Inside this Newsletter cosmetic surgery

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					                      PLACEMENT AND RECRUITMENT UNIT (PRU)
                              Winter – January 2005
                             532 E. Colorado Boulevard, Pasadena CA 91101 * 626-229-3782 * fax: 626-397-9170 *
                                                      Applicant Intake: 888-811-1121 x2
                                                                               Bettye McCoy, Unit Clerk               310-972-3324
Inside this Newsletter                                                         Fax                                    310-222-5548
                                                                         If you know anyone who is interested in adopting a child, have
1   Meet the Gang                                                        them call the Applicant Intake toll free number, 888-811-1121
    The staff at PRU. Meet them!                                         extension “2” to begin the Adoption Process.
1-2 Medical/Behavioral Corner: Craniosynostosis
    What you should know….
2-3 Successful Adolescent Adoptions                            
    Something to think about….                                 
3   Adoption Events
    The BAF and Latino Fiesta events
                                                                         Medical/Behavioral Corner:
3   Featured Child(ren) of the Month
    A terrific little girl that needs a family….                         Craniosynostosis
3   Notable Efforts by CSWs
    These social workers are superstars!                                 A baby’s skull cap is made up of 5 bones to allow for
                                                                         rapid brain growth. These 5 bones are held together by a
3-4 Success Stories                                                      fibrous-like material called “sutures”. Normally, they
    This story will tug at your hearts.                                  remain open as long as the brain grows, which gives the
                                                                         brain room needed to grow in all directions. If 1 or more
4   Top 10 Resources about Craniosynostosis
    Let’s Talk About It…                                                 cranial sutures close or fuse before the brain has finished
                                                                         growing, the condition known as craniosynostosis
4   Calendar of Events                                                   occurs.
4   Suggestions/Comments                                                 In the U.S., incidence of it is 0.04-0.1% and appears
                                                                         equally distributed in both sexes. The cause of
                                                                         craniosynostosis is unknown; the condition may be
Meet the Gang:                                                           hereditary and caused by a genetic defect, or it can occur
                                                                         sporadically in a family with no other affected individuals.
Administrators                                                           The hereditary form often occurs in conjunction with other
 Barry Ginsberg, ARA          818-755-5214                              defects, which can cause seizures, diminished intelligence
  Sari Grant, Program Manager 626-229-3732                              capacity, and blindness. Genetic counseling for people
                                                                         with hereditary (familial) craniosynostosis may help
Placement & Recruiting Unit Crew (Pasadena office)
                                                                         prevent some cases.
   Sai-Yuk Ho-Liang, SCSW             626-229-3789
   Glenda Quintanilla, CSW            626-229-3779                      Closure of a single suture is the most common. And the
   Griselda Garcia, CSW               626-229-3769                      shape of the head is determined by which sutures are
   Maria Sim, CSW                     626-229-3776                      involved. Premature closure can take place before birth or
   Nancy Lan Wong, CSW                626-229-3781                      at any time until the brain stops growing. Because the
   Patrice Berkson Steier, CSW        661-702-6345                      brain is growing normally, it will take the path of least
   William Wong, CSW                  626-229-3783                      resistance which will result in a misshapen head or face.
   Evelyn Santiago, Unit Clerk        626-229-3790                      In severe cases, this condition can also cause increased
   Martha Aguilar, AA                 626-229-3782                      pressure on the growing brain.
   Deborah Perez, Case Aide           626-229-3784
Placement & Recruiting Unit Crew (Torrance office)
   Edwina Lewis, SCSW                  310-972-3215                     Here are a number of symptoms to look for:
   Adriana Lozano, CSW                 310-972-3286                         Absence of the normal feeling of a “soft spot” (fontanelle) on
   Barbara Broome, CSW                 661-702-6234                          the newborn’s skull.
   Eleanor Johnson, CSW                310-972-3290                         Disappearance of the fontanelle early.
   Michelle Annis, CSW         909-868-4564                                 A raised hard ridge along the affected sutures.
   Nicholle Lowe, CSW                  310-972-3288                         Unusual head shape.
   Sharon Morris, CSW                  562-497-3757                         Slow or no increase in the head size over time as the baby
   Angela LaRue, AA                    310-972-3326                          grows.
Some cases are associated with other disorders such as                        The surgeons make an incision or opening in the skull
microcephaly (abnormally small head) and hydrocephalus                        behind the hairline so that afterwards the scar is covered
(excessive accumulation of cerebrospinal fluid in the                         by the hair. The head is not shaved. The bone is
brain).                                                                       reshaped or replaced with bone from another area of the
                                                                              skull. There is a chance that your child may need blood
The first sign of craniosynostosis is an abnormally shaped
                                                                              during surgery or the recovery period. There will be some
skull. Other features can include signs of increased
                                                                              swelling of the forehead and eyes after the operation.
intracranial pressure, developmental delays, or mental
retardation, which are caused by the constriction of the                      Prognosis:
growing brain. Seizures & blindness may also occur.
