to crawl at the age of 8 months, to walk independently at the age of 12 months, and to speak at the age of 2 years, her first teeth came out at the age of 7 months;

·      the girl has been treated in a hospital:

–      11.12.2003. – 23.12.2003. – coeliac disease;

–      02.07.2007. – 06.07.2007. – food allergy. Latent hypothyreosis. Atopic dermatitis;

·      girl has been consulted by:

–      ENT – norm (evaluated by pediatrician);

–      neurologist – norm (evaluated by pediatrician);

–      speech therapist – norm (evaluated by pediatrician);

–      surgeon – norm (evaluated by pediatrician);

–      dermatovenerologist – clean skin (evaluated by pediatrician);

–      pediatrician (01.06.2016.) – healthy;

–      oculist (06.06.2016.) – Vod 1.0/ Vos 0.9-1.0. Rh -0,5-0,5/0,0-0.75;

·      laboratory tests made for:

–      SED (02.06.2016.) – negative;

–      HBsAg (02.06.2016.) – negative;

–      HIV ½ (02.06.2016.) – negative;

·      final diagnosis – somatically healthy. In January 2014 pedagogically medical commission has given an opinion that the girl needs special education school program for children with mental development disorders (level AB);

·      further treatment is not necessary;

·      by a court verdict the mother was deprived of custody rights in January 2005, paternity is not stated. The mother neglected the girl, didn`t take care of her, used alcohol. She has no particular occupation and place of residence. The girl doesn`t have emotional bond with the mother. Relatives haven`t shown any interest in the girl;

·      from March 2005 till December 2015 the girl was in a guardianship (the guardian was the girl`s grandmother, the father`s mother, although the paternity is not officially stated). The guardianship was discontinued due to emotional and physical abuse towards the girl. The girl was placed in a crisis center and received social psychological rehabilitation;

·      the girl has repeatedly been in hosting programs in the USA (in different families), has expressed an opinion that she likes in the USA and she would like to live there;

·      the girl has 3 siblings: one major maternal half-brother, one older maternal half-brother and one younger maternal half-sister, who reside in an out-of-family care institution. The girl doesn`t have any contact with siblings. The decision of the Orphans' Court on separation of the children in case of adoption has been made.

 

17.  Girl, born on February 8, 2009, resides in an out-of-family institution since December 2010. Included repeatedly in the list due to health improvements:

·      the girl has blue eyes and dark hair. She attends specialized boarding school, program for children with mental development disorders. Girl has good self-care skills – she washes and wipes hands, face, cleans teeth, can eat and drink independently, can dress without adults` assistance. Puts her clothes in order, tries to make up her bed, goes to the toilet independently. Learns mathematical figures gradually, distinguish colors. She likes to learn and say poems by heart, to play motion games, to dance to music, to sing. She is active and performs in measures, but can be shy sometimes if there are strangers near. She speaks in sentences, answers to questions, can work in pair and group, plays with other children. She is friendly, helpful, but when she wants to be a leader she can be intolerant. The girl can be irritable, can`t control her emotions often, stubborn – can be silent for a long time. She has unsustainable attention and low concentration skills, finishes the task if it is interesting for her;

·      the girl has had such illnesses: acute obstructive bronchitis, respiratory insufficiency, acute respiratory viral infection, acute nasopharyngitis, acute otitis of the right side, tracheobronchitis, laryngotracheitis, hyperthermia, pyoderma, influenza;

·      information provided in 2016 – the girl attends specialized boarding school, 2nd grade. The girl has physical retardation, weight deficit, weak immunity, often been ill child. The girl likes physical activities, but she gets tired quickly. Understands and fulfills simple instructions. Unstable attentions, difficulties to concentrate protractedly, noises and peers` talking disturbs her. Knowledge about the world doesn`t correspond to her age. The girl is sunny, high-keyed, emotionally unstable, can start to cry of joy and weep for sorrow. She`s also umbrageous and irritable, can blow up her emotions. She doesn`t like to put in order her toys. Likes to listen to music, to watch cartoons and children movies. Can be obtrusive, loud and disobedient. Is communicative and friendly with peers, but could also conflict, she has desire to dominate others. Gladly takes a part in social life, activities of school and orphanage;

·      the child has been treated in a hospital:

–      06.05.2011. – 13.05.2011. – acute obstructive bronchitis;

–      10.12.2011. – 21.12.2011. – acute obstructive bronchitis;

–      30.01.2012. – 07.02.2012. – acute obstructive bronchitis;

–      14.05.2012. – 21.05.2012. – acute bronchitis, acute nasopharyngitis;

–      14.03.2013. – 22.03.2013. – acute nasopharyngitis, acute otitis of the right side;

–      16.09.2013. – 24.09.2013. – acute nasopharyngitis, acute bronchitis;

–      15.05.2014. – 20.05.2014. – acute bronchitis;

·      child has been consulted by:

–      pediatrician (09.07.2014.) – physical retardation;

–      pediatrician (29.07.2014.) – physical retardation, often been ill child, weight deficit;

–      child psychiatrist (19.09.2014.) – F70.0 (mild mental retardation);

–      pediatrician (19.09.2014.) – F70.0 (mild mental retardation);

–      pediatrician (10.11.2014.) – pioderma;

–      pediatrician (22.01.2015.) – influenza;

–      ENT (06.08.2015.) – healthy;

–      oculist (18.04.2016.) – hypermetropia os ambplyopia. The girl needs to wear glasses constantly;

–      pediatrician (16.09.2016.) – weight deficit;

·      laboratory tests made for:

–      SED (09.07.2014.) – negative;

–      HBsAg (10.07.2014.) – negative;

–      HIV ½ (11.07.2014.) – negative;

·      final diagnosis in 2014 – physical retardation. Weight deficit (BMI <5). A child, who often gets ill. F70.0 (Mild mental retardation);

·      final diagnosis in 2016 – F70.0 (Mild mental retardation). Weight deficit;

·      by a court verdict the parents were deprived of custody rights in April 2014. The parents couldn`t provide safe environment and all the necessary for the girl`s development, they used alcohol, the girl was neglected. The mother has visited the girl twice in the out-of-family care institution. The parents haven`t shown interest in the girl;

·      the girl has 1 younger brother, who resides in different out-of-family care institution. A decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

18.  Girl, born on October 10, 2008, resides in an out-of-family care institution since June 2012. Included repeatedly due to separation from her half-sister:

·      the girl has blue eyes and light brown hair. She is friendly and sweet. She attends a specialized school, in program for children with severe mental retardation (level C). The girl has good self-care skills. Change of environment upsets the girl very much;

·      the child was born to a 33 years old mother, from her 6th pregnancy, in her 5th delivery, with weight of 3000g and height 50 cm. The mother was monitored by a doctor during the pregnancy;

·      the child started to sit at the age of 1 year and 3 months, to crawl and walk independently at the age of 1 year and 5 months, first teeth came out at the age of 7 months. At the age of 1 year the girl was tearful, placed her hands on her head and tucked and intersected feet under herself;

·      child has been treated in a hospital:

–      17.05.2010. – 21.05.2010. – early organic central nervous system damage. Psychomotor development delay. Language development tempo delay;

