Components of the Comprehensive Physical Examination Pertinent to Adoption

• Vital signs (temperature, pulse, respiratory rate, blood pressure)
• Growth points, including length or height, weight, head circumference (on all children). Data should be plotted on World Health Organization growth charts, along with comparison with any measurements previously obtained. Body mass index should be calculated and plotted.
• Complete physical examination, with emphasis on the following areas:
 ○ Skin examination
     • Identify infectious diseases, rashes, or infestations, including scabies, lice, and impetigo
     • Identify and document any congenital skin abnormalities, including hemangiomas, nevi, and blue macules of infancy (usually seen in children of Asian, African, or Hispanic ethnicity).
     • Identify and document bruises or scars that may have resulted from previous abuse or previous immunization.
 ○ Careful genitalia examination (including the anus) should be performed to identify any abnormality suspicious for prior sexual abuse or genital cutting.
     • Testing for sexually transmitted diseases should be performed with any suspicion of abuse.
     • Testing for sexually transmitted diseases should be performed if sexually active.
 ○ Neurologic examination, with emphasis on developmental and neurologic abnormalities.