Child Maltreatment, Child Abuse Fatalities Among Internationally Adopted Children

Date: 2007-11-01

Child Abuse Fatalities Among Internationally Adopted Children

Laurie C. Miller
Wilma Chan
Robert A. Reece
Linda Grey Tirella
International Adoption Clinic, New England Medical Center

Adam Pertman, Evan B. Donaldson Adoption Institute

More than 250,000 boys and girls have been adopted from other countries by American parents since 1989 (Immigrant Visas Issued, 2006). Most of these children have experienced prenatal risk factors (low birth weight, prematurity, lack of medical care and/or exposure to drugs, alcohol, tobacco), as well as risk factors associated with institutional care (growth and developmental delays, medical problems and/or lack of individualized attention) (Gunnar, Bruce, & Grotevant, 2000; Jenista, 2000; Johnson, 2002; Miller, 2005a). As a consequence, internationally adopted children frequently experience a complex array of developmental, medical, and behavioral issues (Hjern, Lindblad, & Vinnerljung, 2002; Miller, 2005b; Rutter et al., 1999; Tizard, Cooperman, Joseph, & Tizard, 1972; Tizard & Hodges, 1978; Tizard & Joseph, 1970; Verhulst, Althaus, & Versluis-den Bieman, 1990a, 1990b, 1992; Verhulst, Versluis-den Bieman, van der Ende, Berden, & Sanders-Woudstra, 1990; Versluis-den Bieman & Verhulst, 1995). Nevertheless, most of them exhibit remarkable catch-up growth and development within months after arriving home.

Parents who adopt internationally are generally recognized as an extremely devoted and committed group, who literally “go to the ends of the earth” to form their families. As with other types of adoptions, prospective parents frequently wait for months or even years to complete their international adoptions. Procedural delays and setbacks are common in international adoptions, due in part to the complex requirements of U.S. and foreign government bureaucracies.

Throughout the process, significantly, there are multiple opportunities for agencies to appraise and educate the prospective parents. Parents who adopt in any way, for instance, must undergo a “home study” by a licensed adoption agency to meet legal requirements. Home studies are conducted by trained social workers, in part to obtain comprehensive information about the personal lives, child-rearing beliefs, and psychological preparedness of prospective adoptive parents. Because international adoption is a long and intensive process, agencies often have the opportunity to assess prospective parents under diverse and stressful conditions.

Thus, it has been shocking and horrific to realize that, since 1996, there have been 18 fatalities (in 17 families) of internationally adopted children because of suspected or proven cases of abuse and/or neglect by their adoptive parents. Adoption officials and child welfare professionals in the United States and the children’s countries of origin are understandably concerned, in some cases alarmed (Correspondent, 2005; Morton, 2005; Weir, 2005). Seven girls and 11 boys (14 adopted from Russia, 2 from China, 2 from
Guatemala) have died from causes related to head trauma, suffocation, or neglect (Associated Press, 2004, 2006; Barakat, 2006; Bowers, 1997; Correspondent, 2004; Gordon, 2003; Gurr, 2006; Joyce, 2004; LeMignot, 2005; McCarthy, 2006; McClure, 2005; Reilly, 2001; Robinson, 2006; Ruth, 2004; Sector, 2005; Van Sack, 2002; Vargas, 2006). In 12 of these cases, the mothers were directly accused in the deaths of their children, and in four cases, fathers were directly accused (one of the fathers committed suicide after killing his wife and two children). In the remaining two cases, both parents were accused. The victims were age 36 months or younger in 12 of the 18 cases (67%); the remaining
children were between age 5 and 11 years. Nearly one third of these children died within 6 months of their adoptive placements, and more than one half of these deaths occurred within the 1st year after adoption. At least five families had simultaneously adopted another child, and in five other families, there was at least one other adopted child already living in the home. There have been five deaths in the New England area, two in New Jersey, two in Ohio, one each in Colorado, Indiana, Virginia, North Carolina, Georgia, Tennessee, Illinois, Maryland, and Minnesota. In at least one case, the defense provided by the adoptive parent was that the child’s injuries were self-inflicted, due to severe behavioral
disturbances such as reactive attachment disorder. In other cases, defendants claimed that the children had violent outbursts. In addition to these 18 children, at least two other internationally adopted children (residing in Sweden and Northern Ireland) allegedly have been killed by their parents; these children were adopted from the Czech Republic and Romania, respectively (Lazarova, 2006; Lewis, Cole, & Williamson, 2003). The number of internationally adopted children who have been seriously injured by their adoptive
parents is unknown.

