Take Charge: Home-Based Cognitive and Language Remediation
for Internationally Adopted Children

Published in: Adoption Today, February/March 2006 - Volume 8, Number 4, p.52,53,62,63.

Boris Gindis, Ph.D.,
NYS Licensed Psychologist

We keep telling his teachers that it's as if he has no "hooks" to
clip information onto in his brain and he needs to learn how to
learn. They keep telling us that it's just a language barrier,
switching from one language to the other. I feel it is much more
than that. How can I help my son?
From an adoptive parent's letter.

Children adopted internationally are often educationally "at risk" and present more learning disorders and academic difficulties than their peers in the general population. A major cause of learning problems in international adoptees is profound educational deprivation in their pre-school years.

Normally, young children learn both directly - through observing, experimenting, experiencing, and imitating - and indirectly - through adults, who mediate knowledge for children by selecting and modifying stimuli from the outside world and correcting children's responses. A child may observe steam coming out of a boiling teapot and, touching this teapot and experiencing pain, learn that steam is associated with something hot and painful. The same knowledge could be mediated by the mother pointing to steam, saying "Hot," and imitating pain from her "burned" finger. Through of direct and mediated learning during infancy and early childhood, major cognitive skills and processes are formed, put into action, and continue developing, serving as foundation for further learning. Deprived of essential learning experiences in orphanages, children are indeed disadvantaged and may have cognitive and language problems when moving to more advanced levels of learning after adoption. Reinforcement of this cognitive foundation is the essence of remedial programs for international adoptees.

Signs of deficiencies in cognitive foundation may already show in international adoptees in elementary school. These children display:

• Poor organization of knowledge base, resulting in constant forgetting of learned material and inability to transfer knowledge and skills from one situation to another.
• Lack of age-appropriate cognitive skills and learning strategies.
• Cognitive language deficiency, often concurrent with age-appropriate social "every-day" language.
• Immature self-regulation of behavior, resulting in poor concentration and limited attention span. >
• Diminished intrinsic motivation for learning or achieving in learning activities

The psychological issues behind these observable patterns of behavior often predefine academic failure reinforcing low self-esteem, lack of interest in studying, and constant frustration associated with cognitive efforts.

Remediation

What can be done to put these children on a fast track to catch up with their peers? The answer in many cases is an early, well-planned, focused, and systematic cognitive and language remediation at school, in the community, and at home. The most effective approach is when all three domains are involved in remediation simultaneously, creating a scaffold for the child. Such an approach should include:

• Accurate initial evaluation of educational needs.
• Proper school placement (according to actual readiness rather than chronological age) with supportive and remedial services (such as language therapy).
• Specialized remediation and tutoring (such as the Lindamood-Bell system or Wilson Reading program).
• Home-based cognitive and language remediation.

I will address only home-based remediation of pre-school and early school-age internationally adopted children. The SmartStart program was created by educational psychologist Dr. Carol Lidz, with the participation of international adoption specialist, psychologist Dr. Boris Gindis. The program bears in mind the specificity of international adoptees and introduces basic cognitive concepts and skills which may not have been formed in the child's earlier development. The program provides systematic stimulation of academic language development in children ages 3 to 8. At the same time, SmartStart promotes attachment by providing parents and children with shared enjoyable activities.

At the heart of SmartStart lies the idea that at home young children live, play, and interact with their adoptive parents: home-based remediation is not a substitute for pre-school or school activities and parents are not "second-shift" teachers. Thus, the idea is to make traditional family activities and interactions cognitively remedial and effective for a child. Parents can achieve this in many ways, bringing to the child's attention what should be noticed about experiences, objects, or ideas and providing connections between new ideas and experiences and what the child already knows and will learn in the future. Especially important is challenging the child's thinking by posing questions, using richer vocabulary, communicating ideas that are a bit (not too much) of a stretch for the child, making the child reach just beyond what she or he already knows or can do. Verifying the child's increasing competence and accomplishments, reinforcing evidence that the child can and does learn and keeping in mind that the child's ability to profit from the experience is more important than perfection of the end product - all these make a difference and further stimulate cognitive development.

SmartStart program

The SmartStart program consists of traditional family activities and games which parents are invited to make more meaningful and remedial without taking the fun out. These activities are not randomly picked; they are selected to reflect what is currently known about best practices in promoting cognitive and social development of young children. SmartStart methodology stresses the utmost importance of adult mediation, missed in the early stages of the child's learning. Let's look at 7 paths of cognitive remediation featured.

