To the Editor: The Special Article by Hostetter et al. on the medical evaluation of internationally adopted children (Aug. 15 issue)* rendered a valuable service by calling attention to the high rate of serious but remediable medical problems in such children. The authors' recommendation that screening tests should be a routine part of the medical evaluation of all children adopted from abroad appears appropriate. The appreciation of the magnitude of the problem is limited, however, by the absence of an indication of the population from which this cohort was drawn. Were these 293 children reasonably representative of all children adopted. . .