International Adoption of Children with Special Needs in Spain

International adoption has declined in recent years, although international adoption of children with special needs arises. We aim to describe our experience in international adoption of children with special needs and to analyze the concordance between the pathologies included in pre-adoption reports and the diagnosis made upon arrival. We conducted a retrospective descriptive study including internationally adopted children with special needs evaluated at the reference unit of La Paz University Hospital (Madrid) between 2016-2019. Epidemiological and clinical variables were collected from medical records, and pre-adoption reports were compared to established diagnoses following their evaluation and complementary tests. Fifty-seven children were included: 36.8% females, median of age: 27 months [IQR: 17-39], mostly coming from China (63.2%) and Vietnam (31.6%). The main pathologies described in the pre-adoption reports were hematological (22.6%) and neurological (24.6%). The initial diagnosis that motivated the international adoption via special needs was confirmed in 79.0% of the children. After evaluation, 17.5% were diagnosed with weight and growth delay and 27.4% with microcephaly, not previously reported. Infectious diseases were also prevalent (29.8%). Only 7% provided a complete immunization schedule. Conclusion: According to this series, the pre-adoption reports appear accurate, with a very low rate of new diagnosis. Pre-existing conditions were confirmed in over 75% of cases. Complete evaluation upon arrival, including infectious diseases screening and close follow-up, ideally by experienced multidisciplinary teams in specialized units, is recommended to provide comprehensive care.