Adoption has existed throughout recorded human history. In recent decades, national and international legal and social safeguards to protect adopted children have been widely promulgated. The vast majority of internationally adopted children thrive in their loving, supportive families. Their lives are immeasurably enriched by the opportunities provided by their families, far beyond what would have been possible if they had remained consigned to institutional care in their birth countries. These 18 cases of abuse and neglect are consequences of extreme circumstances and do not reflect the norm among families of internationally adopted children. However, pediatricians and other professionals caring for internationally adopted children must be especially vigilant in identifying parents who may be showing signs of depression, stress, or extreme disappointment. “Postadoption
depression” is becoming more widely recognized and may even be more common than postpartum depression (Foli & Thompson, 2004). Whether postadoption depression contributed to these fatalities is unknown. However, the deaths of these children remind us that traveling a long distance to adopt a child does not prevent a susceptible parent from becoming abusive.

It is incumbent on all practitioners to educate prospective parents for the challenges they might face, and to appraise these men and women for signs that they might have unrealistic expectations or might not be emotionally ready in other ways. Moreover, to facilitate further discussions about matters of concern, professionals involved with these families should offer open-ended questions regarding the child–family transitions, gauge the parents’ ongoing satisfaction with the adoption, and help them understand and
deal with the reality of adoptive parenthood compared to what had been anticipated. Adoption agencies, in particular, must be vigilant about looking for red flags indicating families in crisis as they complete their mandated postplacement reports and visits. All professionals involved with internationally adopted children and their families must be alert to the warning signs and must be willing to decisively intervene—as early as possible—to protect the children.

Associated Press. (2004, September 2). Braintree woman to spend year behind bars in death of adopted son. Portsmouth Herald Maine News. Available at

Associated Press. (2006, March 23). Toddler death: Court denies mother’s appeal. Portsmouth Herald Maine News. Available at

Barakat, M. (2006, May 26). Mother gets 25 years for killing daughter. Washington Times. Available at

Bowers, K. (1997, May 22). Terrible two. Denver Westword. Available at

Correspondent. (2004, April 3). US woman’s husband charged with murder. Available at

Correspondent. (2005). Representatives of U.S. nongovernmental organizations share the concern of the Russian authorities in the death of Russian adoptees. Available at

Foli, K. J., & Thompson, J. R. (2004). The post-adoption blues. New York: Rodale.

Gordon, K. (2003, September 18). Mom guilty in death of daughter. Eagle-Gazette. Available at

Gunnar, M. R., Bruce, J., & Grotevant, H. D. (2000). International adoption of institutionally reared children: Research and policy. Developmental Psychopathology, 12, 677-693.

Gurr, S. (2006, June 22). Testimony heard in child’s death trial. Forsythe County News. Available at

Hjern, A., Lindblad, F., & Vinnerljung, B. (2002). Suicide, psychiatric illness, and social maladjustment in intercountry adoptees in Sweden: A cohort study. Lancet, 360(9331), 443-448.

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Jenista, J. A. (Ed.). (2000). International adoption [Special issue]. Pediatric Annals, 29(4).

Johnson, D. E. (2002). Adoption and the effect on children’s development. Early Human Development, 68(1), 39-54.

