Orphanage Experiences Play a Key Role in Adopted Romanian Children's Development
from Fall 1997 Adoptalk
by Elinor W. Ames, Ph.D.
Elinor Ames, Professor Emeritus in the Psychology Department of Simon Fraser University, Burnaby, British Columbia, recently retired after 40 years of teaching. She is past president of the Canadian Psychological Association, and the mother of two adopted children. The research conducted on Romanian adoptees won the 1996 H. David Kirk Award for excellence in adoption research from the Adoption Council of Canada.
In March 1990, three months after the "revolution" that overthrew Romanian dictator Nicolae Ceausescu, I had a chance to tour some Romanian orphanages. There I saw children more passive and silent than any I had ever seen in my 35 years as a child psychologist. Children younger than about two spent 18 to 20 hours a day lying quietly in their cribs. They had little to look at, and almost nothing to hear. Each caretaker was in charge of at least 10 babies, and seldom talked to the children or picked them up. Most babies and non-toddling "toddlers" were uninterested or unresponsive. Children ages 3 to 6 were more lively, but their behavior toward each other seemed unfocused and they did not play together in organized ways. What happened, I wondered, after these children were adopted into Canadian families?
By 1991, enough parents in British Columbia had adopted from Romania that my colleagues and I could begin to study how former orphanage children were faring since their arrival in Canada. To separate the effects of orphanage life from those of poor prenatal care or adoption, we tried to compare distinct groups of children. The main group consisted of 46 children who had spent at least eight months some up to 4 1/2 years in a Romanian orphanage. On average, the children were 18 1/2 months old when adopted, and most had spent their entire lives to that point in an orphanage.
We compared the main group of orphanage children to two other groups. The first consisted of 46 Canadian-born non-adopted children, each of whom was matched by age and gender with members of the main group. The second, our "early-adopted" group, contained 29 children who were adopted from Romania before they were four months old. This group, which was also matched by age and gender to the main group, had the same poor prenatal and birth care as the orphanage children, but not the prolonged orphanage experience.
My colleagues and I studied the children twice: once (Time 1) when the main group of orphanage children had been in their adoptive homes for almost a year, and again (Time 2) when more than two-thirds were 4 1/2 years old and the rest were 5 1/2 to 9 years old. At both times, we were able to assess how the children in the three groups were doing developmentally, how well they were attaching to their parents, and what problems they had.
One of our most important findings was that most parents did not accurately anticipate the problems their orphanage children would have. Almost all had been concerned about health problems, and while it is true that the orphanage children were malnourished, small, and sickly at first, by the time they had been in Canada for a year, health problems were not a great concern. The orphanage children did, however, remain smaller than children in the other groups. The longer the orphanage stay, the shorter they were for their age.
Nearly a third of the parents were initially concerned about developmental delays and with good cause. When adopted, every orphanage child was developmentally delayed according to a test commonly used by community health nurses in Canada.
Orphanage children who entered the Infant Development Programme made rapid progress. Within a year, they moved from "borderline" to "low average" performance. By Time 2, after three years in Canada, the 4 1/2-year-olds in the orphanage group measured at the low end of the average range for IQs, and IQs of the Canadian-born matches scored at the high end of the average range. Early adopted children scored in the middle of the average range.
The older orphanage children (adopted at age 2 or older, and ages 5 1/2 to 9 at Time 2) scored worst, at the low end of the "slow learner" range. Both the IQs and school placements of these older children were one to two years behind Canadian-born children of the same age.
Ironically, only 18% of adoptive parents were initially concerned about behavioral, emotional, or social problems the area which over the long term caused parents the most stress. When asked at Time 2 to identify the most difficult problem their children had, 72% of the parents stated that their child's "most troublesome problem" was behavioral, emotional, or social.
At first (Time 1), the orphanage children exhibited problems by Internalizing feelings (being withdrawn, anxious) rather than Externalizing (acting out). Typical behaviors included refusing solid food, not knowing when to stop eating, lying quietly in bed without signaling wake up, stereotyped movements like rocking or staring at their moving hands, and avoiding or withdrawing from siblings and peers. Such behaviors declined over time, but three years after adoption, some orphanage children still had stereotyped behavior.
At Time 2, the orphanage children still had more behavior issues than the Canadian-born children, but their problems now involved Externalizing. Of all the children, they had the most trouble getting along with peers. The Canadian-born children had the most social success, and the early-adopted children scored in the middle. More than a third of the orphanage children scored above the level at which professional help is recommended. The longer a child had lived in an orphanage, the more behavior problems he or she exhibited.
Because of the behavioral problems, parents of orphanage children became generally more stressed by Time 2 than at Time 1. Some parents' stress was also exacerbated by their children's lack of attachment. At Time 2, fewer orphanage children than other children had formed secure attachments to their mothers, and a third of the orphanage children displayed atypical insecure attachment not often found in home-reared children, either Canadian-born or early-adopted. Children from orphanages were also much more likely than their counterparts to be indiscriminately friendly with all new adults a behavior which did not decrease from Time 1 to Time 2.
Probably our most important finding was that there was a lot of variation in how well children did three years after adoption. The early-adopted children generally had few serious problems, and as a group looked very much like children born in Canada. Of the children who spent eight months or more in an orphanage, some resembled children born in Canada, but others had many problems and were still very different from their Canadian-born counterparts.
In comparing the children on the basis of the presence or absence of four serious problems an IQ below 85; behavior problems severe enough to call for professional help; atypical insecure attachment found in fewer than 5% of North American children; and the persistence of stereotyped behaviors, e.g. rocking we found that:
The question then became: What caused these differences in how well orphanage children were doing?
When examining the data, we found that we couldn't predict outcome differences on the basis of the children's condition at adoption (all had several problems at the time) or from the quality of the orphanage they came from. Instead, success was more a factor of how adequate the adoptive families' resources were to handle the difficulty of the task they had taken on.
The parenting task was more difficult if children had spent more time in an orphanage, and if the family adopted two children from Romania at the same time. Family success was related to the parents' socioeconomic status and age. Parents with a higher income had easier access to professional help and services including relief from caring for their children. Children also did better if their mothers were older. Mothers of children with no serious problems averaged 39 years of age, whereas those whose children experienced three or four serious problems averaged age 31. We believe the age factor is likely a result of older mothers' more clearly developed philosophy of childrearing and greater ability to fight the establishment to get the help and services their children need.
The combination of a more difficult task with somewhat slimmer family resources did a very good job of predicting poor outcome. In such cases, though the families may have been well equipped to parent a child from an average background, the family resources were simply not enough to match the orphanage child(ren)'s needs.
The results we found through this study are similar to what those studying orphanage children even children from orphanages with relatively good conditions have found in many different countries over many years. Because the problems of orphanage children are very real, we urge prospective adoptive parents to think very carefully about the special needs their adopted orphanage children may have, the demands they will place on the family, and whether the family's resources will be adequate to meet those needs and demands.
Families must carefully appraise the availability of resources such as time, energy, support from family and friends, money, access to services and willingness to work with them, and the ability to seek out and acquire expertise. Where a good estimate of resources is made, and parents are willing to "draw the line" on what they are willing to accept in terms of the numbers and ages of children, the outcome will be much happier both for the child and the family.
Copies of the report on Romanian Orphanage Children Adopted to Canada may be obtained from the Adoptive Parents Association of B.C.: 604-588-7300; fax 604-588-1388.