–      06.09.2012. – 15.10.2012. – F70.0 (mild mental retardation, with the statement of no, or minimal, impairment of behavior), severe degree of F81.3 (mixed disorder of scholastic skills), F98.0 (nonorganic enuresis), Z62.2 (institutional upbringing), Z81.1 (family history of alcohol abuse in anamnesis);

–      22.11.2012. – 27.11.2012. – acute respiratory viral infection. Acute maxillary sinusitis;

–      29.04.2014. – 11.06.2014. – F70.0 (mild mental retardation, with the statement of no, or minimal, impairment of behavior), F80.8 (other developmental disorders of speech and language);

·      child has been consulted by:

–      allergist (05.11.2013.) – chronic rhinitis. No objective data on allergies;

–      neurologist (10.01.2014.) – mental development disorders. Stereotypia. Sound pronunciation disorders;

–      phtisiatrist (04.04.2014.) – without pathology;

–      oculist (28.08.2014.) – H52.0 (hypermetropia);

–      speech therapist (06.03.2015.) – does not pronounce all sounds clearly;

–      surgeon (06.03.2015.) – proportional;

–      dermatovenereologist (06.03.2015.) – skin is clean;

–      ENT (06.03.2015.) – practically healthy;

–      pediatrician (06.03.2015.) – no somatic illnesses;

·      final diagnosis – F71.0 (moderate mental retardation), F80.8 (other developmental disorders of speech and language), H52.0 (hypermetropia);

·      the child has a disability status;

·      further necessary treatment – psychiatrist consultation and control in dynamics. Speech therapy. Oculist consultation and control in dynamics;

·      by a court verdict the parents were deprived of custody rights in February  2015. The parents have alcohol abuse problems, they couldn`t provide appropriate environment for children`s safety and development. The girl received psychologist consultations in the out-of-family care institution;

·      the Orphans` Court has issued a permit for mother to visit her daughters and take them home for the holidays. She uses the permit, visits the girls once or twice a month, once the mother took the girls home for the holidays. The girls are happy when the mother visits them. More than a year ago the mother submitted a petition to the Orphans` Court to regain custody rights, but changed her mind and recalled it the next day. The mother`s sister also expressed a wish to become the girls` guardian, but changed her mind after she met the girls. The Orphans` Court holds a view that the mother`s custody rights won`t be regained because she has alcohol abuse problems and she can`t provide care for the girls;

·      the girl has been in a hosting program in the USA. She was relocated to another host family during the hosting because of behavior problems;

·      the girl has one major maternal half-sister, one older minor maternal half-sister and one older minor maternal half-brother, who are in the guardianship, one older minor maternal half-sister and one younger minor sister, who reside in the same out-of-family care institution and with whom the girl has close emotional bond, and one younger minor brother, who is in the care of the mother. A decision of Orphans’ Court on separation of the children in case of adoption has been made;

·      the girl has a half-sister, which is listed under No.19.

 

19.  Girl, born on October 9, 2006, resides in an out-of-family care institution since June 2012. Included repeatedly due to separation from her half-sister:

·      the girl has blue eyes and brown hair. She is friendly, sincere, communicative, it`s possible to reach an agreement with her. She likes to play, sing and dance. She attends 3rd grade in a specialized school, her results at school are average. The girl has started to show interest in boys, she can be very spiteful. She has close emotional tie with her siblings, who reside in the same orphanage;

·      the child was born to a 31 years old mother, from her 5th pregnancy, in her 4th delivery, with weight of 3900g and height 54cm. The mother was monitored by a doctor during the pregnancy;

·      the child started to sit at the age of 8 months and to walk at the age of 1 year and 5 months;

·      the child has been treated in a hospital:

–      06.09.2012. – 15.10.2012. – F70.1 (mild mental retardation, significant impairment of behavior requiring attention or treatment), F80.8 (other developmental disorders of speech and language), F98.0 (nonorganic enuresis) – episodes;

–      05.11.2013. – 12.11.2013. – acute respiratory viral infection. Acute maxillary sinusitis;

–      08.10.2014. – 14.10.2014. – acute respiratory viral infection. Acute rhinosinusitis. Functional gastrointestinal disorders;

–      29.04.2014. – 11.06.2014. – F70.0 (mild mental retardation, with the statement of no, or minimal, impairment of behavior), F80.8 (other developmental disorders of speech and language);

·      the child has been consulted by:

–      ENT (06.07.2012.) – without pathology;

–      speech therapist (14.09.2012.) – language underdevelopment. Dyslalia. Skills and information does not correspond to age;

–      allergist (05.11.2013.) – chronic rhinitis. No objective data on allergies;

–      oculist (05.11.2013.) – without pathology;

–      neurologist (10.01.2014.) – mental development disorder. Organic emotional lability. Behavior disorders;

–      phtysiatrist (04.04.2014.) – without pathology;

–      surgeon (06.03.2015.) – proportional;

–      dermatovenereologist (06.03.2015.) – skin is clean;

–      pediatrician (06.03.2015.) – no somatic illnesses;

·      final diagnosis – F70.1 (mild mental retardation, significant impairment of behavior requiring attention or treatment), F80.8 (other developmental disorders of speech and language), F98.0 (nonorganic enuresis);

·      further necessary treatment – psychiatrist consultation and control in dynamics. Speech therapy;

·      by a court verdict the parents were deprived of custody rights in February  2015. The parents have alcohol abuse problems, they couldn`t provide appropriate environment for children`s safety and development. The girl received psychologist consultations in the out-of-family care institution;

·      the Orphans` Court has issued a permit for mother to visit her daughters and take them home for the holidays. She uses the permit, visits the girls once or twice a month, once the mother took the girls home for the holidays. The girls are happy when the mother visits them. A year ago the mother submitted a petition to the Orphans` Court to regain custody rights, but changed her mind and recalled it the next day. The mother`s sister also expressed a wish to become the girls` guardian, but changed her mind after she met the girls. The Orphans` Court holds a view that the mother`s custody rights won`t be regained because she has alcohol abuse problems and she can`t provide care for the girls;

·      the girl has been in a hosting program in the USA. She had good contact with the host family but after the hosting the host family didn`t show any interest in hosting the girl repeatedly or starting the adoption process. She participates in hosting program also this winter;

·      the girl has one major sister, one older minor sister and one older minor brother, who are in a guardianship, two younger minor maternal half-sisters, who reside in the same out-of-family care institution and with whom the girl has close emotional bond, and one younger minor maternal half-brother, who is in the care of the mother. A decision of Orphans’ Court on separation of the children in case of adoption has been made;

·      the girl has a half-sister, which is listed under No.18.

