Adoption Professionals Talk About Their Work

Dr. Gindis Answers the Questions
Q. When you do the psychological evaluations, do you see a difference in results based on the country the children come from?

A. It is a complex issue, as I do see a lot of disparities from country to country, from age to age, and child to child. For example, I do see more cases of FASD in the Eastern European kids and more cases of cognitive impairments and autism in children from China that were brought to the BGCenter. The numbers are obviously skewed in relation to the total set of adopted children, as I mostly see those who have "red flags" in their medical documentation and often demonstrate atypical for their age behavior. Thus it's easier to generalize about what is similar and common between all adopted older children (4+) and sets them apart form children in immigrant families I see too. Three similarities stand out immediately:

It seems to me that these 3 major trends among international adoptees who I see are prevailing and overriding any individual and country related differences.

When I test these very different and so similar kids, I can't use different standards in their evaluation - they all will have to cope with the American educational system and there for must be all viewed from this perspective: where they are in the continuum. But their test results always need to be verified from different angles and explained properly - and this part is very important and easily misunderstood by professionals and school personnel.

For that matter, my goal in all assessments is to be flexible, sensible and observant, collect as much additional information as possible and apply that information to interpretation of the standard tests scores in the context of known developmental history, cultural and language differences of a child. At the BGCenter we have developed a specific methodology of testing internationally adopted children. It is called "Combined (bilingual - when necessary) developmental, neuropsychological, and educational assessment". It includes "cross-battery" technique that allows me to cross-reference the results that point to multiple possible outcomes. This methodology is used in both "screening" and "full assessment" procedures applied to all internationally adopted children.

Tatyana Elleseff MA CCC-SLP on the Value of Multidisciplinary Collaboration
As a speech language pathologist who works with internationally adopted children, I often encounter difficult cases on which I require multidisciplinary collaboration from other professionals such as pediatricians, neurologists, psychologists, occupational therapists and other related specialists. However, over the years of working with this unique population, I have noted that among adoption professionals and adoptive parents this practice is not as popular, as I would like it to be, despite evidence based practice recommendations (Catlett & Halper, 1992; Ellingson, 2002; Hwa-Froelich, Pettinelli, & Jones, 2006; Tzenalis & Sotiriadou, 2010). Oftentimes, medical professionals may initially examine a child post adoption, recommend a related service (e.g., “you child needs speech therapy”) but will not follow up with the related service provider regarding the child’s progress or lack of thereof. Of course the same goes the other way, I have also encountered cases where a related services provider (e.g., OT, ST) had made clinically relevant observations and did not find it “important” to follow up with relevant medical professional/s regarding the findings. I’ve also encountered numerous adoptive parents who did not follow through on specific recommendations regarding related services provision (speech or occupational therapy services) or psychiatric/neurological referrals.
Consequently, for the purpose of this article I would like to demonstrate to both adoptive parents and professionals two case examples in which multidisciplinary and parental collaboration was key to confirming specific relevant to social and academic functioning diagnoses, which then in turn supported the provision of relevant services for the children in question, to help them function appropriately.