School Psychologists Working With Internationally Adopted Post-Institutionalized
Boris Gindis, Ph.D.
Published in: "COMMUNIQUÉ"
(a publication of National Association of School Psychologists)
September 1998 (Part l) Vol. 27, #1, pp.6,9 and October 1998 (Part
ll) Vol. 27, #2, pp.20-23
At the beginning of this decade a large unprecedented
number of U.S. citizens began to adopt children from orphanages
abroad. There are many geopolitical, social, legal, economic,
and spiritual factors underlying this phenomenon (Hamilton &
King, 1997). According to the US Naturalization and Immigration
Service, from 1990 to 1997 entry visas were issued to 72,962 orphans
born overseas (see US State Department's Website accessible at:
In 1997 alone, 13,620 children were adopted from abroad, including
3,816 from Russia, 3,597 from China, 1,654 from Korea, 621 from
Romania, 404 from republics of the former USSR, and the rest from
18 other countries. According to the National Adoption Information
Clearing House, 64% of internationally adopted (IA) children were
girls. Over 70% of IA orphans have come from four countries: Russia,
China, Romania, and Korea.. While the majority of IA adoptees
were younger than 4 years old, about 11% were school age at the
time of adoption. Currently, the majority of all children internationally
adopted since 1990 are in preschool programs, elementary, or middle
schools. The chances that school psychologists will be working
with an orphanage-raised IA child are getting higher every year,
and it appears that this trend will continue to the next century.
Are we ready for this new challenge?
As of now, we have only fragmentary knowledge about
international adoptees as a group. Moreover, the very attempt
to present them as one group is a risky assumption due to significant
ethnic/social/cultural differences among their native countries.
Nevertheless, I will try to discuss IA children's problems from
a group perspective, pointing, when appropriate, to cultural differences.
Also, we must understand that what correctly describes the group
is not necessarily applicable to the individual.
Internationally adopted children as a group have
a specific set of characteristics that distinguishes them from
domestically adopted children, from the offspring of recently
immigrated families, from the bilingual population, or from children
at large in need of special education or supportive educational
services. IA children may not be able to be tested by our established
methods of evaluation, may not fit our customary classifications,
and may not respond to our usual remediation. Research data on
this topic are limited, mostly preliminary, and only remotely
relevant to school psychology. The purpose of this article is
to draw attention to this problem and to share some information
and clinical experiences with my colleagues in the field. I will
restrict my discussion to school-aged children (from age 6 to
12), and to the issues related to school adjustment and school
A "High Risk" Group: The vast majority
of those Americans who adopted abroad said that they do not regret
their decision (Hamilton & King, 1997). This does not mean,
however, that they "will live happily ever after" they
bring their new children home. Internationally adopted post-institutionalized
children present a challenge in the areas of health, language,
cognitive and emotional functioning, overall school adjustment,
and performance. Dr. E. Ames, the principal investigator of the
comprehensive research on Romanian children adopted in Canada,
stated that international adoption "....should be considered
to be a special needs adoption" (Ames, 1997, p.1). "Special
needs" in overseas adoptees should be expected by the very
nature of the international adoption: many of the children (at
least in the countries of Eastern Europe and Russia) available
for adoption by foreigners, are children who were put up for adoption
and not adopted by the native citizens due to medical or psychological
needs in these children that simply cannot be met in their motherlands.
In terms of their general physical health, IA post-institutionalized
children are a "high-risk group by any standards", stated
Dr. D. Johnson, a pediatrician from the International Adoption
Clinic at the University of Minnesota (Johnson, 1997, p. 27).
He listed the high occurrence of premature birth, low birth weight,
prenatal alcohol and nicotine exposure, adverse social circumstances,
inadequate nutrition, poor pre- and postnatal care, and long term
institutionalization as major detrimental health factors to the
development of overseas orphans. According to a study, published
in the Journal of the American Medical Association (Albers, et
al, 1997), IA orphanage-raised children had one month of linear
growth lag for every five months in an orphanage. Serious medical
problems were found in about 20 percent of the children evaluated
upon arrival in US clinics. Pediatric exams of a sample (56 children
adopted from Russia) described in the study, found gross-motor
delays in 70 percent of the children, fine-motor delays in 82
percent, language deficits in 59 percent, and social-emotional
delays in 53 percent (no clue was provided, however, on how "social/emotional
delays" were measured - BG). The researchers indicated that
"... many children have significant post-institutional growth
and developmental delays, and additional important unsuspected
diagnoses may be found. ....we suggest that children coming from
these environments should be considered - at least temporarily
- 'special needs' children. Parents and physicians must plan to
provide a period of intensive rehabilitation. Early intervention
and special needs' programs may assist these children to maximize
their developmental potential. The extent of recovery from these
delays is yet to be measured." ((Albers, et al, 1997, pp.