 

20.  Boy, born on April 4, 2004, resides in an out-of-family care institution since December 2014, from September 2014 till December 2014 he resided in a foster family:

·      the boy has blue eyes and blonde hair. He is emotionally positive. Holds his head well while he is on stomach, turns from his back to his stomach. He observes other people and toys, grasps and twists these toys. The boy is being fed through a nasogastric probe, percutaneous endoscopic gastrostomy is planned. The boy`s development is progressing in emotional perception and interest of toys. Also feeding is progressing, he can swallow few teaspoons with food, but is still being fed through a nasogastric probe;

·      the boy was born to a 20 years old mother. There is no other information on the pregnancy and perinatal development of the child. On October 16, 2014 the boy was placed in a hospital with shaken baby syndrome, serial cramps and violent trauma;

·      the boy has been placed in a hospital:

–      16.10.2014. – 15.12.2014. – subdural hematomas of different ages above both cerebral hemispheres. Symptomatic epilepsy. Shaken baby syndrome;

–      03.06.2015. – 09.06.2015. – subcortical damage of the white matter of the brain. Septal agenesis of the brain;

–      06.10.2015. – 21.10.2015. – severe posttraumatic CNS damage with mixed tetraparesis and typical movement disorders. Suction disorders;

–      11.01.2016. – 27.01.2016. – dysphagia (R13);

·      the boy has been consulted by:

–      oculist (12.06.2015.) – hypermetropic astigmatism;

–      allergologist (06.01.2016.) – bronchial asthma. Bronchial drainage disorders;

–      neurologist (10.03.2016.) – other specified disorders of brain (G93.8). Posttraumatic CNS damage with tetraparesis, more marked in legs;

–      speech therapist (20.05.2016.) – swallowing disorders;

–      pediatrician (20.05.2016.) – severe posttraumatic CNS damage with tetraparesis. Swallowing disorders. Is being fed through a nasogastric probe;

·      laboratory tests made for:

–      SED (02.10.2015.) – negative;

–      HBsAg (02.10.2015.) – negative;

–      HIV ½ (02.10.2015.) – negative;

·      final diagnosis – posttraumatic CNS damage with tetraparesis. Swallowing problems. Feeding through a nasogastric probe, percutaneous endoscopic gastrostomy is planned;

·      the boy has a disability status;

·      further necessary treatment – pH monitoring. In case of bronchial drainage disorders – inhalations through a nebulizer;

·      by a court verdict the parents were deprived of custody rights in March 2016. Mother left the child in the care of unknown, intoxicated people protractedly. She didn`t provide baby food for the infant for a long time, didn`t feed him regularly. The child was neglected, care was inadequate. The child has a diagnosis established – shaken baby syndrome that arouses suspicion regarding possible physical violence towards the child. The mother has alcohol addiction problem, the father consumes alcohol and other addictive substances. Parents have antisocial lifestyle. The mother has tendency to rove, and the father is co-addicted;

·      the boy has no siblings.

 

21.  Boy, born on January 25, 2003, who resides in an out-of-family care since December 2006. In the current foster family the boy resides since July 2015:

·      the boy has blue eyes and light color hair. He attends 6th grade at regular school, his school results are average, but currently he is the weakest in his class (average grade 4,7 out of maximal 10). His scholastic work is not systematic, perception skills are average, has difficulties in Latvian and literature, has illegible and obscure handwriting, even when he tries to do his best. The boy may be careless, when he works in a team, individually he works a little bit more accurately. His favorite subjects are music and sports. Attends school regularly, does it with pleasure. There are times at school, when he wants to draw others attention consistently, disturbs them. He has lack of patience and ability to concentrate, can be very spiteful. The boy is very fidgety, that`s why sometimes he breaks school`s regulations of an establishment, disturbs schoolwork, is emotionally unstable. The boy has a talent for music and sports. Last year the boy attended music school, played trombone and singed in a choir, but he left this school and now is interested in sports and more practical things – gladly attends hobby groups of domestic science and sports. The boy gets along with his classmates, takes part in school measures, his behavior there is good, but sometimes he likes that someone begs him to take part in these activities. Last year there were several conflicts in school, discussions were held after then, the boy showed understanding. He has unsustainable attention therefore he needs adult assistance with homework to understand it better and to complete it. Significant improvements have been observed, when he had regular consultations with a psychologist. The boy`s behavior, compared with a last year, has improved, he has become more composed, conflicts are not observed. The foster mother holds a view that all the boy needs is individual approach and attention;

·      the child was born to a 29 years old mother from her 5th pregnancy, in her 4th delivery, with weight of 2900g and height 49 cm. The mother did not attend doctor during the pregnancy;

·      the child has been treated in a hospital:

–      14.08.2014. – 21.08.2014. – check-up after psychiatrist`s recommendation. Reduced intellectual skills, IQ below average. In emotional sphere observed difficulties in relations with peers. His own behavioral problems grieves him, he doesn`t like his behavior, he admits that he tends to behave badly, feels shame about it. It`s recommended to praise and promote his positive behavior, to find his resources, interests, to support his schoolwork, to balance his work and rest regimes. It`s also recommended to be in a surveillance of a psychiatrist, pediatrician, speech therapist, psychologist and oculist, if it is necessary;

·      the child has been consulted by:

–      oculist (21.06.2012.) – OU Hypermetropia;

–      psychologist (July 2013) – general cognitive abilities are on low level – borderline;

·      final diagnosis – OU Hypermetropia. Strabismus. SPH OS+100, OD+200. From the last year the boy wears specialized glasses that helps to reduce strabismus, it`s decreased;

·      further necessary treatment – consultations of a psychiatrist, speech therapist, psychologist and oculist, if it is necessary. Surveillance of a . Doesn`t have to take any medicine;

·      in May 2016 due to conflict in school the boy was placed in a crisis center. Social worker made the following recommendations for further action: the boy needs physically and emotionally safe, supportive environment. It`s important to stimulate his personal development, to develop his interests, that`s why it`s preferable for him to take part in some out-of-school activities. It`s commendatory to evaluate his intellectual development. It`s also important to help him to focus his attention to what`s have to be done, to structure his expressions, to make sure that he understands his tasks, to help him to realize his actions. If the boy will be in an environment that doesn`t correspond to his intellect and level of development, there is a risk that conflicts with peers can become more acute, the boy can be banished and can act risky against himself. It must be taken into account that the boy has said that he has thought about suicide. He can`t assess the risks and often acts on impulse. A music therapy is recommended and it`s needed to support his interest to attend music school that could promote his development (or other interests);

·      by a court verdict the parents were deprived of custody rights in April 2011. The boy was taken out of the biological family because children were neglected, the parents did not take care of them. The parents had problems with alcohol, the mother was physically violent towards the boy. From December 2006 till February 2009 the boy was in a guardianship. The guardian was the boy`s grandmother, after 2 years she died and the children were placed in various foster families. From February 2009 till April 2009 he resided in one foster family, from June 2009 till July 2015 – in another foster family (this family holds a view that in the boy`s best interests it is to live in a family, where he`s the only child and he can get all the attention), and in the current foster family the boy resides since July 2015. The parents have not visited children in foster homes, but they have had episodic communications on Internet;

·      the boy has repeatedly been in a hosting program in the USA, but the host family hasn`t shown interest to start adoption process and the boy was very upset about it. The boy feels unwanted and wants to meet his family very much;

·      the boy has 5 siblings:  one major paternal half-sister, one major brother, two older minor twin sisters, who reside in a different foster family and one older minor brother, who also resides in a different foster family. Siblings do not have close relationship, the boy is not closely attached to any of his siblings. The decision of the Orphans' Court on separation of the children in case of adoption has been made.