Joyce, B. (2004, July 16). Mother sentenced for daughter’s death [Internet]. Channel 3 News-WCAX, Burlington VT. Available at

Lazarova, D. (2006). Case of abused boy given to adoptive parents in Sweden rings alarm bells. Radio Pragu. Available at

LeMignot, S. (2005). Mother found guilty in adopted son’s death. Chicago News CBS 2. Available at

Lewis, R. J., Cole, D., & Williamson, A. (2003). Review of health and social services in the case of David and Samuel Briggs. Craigavon, UK: Department of Health, Social Services, and Public Safety.

McCarthy, P. (2006, June 28). Neglect charges added to assault suspect. Bridgeton News, p. 1.

McClure, S. (2005, December 13). Spring Hill mother charged with murder in child’s death. Tennessean. Available at

Miller, L. C. (2005a). The handbook of international adoption medicine. New York: Oxford University Press.

Miller, L. C. (2005b). International adoption, behavior, and mental health. Journal of the American Medical Association, 293, 2533-2535.

Morton, T. D. (2005, August). Lost in America. Lawrenceville, GA: Child Welfare Institute.

Reilly, M. (2001, October 28). The short life of Viktor Alexander Matthey. Star Ledger. Available at http://www.nj .com/specialprojects/index.ssf?/specialprojects/viktor/viktor.html

Robinson, R. (2006, June 27). Luke’s adopted father testifies. Northwest Indiana Times. Available at

Ruth, R. (2004, December 12). Diary of an adoption tragedy. Columbus Dispatch. Available at

Rutter, M., Andersen-Wood, L., Beckett, C., Bredenkamp, D.,

Castle, J., Groothues, C., et al. (1999). Quasi-autistic patterns following severe global privation. Journal of Child Psychology and Psychiatry, 40, 537-549.

Sector, C. (2005, November 17). Boy’s death may halt U.S. adoption. ABC News. Available at

Tizard, B., Cooperman, O., Joseph, A., & Tizard, J. (1972). Environmental effects on language development: A study of young children in long-stay residential nurseries. Child
Development, 43, 337-358.

Tizard, B., & Hodges, J. (1978). The effect of early institutional rearing on the development of eight year old children. Journal of Child Psychology and Psychiatry, 19(2), 99-118.

Tizard, B., & Joseph, A. (1970). Cognitive development of young children in residential care: A study of children aged 24 months. Journal of Child Psychology and Psychiatry, 11(3), 177-186.

Van Sack, J. (2002, October 21). Police say man killed family, self. Boston Globe, p. 81.

Vargas, T. (2006, March 2). Mother admits killing daughter. Washington Post. Available at article/2006/2003/2001/AR2006030102380.html

Verhulst, F. C., Althaus, M., & Versluis-den Bieman, H. J. (1990a). Problem behavior in international adoptees: I. An epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 94-103.

Verhulst, F. C., Althaus, M., & Versluis-den Bieman, H. J. (1990b). Problem behavior in international adoptees: II. Age at placement. Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 104-111.

Verhulst, F. C., Althaus, M., & Versluis-den Bieman, H. J. (1992). Damaging backgrounds: later adjustment of international adoptees. Journal of the American Academy of Child and Adolescent Psychiatry, 31(3), 518-524.

Verhulst, F. C., Versluis-den Bieman, H., van der Ende, J., Berden, G. F., & Sanders-Woudstra, J. A. (1990). Problem behavior in international adoptees: III. Diagnosis of child psychiatric disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 29(3), 420-428.

Versluis-den Bieman, H. J., & Verhulst, F. C. (1995). Self-reported and parent reported problems in adolescent international adoptees. Journal of Child Psychology and Psychiatry, 36(8), 1411-1428.

Weir, F. (2005, July 4). Foreign adoptions in Russia become political issue: Abuse claims disputed. NewsWire: Canadian Press. Available at

Laurie C. Miller, MD, established the International Adoption Clinic at New England Medical Center in 1989. She is an associate professor of pediatrics at Tufts University School of Medicine and is the author of The Handbook of International Adoption Medicine (2005), Encyclopedia of Adoption (with C. Adamec, 2006), and more than 70 peer-reviewed articles in pediatrics.