There are no reliable statistics on the number of
internationally adopted children in need of rehabilitative and
remediation services. A follow-up study four years after adoption
of Romanian orphans in Canada ((Jenista, 1997) revealed that about
one-third of the families noted no significant problems, one-third
mentioned one to three areas of deficits, but admitted that the
children are doing "relatively well". About one-third
reported serious and sometimes worsening cognitive and behavioral/emotional
It is considered common knowledge, that children
who have spent any appreciable time in institutional care may
be at risk for having developmental delays and/or psychological
problems (Tallbot, 1998). The absence of irrefutable scientific
data, however, does not allow us to accept this tenet without
further questions. Which factor(s) - age of placement in an orphanage
or time spent there, or both - are the most detrimental to a child's
development? What specific factors of institutionalized life are
most damaging to children of a certain age? What constitutes the
essence and specificity of an institution-induced delay as opposed
to developmental delays found in family-raised children? In international
adoption what are the cultural differences that may be perceived
as developmental or emotional impairments? Does institutional
care have an irreversible (or long-lasting) effect on a child's
development, or can this effect be corrected and compensated for
either through proper intervention or spontaneously in the course
of maturation? Thorough research is needed to answer these and
other questions to properly guide our practical work with this
"at risk" group of students. The issue of institutional
effects on a child has tremendous practical significance: unfortunately,
there is no hope that in the future all children will be raised
in families; therefore, institutional care is not a choice but
Beyond the Bilingual Issue: English Language Acquisition
for a School-Aged Internationally Adopted Child. 7-year-old Alyona,
who just arrived at her New York home from a Russian orphanage,
has to adjust to life in a family vs. life in an institution,
to a new physical and technological environment, to a new cultural
and social milieu, and to a new school. But she has to start with
English language acquisition, because the whole process of adjustment
to a new life is mediated by the new language. And this is an
arduous task for Alyona: a psychoeducational and language assessment
performed on her arrival in this country detected a wide range
of speech and language deficits that require immediate attention
and remediation efforts.
Delays in language development are the most common
diagnosis found in medical records of IA post-institutionalized
children age 4 and up. I would call this condition a "standard
feature" (the most common deficit) of the children from orphanages
overseas (Gindis, 1997b). In a book published in Moscow by a group
of Russian psychologists (Dubrovina, et al., 1991), the authors
describe what they call a "temporal delay in psychological
development" as typical of children raised in orphanages
due to the lack of stimulation in early childhood. They specifically
point to delays in speech and language development. The common
picture for many children living in orphanages at the age of 3
is incomprehensible speech with only a few phrases used, very
limited vocabulary, poor receptive language skills, and slowness
in learning new words. At the age of 4 the same problems persist
with attempts to use somewhat longer sentences usually with faulty
grammar. In one research study described in the book, it was found
that about 60% of all 2-&-1/2-year-olds in an orphanage for
preschoolers had no expressive language at all. A year later only
14% used two-words sentences. Our colleagues in Russia suggested
that this situation is not only due to a severe lack of enough
quality and quantity of verbal interaction between a child and
an adult during the so-called "critical periods of development",
(from birth to 5), but mostly because of the very context of communication.
Mutual object-related activity and cognitive learning activities
are very limited, detrimentally impacting on language emerging
as a means of communication, thinking, and regulation of behavior
(Dubrovina, et al., 1991, pp. 101-123). In light of the latest
finding in neuroscience, it is understood that children in orphanages
are likely to have a neurological predisposition for language-related
problems due to the lack of specific social/cultural mediation
normally provided by grown-ups. The rate of early learning - literally
the first months and years of life - determines the child's level
of language functioning for many years to come: what has not been
mastered within certain developmental ranges may not be totally
compensated for in spite of heroic efforts in the future (Locke,
It is only natural for Alyona, in the process of
a new language acquisition, to exhibit negative emotional and
behavioral patterns clearly related to communication problems
such as frustration, anger, acting out, temper tantrums, etc.
