Managing the Aftermath of Adoption
Nancy Hemenway's daughter was 15 months old and 13 pounds when she was adopted in China.
"My beautiful child was ignored and abused by Western standards," says the Arlington, Va., mom, explaining how her daughter, now 6 years old, still suffers from chronic post-traumatic stress disorder and severe sensory processing disorder and still doesn't verbally communicate.
Despite the life her daughter had in the institution, where young children were tied to cribs and potty chairs, the orphanage was still the only home she had known until she was adopted. "It's almost like you kidnap the child from the home she was in," Hemenway says. "There is no easing into it. It's traumatic."
On some level, every child who is adopted experiences some type of trauma, including children who are joined with their adoptive family immediately after birth. This is because infants have an innate need to bond with their biological mother, according to Marcy Axness, an early development counselor from Granada Hills, Calif.
"Though in general we don't tend to think about pre-verbal children needing to 'process' the myriad experiences that go on around them, they do, especially when those experiences fall outside the realm of what is natural and biologically expected, as happens in adoption when there is separation from the biological mother at birth," Axness says. "If we don't support and participate in this processing, the 'undigested' experience will get 'acted out' in a variety of ways that might not be so pleasant – for them or for us as parents!"
Melanie Tem of Denver, Colo., director of the Waiting Child Program with Adoption Alliance, agrees. "Conventional wisdom holds that the younger the child is when placed in an adoptive family, the less damage there will be from the abuse and neglect that led to termination of birthparents' rights," she says. "Sometimes this is true, but sometimes younger children are more seriously affected, and often their trauma is harder to heal because it occurred pre-verbally, before they had words to conceptualize and name what happened to them."
Children from the United States who are adopted after infancy are usually in foster care, where they first experience the trauma of being separated from their birth family, often land in multiple placements and may suffer from neglect or abuse, according to Kala Lilani of Wynnewood, Pa., a representative from Adoptions from the Heart. International adoptions, she says, often involve children who were institutionalized and also experienced neglect. Again, because these children are pre-verbal, they cannot tell what happened to them.
Signs to Look For
Although every child and every situation is different, there are some general signs that signal to parents that their child is experiencing deep emotional pain.
Margaret Schwartz from Falls Church, Va., adopted two children, 19 months and nearly 3 years old, from the Ukraine in December of 2003. Her sons would head bang, a gesture that is common among children who were institutionalized.
"From what I understand, children do this often at the orphanage," says Schwartz, who is also the author of The Pumpkin Patch: A Single Woman's International Adoption Journey (Chicago Spetrum Press, 2005). "I believe this is done as a way to vent frustration since they lack the verbal skills to communicate. My sons both banged their head on the floor, rather hard, whenever they were upset or angry."
Hemenway's daughter has an intense fear of bath tubs. "I don't know what happened, but she is terrified of the tub," she says. She also says her daughter, like many children, is often afraid to go to sleep. "My daughter never slept more than a few hours, and when she did sleep it wasn't a deep sleep," she says. "Kids who are institutionalized are hyper-vigilant."
Other signs of trauma or emotional problems include the following:
- Hoarding food or other items
- Age-inappropriate or excessive sexual behavior
- Withdrawal from touch
- Toilet accidents beyond the usual age
- Increased acting out as family bonds grow closer
Soothing the Pain
Even if the child can't verbally explain how he feels or why he feels that way, the parents and families can take steps to soothe the child's emotional pain.
"Parents should put themselves mentally or emotionally into the child's situation and do it without sentimentalizing it," Axness says. She recommends trying to find out as much as possible about the child's life before the adoption, including visiting the places the child lived, if possible. "Parents need to see that painful things have happened," she says.
Axness tells the story of one mother she counseled who had adopted a child from Romania. "The mother held her daughter and just started talking, telling the story of her daughter's life, said with a lot of empathy," she says. As the mother spoke, she could feel the shift in her daughter's body language. The child softened and opened herself to her new family.
Experts also say to gently hold the child, providing physical comfort as much as the child will let you. Tem recommends finding a mental health therapist who is familiar with the issues of adopted children and their families. Parents should try to find support groups. Lilani says while parents need to be empathetic, they can't condone or tolerate poor behavior. "The child still needs to learn how to behave in society," she says.
Finally, Lilani says to remember that this is a difficult transition period for everyone. "Parents must understand that this is not a personal rejection or a lack of parenting skills," she says. "There are differences between raising an adopted and biological child."
Tem agrees. "When parents suspect their children may be in pain because of things that happened to them in earlier situations, the most fundamental response needs to be a re-statement that their parental commitment is forever and unconditional," she says.
Showing that love and commitment, no matter what, is the first – and best – step to healing the hurting child.