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Adam Pertman

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Before It's Too Late: Understanding the Impact of Institutionalization on Children

Posted: 01/23/2013 5:33 pm

Through all the dark shadows that Russia has cast with its ban on adoptions by Americans -- on the affected girls and boys, on the U.S. citizens seeking to become their parents and on the process of international adoption itself -- a thin glimmer of light is struggling to emerge. That is, for the first time in recent memory, the consequences of institutionalization on children are receiving serious (albeit still superficial and sporadic) public attention.

For the record, the consequences can include emotional and social disorders; loss of IQ points and intellectual capacity; stunted growth and other physical ailments; and a host of additional psychological, physiological and behavioral challenges. Some of these impairments cause developmental delays that can be remediated and others can severely undermine the child for his or her lifetime.

Even knowing all this, I am not about to suggest that international adoption is the optimal answer for the vast majority of infants, children and youth around the world -- including in our own country -- who don't live in secure, nurturing families. Nor do I intend to single out Russia as an exemplar of the problem, though the way in which it cut off one potential escape route for a small minority of its institutionalized children was particularly disconcerting.

Finally and very importantly, I do not mean to alarm potential adoptive parents or to stigmatize the children who need our help by laying out these realities so starkly. The uplifting fact is that children are resilient, and many of all ages do well from the get-go once they are being raised by parents who provide the individualized love and attention they need; for the rest, providing permanency and nurture as early as possible can make a titanic difference -- which is to say that even those who face the challenges listed above begin to heal, make progress and even thrive once they are in caring families.

All of which leads to a few bottom-line suggestions for politicians, policymakers, child welfare officials and the general public in the United States, Russia and every other country:

• Beginning tomorrow morning, provide the funding and resources necessary to ensure that children can grow up safely and successfully in their families, cultures and nations of origin -- and so that the women and men who created them are treated without stigma and with respect.

• Beginning tomorrow morning, provide the funding and resources necessary to prevent institutionalization, to replace institutions with more-beneficial interventions, to make out-of-home care as short and effective as possible, and to restore families whenever feasible.

• Beginning tomorrow morning, reshape domestic norms so that adoption and other types of permanency are understood as positive ways of forming families for children who need them -- and so that the parents who choose these paths are treated without stigma and with respect.

Those aren't quick or easy solutions; in fact, it would be fair to describe them as idealistic, long-term dreams rather than as realistic, near-term goals, and that's the point. Taking the steps necessary to help the millions of children who deserve to live in safe, stable and successful circumstances will take a long time, a lot of money and a level of commitment that few governments, anywhere, have ever provided.

So, while I mightily hope that President Vladimir Putin means it when he says Russia will now strive to take better care of its children, including getting more of them adopted domestically if they cannot return to their families of origin, I need to ask: Can you do that by tomorrow morning and, if not, what will happen to those who remain in government custody during the years, and probably decades, it will take to improve your child welfare system?

Again, that is not a question just for or about Russia. There are many children, everywhere, whose parents and other relatives should get the financial and social support to keep their families intact. There are many children, everywhere, who need interim living arrangements while they receive help for their medical and mental health issues. And there are many children, everywhere, who would benefit from moving into families willing to provide them with love and sustenance for the rest of their lives.

It's hard to imagine there are many children, anywhere, who are better off remaining institutionalized.

The public discourse about these children to date has focused primarily on other concerns, ranging from national pride to money and regulation; from protecting the rights of parents to preventing the exploitation of children; from retaining original cultures to creating new opportunities. And, of course, they have included provocative debates about whether international adoption should play a role and about why Americans adopt from abroad when there are children in the U.S. who need families. (There are good answers to these questions, by the way, but that's a conversation for another day.)

For now, I think it's fair to say that these concerns and many others are real, vital and should be seriously discussed. They illustrate the complexity of the problems faced by the international community, by individual nations and by the interested parties in solving the so-called "orphan crisis," which is a misnomer because a large percentage of the affected children still have at least one living parent -- which, of course, makes the whole matter even more complicated.

Perhaps it is because the puzzle has so many pieces that so few countries, including our own, have been able to see the big picture, the one that shows millions of children languishing in temporary care while the adults who control their lives engage in genuinely important deliberations. So I suggest that whenever we look at these important issues, on the ground or at a policy level, we use the glimmer of light that Russia provided a few weeks ago to see them within a different framework, defined by a cliché that every country at some point claims to embrace: the best interests of the child.

It simply cannot be in the best interests of any girl or boy to remain in a setting where she or he loses ground every day. So, while we adults attempt to find the best possible medium- and long-range solutions for these children, let's also carefully, thoughtfully, ethically implement every short-term measure possible -- including family preservation and adoption -- to prevent them from deteriorating to the point where even the best solutions will no longer make any difference.

 
 
 

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Through all the dark shadows that Russia has cast with its ban on adoptions by Americans -- on the affected girls and boys, on the U.S. citizens seeking to become their parents and on the process of i...
Through all the dark shadows that Russia has cast with its ban on adoptions by Americans -- on the affected girls and boys, on the U.S. citizens seeking to become their parents and on the process of i...
 
 
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Correkt the Spelling and Pick on the Moniker
08:18 PM on 01/29/2013
The Russians have tried to ban US adoptions of Russian children because it is a big, and horrifying scm: Dima Yakovlev died of heatstroke after his adoptive father left him in a parked car for nine hours, , , children exported for the organ trade; children who vanished after being adopted by bogus parents; children adopted to be re-adopted; children dropped off at airports with one-way tickets back to Russia . . . Masha Allen, or the “DisneyWorld Girl”, as she was called by the US media. She was five years old in 1998 when she was shipped from her native Russia to come live with 41-year-old Matthew Mancuso, a single American millionaire and a rabid pedophile.