Developmental and personality factors, as well as the degree of
IA children's native language proficiency may influence the dynamic
of their mastery of the English language. The rate of English
language acquisition is not a direct indicator of general cognitive
abilities: language learning is a very complex process where intellectual
aptitude is only one of many factors.
In her classroom, Alyona met another girl, who recently
immigrated from Russia with her family. Both girls know only Russian
for now. Will they learn English in the same way? To what extent
is language acquisition in IA post-institutionalized children
similar to what is known about children from immigrant families?
In other words, to what extent is this a bilingual issue? A common
understanding of bilingualism includes functional use of more
than one language within a developmentally appropriate and socially
expected range of language skills (Vygotsky, 1997/1935). In this
respect the majority of IA children do not belong to a bilingual
category at all. Or they may be bilingual for only a short period
of time. They are monolingual at arrival (let us say, Romanian
only) and after several months they are monolingual again, this
time English only. There are exceptions with older adoptees (who
may be literate in their native language), particularly in twins
and sibling groups. One of the most shocking discoveries I made
for myself working with IA children was the swiftness of their
losing their mother tongue, and more often then not, their negative
emotional reactions to their native language. I was unable to
find any relevant research data on this matter (losing first language
in an internationally adopted child) to substantiate or reject
the following personal clinical observation: an IA child between
age four and eight will lose the bulk of her expressive native
language within the first 3 to 6 months in this country. Her receptive
language for the purpose of simple communication may last longer,
but eventually all functional use of the native language will
disappear within the year if not in a few months in an exclusive
English language milieu (Gindis, 1997b). Among the factors that
speed up native language loss in IA post-institutionalized children
are a low level of language skills in the native language, no
motivation to continue to use native language, no opportunity
to practice native language, no practical support of the first
language in their micro (family) and macro (community at large)
It has been found in children from immigrant families
that those who have well-developed first language skills (for
their age level) - usually acquire the second language more quickly
and easily. The reverse is also true. The whole notion of bilingual
education is based on this observation (Cummins, 1996). From what
I have discussed earlier, it is apparent that the majority of
post-institutionalized IA children are weak in their first language
and, therefore, they are "at-risk" in learning their
new language. The most obvious difference in second language acquisition
for immigrant and IA post-institutionalized children age 4 and
up is in their respective model of language learning. For children
from immigrant families second language acquisition is often based
on the so-called "additive" model, while for adoptive
children this almost always is based on the "subtractive"
model. In the process of second language learning there is a dynamic
relationship between first and second languages: children may
switch their dominance, their subjective significance, and their
relative mastery. When and if in the process of second language
acquisition the first language diminishes in use and is replaced
by the second language, we have the so-called "subtractive"
model of second language learning. When the second language is
added to the child's skills with no substantial detraction from
her native language, we call this the "additive" model
of bilingualism. In a school-aged IA child within the first year
at her new home the native language gets extinguished rapidly
and English takes over. The tempo of losing and replacing language,
however, does not coincide. Losing language occurs much faster
than mastering a new one. But the demand for three major language
applications - communication, behavior regulation, and cognitive
operations - is as strong as ever. That is where the root of many
future school troubles is based and that is when the systematic
and appropriate actions in helping adopted child should take place
(for more information, see: Gindis, 1997b).
From the school's perspective, the most "at-risk"
(language-wise) group is children between the ages of 4 to 8.
Children adopted before the age of 4 have at least several years
of development mediated by their new language before they enter
school. Children older than 8 in many cases (in particular those
who came from Russia and Eastern Europe) have learned to read
and write in their native language, and they have an opportunity
to transfer some of their cognitive language skills into their
new language. Also, language problems in children older than 8
are relatively easy to identify and remediation strategies are
likely to be straightforward. Those between 4 and 8 really fall
between the cracks. Their language problems are difficult to pinpoint
because they are disguised by the dynamic of second language acquisition,
which is mostly in communication, not in the cognitive area. Adoptive
parents are usually amazed and pleased by their children's progress
in mastering basic communication skills, and they see no apparent
reason for any extra language remediation. The problem is that
when it eventually becomes apparent, it may require "heroic
efforts" and may result in a lesser degree of success.
Behavioral/emotional issues in IA children: It appears
that emotional/ behavioral problems are present in IA post-institutionalized
children in a greater proportion than in their family-raised peers.