                                                                              The prognosis for craniosynostosis varies depending on
Signs and tests:                                                              whether single or multiple cranial sutures are involved or
                                                                              other abnormalities are present. The prognosis is better
A neurologic exam would help diagnose the condition,
                                                                              for those with single suture involvement and no associated
    Measurement of the infant’s head circumference
                                                                              A significant problem associated with early corrective
    Doctor palpating (feeling) the skull
    X-rays of the skull and/or a CT scan of the head.
                                                                              surgery is a higher risk of recurrent deformity. However,
                                                                              the surgery is usually very successful, and most children
There are 4 classes or types of craniosynostosis:                             go on to lead normal lives with residual effects of their
1.   Scaphocephaly – sagittal suture is located on top of the
     head extending from the soft spot to the back of the head.
                                                                              Excerpts from:
     This is the most common type and it occurs frequently in
     premature infants. Most commonly found in males; males         
     are affected 3 times as often.                                 
2.   Plagiocephaly – coronal suture is located on side of the
     head extending from the soft spot to the area in front of the
3.   Trigonocephaly – located between the soft spot and the         
     root of the nose, the metopic suture allows the forehead to              www.faces-cranio/org/Disord/Cranio.htm
     grow normally and the eye sockets to separate                  
     appropriately. The abnormality usually resolves with time,
     so cosmetic surgery frequently is performed but is not
     medically necessary.                                                     Successful Adolescent Adoptions:
4.   Posterior Plagiocephaly - The premature closure of the
     lambdoid suture is the least common of all.                              The Center for Child and Family Studies at the University
The terms brachycephaly, oxycephaly, and turricephaly                         of South Carolina’s College of Social Work conducted a
are used for various forms of synostosis affecting both                       research project on adolescent adoption. They
coronal sutures in the former or in combination with the                      interviewed 58 adoptive parents and 37 of their children
sagittal and sphenofrontal sutures in the latter forms,                       who had been adopted when they were 12 to 18 years old
usually encountered in syndromic types.                                       and whose adoptions had never dissolved.
Treatment:                                                                    When asked about keys to success in their adoptions,
                                                                              parents and adolescents cited a variety of factors:
For some children with less severe problems, cranial
molds can reshape the skull to accommodate brain growth                              Commitment
and improve the appearance of the head.                                              Realistic expectations
                                                                                     Support from professionals, family, and friends
However, the main treatment for craniosynostosis is                                  Personality characteristics, including flexibility, good
surgery during infancy. The surgery is usually performed                              communication skills, and a sense of humor
between four and eight months of age. The surgical goal                              Compatibility
is to relieve intracranial pressure, a skull has the capacity                        Positive attitude
to accommodate the brain’s growth, and cosmetically
                                                                              Based on the results, a number of recommendations were
improve the appearance of the child’s head.
                                                                              proposed for agencies to promote the successful adoption
Surgical correction of craniosynostosis is carried out by                     of adolescents:
surgical craniofacial teams performing a variety of
                                                                                     Offer opportunities for adults in the community to get to
procedures which often times leads to successful                                      know adolescents in foster care. Research showed
correction of the associated deformities. While the                                   that many of the adults had never considered adoption
deformity may vary from very mild to severe, the                                      until they met a particular teen. By creating
psychological effects of a misshapen forehead and face                                opportunities for adults to become acquainted with
can cause great problems and is a very important reason                               teenagers in need of homes (through programs like Big
for seeking treatment.                                                                Brothers/Big Sisters), the pool of possible adoptive
                                                                                      families is expanded.
The type and timing of surgery varies with the child and                             Promote coordination among public and private
diagnosis. However, there are some common elements.                                   agencies so that parents do not have to contact many

                                                                     Page 2
         different places to find information. A number of                     Ashunique was born premature being prenatally exposed to
         parents cited the frustration of having to contact                    cocaine and has a cranial deformity secondary to
         multiple agencies before finding one that fit their needs,            Craniosyntosis. She currently wears a cranial orthotic
         and many were discouraged early in the process.                       "headband" 23 hours daily, which helps to reshape her head
        Allow adults & teens enough visitation before moving                  and receives weekly cranial therapy. There is also a history
         teens into the home. Adolescents & adults needed to                   bradycardia & reactive airway disease. Children's Hospital,
         be allowed time to get to know each other before                      Pediatric Neurosurgery is involved in her care to ensure that she
         having to make the adjustment to living together.                     receives appropriate treatment and services.