 

22. Boy, born on January 3, 2014, resides in an out-of-family care institution since June 2014:

·      the boy has grey eyes and light brown hair. He walks without assistance, but unsteady, can climb up on a sofa. He likes to operate with rags (as toys), to construct towers of 3 or 4 blocks, to play with toys. He pronounces few words correctly, says „ma-ma”, „pa-pa”, „ta-ta”. Reacts to music with moves, understands denial „no”, he likes, when someone praises him, feels proud about it. The boy likes to co-operate with adults, prefers to be with people he knows. He is sad and angry if he doesn`t achieve the desired. The boy sits at the table, eats with a spoon and drinks from a cup with assistance. He is curious, shows interest in activities around him, operates with objects purposefully;

·      the boy was born to a 29 years old mother, from her 8th pregnancy, in the 5th delivery, in 39th week of gestation, with weight of 2185g and height – 45cm, 7/8/8 points by Apgar scale. The mother was not in a doctor’s surveillance during the pregnancy;

·      the child started to crawl at the age of 1 year and 5 months, to walk at the age of 2 years, his first teeth came out at the age of 10 months;

·      the boy has been treated in a hospital:

–      25.06.2014. – 27.06.2014. – congenital heart disease (Tetralogy of Fallot). Cardiovascular insufficiency, stage II (NYHA);

–      15.07.2014. – 17.07.2014. – VCC (Vitium cordis congenitum): Tetralogy of Fallot. Cardiovascular insufficiency, stage II. Bronchial drainage disorders;

–      06.08.2014. – 01.09.2014. – congenital heart disease. Tetralogy of Fallot. Cardiovascular insufficiency, stage II-III (NYHA). Acute respiratory viral infection. Acute rhinitis. Acute bronchitis;

–      21.09.2014. – 01.10.2014. – acute respiratory viral infection. Acute rhinopharyngitis. Acute obstructive bronchitis. Congenital heart disease. Tetralogy of Fallot. Cardiovascular insufficiency, stage II-III (NYHA);

–      20.10.2014. – 26.11.2014. – congenital heart disease. Tetralogy of Fallot. Cardiovascular insufficiency, stage II (NYHA). Chronic hypoxemia. Planned operation – correction of Tetralogy of Fallot;

–      07.02.2015. – 03.03.2015. – acute bronchitis with wheezing. Etiology of acute norovirus gastroenteritis. Congenital heart disease. Tetralogy of Fallot. State after operation. Cardiovascular insufficiency, stage II (NYHA);

–      16.03.2015. – 24.03.2015. – acute obstructive bronchitis. Acute mutual exudative tonsillitis. Acute conjunctivitis. Congenital heart disease. Tetralogy of Fallot. State after operation. Cardiovascular insufficiency, stage II;

·      the boy has been consulted by:

–      roentgenography for chest (24.06.2014.) – VCC with symptoms of congestion;

–      neurologist (24.07.2014.) – muscular dystonia with delayed stabilization of movement posture;

–      roentgenography for chest (06.08.2014.) – no convincing infiltrative alteration in lungs. No explicit cardiomegaly;

–      cardiologist and echo (06.08.2014.) – VCC. Tetralogy of Fallot. PDA. Cardiovascular insufficiency, stage II (NYHA). Acute bronchitis. To station in hospital;

–      cardiologist and echo (11.08.2014.) – situs solitus. Normal drainage of lungs and pulmonary veins. Atrioventricular and ventriculoarterial concordance. Influence of small PDA. No pathological fluid collection;

–      USS for abdominal organs (13.08.2014.) – without pathology;

–      cardiologist and echo (21.09.2014.) – VCC. Tetralogy of Fallot. Cardiovascular insufficiency, stage II (NYHA). Planned cardiovascular surgery after recovery;

–      caridiologist and echo (21.11.2014.) – little explicit insufficiency. No residual VSD. Good ventricular systolic function of both ventricle. Good postoperative results;

–      cardiologist and echo (30.12.2014.) – state after correction of Tetralogy of Fallot. Residual, moderate insufficiency of pulmonary artery valve and tricuspid valve (TV) without hemodynamic disorders;

–      pediatrician (22.01.2015.) – OS ptosis palpebral. OU hypermetropia cum astigmatism. Cardiovascular insufficiency, stage I. Protein energy malnutrition. Physical development delay. Language development delay;

–      oculist (22.01.2015.) – OS ptosis palpebral. OU hypermetropia cum astigmatism;

–      cardiologist and echo (24.03.2015.) – state after correction of Tetralogy of  Fallot. Moderate pulmonary valve (PV) insufficiency;

–      neurologist (09.07.2015.) – psycho-emotional and movement delay. Positive dynamics in activity of movement;

–      cardiologist and echo (22.09.2015.) – VCC. Moderate, residual stenosis and insufficiency of pulmonary artery. State after correction of Tetralogy of Fallot;

–      neurologist (26.10.2015.) – congenital Tetralogy of Fallot. Diffuse muscular hypotonia. Protein energy malnutrition. Psycho-motor development delay. Language development delay;

–      psychiatrist (08.12.2015.) – organic personality and behavioral disorders with decline of cognitive abilities. Language and speech development disorders;

–      Munich Functional Development Diagnostics (MFDD) (11.02.2016.) – the child’s psychomotor development delayed in all functions: walking age by 8 months, sleight of hands by 7 and a half months, perception by 3 months, self-dependency by 7 months, social age by 2 months. Walking age – walks 3 steps independently. Sleight of hands – draws stripes back and forth. Puts 2 rings on pyramid. Puts 2 sticks in stand. Throws 2 discs in container. Grasps small object with forefinger and thumb. Perception age – puts all 3 containers in one. Finds object under one of two container. Puts big circle in frame. Tries to draw with pencil. Social age – helps to straighten out toys sometimes. Plays with peers gladly. Can stay with known people for some time. Imitates moves, for example, sweeping. Self-dependency age – lifts full spoon to mouth. Holds cup himself when is drinking. Takes off his shoes if it`s open. Helps with his moves while dressing;

–      cardiologist and echo (25.02.2016.) – moderate stenosis and insufficiency of pulmonary artery. State after correction of Tetralogy of Fallot. Cardiovascular insufficiency, stage I (NYMA);

–      speech therapist (01.03.2016.) – language development delay on background of reduced general development. There are inarticulate sounds and syllables in his speech. Can tell some separate words. Can point on things he wants with sounds. Responds to his name, can fulfill simple directions, gestures needed sometimes. Can show some parts of his body;

·      final diagnosis – OS ptosis palpebral. OU hypermetropia cum astigmatism. Cardiovascular insufficiency, stage I. Protein energy malnutrition. Physical development delay. Language development delay;

·      further necessary treatment – regular surveillance of a cardiologist, pediatrician, speech therapist. Control of ophthalmologist in dynamics;

·      by a court verdict the mother was deprived of custody rights in February 2016, the father – in December 2014. The mother has alcohol abuse problems, she has tried to commit suicide. In 2014 the mother visited her son for 3 times, called 4 times, in 2015 she visited him once;