Wilma Chan, BS, graduated from Tufts University in 2003, after majoring in child development and biology. She worked as a research assistant in the International Adoption Clinic program at New England Medical Center for 3 years. She is currently a second- year medical student at Tufts University School of Medicine.

Robert A. Reece, MD, is clinical professor of pediatrics at Tufts University School of Medicine. He has been the chair of the Child Abuse Section of the American Academy of Pediatrics and has served on the executive committees of the American Professional Society on the Abuse of Children, Prevent Child Abuse (America), and the National Children’s Alliance. He is the editor of three editions of Child Abuse: Medical Diagnosis and Management, the editor of Child Abuse Treatment, and is the executive editor of the Quarterly Update.

Linda Grey Tirella, OTR/L, MS, MHA, has worked at the International Adoption Clinic as a developmental therapist since 2001. She has specialized training in sensory integration disorders and 18 years experience as a therapist in the public schools working with children with developmental disabilities.

Adam Pertman is the executive director of the Evan B. Donaldson Adoption Institute, the preeminent research, policy, and education organization in its field. He also is the associate editor of Adoption Quarterly, the premier academic journal in its field. A former journalist who was nominated for a Pulitzer Prize for his writing about adoption, he is the author and editor of numerous articles and book chapters on issues relating to adoption and foster care. His book Adoption Nation has been reviewed as “the most important book ever written on the subject.”

CHILD MALTREATMENT, Vol. 12, No. 4, November 2007 378-380
DOI: 10.1177/1077559507306716
© 2007 Sage Publications

Authors’ Note: Address correspondence to Laurie C. Miller, MD, Box 286 NEMC, 750 Washington St., Boston, MA 02111; phone: 617-636-4285; e-mail:
We thank Thais Tepper and Daniel and Elizabeth Case for helpful discussions and bringing some of the details of these cases to our attention.

Downloaded from by on January 12, 200


Doing a recount

In the context of inter-country adoption, counting seems to be a problematic issue. We already demonstrated that the statistics of sending and receiving countries hardly ever match. The same can be said about abuse fatalities in inter-country adoption. Articles are written and assumptions made upon the perceived number of fatalities, but a proper counting rarely takes place.

The above article claims 18 such fatalities happened between 1996 and 2007, while a recount show that 25 foreign adopted children died due to abuse or neglect during that time period.

The literature on fatalities of foreign adopted children, usually focuses on the Russian cases, and tries to seek an explanation for the abuse/neglect in the conditions of Russian orphanages.

The overemphasis on Russian adoptions contributes to the miscount. The above article missed counting 7 cases, only one of them a Russian case. Two Chinese cases were missed. One Guatemalan, one Honduran, one Indian, and one Vietnamese case was missed.

The chosen bracket (1996-2007), also leads to an overemphasis on Russian cases. When we look at a larger time range (1955-2010), it becomes apparent that there are not two, but six Chinese fatalities; that there were four El Salvadoran fatalities prior to 1996; that five Guatemalan children died at the hands of their adopters, not two; that ten South Korean children were killed by their adopters.

Looking beyond the Russia-biased time frame, it becomes evident, that Russian children are still overrepresented among the fatalities, but not by such wide margins as commonly stated. The ratio of fatalities between Chinese and Russian is not 1:7 as the above article suggests, but 1:3.

Better counting and expanding the time bracket shows that not 14 out of 18 fatalities relate to Russian children but 18 out of 49.

While still being the biggest source of fatalities, Russian specific factors can no longer be used as an explanatory factor. Often institutionalization is mentioned as the main contributing factor to the abuse, but when Russian cases make up less than half of the total number of cases, Russian institutionalization can no longer be the only factor.