        Employ caseworkers who specialize in adolescent
                                                                               Despite being prenatally exposed to substances she had no
         adoptions and have positive attitudes about teenagers.
                                                                               withdrawal symptoms and was recently taken off of an apnea
         In this study, several of the adolescents were not
                                                                               monitor. Ashunique continues with weekly occupational therapy
         considered for adoption until their cases were turned
                                                                               through Regional Center to assist in her motor skill
         over to agencies that specialized in placing older
        Prepare adolescents for adoption through steps that                   Ashunique's prognosis is good as her cranial deformity will
         include explaining their legal status, offering adoption              improve over time and is not a life long condition. Based upon
         as an option, explaining the adoption process, and                    her healing, a recent medical report indicates that the headband
         providing support.                                                    can be removed permanently in the near future and that her
        Provide post-adoption support services, and make sure                 overall development will increase to meet age appropriate
         that families know about the services and how to                      milestones given the proper attention.
         access them.                                                          Ashunique is an easy going little girl who loves affection. If you
It’s important for us all to realize that adoption can be a                    have a family who would like to provide Ashunique a loving and
reality for older children; we need to make it a goal that we                  permanent home, please contact Nicholle Lowe at 310-972-
strive for instead of just allowing the face of adoption be                    3288. Thank you.
the baby that everyone wants to adopt. Children who need
adoptive homes are babies, toddlers, and yes, adolescent
teens. Let’s open our hearts to that need…
                                                                               Notable Efforts by CSWs:
Information on this study, “Field-Initiated Research on Successful                Blanca Bonilla (Lakewood office) – With 3 different cases
Adolescent Adoptions”, can be accessed on                                          in PRU, you would wonder how she can do it. Blanca has                                       been amazing and now 2 of the 3 sibling sets are already
“Permanency for Adolescents” in the October 204 issue of Children’s                                                       rd
                                                                                   placed with adoptive families and the 3 is in the works!
Bureau Express ( highlights some                      Thank you Blanca.
programs that offer permanency options for adolescents.
                                                                                  Sandra Hardy (Lakewood office) – Once in a while you
Excerpts from:                                                                     meet a CSW who is truly passionate and you can see how                           much she cares about her kids. Sandra is one of them.
                                                                                   Thank you Sandra for all your hard work and for being
                                                                                   persistent. Because of Sandra’s desire for permanency for
Adoption Events:                                                                   her kids, an adoptive home has been located. Thanks
                                                                                   Sandra! You’re an inspiration.

These past few months we were really busy with two                                Sue DeFrancis (Santa Clarita office) - Sue is a dedicated
adoption events. The Black Adoption Festival (BAF) was                             worker for her children. She brought Pedro to the Latino
                                                                                   Fiesta last year. He did not want to move and sabotaged all
on October 23, 2004 and the Latino Fiesta was on                                   the matches. Almost a year passed and Sue remembered
November 6, 2004. Both events were quite successful.                               a family from the event that impressed her. The family was
The BAF received a lot of media spotlight especially                               on hold, but they decided to adopt once they heard Pedro
because Shaun Robinson reporter for Access Hollywood                               was available. Pedro is now in their home & he is doing very
has become our spokesperson to recruit more families for                           well. What great work! Thanks Sue.
waiting African American children. The BAF had 13
matches and the Latino Fiesta had 29 matches (including                           Tina Luke (Lakewood office) – Tina is a dedicated and
                                                                                   conscientious advocate for her children. She was able to
a match for a sibling set of 9!). Thanks to the coordinators                       facilitate permanency for two siblings. Thank you Tina for
for such wonderful successful events!                                              valuing children and for maintaining their important
Featured Child(ren) of the Month:
                                                                               Success Story:
The featured child of the month is
Ashunique, a delightful one year old girl                                      This month we have a truly wonderful success story of an
who loves engaging with others and is
quick to smile and laugh. She is a very                                        11 ½ year old Latino boy named Nicholas. Nicholas had
happy child who rarely cries, has a                                            been in multiple placements and in the system since 1993.
healthy appetite and sleeps well through                                       He went through a lot during those 11 years in the system,
the night. Ashunique enjoys talking and                                        he had returned home for a trial visit which did not work
has really grasped the words "mama and                                         out and lived with relatives. However, the one constant
dada."                                                                         was his Adoptions CSWs Jennifer Cohen (Wateridge)
                                                                               and Goretti Medrano-Corbett (Wateridge). CSW Cohen
                                                                      Page 3
had known Nicholas for the longest and had a great                      1.   Plastic & Craniofacial Surgery for Infants & Children, 6300
relationship with Nicholas. CSW Medrano-Corbett was                          Harry Hines Blvd, Suite 600, Dallas, Texas 75235, 214-
Nicholas’ worker for the past 3 ½ years; both provided him                   456-888.
with excellent service.                                                 2.   National Organization for Rare Disorders (NORD), 55
                                                                             Kenosia Avenue, Danbury, CT 06813-1968.