·      the boy has one older minor sister and one older minor brother, who reside in a foster family, and one older minor brother, who resides in another out-of-family care institution. A decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

23. Girl, born on December 19, 2012, resides in an out-of-family care institution since September 2013:

·      the girl has greyish-blue eyes and brown hair. The child is being fed through a stoma, is positioned, has spasms, but as a result of the therapy has become calmer. She recognizes staff by voice, she likes toys with a sound and bubble bath procedures. She doesn`t move around independently, is immobile child. The girl has weak control of her head in all postures, she doesn`t operate with objects and she has limited skills to carry out most simple actions;

·      the girl was born to a 18 years old mother, from her 1st pregnancy, in the 1st delivery, with weight of 2760g. There is no other information on pregnancy and perinatal development of the child;

·      the girl has been treated in a hospital:

–      01.09.2013. – 14.10.2013. – shaken baby syndrome. Subarachnoid hemorrhage. Extensive, diffuse, deep hypoxic ischemic changes in the cerebrum;

–      12.02.2014. – 14.02.2014. – umbilical hernia. Planned surgery performed on February 14, 2014;

–       26.08.2014. – 08.09.2014. – pyelonephritis of the left side. Acute bronchitis with obstruction. Cerebral palsy. Spastic tetraparesis. Symptomatic epilepsy. Psychomotor development delay. Palliative care since November 11, 2013;

–      20.09.2014. – 20.10.2014. – chronic bronchitis with aspiration (pseudomonas aeruginosa). Acute laryngitis, moderate/severe. GERD. Cerebral palsy. Spastic tetraparesis. Symptomatic epilepsy. Pseudobulbar syndrome. Nasojejunal tube since September 30, 2014;

–      20.10.2014. – 07.11.2014. – chronic bronchiolitis with aspiration. Cerebral palsy. GERD. Spastic tetraparesis. Symptomatic epilepsy. Pseudobulbar syndrome;

–      19.05.2015. – 25.05.2015. – organic CNS damage. Hip dysplasia dextra with dislocation of right hip. Surgery performed on May 20, 2015, reconstruction of the right hip;

–      01.07.2015. – 01.07.2015. – organic CNS damage. Hip dysplasia of the right side with dislocation of the hip, surgery – change of plaster cast of coccyx;

·      the girl has been consulted by:

–      computed tomography (CT) of the head (02.09.2013.) – extracerebral hemorrhage of membranous covering of the brain. Fresh subarachnoid hemorrhage, can`t exclude subdural, epidural hemorrhage of right lobe of the brain. Symptoms of hygroma of the frontal lobe. Acute ischemic zone of the right lobe of the brain. Supposedly shaken baby syndrome;

–      CT of the head (07.09.2013.) – without aggravation in dynamics;

–      magnetic resonance of the head (27.09.2013.) – extensive, diffuse, deep hypoxic ischemic changes in the largest  lobes of the brain and basal ganglia. Dilation of lateral ventricles of the brain compared with the latest CT, dilation of the ventricles of the brain is increased because of explicit atrophyc changes;

–      palliative care service (11.11.2013.) – corresponds to the level of palliative care;

–      oculist (25.03.2015.) – OU myopia, stage I. OU atrophia n.atici;

–      oculist (07.05.2015.) – OU atrophia n.atici. Low vision OU myopia cum astigmatism;

–      abdominal USG (27.08.2014.) – can`t exclude acute pyelonephritis of the left kidney;

–      abdominal USG (31.03.2015.) – kidneys of normal form, echostructure corresponds to the age, without urinary flow disorders;

–      neurologist (13.12.2013.) – emotionally monotone – particular movements of smacking lips. Hydrocephalus form of the head with flattened left side and occiput. Tense neck musculature, lower jaw musculature with „snub” tongue root, pushes out tongue at times, but doesn`t relax it. Spastic tetraparesis;

–      neurologist (04.04.2014.) – shaken baby syndrome with problems of the brain and vision. Symptomatic epilepsy. Continues clonic-tonic spasms periodically. Neurological situation, more cramped palms;

–      neurologist (23.10.2014.) – shaken baby syndrome. Spastic tetraparesis with psychomotor development delay. Symptomatic epilepsy. Doesn`t have contact with outside world because of vision problems, pays attentions and shows pleasure to tactile sensation. Has no active, rational movements. Has epilepsy with clonic-tonic seizures periodically;

–      neurologist (18.03.2016.) – shaken baby syndrome. Spastic tetraparesis. Symptomatic epilepsy;

–      psychiatrist (21.11.2014.) – organic personality and behavioral disorders due to brain dysfunction with decrease of cognitive skills and with severe mental retardation. Profound mental retardationwith the statement of no, or minimal, impairment of behavior (F73.0). Cerebral palsy. Spastic tetraparesis. Symptomatic epilepsy;

–      psychiatrist (15.07.2015.) – organic personality and behavioral disorders due to CNS damage with decrease of cognitive skills in the level of unspecified mental retardation. Symptomatic epilepsy;

–      speech therapist (26.10.2015.) – speech development of the child corresponds to development of newborn. Snoring in the throat observed, very weak vocal sounds “a-a”. Screams when she dislikes something, active suction, communication isn`t possible;

–      surgeon (15.01.2014.) – umbilical hernia. Planned surgery indicated;

–      surgeon (14.04.2015.) – hip dysplasia dextra with dislocation of right hip. Shaken baby syndrome. Operative therapy prescribed;

–      functional evaluation (26.10.2015.) – classification system of gross motor functions – level 5 – doesn`t move around independently, immobile child. Increased muscular tonus in arms and legs because of neurological disorders. Weak control of the head in all postures. Classification system of manual skills – level 5 – doesn`t operate with objects and has limited skills to carry out most simple actions. Classification system of communication skills – level 5 – child needs absolute assistance;

–      observations of physiotherapist (26.10.2015.) – spasticity in musculature of arms and legs. Decreased muscular tonus of body. Asymmetrical posture in supine position – right leg in small external rotation, left leg larger in flection. Doesn`t strike a lateral pose actively. Placed passively holds lateral pose in flection state on both sides. Thumbs inclined, cramped palms;

–      pediatrician (20.04.2016.) – chronic bronchitis with aspiration (pseudomonas aeruginosa), pseudobulbar syndrome, patient of palliative care since November 11, 2013;

·      final diagnosis – chronic bronchitis with aspiration (pseudomonas aeruginosa). Cerebral palsy. Spastic tetraparesis. Symptomatic epilepsy. Pseudobulbar syndrome. Patient of palliative care since November 11, 2013;

·      the girl has a disability status since November 6, 2014;

·      further necessary treatment – positioning. Use of technical aids. Surveillance of a pediatrician;

·      by a court verdict the mother was deprived of custody rights in February 2016, father – in December 2015. The girl was diagnosed with shaken baby syndrome, medical personnel had suspicion that the head trauma is a result of careless or violent action towards the child. The father hasn`t expressed any interest in the child, the mother and her parents has visited the girl;

·      the girl has one younger maternal half-brother, who resides in another out-of-family care institution, is not adoptable. A decision of Orphans’ Court on separation of the children in case of adoption has been made.