Among psychiatric diagnoses, the most common are Post-Traumatic
Stress Disorder, Reactive Attachment Disorder, and Adjustment
Disorder. In schools, behavioral complaints range from "annoying/immature/hyperactive"
to (I am citing from real referrals): "indiscriminate hostility",
"fierce fighting", "wild temper tantrums",
"constant attention demanding behavior", "she is
overly affectionate to strangers with no sense of appropriate
interaction", "open" and "sneaky" aggressiveness
toward classmates", "he needs to dominate while in a
group". A classification of "seriously emotionally disturbed"
is not uncommon among IA children, although our understanding
of the nature of their "disturbances" is confusing,
to say the least.
First, we have to realize what constitutes "normal"
behavior in an orphanage and what "normal" (that is,
expected and common) post-institutionalized behavior is? Behavior
problems in school may stem from a specific mode of development
produced by the neurological impairments (e. g. ADHD or Tourette's
syndrome) or from previous experiences, e.g. learned behaviors
that could be adaptive and effective in institutions but become
maladaptive and counterproductive in the new school and family
environment. For example, many symptoms of the syndrome known
in this country as "Reactive Attachment Disorder" (RAD,
DSM-lV code 313.89) are described in Dubrovina's book as "survival
skills" and "routine daily interaction" typical
for an orphanage. Interestingly enough, while RAD is a relatively
common characteristic of children from Russian or Rumanian orphanages,
it is virtually unknown in children from China and South Korea
In terms of adaptive behavior, IA children face
the task of transforming their orphanage survival skills into
functional family/school relationships. They have to learn new
patterns of behavior and new social skills with both adults and
peers. For example, 8-year-old Anton (adopted recently from a
Ukrainian orphanage) expressed confusion regarding the fact that
neither in his new family nor in his new school did adults beat
children who misbehaved. For him to follow instructions from adults
who do not hit children was a great difference from what used
to happen in an orphanage. Therefore, he kept testing the limits
to see when he would get hit. With peers in an orphanage, daily
relationships were based on the dominance and submissiveness/inferiority
model (Dubrovina, et al., 1991). To switch to an "equal opportunity"
model is a great transition for a post-institutionalized child.
In terms of other deficiencies in social skills, I have to point
to an age and sex segregation issue common to Russian and East
European orphanages where children are confined to their age group
and have very little contact with children from other age groups.
Add to this the almost complete absence of male caregivers (again,
at least in Eastern Europe orphanages where direct care staff
is exclusively females): children may not see or interact with
an adult male for years (Sloutsky, 1997).
In IA post-institutionalized children, adjustment
to a new life often revolves around the issue of self-regulation
of behavior and emotions. One of the characteristics of an overseas
orphanage is a peculiar combination of a rigid routine with ongoing
uncontrollable changes in the environment. The constant turnover
of caregivers, changes of the domicile/school arrangements as
children reach a certain age or their educational/medical needs
change, etc. lead to a tremendous sense of instability and lack
of control. On the other hand, their everyday routine is rigidly
fixed with virtually no personal choices, no private possession
of toys, clothes, etc., "emotional monotony", and, as
a result, a minimal need for behavioral self-regulation. Emotional
"immaturity" (that is, a lack of emotional self-regulation
at the level expected by a certain developmental stage) is a distinct
"marker" of a post-institutionalized child, noted and
described by a number of researchers (Dubrovina, et al., Terwigt,
et al). It is truly an orphanage-induced distorted pattern of
"emotional processing", with the question being: how
deeply it has been internalized by IA children, and will it be
remedied naturally or does it need special educational efforts
or even counseling/ psychotherapy?
The school psychologist as a part of a post-adoption
support system: It is not rare or unusual for prospective adoptive
parents to come to school or a district office prior to an adoption
to discuss the issues of placement, testing, supportive services,
and share their worries and anxieties. This is a good time to
meet with them to review the options available in your school,
school district, and community at large. Be supportive, but realistic
and make sure to honestly inform parents about the capabilities
of your school district to take on the challenge of rehabilitating
a post-institutionalized child.
