Newsletter #60 for Internationally Adopting Parents
May 10, 2007
PAL Center Inc.

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Gary Direnfeld, MSW, RSW
Happiness won’t save you if the pond you are swimming in is polluted
Parental alcohol use and corporal punishment are co-related to problems in the offspring. The greater the use of alcohol and corporal punishment by parents, the greater the risk of depression, anxiety, marital and vocational problems for their children come adults.

Gary Direnfeld, MSW, RSW
Parenting Coordinator in the Province of Ontario
Think of the Parenting Coordinator as a referee for separated or divorced parents in conflict. Particularly of value in high conflict situations, the Parenting Coordinator provides an alternate dispute resolution mechanism to the constant return to lawyers or the Court.

A "Laundry List of Symptoms" or
Impaired Neurology?

Parenting of internationally adopted post-institutionalized children is a great challenge. This is a special group of children who are in care of a special kind of parents. Many of these parents are well educated and knowledgeable individuals. At the same time, because all of them "navigate uncharted waters" so to speak, they are anxious to be proactive and effective and often fall in the trap of what I call "a laundry list of symptoms". The most notable example is the list of symptoms related to Attachment Disorder. It is so easy to click the button and serf the Internet to encounter a catalog of symptoms, usually long and vague, which seems to be applicable to your child. And almost instantly to experience an insight (an "aga!" moment): "That is what my child has". Often after some further search and discussion with adoptive parents or, sometimes, professionals the outcome will be a firm belief that "my child has attachment issues (or ADHD, or bi-polar disorder, etc)". Subscribing too quickly to an "obvious" symptom may result in months (and thousands of dollars) spent on therapies that would not help because the wrong problems are being addressed.

It's important to understand that a significant number of internationally adopted post-institutionalized children are neurologically compromised as a combined result of pre-nattily weakened or damaged Central Nervous System and years of deprivation, neglect, and institutionalization. They may consistently demonstrate patterns of behavior resembling many known emotional and behavioral disorders and still do not have these disorders: they suffer from the impaired neurological functioning.

Let me cite at this point Harriet McCartney, one of the most knowledgeable and insightful adoptive parents I ever met, who speaks from her own experience:

….I've parented one of these difficult, scrambled kids for almost 11 years, so I've had plenty of time to watch the progression and have the advantage of hindsight. He was adopted at the age of 5 years, 2 months and possessed no working memory and no self-generated language, although he could repeat words. Our early relationship was fraught with frustration on both our parts and I found myself wondering about attachment issues. Along the line, early-on, I filled out part of an intake application for an attachment clinic here in the area. I stopped mid-way because it was clear that what I was seeing with my son didn't jibe with what the attachment experts were looking for.

In my quest for an answer to why my son acted the way he did, I discovered the world of sensory integration disorder, language processing and auditory processing disorders, psychological therapies, physiological abnormalities, post-traumatic stress syndrome, anxiety disorder, learning disabilities and dyslexia, ADHD (or what looked like it) and alcohol-related neurological disabilities among many other, now thoroughly integrated issues. What overrode all of these individual symptoms was the neurological component which turned out to be a fundamental element in every single one of the symptoms. What looked like an inability to attach was actually a neurological inability to integrate all the incoming data of finally having a family to relate to on an emotionally meaningful basis. What looked like oppositional behavior and/or indifference was a fundamental and very severe language processing problem - both receptive and expressive. What looked like acting-out for its own sake was actually a response to triggers from a severe case of post-traumatic stress. And so it went. For the first two years, my son couldn't remember if I was the "Mom" or the "Pop", so he compensated by sticking the two names together and called both of us "MomPop". He had no idea of the concept of "Mother", so what looked like rejection to me was actually his inability to integrate the concept with whatever memory he already had (which wasn't much) of a deceased mother/combination orphanage worker and the single-minded madwoman he was currently living with)...

An overlooked weakened neurology of a child is only one factor leading to a frustrating "search-for-a-diagnose" problem. Three other contributors commonly ignored or misinterpreted as symptoms of emotional and behavioral disorders are:

• The influence of an abrupt language loss by a child
• Cultural components of behavior that define the perceptions
• Learned "orphanage survival skills" and reaction to family life adjustment

How many times in my clinical practice, a child would be brought to our Center with a list of symptoms pointing to CAPD, ADHD, RAD, etc. (you may include all the letters of English alphabet here!) just to end up with a specific neurologically based diagnosis that explains all this "seven-soup" of different manifestations. I clearly remember an 8-year-old girl adopted as a toddler from Rumania who was diagnosed with five (!) different disorders, including attachment, post-traumatic stress disorder, and hyperactivity, who, in fact, had a high-functioning autism that explained all her issues. The presence of a neurologically-based disorder (e.g. alcohol-related neuro-developmental disorder, also known as FAS or autism-spectrum disorder, etc.) may include secondary emotional disturbances, but at the core of it is a damaged Central Nervous System.

In search of what is wrong and how to address the issue(s), it's very important to have a plan and start from the essential things first: do a thorough neuropsychological assessment (if needed, after a neurological evaluation); familiarize yourself with possible affects of three contributing factors above and carefully rule out the causes of other seemingly "obvious" issues.

Boris Gindis, Ph.D.

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