 

24. Boy, born on October 23, 2010, who resides in an out-of-family care institution since December 2010.Included in the list due to health improvements:

·      the child has brown eyes and dark brown hair. The boy is emotionally positive and responsive. He knows his name. Recognizes persons, reacts emotionally to social situations. He drinks well from a cup and eats – he is being fed. He turns actively in a side position to the left. He grasps toys. The child needs a special care;

·      information provided in 2016 – spastic paresis of the right side in anamnesis. The boy works with left hand, eats independently, follows daily regimen successfully. The child is positive in communication, wants to communicate with adults (both physical contact and dialogue). Integrates in a team very well, wants individual attention. Benevolent, well-wishing towards other children. Language corresponds his diagnose – symptoms of dysarthria, stereotypy. The boy is flexible, acquires standards of hygiene (to sit on a potty, to wash hands, to brush teeth). Periodically wears orthosis for right hand. Wears orthopedic shoes, right foot leans on fingertip in his gait, walks independently. Takes part in every activity with pleasure. It`s possible to improve his development. Receives partly granulated food that corresponds to his age. Weight – 19,5kg, height – 123cm. In January 2017 planned consultation of oculist;

·      the boy was born to a 38 years old mother from her 3rd pregnancy, in her 3rd delivery, with weight of 2940g and height 54cm, 8/9 points by Apgar scale. The mother was not monitored by a doctor during the pregnancy. The child was diagnosed with congenital hydrocephalus;

·      the child started to speak at the age of 2 years, first teeth came out at the age of 7 months. The child has spastic right-side hemiparesis;

·      the child has been consulted by:

–      pneumonologist (02.02.2012.) – bronchial asthma, moderate, controlled;

–      speech therapist (08.11.2012.) – active articulation – adequately pronounces three words;

–      oculist (20.04.2012.) – view paresis. Optic nerve hypoplasia. Suspicion of atrophy. Secondary nystagmus;

–      pediatrician (08.11.2012.) – congenital occlusion hydrocephalus. The right-side hemiparesis;

–      psychiatrist (24.09.2012.) – F 83 (Mixed specific developmental disorder), G80 (Cerebral palsy), G40.9. (Epilepsy). Congenital hydrocephalus. Symptomatic epilepsy;

–      audiologist (07.06.2011.) – no hearing disorders;

–      rehabilitologist (06.12.2016.) – spastic hemiparesis of the right side. It`s necessary to restore his orthosis;

–      neurologist (08.12.2016.) – emotional disorders. Stereotypic speech;

·      final diagnosis – congenital occlusion hydrocephalus. Condition after ventriculoperitoneal shunting on 30.11.2010. Corpus Collosum in agenesis. Spastic hemiparesis of the right side. Symptomatic epilepsy (seizure episodes haven`t been observed for 2 and a half years, doesn`t need medical treatment). Optic nerve hypoplasia. Bronchial asthma, controlled, permanent remission. Mixed specific developmental disorders;

·      the child has a disability status;

·      further necessary treatment – consultations of a physiotherapist, speech therapist and ergotherapist. Consultation of oculist. Hyperallergic diet, orthopedic shoes, orthosis for the right hand;

·      by the court verdict the parents have been deprived of custody rights in September 2012. The child was left in a hospital, because the mother was hospitalized for tuberculosis treatment. The parents while under influence of alcohol announced to police that the child is missing or frozen. The place of residence was not adapted to the needs of a new-born child. The parents have a tendency to wander around, the child was neglected;

·      the boy has no siblings.

 

25. Boy, born on July 21, 2010, who resides in the foster family since March 2013:

·      the boy has greyish-blue eyes and dark blonde hair. He is communicative, calm, sweet, clever, may be capricious if become nervous, can even shake his fist at somebody, but isn`t aggressive and ceases being capricious very fast. Boy has a good memory, he remembers letters, can retell small sentences. Helps in housework with pleasure. The boy has good self-care skills, he can wash and get dressed, eat and go to potty himself. He understands everything, but doesn`t pronounce particular words or pronounces it as he can. The boy can draw, scissor, he learns Latvian;

·      information provided by his foster father in 2016 – the boy is friendly, helps in housework with pleasure, is very curious, asks many questions. The boy has begun to speak, write and read better, because in the kindergarten he attends group for children with language development disorders and visits speech therapist regularly. It`s necessary to encourage him to train in writing and reading at home, sometimes he gets stubborn and doesn`t want to learn. Previously there was drug therapy prescribed by a psychiatrist for the boy, but he doesn`t take them anymore. Sometimes the boy has light sleep. The foster father holds a view that the boy has no physical delay;

·      the child was born prematurely to a 33 years old mother, with weight of 2300g. There is no detailed information on the pregnancy, child’s birth and perinatal development of the child;

·      the child has been consulted by:

–      neurologist (25.10.2012.) – psychomotor development delay. Language development delay;

–      psychiatrist (18.10.2013., 28.01.2014., 2015) – mixed developmental disorders with mental development delay, expressive language disorder, stereotyped movement disorders on background of early organic CNS damage. Other pervasive developmental disorders (F84.8). Expressive language disorder (F80.1). Stereotyped movement disorders (F98.4);

–      oculist (13.02.2015.) – healthy;

–      pediatrician (10.11.2016.) – mixed developmental disorders with mild mental development delay, expressive language disorder, stereotyped movement disorders on background of early organic CNS damage. Other pervasive developmental disorders (F84.8). Expressive language disorder (F80.1). Stereotyped movement disorders (F98.4). Consultations of speech therapist recommended;

·      final diagnosis – somatically healthy. Mixed developmental disorders with mild mental development delay, expressive language disorder, stereotyped movement disorders on background of early organic CNS damage. Other pervasive developmental disorders (F84.8). Expressive language disorder (F80.1). Stereotyped movement disorders (F98.4). Consultations of speech therapist recommended;

·      further necessary treatment – surveillance of a psychiatrist. Consultations of neurologist, speech therapist and rehabilitologist;

·      by a court verdict the parents were deprived of custody rights in March 2015. Parents have alcohol abuse problems, but at the moment they don`t use it. They neglected the boy, were emotionally violent towards him, there were constantly quarrels in the family. The parents didn`t show any interest to regain custody rights of the boy, haven`t visited him. The boy doesn`t remember his biological parents;

·      the boy has 8 siblings:  3 older brothers, 4 older sisters and 1 younger sister. All siblings are in the care of their parents. Siblings were returned to the family because parents were interested to cooperate and regain custody rights of all the children except the boy, parents didn`t have any emotional bond with him, they didn`t show any interest. The boy is not closely attached to any of his siblings. The decision of the Orphans' Court on separation of the children in case of adoption has been made.

