Thank You, Uncle Dan

Around the world, children with Down syndrome are more likely to live out their lives in institutions. But for one 2-year-old boy with a heart condition, the Rhoads family was eager to welcome him into their home — and, with the help of Holt President Dan Smith, ensure he receive the surgery he urgently needed.

Throughout grade school growing up in Pennsylvania, Jenna Rhoads served as a “peer helper” — volunteering her time to help students with disabilities or developmental needs transition to a mainstream classroom environment.

“I don’t know how they partnered us up, but I was always partnered with students with Down syndrome and I just kind of fell in love with the Down syndrome community,” says Jenna, now a mother of five children —— including Keith, a 4-year-old boy with Down syndrome who she and her husband, Jon, adopted from Hong Kong in 2023.

After they had their fourth and final biological child, Jenna and Jon felt a desire to welcome more children into their family. They began looking into adoption — specifically for a child with Down syndrome.

“Being around a lot of people with special needs through our public schooling system and in other ways throughout our lives, I think God laid it on our hearts and gave us a willingness and desire to grow our family in this way,” Jenna explains.

They soon learned of the tremendous need for families to adopt children with special needs, including Down syndrome, from countries overseas. In many countries, children with Down syndrome are unlikely to be adopted domestically — and few resources are available to help them reach their potential and live as fully and independently as possible. Far too often, children with Down syndrome spend their entire childhood in an orphanage, before transitioning to adult institutional care for the remainder of their lives.

“That just kind of led us on the path of international adoption — because there were so many children with special needs waiting for homes,” Jenna says.

An Urgent Medical Need

While their hearts were open to caring for a child with developmental needs, Jenna and Jon also recognized that Trisomy 21 — Down syndrome — came with an increased risk of certain medical conditions. About half of all children born with Down syndrome have a congenital heart defect and many also experience pulmonary hypertension, hearing loss and vision problems.

When Holt contacted the Rhoads family about Keith, they reviewed his medical information with CHOP — the Children’s Hospital of Philadelphia — and after careful consideration decided they were ready and equipped to care for his medical needs.

“Through the Hong Kong program, we received very detailed medical reports, which was helpful in that we could at least start preparing before we were together as a family,” Jenna says.

One of Keith’s medical needs, they learned, was an atrial septal defect — a “hole in his heart.” Small holes in the heart may never be cause for concern and some close during infancy or early childhood. Others require surgery to prevent complications. In Keith’s case, the severity of his condition was unknown — one of many unknowns the Rhoads knew to anticipate with international adoption.

But once Keith arrived in the U.S., the urgency of his condition became clear.

“We came home at the end of October 2023 and within three weeks we were meeting with a cardiologist,” Jenna says. “When the cardiology department at CHOP performed their own scans on Keith’s heart, they were like, ‘Oh, this is a bigger issue than we thought it was. We need to get this taken care of.”

Immediately, Jenna and Jon began preparing their newly adopted son for surgery.  

“In the days leading up to the surgery, we were going through the usual pre-surgical preparations when I got a call from the hospital,” Jenna says. “They explained that we couldn’t sign off for Keith to have surgery because we weren’t his legal parents yet.”

With some international adoptions, adoptive parents are temporary guardians until their adoption is finalized in the U.S. The time it can take to finalize varies by country program and state of residence. In the case of Hong Kong, it typically takes between 6-12 months to finalize.  

 But Keith had only been home a few weeks. And he needed surgery now.

“That’s when we really got to know Dan,” Jenna says, referring to Holt’s president and CEO, Dan Smith. “Because he had to help us give the hospital the necessary paperwork and information that would allow the surgery to happen.”

A Child-Centered Adoption

Dan noted that he had signed paperwork for dozens of children from Hong Kong, and it felt like a formality because he’d never met the children or their parents. Then, this formality turned to a real need, because Keith wasn’t going to get his surgery without his help.

