Early Interventions for internationally adopted children

Early Family Interventions as Prevention of Escalation of Behavioral and Emotional Problems in Internationally Adopted Children

Irene Feigin, Licensed Psychologist

Nearly all studies of adoption have documented the resilience of internationally adopted children of all ages (Tizard, 1991; Welsh, Viana, Petrill & Mathias, 2007). The majority of them do not demonstrate severe or persistent behavior and developmental problems. Nevertheless, existing research suggests that adoptees are at higher risk of developing serious mental health problems in adolescence and young adulthood and more likely to die from suicide, to be admitted for a psychiatric hospital, have drug and alcohol abuse problems then population at large (Hjern, Lindblab & Vinnerljung, 2002) and that they are overrepresented in psychiatric care facilities (Verhulst, Althaus &Versluis-den Bieman, 1990).

The data concerning adjustment of older children adopted from other countries is inconsistent. According to Verhulst, Althaus & Versluise-den Bieman (1992) "The older the age of the child at placement the greater the probability that the child will be subjected to psychosocial adversities". Other studies indicate no age-related difference in adjustment (Juffer & van IJzendoorn, 2005).

Adoptees behavioral problems are usually explained by the effects of early trauma, disturbed attachment, institutionalized behavior, and delays in cognitive development, i.e. pre-adoption vulnerabilities and deficiencies; they are primarily conceptualized within the framework of Attachment Theory. In clinical practice, transient attachment difficulties of the adoptee are often assumed to be the child's stable dysfunctional behavioral patterns-disorders of attachment. Difficulties between parents and adopted children are corrected through attachment interventions by attuning parental response to the child's behavioral cues. Attention is given to such factors as parents' sensitivity and ability to read cues and miscues, and qualities of the child' signals. (Marvin& Whelan, 2003). Such studies make an assumption that adoptive parents are "presumably sensitive caregivers" (Marvin & Whelan, 2003). The latter researchers also suggest that parents' extreme sensitivity to criticism is responsible for the lack of exploring their role in the disordered attachment".

Yet rarely do researchers see adoption itself as a source of distress for older children, or consider relationship aspect of adjustment. The role of the adoptive family is viewed as one of rehabilitation. Recommendations for prospective adoptive parents are written in a language of psychiatry to alert them about risks of compromised early development. Suggestions are given to accelerate the adoptee's access to mental health services and admissions. For attention difficulty and depression parents are advised to use medication (Johnson, & Dole, 1999). Thus a child becomes a passive object of necessary interventions

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