 

26. Boy, born on November 13, 2009, resides in an out-of-family care institution since December 2009:

·      the boy has brown eyes and brown hair. He is responsive in contact with peers, looks for contact with adults, is friendly, emotional, gets attached quickly, wants individual attention, can express his emotions. The boy likes to play alone. He attends specialized pre-school institution. According to the decision of a pedagogically-medical commission of April 2014, the boy needs to study in program for children with severe mental development disorders. He has severe mental development disorders. He likes music, in his language he imitates singing and piano playing. The boy has sense of rhythm. In out-of-family care institution the boy attends Montessori program and consultations of ergotherapist. He needs twenty-four hours surveillance because of severe mental development disorders;

·      the boy was born to a 30 years old mother, from her 1st pregnancy, in the 1st delivery, with weight of 2850g and height – 49cm, head circumference 33cm, chest circumference 32cm. The mother was not in a doctor’s surveillance during the pregnancy. The mother has mental development delay, she lives in a care home, the boy was born in there;

·      the child started to sit at the age of 11 months, to crawl at the age of 1 year, to walk independently at the age of 1 year and 9 months, his first teeth came out at the age of 8 months;

·      the boy has been treated in a hospital:

–      17.11.2009. – 09.12.2009. – intrauterine infection possibility. Conjugated jaundice. Social problems;

–      16.09.2014. – 17.09.2014. – adenoids. Hyperplasia tonsilla palasiner;

–      25.01.2015. – 27.01.2015. – acute respiratory viral infection. Influenza;

·      boy has been consulted by:

–      surgeon (26.03.2015.) – gait asymmetry. Coordination disorders, “throws” right leg;

–      neurologist (11.02.2016.) – mixed specific developmental disorders;

–      oculist (02.05.2016.) – OU astigmatism, hypermetropia;

–      ENT (06.05.2016.) – state after adenoidectomy and tonsillectomy (17.09.2014.);

–      speech therapist (06.05.2016.) – doesn`t speak;

–      dermatovenerologist (06.05.2016.) – nevus reg. dorsi (5x3,0mm);

–      pediatrician (06.05.2016.) – moderate mental delay. Psychomotor and language development delay. Mixed specific developmental disorders. OU astigmatism. Hypermetropia. Posture disorders. Gait asymmetry. Nevus reg. dorsi;

·      laboratory tests made for:

–      SED (17.11.2009.) – negative;

–      HIV ½ (24.11.2009.) – negative;

–      HBsAg – has been vaccinated;

·      final diagnosis – moderate mental delay. Psychomotor and language development delay. Mixed specific developmental disorders. OU astigmatism. Hypermetropia. Posture disorders. Gait asymmetry. Nevus reg. dorsi. Health group II;

·      further necessary treatment – no drug therapy at the moment. Remedial gymnastics;

·      by a court verdict the mother was deprived of custody rights in March 2016, paternity has not been stated. The mother has disability status, she has moderate mental delay, she lives in a care home. Because of the status of health the mother doesn`t have skills to take care of the child. The boy was endangered while was in the care of his mother. The boy doesn`t have close emotional bond with his mother and grandmother. The mother has visited the boy in the out-of-family care institution 5 times, the grandmother – twice;

·      the boy has no siblings.

 

27. Girl, born on October 2, 2003, resides in an out-of-family care institution since October 2003:

·      the girl has greyish-blue eyes and light grey hair. The girl attends 6th grade at specialized boarding school. She is communicative, friendly and active, always wants to take a part in all activities. She likes music and dancing very much, she has learned to ride a bike, with pleasure attends music lessons, domestic science and sports. The girl gets dressed herself, has self-care skills. She has active speech disorders, the girl can`t concentrate for one exercise for a long time, gets bored quickly. She uses to command other children, sometimes hurts them. She needs constant surveillance and care round the clock;

·      information from the boarding school (April 2016) – the girl attends program for children with severe mental retardation. She is physically active, can move around independently, she has self-care skills. She can clean up herself, in familiar environments orients well. Learning skills are encumbered due to communication and intellectual disorders. The girl needs to wear glasses. She attends school regularly, is somatically healthy. The girl has language delay, speech of people around she comprehends partly – comprehends opening statements, but understanding of statements is very limited. She has small active vocabulary. In communication she often uses particular sounds and strings of sounds, simple gestures, understands some pictograms. Passive vocabulary is wider – it contains the most commonly used words, phrases and persons` names in everyday situations. She needs regular assistance in the learning process, encouragement, bright visuals and direct cooperation with a teacher. The girl has started to construct simple unextended sentences, but they are very unintelligible. She acquires new numbers and letters unwillingly, but there is progress observed in Latvian and mathematics – she learns to write numbers and letters by drawing them over the dots. The girl doesn`t have deliberate motivation, she has unsustainable attention and weak will, it`s difficult for her to focus on learning if she is along with other children. Attention is more persistent if someone is working with her individually. The girl has memory disorders, it`s necessary to repeat everything for her. She can accomplish simple action individually – to take, to put back, to give, to observe pictures, to point on some objects in those pictures, to color over lines. She actively takes part in motion games and sports activities, sings and dances in music lesson. In literature class she tries to tell story independently, listens to the reading material, comprehends it partly. In the free time she plays with dolls and turns the pages of a magazine. Girl is emotionally unstable, often feels anger against people around, resents quickly, tendency to run away is observed. At the same time the girl is kind-hearted, polite, responsive. She likes to participate in all measures. The girl holds leader position in her class and behavior problems are observed, she may fight and yell;

·      the girl was born to a 37 years old mother, from her 2nd pregnancy, in the 2nd delivery, with weight of 3350g, height – 55cm;

·      the girl started to sit at the age of 2 years, to crawl at the age of 1 year and 6 months, to walk independently at the age of 4 years, some words she speaks since age of 4 years, her first teeth came out at the age of 10 months;

·      the girl has been treated in a hospital:

–      03.10.2003. – 27.10.2003. – Morbus Dauni (Down syndrome). Posthypoxic SHE. Neonatal polycythemia. Intensive physiological jaundice;

–      22.01.2004. – 20.02.2004. – obstructive bronchitis. Pneumonia. M.Dauni. Foramen ovale apertus;

–      05.03.2004. – 25.03.2004. – bilateral pneumonia. M.Dauni. Congenital stridor. Contact with varicella;

–      13.04.2004. – 17.05.2004. – bronchial asthma, exogenous form, moderate, persistent, state after exacerbation. GERD. M.Dauni. Psychomotor development delay. VCC (vitium cordis congenitum). Foramen ovale apertus;

–      17.06.2004. – 05.07.2004. – pneumonia acuta bilateralis. M.Dauni. VCC foramen ovale apertus. GERD;

–      30.09.2004. – 12.10.2004. – acute respiratory infection. Rhinophanyngitis acuta. Bronchitis obstructive. Pneumonia dxt.acuta. Otitis media acuta purulenta sin. M.Dauni. VCC;

–      12.06.2013. – 18.06.2013. – acute pneumonia. M.Dauni. Strabismus;

·      the girl has been consulted by:

–      ENT (01.12.2014.) – bronchial asthma. Allergic rhinitis. Hyperplasia of palatine tonsils of the left side. Adenoides;

–      ophthalmologist (01.06.2015.) – astigmatism. Hypermetropia. Girl needs to wear glasses for distance;

–      allergologist (07.07.2015.) – moderate, persistent bronchial asthma, partially controlled pace. Allergic rhinitis. Adenoides;

