Pediatrics World Conference 2026

Abstract

Background:
Children with special needs—including those with congenital anomalies, developmental disabilities, chronic illnesses, neurological disorders, and multiple disabilities are among the least likely to be placed in permanent families and often remain in institutional care for prolonged periods. One of the major barriers to timely adoption is the absence of standardized, reliable, and comprehensive medical assessments that enable prospective adoptive parents to make informed decisions. Recognising this challenge, India has institutionalised a multidisciplinary medical assessment model under the Juvenile Justice (Care and Protection of Children) Act, 2015 and the Adoption Regulations, 2022. In this framework, the Chief Medical Officer (CMO), supported by paediatricians and other specialists, undertakes a structured evaluation to determine whether a child qualifies as having special needs and to prepare a comprehensive medical profile for adoption.
This paper presents India's Chief Medical Officer–led multidisciplinary assessment framework as a best practice for improving the identification, documentation, and ethical placement of children with special needs in permanent family-based care, particularly through inter-country adoption.

The paper describes the development and implementation of the national medical assessment protocol within India's adoption programme. It examines the multidisciplinary approach involving Chief Medical Officers, paediatricians, medical specialists, psychologists, and rehabilitation professionals, supported by standardized clinical documentation and digital case management through the CARINGS platform. The analysis draws upon administrative experience in strengthening medical assessment procedures and facilitating adoption planning for children with special needs.
The standardized assessment framework has significantly improved the quality, consistency, and transparency of medical evaluations across adoption agencies. Comprehensive medical documentation has enabled prospective adoptive parents to better understand children's health conditions, prognosis, developmental potential, and support requirements before placement.
 
The multidisciplinary assessment process has increased confidence among adoptive families, reduced uncertainty, and facilitated the successful placement of many orphaned and destitute children with special needs who previously had limited prospects for domestic adoption. The model has been particularly effective in supporting ethical inter-country adoption by ensuring complete and reliable medical information for receiving countries while safeguarding the child's best interests.

Medical assessment should be viewed not merely as a diagnostic exercise but as a critical child protection intervention that directly influences a child's opportunity to grow up in a permanent family. India's Chief Medical Officer–led multidisciplinary model demonstrates how collaboration between paediatricians, specialists, and child protection professionals can strengthen ethical decision-making, improve transparency, and expand adoption opportunities for children with special needs. This best practice offers a scalable model for countries seeking to integrate high-quality paediatric assessment into adoption systems while upholding children's rights, promoting family-based care, and ensuring that no child is denied the opportunity to belong to a loving and nurturing family because of disability or medical complexity.