Nicholas was referred to PRU in 1998 to identify an                 800-
adoptive family for him, and initially was placed with a                     999-NORD.
prospective adoptive family in 1999, however, it did not
work out and he returned to PRU again in 2000. Nicholas                 3.   The National Craniofacial Association, P.O. Box 11082,
                                                                             Chattanooga, TN 37401. 800-332-2373. Faces@faces-
was featured on Sunday's Child (now called "Wednedsay's
Child"), the internet sites, attended adoption events,
photofeatured in the Picture Book, and many other types                 4.   CAPPS (Craniosynostosis & Positional Plagiocephal
of media recruitment.                                                        Support, Inc.), Jenifer Pitchke, Executive Director, 6905
                                                                             Xandu Court, Fredericksburg, VA 22407. 540-786-9563.
Nicholas was a friendly, sweet, gentle boy who was                 
outgoing and very engaging, however, his learning and
                                                                        5. (excellent internet resource designated
behavioral needs made some families nervous. He had                          by parents of children with craniosynostosis.)
some difficulties with behavior at school, attended therapy,
and was on medication for ADHD. Nicholas had been                       6.   Children’s Craniofacial Association, P.O. Box 280297,
diagnosed with several different disorders and it was often                  Dallas, TX 75228. 800-535-3643.
                                                                    (ask for the Guide to
difficult to figure out what was his actual diagnosis.
                                                                             Understanding Craniosynostosis written by Dr. Fearon)
Nicholas had been in a previous matches with several
adoptive families during the next 2 years, however, they                7.   The Craniofacial Center, Dr. Jeffery A. Fearon, Director,
were released for different reasons (ie/they wanted a                        7777 Forest Lane, Suite C-700, Dallas TX 75230. 972-566-
younger child, felt Nicholas had too many behavioral                         6464.
issues, etc).                                                           8.   Children with Facial Differences: A Parent’s Guide. Written
                                                                             by Hope Charkins, MSW. Published by Woodbine House,
Finally he was matched with a prospective adoptive family                    1996. 1-800-843-7323.
in September 2002. Nicholas remained in contact with the
adoptive family via phone calls every other day because                 9.   MUMS, National Parent to Parent Organization, c/o Julie
the family lived out of state. He also received pictures of                  Gordon, 150 Custer Court, Green Bay, WI 54301-1243,
the prospective adoptive family. Nicholas met the adoptive
family in January 2003 and then visited their home in                   10. AboutFace USA, P.O. Box 458, Crystal Lake, IL 60014.
March 2003 (his first plane ride!). Then he was adoptively                   888-486-1209. (ask for a copy of
placed with the family in April 2003.                                        the AboutFace booklet entitled, “Apert, Crouzon & other
                                                                             Craniosynostosis Syndromes”.
At his new home, he learned how to fish, took horseback
riding lessons, joined the Cub Scouts, and was becoming
an active swimmer. He also received tutoring, was in                    Calendar of Events
Special Education, and participated in therapy (the
adoptive family also participated in therapy during some of             Upcoming Adoption events:
                                                                        We have 4 scheduled Adoption events for the year 2005, keep
the transitional phases). Nicholas was so happy in his new              your eyes and ears open for the upcoming news about them.
home. The adoptive family was so committed to Nicholas                  The adoption events are tentative dates.
& also committed that he maintain his cultural background;
                                                                            Spring Spectacular 2005                  March 2005
they wanted Nicholas to maintain his Spanish & enrolled
                                                                            Kids Conference                          May 2005
him in a language summer camp.                                              Summerfest 2005                          June 2005
Unfortunately, Nicholas couldn't be placed with his other                   Black Adoption Festival (BAF) 2005       September 2005
siblings also in the system. However, Nicholas maintained                   Latino Fiesta 2005                       November 2005
sibling contact via phone calls & emails with one brother.
Once he was placed with the adoptive family, the adoptive               Suggestions or Comments?
mother & Nicholas had a phone call with his birthmother
where she answered questions that Nicholas had & she                    If you have suggestions, comments, or success stories, please
asked adoptive mother to take care of him.                              contact Maria Sim via e-mail or call at 626-229-3776.
One and a half years later, the case finally finalized in
December 2004. This is truly an exceptional story about a
worker who wouldn't give up and a boy who wouldn't give
up on his dream for a forever family. Thank you Goretti
and Nicholas! A true success story for everyone…

Top 10 Resources on Craniosynostosis:
The following are some helpful information on
                                                               Page 4

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