Unit 1: Introduction.
The specificity of cognitive remediation of an internationally adopted child.

Unit 2: Noticing our world.
Recognizing and developing patterns and sequences using and naming noticeable details. Basic patterning and sequencing skills, formed by ages 3 - 4 in a typically developing child, may not be present in a 7 or 8-year-old former orphanage resident. But certain more complex math and reading skills rely on these basic cognitive notions. Thus, without re-building the base, no successful remediation is possible in mastering, for example, math reasoning.
Example of activity: With crayons and paper, encourage your child to fill the whole page with different patterns (i.e., a row of circles then a row of crosses). Repeat these rows in a different pattern. Create patterns within a row. Model the making of a "pattern page" for your child.

Unit 3: Let's make a plan.
Developing the habit of planning steps to reach the goal, determining if there is a necessary sequence of steps or something is missing in the plan, and later evaluating how the plan worked. Planning is the essence of goal-directed behavior at school; without skills in planning child's activities are mostly impulsive, reactive, and unsuccessful in the classroom.
Example of activity: Suggest that your child invites a friend over to play. Help your child think through the toys and how to get them ready, and what might be a good snack to have with the friend. Afterwards, talk with her about how it went: what the friend seemed to enjoy the most, what could have gone better, what to think about next time.

Unit 4: That's fantastic!
Developing hypothetical thinking and thinking of alternatives. Imagination is an important foundation for the development of abstract thinking.
Example of activity: Encourage your child to play thematic games with toys and household objects: "In the airport", "In a supermarket", "At school", etc., imagining being a pilot, doctor, or teacher and transforming toys into the necessary props. Take the role of someone who is interested, watching, and describing, but not directing. Encourage him to interact with the toys and just add enough to help the flow of action or conversation. If he wants you to take a more active part, encourage him to be "the director" and follow his lead.

Unit 5: The nimble symbol.
Understanding and creating symbols. We live in a symbol-using culture. Children need to learn to use symbols in order to adapt successfully to our high-tech world. Reading and writing are processes of symbol manipulation. Among all high-order cognitive skills, symbol creation and use are the most deficient in former orphanage residents, mostly due to their comprehensive cultural deprivation.
Example of activity: Suggest a "measuring game." The aim is to find all the different ways something can be measured. Give an example, such as "See this table? I can measure it with my hands. Let's see how many hands long it is! Now, I think I'll measure it with this pencil. Let's see how many pencils it is!" Then ask your child to pick something to use for measuring, and, once done, to think of another way to measure the same thing.

Unit 6: What's the big idea?
Recognizing that there are general rules and principles. Thinking in terms of rules and principles helps apply learning to new situations and independent learning. If children get the main idea and know the general rule, they don't have to be told what to do and how to do it each time a new situation arises or a slight change occurs.
Example of activity: Make up your own games with rules, for example, a ball game: decide how long to hold the ball, who can throw to whom, or a different way to move the ball (for example, with your hands, with your feet, with your nose, with your knee...).

Unit 7: Who is in charge?
Learning to regulate movements, attention, and feelings. Children need to learn to wait for their turn, share, postpone... Immature self-regulation of behavior and emotions is an unfortunate "trade-mark" of post-institutionalized children. Teaching regulation and practice of rule-governing behavior is a must in school preparation.
Example of activity: Tell your child, "This is a special kind of ball game. We're going to sit on the floor and roll this ball. We'll try to hit one of those toys with the ball. But, FIRST, you have to say which toy you are going to touch. THEN you roll the ball and try to hit it. Watch me do it first."

Unit 8: Making connections: understanding the past, facilitating the future.
Emphasizing linkages between past and present. On a more advanced level this unit encourages cause and effect thinking.
Example of activity: Let your child know that the ancestors of most people in this country used to live somewhere else. Make it interesting and fun to think about where all the different people came from, especially your own family.

The unique and prominent feature of each unit is a vocabulary section: which words to introduce and how to explain an activity to the child in order to make it more remedially meaningful. For international adoptees, learning their new language is a major adjustment activity. They learn English and the American lifestyle as a by-product of everyday interactions with their adoptive parents. The SmartStart program gives adoptive parents a large set of activities and provides the language that mediates these activities.

As educators and adoptive parents, we have learned that love and good nutrition are not enough to accelerate cognitive development and promote thinking, learning, and literacy in children who had been victims of deprivation, neglect, and institutionalization.