The roughly 120,000 children adopted in the United States every year have high risk for physical, developmental and mental health issues, conditions that may have been unknown before joining their new families.

A clinical report published online recently by the American Academy of Pediatrics offers guidance for pediatricians on the initial comprehensive medical evaluation of newly adopted children. The evaluation helps parents fully address their child’s physical and mental health and developmental needs, said V. Faye Jones, M.D., Ph.D., M.S.P.H., professor of pediatrics at the University of Louisville School of Medicine, and lead author of the report.

“The physician can help families prepare and work through expected questions and concerns during an early visit, even if they have limited information about the child’s past,” Jones said. “We know that many adopted children have previous chronic illnesses or are at risk for developing physical or mental health problems.”

Children awaiting adoption are at high risk of having been exposed prenatally to illegal drugs and/or alcohol as well as physical, emotional and sexual abuse, according to the report. Other early childhood factors that impact the health of adopted children include poverty and inadequate developmental stimulation. Common health issues these children face include growth failure, asthma, obesity, vision impairment, hearing loss, neurologic problems and sexually transmitted infections.

Soon after a child’s adoption, a pediatrician should conduct a comprehensive medical evaluation to confirm and clarify existing medical diagnoses, assess for previously unknown issues, discuss developmental, mental and behavioral concerns with parents and make referrals. The evaluation should include a thorough review of the child’s medical history, a complete physical examination and necessary diagnostic testing, according to the report.