TABLE 6

Behavioral and Mental Health Recommendations

• Review behavior, including past and present concerns
 ○ Adjustment
 ○ Fostering of positive relationships
 ○ Aggressive behavior
 ○ Hyperactive
 ○ Impulsivity
 ○ Internalizing behaviors (withdrawal, anxiety)
 ○ Sleep issues
 ○ Feeding issues, including overeating or hoarding food
 ○ Enuresis
• Document psychiatric medications used currently or in the past
• Document any past psychiatric hospitalizations
• Previous violent behavior or animal cruelty
• Sexualizing behaviors
 ○ Sexual promiscuity or acting out
 ○ Excessive or inappropriate masturbation
• Substance abuse
 ○ Tobacco, alcohol, illicit substances
• Suicide
 ○ Suicide ideology
 ○ Previous suicide attempts
• Children need to be monitored for issues related to loss and grief, attachment disturbances, posttraumatic stress disorder
 ○ Children may not admit to previous abuse or neglect until they are secure in an adoptive home
 ○ Even children placed as newborn infants may have issues related to their history of adoption (ie, identity development) that do not necessarily rise to the level of mental health issues