–      stomatologist (06.08.2015.) – correction of teeth performed;

–      endocrinologist (15.10.2015.) – M.Dauni. Primary hypothyroidism;

–      pediatrician (22.07.2015.) – somatically healthy;

–      pediatrician (20.10.2015.) – somatically healthy;

–      pediatrician (02.05.2016.) – somatically healthy. State of health corresponds to girl`s basic diagnosis;

–      psychiatrist (03.05.2016.) – severe mental retardation with significant impairment of behavior requiring attention or treatment (F72.1);

·      final diagnosis – M.Dauni (Down syndrome).  Severe mental retardation with significant impairment of behavior requiring attention or treatment (F72.1). Subclinical (latent) hypothyroidism. Bronchial asthma. Astigmatism. Hypermetropia. The girl needs to wear glasses for distance;

·      the girl has a disability status since February 2013;

·      further necessary treatment – to continue drug therapy prescribed by endocrinologist. Surveillance of an endocrinologist, allergist, pediatrician. Glasses for distance;

·      the girl`s mother couldn`t provide permanent social care and rehabilitation for the girl, that`s why in October 2003 she wrote petition to place the girl in a social care center because of her disability. The mother died in April 2016. Until then she visited the daughter regularly, took her home for a short time, went for walks with her. The girl`s major half-sister also has visited her. Some time ago the half-sister expressed a wish to become the girl`s guardian, but changed her mind, because understood that she can`t take care of the girl due to her state of health;

·      the girl has one major maternal half-sister, she visits her in the out-of-family care institution.

 

28. Girl, born on October 5, 2010, resides in an out-of-family care institution since November 2014:

·      the girl has brown eyes and brown hair. Girl is very active, she likes bubble bath procedures after which the girl becomes calmer. She eats from a spoon with assistance of an adult, can take toy in her hand, but doesn`t play with toys independently, only together with an adult. Sometimes strums piano unawarely and listens to the sound of music. The girl rolls, listens to the voice of an adult, screams loudly, when unpleasant feelings takes her over. Sometimes calmly observes festive activities. She is a patient of a palliative care;

·      the girl was born to a 32 years old mother, from her 1st pregnancy, in the 1st delivery, in the 38th week of gestation, with weight of 3000g, height – 51 cm, was evaluated 8/9 in Apgar’s score. The mother wasn’t under supervision of a doctor during pregnancy;

·      the girl has been treated in a hospital:

–      22.08.2014. – 27.08.2014. – functional gastrointestinal disorders. Acute respiratory viral infection. Cerebral palsy with tetraparesis. Symptomatic epilepsy;

–      20.04.2015. – 23.04.2015. – cerebral palsy. Spastic tetraparesis. Microcephaly. Secondary epilepsy. Amblyopia. Myopic astigmatism;

·      the girl has been consulted by:

–      abdominal USS (23.08.2014.) – without pathology;

–      palliative care service (08.12.2014.) – child is in palliative care since December 8, 2014;

–      surgeon (20.01.2015.) – severe mental retardation. Organic CNS damage. Full amount of movements in joints, tonus decreased markedly. It`s necessary to verticalize, to wear orthopedic shoes with high counter. Control approximately after a year;

–      neurologist (19.03.2015.) – cerebral palsy. Spastic tetraparesis with delay of movements. Microcephaly. Symptomatic epilepsy. It`s necessary to continue therapy of Depakine, repeat EEG in sleep, continue rehabilitation, consultation of psychiatrist;

–      EEG (20.04.2015.) – basic rhythm corresponds to the age, but it`s hard to evaluate because premedication is used, but the child doesn`t fall asleep. Without epileptiform changes at the time of recording;

–      oculist (21.04.2015.) – amblyopia. Myopic astigmatism;

–      psychiatrist (15.07.2015.) – organic personality and behavioral disorders due to organic CNS damage with decrease of cognitive skills in the level of unspecified mental retardation that clinically, visually corresponds to severe mental retardation. Spastic tetraparesis. Symptomatic epilepsy;

–      functional evaluation (26.10.2015.) – classification system of gross motor functions – level 5 – physical handicaps limits deliberate control of movements and ability to maintain head and body postures towards gravitation. All areas of motor function are limited. Functional limitations aren`t compensated by using aids. Classification system of manual skills – level 5 – doesn`t operate with objects and has limited skills to carry out most simple actions. Child needs absolute assistance. Classification system of communication skills – level 5;

–      physiotherapist (26.10.2015.) – doesn`t move around independently because of neurological disorders. Weak control of head in all postures;

–      ergotherapist (26.10.2015.) – absolute assistance is needed in all daily situations. During eating girl is being positioned in a sitting position in the activity chair. Is being fed with a spoon. Uses diaper daily;

–      speech therapist (26.10.2015.) – child orients to the sounds by turning her head or eyes. Few sounds (“o”, “e”) observed in the expressive speech. Verbal communication isn`t possible. Girl has no imitation skills;

–      pediatrician (02.03.2016.) – organic personality and behavioral disorders due to organic CNS damage with decrease of cognitive skills. Spastic tetraparesis. Symptomatic epilepsy. Severe mental retardation. Microcephaly. Amblyopia. Myopic astigmatism. The girl is a patient of a palliative care;

·      final diagnosis – organic personality and behavioral disorders due to organic CNS damage with decrease of cognitive skills. Spastic tetraparesis. Symptomatic epilepsy. Severe mental retardation. Microcephaly. Amblyopia. Myopic astigmatism. The girl is a patient of a palliative care;

·      the girl has a disability status since July 2, 2014;

·      further necessary treatment – to use treatment for epilepsy regularly. Regular consultations of ergotherapist and physiotherapist. Absolute assistance in all daily activities. To continue girl`s psychomotor development with environment, activities and care that corresponds to her development and age. It`s necessary to provide possibility for her to move around freely on tight ground. It`s also important to develop contact with the girl with talking, looking in the eyes, working calmly. To use following technical aids according to postural regime: activity chair Wombat, positioning chair, verticalizator;

·      by a court verdict the parents were deprived of custody rights in December 2015. Parents had alcohol addiction problems, they were in severe intoxication, with unknown persons in the place of residence. The mother hasn`t expressed any interest in the child, the father has called few times;

·      the girl has one major paternal half-sister, who hasn`t expressed desire to take care of the girl, and one younger maternal half-brother, who is in the care of his parents.Orphans’ Court will make a decision on children separation in case of adoption.

 

If there is information at your disposal on family or person who complies with the requirements stated in Article 15 of the Convention and who would be interested to become personally acquainted with any of these children or obtain additional information, we kindly ask to inform the Ministry by January 6, 2017.

Additionally we would like to inform that due to the fact that the information on the children is provided simultaneously to Central Authorities and Accredited Bodies of several countries, additional information on the child or children will be provided after January 6, 2017 to the institution representing the family or individual who will be able to submit their adopters’ file sooner than other families if there are several families showing interest on the same child or children.

 

 

Deputy State Secretary                                                                                L.Āboliņa

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sunne 67782954

Klinklāva 67021619

21.12.2016.

16-N/16875