Navigating Uncharted Waters:
School Psychologists Working With Internationally Adopted Post-Institutionalized Children

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

Introduction

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: http://www.travel.state.gov). 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 functioning.

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. 922-924).

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 problems.

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 a necessity.

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, 1993).

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) environment.

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 (Talbot, 1998).

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 IA children.

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 family.

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 procedures).

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 standardized inventories.

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 language.

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 of life.

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 background.

Conclusion

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 support system.

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 (http://www.frua.com), 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 http://www.adoptioninstitute. 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

References

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