Don't believe anything you read in the US media.

http://www.counterpunch.org/2013/01/29/putins-baby-crime/
12:34 AM on 01/29/2013
Thanks, Adam, for adding your insight and passion to this excrutiating situation. It's unconscionable when bureaucrats use children as pawns. I can't add anything to what you've written but I hope lots and lots read it, and that Russians finally pay attention to this information.
02:36 PM on 01/24/2013
Start tomorrow and realize that children are our greatest natural resource. It is not just in the child's best interest to find a stable loving home it is in all our best interest. START TOMORROW.

D.Radis los Angeles
02:16 PM on 01/24/2013
Thanks, once again, Adam, for raising an important issue with excellent comment about ultimate goals and shorter term solutions. You have stated our ultimate goals well, and it is our responsibility as advocates to begin by taking the first steps. Changing cultural attitudes is like turning the Titanic around, but rearranging the chairs on the deck as the ship goes down is hardly the answer. We have not done an adequate job in our own country to serve our children by regulating adoptions in all arenas; educating and supporting adoptive parents before placement, as well as when their families are in crisis; or making sure that there are enough adoption competent mental health professionals to help avoid out-of-home placements. Even in out-of-home placements there is little adoption competence, and possibly less understanding of the after effects of insitutionalization on the child, so that repair can begin. Thanks for raising another important issue. Keep them coming!!!
12:28 PM on 01/24/2013
We have five adopted children from Romania and Ethiopia. The two from Romania were each institutionalized within a week of their birth and came home at the ages of 3 and 4. They are now about to turn 15 and 16. The three from Ethiopia were placed in an orphanage at various ages (4, 2, 6 -- though skeletal age suggest older) due to the loss of their parents from AIDS. They are now at or around 15, 11, and 13). I believe that because we have always been honest and up front with them their emotional scaring has been limited. Raising them as "ours" and allowing them to question themselves seems to be key. More can be read at www.moving-forward-in-reverse.com
Scott Martin
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11:19 AM on 01/24/2013
Great post Adam!
07:05 PM on 01/23/2013
It's also important for adoptive parents to seek help from QUALIFIED medical professionals if their child is suffering from the after-effects of institutionalization, aka orphanage life.

There are way too many self-proclaimed "trauma mamas" that encourage non-traditional and possibly harmful treatments for kids from "hard places".

Adoptive parent Lisa Qualls (who blogs at onethankfulmom.com and gets paid to give advice about parenting internationally adopted kids) recently (allegedly) sent her daughter "Dimples" (adopted from Ethiopia a few years ago) to the unlicensed Ranch for Kids in Montana.

Diana (not a licensed therapist of any kind) sells parenting classes for $8 a pop on her blog fromsurvivaltoserenity.blogspot.com

Lauren's super-successful approach to parenting has led her to 1) kick one adopted child to the curb, 2) ship another adopted child off to an unlicensed facility for "treatment" of reactive attachment disorder) and yet offer parenting advise via her blog:
Ourjourneyoffaith.net

This trauma mama excluded her adopted daughter Sophie from a fun family vacation and criticism her for not understanding why mommy took only her biological daughters to Orlando (Disney! Princesses! Swim with dolphins!!) in order to " recuperate" from the horrors of raising her adopted kid. And mommy was baffled as to why the adopted kiddo felt left out
Ourhaitianjourney.blogspot.com
07:41 PM on 01/26/2013
Jeannette,

The impairments and delays mentioned above deserve serious attention, and they are not limited to children who have been institutionalized. Any children who have been separated from their families of origin have suffered trauma as well, and they may very well exhibit impairments and delays similar to those children who have been institutionalized.

ALL these children have the potential to exhibit very challenging behaviors when they are brought into an adoptive family’s home. Qualified medical care alone can’t solve these issues. Perhaps by “medical” care you also meant to include mental and behavioral health care, but these are in fact a different group of professionals. Even most psychiatrists, who do have medical degrees, generally do not provide any therapy other than medication management. Medication alone will not resolve the traumatic experiences these kids have survived, nor change their behaviors long-term, nor catch them up developmentally and academically.

If you meant to include mental and behavioral health professionals, please understand that finding “qualified” professionals in that category is challenging. Many licensed professionals have little to no training or experience with trauma and attachment issues and some do more harm than good. Those who are unhelpful waste the time of their clients even if they do no harm – and this in an area where the earlier the intervention, the greater the likelihood of a faster and more complete “recovery.” This is not rocket science; when children are behind developmentally, the sooner we get them on track, the better.
07:44 PM on 01/26/2013
(Part 2)
Many licensed therapists are trained primarily in types of talk therapy, which is not terribly effective in dealing with pre-verbal trauma – it’s hard to talk about experiences cannot be remembered explicitly. There are therapists trained in methods more appropriate to treating trauma, but they are not widespread. If you’re not living in a larger metro area, your chances of finding an appropriate professional are slim. Hence, parents reach out to other parents, and to online support.

Most of the parents who end up resorting to non-traditional approaches end up doing so after watching traditional method after traditional method fail, and watching their children get bigger, older, farther behind, and quite possibly more violent or more into self-destructive behaviors. When such parents find methods that give them hope, it’s natural to want to share them with others who are in similar situations.
06:55 PM on 01/23/2013
It's also important to be aware