Adoptive parents of IA schoolchildren in many respects
are distinct from "regular" parents you are accustomed
to. Their "group psychological profile" may include
the following characteristics. They are older (in their early
40s and 50s), well-educated, affluent, well-informed, and strongly
motivated to be super-parents. They are screened for their parental
duties by the state authorities, and take parental training provided
by adoption agencies. Many of them belong to parent networks of
support groups (see addendum below), and have acquired the latest
information related to their soon-to-be-adopted children. They
avail themselves of many consultations with specialists (e.g.
they have video and medical records of the prospective child reviewed
by professionals), and attend specialized pre-and post-adoptive
seminars. They are truly ready to go the extra yard for the well-being
and rehabilitation (if needed) of their children. An interesting
observation is that the higher incidence of a diagnosis of school
problems in adopted children than in the general population is
impacted by the fact that "...adoptive parents tend to be
extremely watchful of their children. If a child shows the slightest
sign of a problem, adoptive parents tend to quickly seek professional
help. Thus adopted children may simply be diagnosed as having
learning problems sooner than other children" (Smith, 1997,
p.11). In short, parents of IA children, as a group, are the source
of unique information for you. Please be open to these families'
experiences, listening to them, trying to understand their unique
backgrounds, and, - an unusual bit of advice - let them be your
"navigator" through the uncharted waters of helping
I am, however, far from glorifying this group of
parents. For some of them the emotional roller coaster of international
adoption has been too much. Along with the above mentioned positive
characteristics, they are often overly anxious, overly zealous,
overly fearful, and often are susceptible to many unfounded beliefs
and opinions. Several of these are that "love and good nutrition
are all that these children need" and "love, patience,
and time will work wonders", and that "children just
outgrow their problems". In spite of the broad press coverage,
existing support groups of adoptive (experienced) parents, the
efforts of many adoptive agencies, and, last but not least - the
Internet with its wealth of information on the subject - some
adoptive parents are still perplexed at discovering that their
children have significant developmental, cognitive, and emotional
problems that are not going to be fixed with "love and time".
That is where help from a school psychologist may be invaluable
in the proper identification of existing problems and for consultation
regarding remediation and compensation for deficits.
School psychologists may be consulted by parents
and school administration alike regarding academic placement,
remediation, and supportive (special) services for a newly-arrived
school-aged IA child. Decisions should always be highly individualized
and based on a thorough consideration of many factors. In terms
of academic placement, it has been my personal experience that
placement according to "age-level", as is usually practiced
with children from immigrant families, may not be right for many
post-institutionalized IA children and may lead to tremendous
frustration for a child and her new family. Academic pressure
heaped on top of general acculturation, language acquisition,
and often accompanied by health and neurological problems may
be a psychological "Molotov cocktail" thrown at an adoptive
The bilingual education programs and bilingual related
services, available in some school districts, could be a contentious
placement decision for an IA child. While a short-term transitional
bilingual program may be quite appropriate, any long-term bilingual
placement "in order to save the child's first language"
would be a waste of time and resources (and might even impede
the child's learning of English) for the following reasons. An
adopted child lives in a monolingual English-speaking family,
not in a bilingual immigrant family. Her native language has no
functional meaning or personal sense for her, while she needs
functional English for survival. Her native language will not
be supported by her family, but the same family will provide her
with patterns of proper English. Bilingual education or services
(for only part of the day and without family support) may lead
to communication confusion and "mixed" verbal conditioning.
On the other hand, English as a Second Language
(ESL) has proved to be a valuable resource for IA children. ESL
is a mandatory program in many states for every non-English speaking
child entering the school system. IA children are automatically
eligible for this service, although they do not fit into the typical
ESL student's profile: English is, indeed, their home language!
ESL instructions for IA students should be individualized and
modified accordingly with a possibility of enrichment at home
and more active parental involvement in the process of new language
learning. The quality of instruction in ESL varies significantly
from school to school, but most of them do take into consideration
both social (communication) and academic (cognitive) language.
By and large, ESL means extra help and extra support IA students
and their parents should take advantage of.
Different states have different criteria of eligibility
for special remedial and supportive services (e.g. speech, occupational,
or physical therapy). Every decision regarding IA children's eligibility
should always take into consideration not only their current actual
status, but their past as well. Not many of them were able to
escape institutionalization unscathed and their particular vulnerability
to stress and pressure must be taken into consideration.