“It was really only in a paperwork sense that I was his legal guardian,” Dan says. “But at the same time, it’s a huge responsibility and he needed surgery. So I worked with [Holt’s China regional adoption team] to get them the paperwork they needed.”

After the surgery, which went well, Jenna and Jon sent an update with photos to thank Dan and Holt’s adoption team for ensuring Keith received the urgent care he needed. Dan reached out to congratulate them and soon, they began exchanging emails back and forth — including a celebratory update on the day Keith’s adoption was finalized in court.

“I said, you know, this is really great, and I hope I can still maintain like an ‘Uncle Dan’ status,” Dan says, with a laugh.

Although Dan wasn’t called upon to take further action on Keith’s behalf, he developed an ongoing friendship with the Rhoads family. So it was only natural for them to share with Dan that they were adopting again.

Jenna and Jon hadn’t planned to adopt again. But this time, it was Holt and our partner in Hong Kong that initiated their second adoption journey — contacting the Rhoads about a little girl from Keith’s same care home in Hong Kong.

“She and Keith were really close because they both have Down syndrome and they were both about the same age,” Jenna explains. “So naturally, in the care home they partnered them up for all their therapies.”

Jenna had even asked Holt’s adoption team to let them know when this little girl joined a family in the U.S. — hoping Keith could maintain contact. But Holt’s team in Hong Kong was struggling to find a family for her. That’s when they thought of Jenna and Jon. 

“From the day that we were founded, Holt has believed that children should be raised in families, not orphanages. It is especially difficult for children like Keith to thrive in orphanages because of the complex care requirements and access to quality healthcare for children with special needs.” — Dan Smith, Holt President & CEO

“Her social worker was in the orphanage one of the days we were there, and she remembered us,” Jenna says. “So she pulled our file and she was like, ‘We would like them to adopt her. Would they be open to it?’”

Excited about the possibility of welcoming yet another child into their family, Jenna and Jon carefully reflected on what raising another child with special needs would mean for them.

Holt’s adoption team suggested they speak with one of Holt’s long-time board members — Becca Brandt — to offer guidance and support. Becca and her husband, Kim, are the parents of eight grown children, including six adopted children — two of them with Down syndrome. 

Becca now does volunteer work with a Down syndrome support group, and when the Rhoads reached out, she was delighted to take their call.

“Hearing from Becca was both comforting and reassuring,” Jenna says. “It was comforting to hear her share about the joys of her family while still being honest about the challenges. And it was reassuring to see that this was the direction God was leading our family, too.”

And after much prayer and consideration — and reflecting on what Becca and other families had shared — they decided to say yes.

That is when they shared the news with Dan, who was excited to become an uncle once again.

“It just warmed my heart to the point I was like, ‘Oh my gosh, they’re opening their hearts again,’” Dan says.

For Dan, it also exemplified Holt’s child-centered ethos and approach to adoption.

“That really exudes our philosophy of working in the child’s best interest and being child centered,” he says, emphasizing that Holt finds families for children — not the other way around. “The team heard about that little girl and thought, ‘Well, we think the best family for this child would be the Rhoads family because of their experience, because of their commitment, because of their love for their family.’”

Jenna and Jon are now waiting for travel approval and will likely make their second journey to Hong Kong sometime between January and March.

Why International Adoption Must Continue

While they prepare to welcome their daughter from Hong Kong, the Rhoads are soaking up their days with Keith — or “Kit” as they sometimes call him. Now 4, Keith has grown and changed so much.

“When we got him at 2 1/2, he wasn’t walking yet,” Jenna says. “He was close but now he is running and jumping. He’s really taken off in that way.”

Keith just started preschool, which he loves, and although he has some language delays, he has maintained the sign language he learned from his caregivers in Hong Kong. His caregivers also practiced English with him so he would understand what his new parents were saying to him, even if he couldn’t respond in words. Still mildly verbal, he knows a handful of words. But he communicates well through sign language, which his family has also learned — including his four older siblings.