Several countries in the following list, don't have institutionalization Russian-style. South Korea, for example, usually places healthy infants, yet at least 10 South Korean children (six separate cases) died at the hands of their adopters. Guatemala also placed mostly healthy infants, yet there are five cases of fatal abuse or neglect of Guatemalan children.

So far, the reason for fatalities has been sought in early childhood trauma/damage. With  Russian cases dominating the fatality count, the blame for the abuse can be laid with the children and the orphanages they come from.

This line of reasoning was already dubious. The United States adopted about as many children from Russia as the rest of the world combined, yet there is only one fatal abuse case of a Russian child outside the United States. Only that figure shows the problem is much less the result of Russian orphanages than it is a problem of the American adoption system.

The recount presented here shows, that Russia is not the exceptional outlier it is presented to be. The United States of America is the exceptional outlier. The US, imports approximately half of the children placed for adoption internationally, resulting in 49 fatal abuse cases. The rest of the world imports the other half of the children placed for adoption internationally, resulting in 3 fatal abuse cases.

The same pattern emerges when looking at the much larger number of non-fatal abuse cases. Again the United States is responsible for the vast majority of cases, hundreds of American cases versus a handful of cases outside the US.

If there is any factor responsible for the number of abuse fatalities of foreign adopted children, it has to be sought within the American adoption system. The commercial nature of the American adoption system, could very well be that factor.

Meghan Hawkins-Rusch China 1992
Ellana Lin China 2003
Mia Depaillat China 2004
Emma Mei Alvey (Mei Fu Ping) China 2005
Hei Min Chung (aka Chaeli Kyrie) China 2007
Lavender Banks China 2009
Heather Allison Riggs Colombia 1988
William G. Rohrer III "Billy" (Miguelito Alvarada) El Salvador 1975
Carlos Beltran (1984) El Salvador 1984
Maria Catherine Ostlund El Salvador 1986
Shaun Williams El Salvador 1991
Nathaniel Jacob Allen Guatemala 2002
Gustavo Adolpho Hunt Guatemala 2004
Jackson Wingo Guatemala 2007
Enna Isabel Barreto Guatemala 2008
Joshua Pinckney Guatemala 2009
Kyle Golebieski Honduras 1993
Christine Montalbano Honduras 1997
Rohit Chakravarthy India 2006
Lydia Schatz Liberia 2010
David Polreis, Jr. Russia 1996
Logan Higginbotham Russia 1998
Viktor Alexander Matthey (Viktor Sergievich Tulimov) Russia 2000
Jacob Lindorff Russia 2001
Luke Evans Russia 2001
Maria Anastasia Bennett Russia 2002
Yana and Anatoli Kolenda (Russia, 2002) Russia 2002
Zachary Higier (Nikita Khoryakov) Russia 2002
Jessica Albina Hagmann Russia 2003
Alex Pavlis (Alexei Vasilovich Geiko) Russia 2003
Liam Thompson (Dmitry Sergeyvich Islankulov) Russia 2003
Nina Hilt (Viktoria Bazhenova) Russia 2005
Dennis Gene Merryman (Denis Uritsky) Russia 2005
Isaac Jonathan Dykstra Russia 2005
Chase Harrison (Dmitry Yakovlev) Russia 2008
Nicolai Emelyantsev Russia 2008
Nathaniel Michael Craver - (Ivan Skorobogatov) Russia 2009
Wendy Kay Ott South Korea 1957
Kim Marie Firth South Korea 1972
Danielle Christine Neal South Korea 1976
Kayla Erlandson South Korea 1991
Holly and Nicole (O'Connor) Cooke South Korea 1994
Ethan, Seth, Mira, Eleanor Sueppel South Korea 2008
Casey "C.J." Elgie Vietnam 2000

Abuse fatalities of foreign adopted children

I think abusing kids is

I think abusing kids is ......

I hope they rot away

I hope they rot away forever!!!

