OUR family celebrated a milestone last week.  It was seven years ago that our second daughter was born.  We had recently re-located to Sofia after spending four years in Moscow.  We opted to return to the States for the birth of our baby. 

Once she was born, it became obvious to us that there was a problem with her ability to swallow.  Even though we mentioned our concerns to the nurses and to the doctor, we were reassured that our baby was healthy and the hospital released us from their care.  In the weeks after her birth and prior to our return to Sofia, she continued to struggle with swallowing and was slow to respond to sound.  We insisted upon having her hearing tested and her throat x-rayed for problems.  The doctors, again, reassured us of her good health and, again, dismissed our concerns as those of over-diligent parents.

At five weeks of age, she made her first transcontinental flight.  The short flight from Kansas City to Boston was as uneventful as can be expected with a three-year-old and a newborn.  After disembarking and entering the terminal, we were alarmed to see this wee one begin to turn red and struggle to pull air into her lungs.  We cleared her airway and her breathing immediately resumed.   The lusty cry that reverberated through the terminal brought us great joy.  However, it was with horror that we found ourselves struggling with the same scenario on the second and third legs of our journey, always a few minutes after the plane had landed.  As we arrived in Sofia, we were convinced that the doctors had made a grave error. 

Subsequent trips back to the States in the following two years would prove to be frustrating as we endeavoured to figure out what had happened on the aeroplane. Several factors complicated the issue.   Our growing little baby was healthy - she had a good appetite, and she was active, alert, and playful. Aside from the fact that she sometimes struggled to swallow and the three incidents on the aircraft, she seemed fine, so doctors were hesitant to give much credence to our concerns.  Secondly, we were in the process of transitioning our residency to a different state, which meant new doctors, new medical records, and an inconsistent medical history.  Finally, the medical process in our state based itself upon a system of referrals, which meant that in order to see a specialist for the nose, ears, and throat, we first had to have a general physician willing to say a problem existed.  It was a disturbing and frustrating process. 

As our little girl's speech missed significant development markers, it finally became apparent to others that there was a problem, yet distance and expense complicated our ability to secure a diagnosis. 

Eventually we would hear the doctor confirm a birth defect.  Although we had been aware of a problem just hours after her birth, it took four years to hear a health professional validate the existence of a problem and identify it by name.  Only then could healing begin.  As we learned more about her particular defect, we were stunned to find that speech therapy for her condition should have started at the age of ten months.  We also learned that her defect was correctable with a series of surgeries and speech therapy prior and post surgery.  Her chances for normal speech were contingent upon these interventions.  The seriousness of the situation became clear when the doctor informed us that for best results, the surgery had to be done by the age of five.  She was four at the time.   We learned that the waiting list for the procedure was over a year.  Sitting in the plastic surgeon's office, we listened to him say that the best choice for our daughter was immediate speech therapy and expedient surgery.  We already had tickets to fly back to Sofia in exactly one week.  He looked into our eyes and said, "The best thing you can do for your daughter is to stay in the US and have these surgeries now."  We were caught in the middle of a complicated and bewildering situation, which was intensified by the fact that we lived overseas. 

Moving to another country emphasises the issues that a family faces when a child with special needs is involved.  There can be long-lasting and even traumatic repercussions for families who have already established themselves in a foreign country and then discover that their child needs special care.  Such was the case for our family.  Therefore, it was with great interest that I attended an informal meeting of education professionals here in Sofia.  The subject of the round-table discussion revolved around the issue of available resources and interventions for challenged children in Sofia.  The term `special needs' covers a gamut of issues which include the behavioural, physical, emotional, and developmental processes.

Those present at the discussion were representatives from two of the all-English international schools here in Sofia:  The Anglo-American School of Sofia, and The American English Academy.   The panel consisted of a school psychologist, a school counsellor, a deputy director of one of the schools, and a special needs specialist.  The panel's conclusion was sobering.  

The Anglo American School is able to resource children with low to medium needs.  It is probably unique to find an international school in Eastern Europe as well equipped as is this one.   Parents of children with low to medium needs will find a conscientious and capable faculty at AAS who are ready to facilitate the education process for individual children.  The American English Academy has a qualified school psychologist.  Both of these schools are highly motivated to help their student population excel.  Unfortunately, geography and language limit the assistance that students can expect to receive.

The limitations can be discouraging.  For example, diagnostic testing should be done in the child's first language.  This will most certainly require a trip back to one's home country if the first language is anything other than English or Bulgarian.   Medicines, such as those required to treat children with Attention Deficit Disorder, or any of the related disorders, present problems.  According to one dependable source, the necessary medicines are impossible to purchase in Bulgaria.  A doctor from the patient's home country must write a prescription and the medicines must be transported via secured shipping.   Therapy needs, such as speech therapy, are possible to meet but there are some drawbacks.  While competent Bulgarian speech therapists can be found, the ideal would be for a child to work with a therapist from the same language group.  Family and marital/couples counselling is another area of concern.  There are very few Western-trained psychologists or family therapists in Bulgaria.  Again, ideally, therapy would happen in the client's first or primary language.   Exceptional children with higher IQ scores also need consideration.   And finally, although things are improving, families with children with physical challenges, especially if a wheelchair is required, will find circumstances difficult in Bulgaria. 

It was the consensus of the professionals at the meeting to encourage families to put the needs of their children before the demands of a career.  Better resources exist in the home country of children with medium to high needs.  Parents thinking seriously about a move to Bulgaria would be wise to have a child with possible special needs evaluated prior to the move.   It is advisable to make employers aware of the situation.  Currently, AAS is the only international school able to adequately resource children with the more challenging situations. 

Clearly, sobering limitations exist here in Sofia for families with special needs.  However, there are stories of victory.  Such is the case for our family.  We missed that flight back to Sofia, spent a year in speech therapy and hospital waiting rooms but it was worth it all.  Recently, that very same daughter sang a solo in her school's Christmas programme.  Last week, during her seventh birthday party, someone looked at me and commented, "She never stops talking does she?"  I responded with a joyful heart, "No.  She does not."

The panel was able to generate the names of a few professionals able to deal with special needs, such as speech therapy and counselling.  While I am hesitant to include those names in the article, I would be willing to share those contacts on an individual basis.  If you are interested in those numbers, please contact me through the Sofia Echo forum website: www.sofiaecho/forum.com . Go to `General Discussion' and leave a comment.  I will respond.