He especially adores his siblings.

“I can tell he knows when it’s getting close to when they’re coming home [from school] because he’ll start signing their names,” Jenna says. “I’m like, ‘Yep, they’re coming soon.’”

Although equally close with all of them, Jenna says Keith’s bond with each of his siblings is different. “He looks to my 13-year-old daughter as the nurturer so he goes to her for care and comfort,” Jenna says. “And our two boys are rough and tumble so he’s always running up to them and wants to wrestle. … My nine-year-old daughter stays busy and he just always wants to keep up with her. She’s also picked up ASL very quickly and translates for those in the family that don’t have as many signs memorized yet. Keith knows she’ll understand his signs.”

Jon loves Keith’s laugh. “It’s really contagious, especially when he’s a little sleepy,” he says. “People who don’t even know him will look over when he’s laughing because it’s very unique and funny.”

Jenna and Jon both love his determination and drive to accomplish things, even if it takes him a little longer than others. “People with Down syndrome often have low muscle tone and he does have really low muscle tone. It slows down things for him even down to like grasping things with his fingers,” Jenna explains. “But he is just so driven, and I love that about him.”

Medically, Keith is doing much better. He now sees half the number of medical specialists he used to see — from 12 to six — and many of his needs have resolved on their own. But without the surgeries he received at CHOP, he would not be the thriving boy he is now. In addition to heart surgery, he’s had neurosurgery involving major surgery on his skull as well as eye surgery — all conditions related to Trisomy 21.

Although his orphanage caregivers provided the best, most nurturing care they could, Jenna and Jon don’t know if Keith would have ever received these surgeries in Hong Kong. While in the orphanage, he received routine care from volunteer doctors. He also received physical, occupational and speech therapies. But both his skull and heart condition were pressing needs that hadn’t been addressed by the time he joined his family in the U.S.

“Both his neurosurgeon and his cardiologist said, ‘We would have done all these when he was younger,’” Jenna says.

This is one reason why it’s so important that international adoption remain a viable option for children with disabilities and medical needs. Not only are children with special needs less likely to be adopted in their birth country — and thus more likely to grow up in an institution — many are also at risk of never receiving the medical and therapeutic care they need. In many places around the world, orphanages simply don’t have the resources to provide such costly medical care. In some cases, the advanced care they require isn’t even available to them in the country where they live.

“From the day that we were founded, Holt has believed that children should be raised in families, not orphanages,” Dan explains. “It is especially difficult for children like Keith to thrive in orphanages because of the complex care requirements and access to quality healthcare for children with special needs. Keith’s journey into a loving family with access to the Trisomy 21 care team at CHOP is an example of why intercountry adoption can be the best option for some children.”

A Champion Patient

While his urgent needs have all been met, Keith continues to receive services through the Trisomy 21 program at CHOP in Philadelphia. Well known and beloved by the staff, he was recently invited to be a “Champion Patient” during their annual fundraiser.

Of course, when they found out, Jenna and Jon had to tell Uncle Dan.

“They host it in the Lincoln Stadium where the Philadelphia Eagles play,” Jenna wrote in an email to Dan. “Every year they choose a handful of patients to be their Champion Patients for this big fundraiser event. This year, Keith was chosen as one of the Champions. Essentially, this honor gets him a little extra attention on the fundraiser day. … Part of the reason he was chosen was because of the many surgeries he’s had since 2023. Which again made me think of you and your role in Keith’s medical journey. Thank you so much for your support as Uncle Dan!” 

On the CHOP webpage, Kit smiles so big beneath his blue-rimmed glasses that you can’t see his eyes. Just his adorable face. He looks like the healthiest, happiest kid you ever saw.

“He’s thriving. He’s a ham. Yeah, that picture pretty much sums him up,” Jenna says. “I feel like it’s him in a nutshell.”