Instruments and procedures in evaluating of IA post-institutionalized
children: Psychoeducational assessment is one of the distinct
responsibilities of a school psychologist. Choosing appropriate
tools and procedures in psychological evaluation of children from
another country coupled with their "atypical" background
presents a formidable task. There are three important aspects
of the psychological assessment of IA children to consider: when
(time frame), who (professionals), and how-to (instruments and
It is well understood that timely intervention is
the key factor in effective remediation. Almost all IA children
go through a medical check-up on arrival for possible medical
rehabilitation or prevention. Unfortunately, a psychoeducational
and/or speech/language assessment is the exception rather than
the rule. Too often school districts assume a "wait-and-see"
attitude rejecting a request for an evaluation in order "to
wait until she learns enough English". Sometimes adoptive
parents following the slogan "love and time will cure all"
may procrastinate with the beginning of remediation efforts. There
are, of course, cases when IA children do "catch-up"
on their own with no extra help. The problem with many of them,
however, is that the neurological base of their development appears
weaker than in their peers at large, and institutionally-induced
deficiencies may be too significant, thus reducing their chances
for recovery on their own. In many cases, we just cannot afford
to lose time without proper assessment and remediation.
In my experience there are two major time periods
in the assessment of school-aged IA children: first, on arrival
(that is within the initial 2 to 8 weeks in the USA) and second
within the next year or two. The first type of evaluation is usually
initiated by parents in order to "screen" for possible
problems, to "check out" the original diagnosis (e.g.
"oligophrenia", see Gindis, 1997a), or to determine
immediate eligibility for special education and/or related services.
The second type of evaluation is usually initiated by a school
district because of particular problems observed in school. Two
main concerns are the cognitive ability of a child to cope with
age-appropriate instructions and/or a child's behavior/emotional
state that may prevent him/her from benefiting from mainstream
schooling. Although there is a lot of commonality between these
types of evaluations, they may require different assessment strategies,
instruments, and procedures.
First, as I indicated above, in both cases we are
dealing with practically a monolingual child (only native language
in the first scenario, or English as the only functional language
in the second scenario). In both cases, however, in order to estimate
the child's psychoeducational status comprehensively and fairly,
an evaluation should be done by a bilingual psychologist. The
evaluation in the native language should be done as soon as possible
after arrival, before the turning point when the "subtractive"
process will take its toll and the child's native language will
be her weaker language modality. Assessment in the English language
should take place only when this language becomes, beyond a reasonable
doubt, the dominant (the stronger) means not only of communication,
but of reasoning as well (cognitive language). The most beneficial
for a child, of course, is when an evaluator is able to use English
and native languages to evaluate a child's true potential. Unfortunately,
bilingual evaluation in languages other than Spanish is a rare
commodity, and it is unreasonable to expect in the foreseeable
future an availability of bilingual psychologists to accommodate
all IA children. However, the least of what adoptive parents may
expect from a school is a sincere effort to find a bilingual professional:
according to IDEA, bilingual evaluations are not an option, they
are the law!
The issues of the mode of evaluation, procedures
to be followed, and instruments to be used are the most controversial.
There is no need to explain to certified school psychologists
why norm-referenced tests and standardized behavior scales are
not proper instruments for the evaluation of immigrant orphans.
However, school psychologists should be ready to explain to adoptive
parents why it is not legitimate to compare these children to
the sample population at large, and why this comparison would
be of no value and even misleading for placement and remediation
purposes. Unfortunately, the practice of bilingual assessment
is not of great help either: it is itself in a state of great
confusion with a lack of even the most general guidelines (without
even mentioning particular instruments) that may be applicable
to IA children. In addition, as I indicated earlier, IA children
do not fit comfortably into the bilingual category.
It is my firm conviction that the optimal evaluation
procedure for an IA post-institutionalized child is "dynamic
assessment" in the format developed by Lidz (1991). This
is an interactive procedure that follows a test-intervene-retest
format, focusing on learning processes and cognitive modifiability.
It also provides the possibility of a direct linkage between assessment
and intervention. This approach has demonstrated its value in
assessing Limited English Proficiency students, particularly in
the area of speech and language, where the problem of distinguishing
between "language different" and "language deficient"
students has been worked on for years (Pena, et al, 1992). This
procedure is ideally suited for the so-called "marginal"
population - and what else are IA post-institutionalized children?
We do not need to compare their current level of intellectual
functioning with their peers in this country - we know that they
are different due to their unique backgrounds. We do know that
they are delayed in regard to many developmental skills and accomplishments.
We do know that their specific knowledge base is weaker and different
from the one acquired by their peers in American schools. Our
diagnostic question is the responsiveness of an IA child to intervention,
"the repertory of problem-solving processes employed or not
employed, and the means by which change is best effected"
(Lidz, 1991, p. Xl). From the comparison of pre-test with post-test
performance following test-embedded intervention, we can derive
the most important information about the post-institutionalized
child: her cognitive modifiability, her responsiveness to an adult's
mediation, her amenability to instructions and guidance. Is this
not what we need to know for effective remediation? Is this not
the ultimate goal of our assessment?
