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 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.
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,
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 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
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 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
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 background.
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
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- Ames, E. (1997). Recommendations
from the Final Report "The development of Romanian Orphanage
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1-3 (publication of the Parental Network for the Post-institutionalized
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