There are hundreds of children with special needs in the United States every year who need adoption. Sometimes it is the birth family making an adoption plan, other times the child is in foster care and is ready for an adoptive family.

It’s recommend that families considering adopting a child with medical needs consult with a pediatrician about diagnosis, treatment, and prognosis of specific conditions to consider if your family has the ability to provide the care a child will need. Additionally, adoptive families are asked to consider their community resources: are there medical resources nearby for the child? Will I be able to access the specialists my child may require for treatment, for example physical therapy, occupational therapy, special education classes, speech and language therapy?

Here are answers to common questions about domestic special needs adoption!

  1. What are special needs?

It depends on who you ask! In adoption from foster care or public adoption, special needs may refer to medical needs, but also hard-to-place children such as teenagers or siblings. In private adoption, special needs often refers to medical needs. It’s an important to ask how an agency defines ‘special needs’ when exploring adoption. This will help you become familiar with the needs of children and consider the type of needs you may be open to.

  1. What financial supports are available?

Many children with special needs are eligible for Early Intervention Services, Social Security Disability, Adoption Subsidy, and Medicaid.

Adoption subsidies are monthly payments from your state that may be available based on the special needs of the child. Adoptive parents, often with the help of their adoption agency, apply for the adoption subsidy after placement and before adoption finalization. According to NYS OCFS, subsidies are provided to encourage prospective adoptive families to move forward with the adoption and to help meet the ongoing needs of children.

  1. Can you adopt across state lines?

Yes! It is possible to adopt across state lines through private adoption (through an agency or attorney) or through foster care.

  1. What paperwork will I need?

Every adoptive family will need to complete a home study. A home study is a process that culminates in a document. How it is written and what’s included is governed by state regulations and that’s why it’s important to work with an approved home study provider in your state. Common documents that are needed include birth and marriage certificates, divorce decrees, financial and medical information, reference letters, and clearances. Often, adoptive parents are required to attend classes or read books in preparation for adoption. Adoption Learning Partners is an example of types of classes that may be included in the home study process. A social worker may request specific resource plans or preparation for a special needs adoption to document why your family is ready and excited to adopt a child with special needs.

  1. What medical needs are common?

The identified medical conditions range from prenatal risks, to significant developmental issues, and serious medical and congenital conditions. Medical conditions usually require therapeutic and/or medical interventions during the child’s entire life. These non-correctable conditions can include:

  • Genetic Disorders
  • Brain Anomali
  • Neurological Disorders
  • Rare Syndromes
  • Cardiac and Pulmonary Disorders
  • Shortened Life Span
  • Excessive Drug and/or Alcohol Prenatal Exposure
  • Significant Risk of Psychiatric Disorders

It’s important to speak with a doctor about a child’s specific diagnosis to understand the child’s treatment plan and prognosis.

  1. How do I find out about children in need of adoption?

Many state foster care agencies have photo-listings of children ready to be adopted, as do adoption agencies like Spence-Chapin ( AdoptUSKids is a national resource for parents to explore children in foster in need of adoption ( and RainbowKids ( is a resource for private domestic and international adoption.

By Katherine Foley, Spence-Chapin


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