Other cases

There are other cases that never hit the media or the AP's were not charged with a crime, but kids are dead none the less. There are also quite a few internationally adopted children who are "missing" and none of the authorities (State or Federal) seem to know or care where they are. The goal of the system is to get them adopted and move on. Case closed.

under the carpet

What you say is very true and is part of a much bigger problem.

When an adoption is finalized, the responsibility of outside parties (agencies, federal or state government) stops and parental rights take over. As a result, some adopted children end up living with families like that of Tom and Debra Schmitz, other children end up missing for years, while adoption subsidies continue to be paid. Foreign authorities keep complaining about missing post-placement reports.

Some authorities and adoption service providers will be glad their responsibility ends as quickly as possible, other's seem to be annoyed with the fact they cannot properly monitor placements. Yet the fact remains, proper post-adoption monitoring is legally impossible. This is not just true in the US, but is an issue in almost all countries.

Despite the fact that many cases probably fly under the radar, many do get reported in the news (otherwise we wouldn't have such an extensive archive of abuse cases). The vast majority of cases relate to the US, which makes me wonder: is the abuse problem of adopted children in the US so much bigger than in other countries, or are other countries so much better brushing things under the carpet?

Post-Placement Studies

Countries like Guatemala do not require PP studies, even though some agencies do charge APs a fee for doing one, some agencies do not even visit the child after they arrive in the US. So those PP studies just wind up in a file with the agency.

So many biomothers will never know what happened to their children. I doubt that those that voluntarily relinquished and those that were coersed or kidnapped... ever imagined that their child would be murdered... or...missing... or....the adoption dissolved... or ...their child trafficked using Yahoo parent groups, using the new term "rehoming".

Were the mothers of Ena, Joshua, Nathaniel, Guatavo, Jackson and others whose adoption were dissolved ever told where their children are and what their fate ultimately was? Answer: NO!

There is NO accountability people! Open your eyes.


Some countries make PAP's sign a form stating they allow officials to visit the child at any time in their new country. I signed this agreement. The fact is most of the kids adopted internationally retain their first citizenship until age 18. So far, country officials have only visited children who's parents voluntarily agree to such meetings and it is usually hosted by large adoption agencies to show officials how well the children are doing. It would be interesting if someone were to put this to the test and see how it stands up legally. It kind of reminds me of so-called legally enforceable open adoption agreements in California. If the AP's refuse to comply, what is the court really going to do?

Agreeable Parties

 It would be interesting if someone were to put this to the test and see how it stands up legally. It kind of reminds me of so-called legally enforceable open adoption agreements in California. If the AP's refuse to comply, what is the court really going to do?

Compliance would have to come from the adoption agency, as well, wouldn't it?  Meaning, each agency, even the small mom-and-pop adoption shops involved in ICA would have to provide information needed by sending-country officials.

Considering how quickly a small adoption agency can go belly-up (or tank -- choose your euphemism for closing), how can agency compliance be guaranteed? 

Also, let's not forget, those likely to agree to such an agreement are adopting for decent reasons, and more than likely NOT (closet pedophiles) planning on sexually abusing or sexually exploiting the child "saved" from foster/institutional-care.


Unless Korea has changed: The child has dual citizenship upon arriving in the USA. Once the child has been formally adopted here in the states, you send a copy of the new birth certificate to Korea;  then Korea cancels the citizenship of the child.  Supposedly, when the child arrives in the USA, and the adoption is either finalized, or the child is re-adopted here in the states, the child automatically becomes a citizen.  Most AP's go ahead and do the paperwork for the formal citizenship which entails a ceremony and a certificate, and costs around $400.00.
VietNam requires a yearly report from the AP's, including pictures, until the child is 18.  But if the AP's opt not to do this, there are no repercussions for them; it falls on the agency to say whatever it takes to appease the sending country.  Not only a disrupted adoption, but divorce, CHILD ABUSE etc., could cause this situation.   I've heard a SW explain it this way, "We know what they want to hear."

Pound Pup Legacy