Unfortunately, in the field of school psychology
we have a lack of professionals who are properly trained and eager
to apply this approach (Lidz, 1997). Some sort of a compromise
seems to be unavoidable. Based on my experience, I may recommend
the following instruments and procedures to be used in different
combinations either with the first ('on-arrival") or the
second type of evaluations. While some of them can be used as
directed in their respective manuals (e.g. the UNIT), others should
be used mostly as non-standardized instruments.
1. A thorough review of medical records and all
pertinent documentation related to the adoption, including reports
from the country of origin, however incomplete and obscure they
may appear to you.
2. A comprehensive interview with adoptive parents
and teachers, using behavior scales (e.g. Vineland ABS, CARS,
etc.) and questionnaires as a guideline and structure, not as
3. An essential part of the IA children's assessment
is the determination of their language proficiency, both communicatively
and cognitively, either in their native language or in English.
(This part of a school psychologist's assessment should not substitute
for a specialized speech and language evaluation). For this purpose
I would recommend the Bilingual Verbal Ability Test (BVAT) recently
distributed by the Riverside Publishing Co. This test scales the
overall combined (in English and native tongues -15 of them!)
cognitive-academic language skills. All subtests are administered
in English first. Any item that was missed is then administered
in the native language. If the child gets that item correct in
her native language, it is added to the score for that subtest,
The end result is a score that reflects the child's knowledge
in both languages. In order to measure cognitive/academic language
proficiency in the English language only, a school psychologist
can use the Woodcock-Munoz Language Survey (The Riverside Publishing
Co., 1993). The informally used Token Test or any similar instrument
will help you to collect enough information about a child's receptive
4. For cognitive assessment, the non-verbal tests
seem to be the way to go for many reasons. UNIT (The Universal
Nonverbal Intelligence Test), published by the Riverside Publishing
Co. and the recent revision of the Leiter Test (Leiter International
Performance Scale-Revised) published by Stoelting are the most
informative tests because they approach cognitive assessment from
different perspectives while the examiner's instructions and examinee's
responses require no language. The Brigance (Diagnostic Inventory
of Early Development-Revised) published by the Curriculum Associates,
Inc. is a good descriptive tool to depict an IA child's functioning
in relation to his/her age- expected skills in different domains
5. Behavior/emotional functioning may be scrutinized
by using different behavior scales (e.g. Devereux, school form)
as a guideline in depicting patterns of behavior and emotional
status. Direct observations, clinical interviews with a child,
conferences with parents and teachers provide you with the most
valuable clinical information. Projective material may be too
risky with IA children due to their "atypical" cultural
We are witnessing a unique natural experiment: never
before in human history have so many children from foreign orphanages
been adopted in one country over such a short period of time.
It appears that factors that motivate international adoptions
will continue to be relevant and active in the new millennium.
School psychologists, as well as other educational and mental
health professionals, ought to be an essential part of a post-adoption
The last thing I want to do writing
this article is to create an impression (a stereotype) of a post-institutionalized
child who is "handicapped" by virtue of the fact of
being from an orphanage. The majority of adoptions from overseas
are rewarding, successful experiences. They give a new meaning
to the old saying that it takes a village to raise a child. In
light of an exponential increase in international adoptions, we
may now say that it takes the global village to provide a child
with an opportunity for a normal childhood.
Addendum: As resources for school
psychologists working with internationally adopted post-institutionalized
students, I would like to provide names of several nationwide
organizations and major Internet sources.
* The Parent Network for the Post-Institutionalized
Child (PNPIC) is an effective volunteer organization that runs
numerous workshops and conferences all over the country, publishes
a very informative, high quality and honest newsletter called
"The Post" (P. O. Box 613, Meadow Lands, PA 15347),
and many brochures, keeps an enlightening website on the Internet
(PNPIC.org), directs efforts of professionals and parents alike
to help IA children, and advocates for their well-being (to know
more, contact PNPIC at PNPIC@aol.com).
* The Family for Russian and
Ukrainian Adoption (FRUA) is a dynamic national not-for-profit
organization that has chapters in 22 states, a prize-wining website
and a newsletter "Family Focus" publishes wonderful
supportive material for adoptive parents and sponsors informative
conferences. The NY and NJ chapters are particular active.
* The Families with Children
from China (FCC) is a national not-for-profit organization with
local chapters some of which have established websites and publish
a newsletter announcing cultural events and sharing resources.
New York's site (accessible at http://www.fwcc.org/welcome.html)
is particularly good: it contains excellent resources and Internet
links, as well as a listing of local chapters.
* One of the most dynamic and
informative (and my favorite!) among the Internet electronic forums
on international adoption issues is East European Adoption Coalition,
available at http://www.eeadopt.org/
(to enroll, send a message to REQAPR@EEADOPT.ORG).
This electronic discussion list is not only a valuable source
of information and emotional support for adoptive parents, but
also a unique and passionate document of the human struggle in
the search for happiness.
* Those school psychologists
who are interested in the specifics of assessment and consultations
(counseling) for IA post-institutionalized students are invited
to my website at http://www.bgcenter.com
* If you are interested in ongoing
research projects related to post-institutionalized children,
contact the Association for Research in International Adoption
accessible at http://www.adoption-research.org
and/or the Evan B. Donaldson Adoption Institute accessible at
org/research/ressea.html (the database of adoption
research conducted and/or published from 1986-1997 is excellent
and is updated monthly).
The author expresses his gratitude to Margot Mahan
and Teena McGuiness for their help in selecting the above resources
on international adoption
- Albers, L., Johnson, D., Hostetter,
M., Iverson, S., Miller, L. (1997). Health of Children Adopted
From the Former Soviet Union and Eastern Europe: Comparison
With Pre-adoptive Medical Records. The Journal of the American
Medical Association, # 278, pp. 922-924.
- Ames, E. (1997). Recommendations
from the Final Report "The development of Romanian Orphanage
Children Adopted in Canada". The Post, #10, 03/97, pp.
1-3 (publication of the Parental Network for the Post-institutionalized
- Dubrovina, I., et al. (1991).
Psychological development of children in orphanages ( "Psichologicheskoe
razvitie vospitanikov v detskom dome"). Moscow, Prosveschenie
- Cummins, J. (1996). Negotiating
Identities: Education for Empowerment in a Diverse Society.
- Gindis, B. (1997a). Understanding
Your Child's Medical Report: Oligophrenia. The Post, #10, p.
2-3 (publication of the Parental Network for the Post-Institutionalized
- Gindis, B. (1997b). Language-Related
Issues for International Adoptees and Adoptive Families. The
Post, #13, pp. 2-7. (publication of the Parental Network for
the Post-Institutionalized Child).
- Hamilton, K. and King, P.
(1997). Bringing Kids All the Way Home. Newsweek, June 16, pp.
- Jenista, J. (1997). Romanian
Review. Adoption Medical News (a publication of Adoption Advocates
Press), Volume lll, # 5.
- Johnson, D. (1997). Adopting
an Institutionalized Child: What are the Risks?
- Adoptive Families. Vol. 30,
# 3, pp. 26-30.
- Lidz, C. (1991). Practitioner's
Guide to Dynamic Assessment. New York: The Guilford Press.
- Lidz, C. (1997). Dynamic Assessment:
Restructuring the Role of School Psychologists. Communique (NASP
Publication), V. 25, # 8, pp. 22-23.
- Locke, J. (1993). The Child's
Path To Spoken Language. Harvard U Press, Cambridge, MA.
- Pena, E., Quinn, R., &
Iglesias, A. (1992). Application of dynamic methods of language
assessment: A nonbiased approach. Journal of Special Education,
#26, pp. 269-280.
- Sloutsky, V.M. (1997). Institutional
Care and Developmental Outcomes of 6-and 7-year old Children:
A Contextualist Perspective. International Journal of Behavioral
Development, 20 (1), pp. 131-151.
- Smith, D. (1997). Adoption
and School Issues The Family Focus (a publication of Family
for Russian and Ukrainian Adoption). Volume 4, #1.
- Talbot, M. (1998). Attachment
Theory: the Ultimate Experiment The New York Time Magazine,
- Terwogt, M., Schene, J., Koops
, W. (1990). Concepts of Emotion in Institutionalized Children.
Journal of Child Psychology and Psychiatry. Volume 31, # 7,
- Vygotsky, L. (1997). The Question
of Multilingual Children. The Collected Works of L. S. Vygotsky.
Volume 4: The History of the Development of Higher Mental Functions.
New York: Plenum Press.