POST ADOPTION SURVEY OF RUSSIAN AND EASTERN EUROPEAN CHILDREN

COMPLETED BY RAINBOW HOUSE INTERNATIONAL

by Donna Clauss, M.A., L.M.S.W. & Sonia Baxter

Sept 1997

Over the last year there has been ever increasing media coverage on adoptions from Eastern Europe and on Russian adoptions in particular. The reports have consistently characterized most Russian orphans as severely damaged with extreme behaviors problems.

Our agency has been placing children from Russia for 5½ years and has had ongoing contact with the majority of our adoptive families through the years. The characterizations of Russian adoptees portrayed in the press and on numerous television shows has not aligned with what most of our adoptive families have reported. In order to gain a further understanding and perhaps some new insights about our placements, Rainbow House International decided to survey our adoptive families of Russian and Eastern European children. We sent out a standardized questionnaire to 215 families. We received 206 surveys back. We were both shocked and delighted with the high rate of return.

There were several considerations that went into designing the questionnaire. The first was that the questionnaire should be "USER FRIENDLY" meaning that it should be short, concise, and easy to complete without requiring a large time commitment. We wanted the adoptive family's assessment of their child rather than a third party assessment. After all, it is most often the parent who first identifies or senses a problem with their child before seeking a professional evaluation or reaching out for professional services. Since Therapists, OT, PT and Sensory Integration Specialists generally target their practice to the treatment of clients with problems, it seemed that we would get a better overall profile of the full pool of children by having the adoptive parent complete the survey rather than restricting the completion of the survey to professionals whose services were being sought or rendered for a problem. We wanted to standardize responses so we used a "check off" format, but we also offered families wishing to elaborate or share additional comments the option of writing their comments in blank spaces provided and continuing with their comments on the back page of the questionnaire. We wanted families to be able to disclose information in a non-threatening manner so we left the option of not filling in their name on the survey if they wished to be anonymous. Another consideration was to compare diagnoses provided on the adoptee at the time of referral with the findings of their local pediatricians after arrival. We assumed that children would have delays upon arrival and asked the families to check off the applicable areas of delay. The families were then asked if their child presently had any delays in development and if so, to indicate in which areas. Lastly, we wanted to evaluate attachment and bonding risk factors so provided a list of twenty one characteristics and asked families to check each characteristic that their child exhibited. These twenty one characteristics were not identified as attachment and bonding risk factors so as not to prejudice the responses.

We wanted feed back from as many families as possible so we designed the questionnaire to fit on one page and enclosed a stamped, addressed, return envelope. Since our agency accepts applications from families in all fifty states, there is usually more than one agency involved with the family: The Primary Agency, or the Homestudy Agency, and the International Placement Agency which would be our agency. We felt it would be helpful to solicit feedback from families with regard to the services our agency had provided to them in order to evaluate our services and consider possible future services to add. Therefore, three questions for this purpose were included in the survey. One of the questions asked the family to state whether they were as informed as possible by RHI about the condition of their child prior to deciding to adopt. A second question asked whether the family would recommend RHI to prospective families and lastly, the family was asked to comment about how RHI could have better assisted them in the adoption process. A sample of the actual questionnaire is included.

SUMMARY OF FINDINGS

The average age of the child at the time of adoption was 37 months. The average number of months the child resided in the adoptive home was 23 months. The average number of months the children lived in the children's home/orphanage prior to adoption was 30 months. 54 children out of 206 children( about 26%) resided with their birth family prior to being institutionalized and lived with the birth family an average of 23 months. The sex of the children was almost even. There were 104 females and 102 males represented in the survey. Parents reported that 34.5% of the children had undiagnosed problems, which will be listed later. 92% ( 192 respondents) of the adoptive parents said that they felt that they were as informed as possible by Rainbow House about the condition of their child prior to adoption. Five families left this question blank. One family stated yes except they did not anticipate their child would have a speech delay. One family stated that it would have been helpful to have a psychological exam on their child. One family stated that they were as informed as possible about developmental delays, but not as informed as they should have been by their homestudy agency about post-institutionalized children. One family stated that they received new additional information just prior to departure which was unsettling. One family responded that they had never considered the severity or possibility of getting a child with attachment difficulties and in looking back wished that their homestudy agency had included this information as part of their preparation. They were happy to receive the complimentary training books that Rainbow House provides to families, but felt that this would not have been enough information should they have had a child placed with attachment difficulties. One family wished they could have had more background information on the biological family. One family stated yes and no: They knew about the child having chicken pox prior to departure, but indicated that neither RHI nor they knew the child had also had the flu. One family stated they would like to see even more information about how to deal with older children. One family stated that they were prepared about how to handle emotional problems but needed more information about neglect and its effect on children. One family stated that they were not prepared for the changes and delays in their itinerary or the ensuing frustration they experienced.

CHILDREN WITH DELAYS ON ARRIVAL

Of the 206 surveys, 27% of the adoptive families reported that their child had NO DEVELOPMENTAL DELAY AT ARRIVAL.

38% of the adoptive families reported that their child had DELAYS IN FINE MOTOR SKILLS.

39% of the adoptive families reported that their child had GROSS MOTOR SKILL DELAYS.

40% of the adoptive families reported that their child had SOCIAL SKILLS DELAYS.

54% of the adoptive families reported that their child had DELAYS IN LANGUAGE AND SPEECH. LEARNING PROBLEMS were reported for 15% of the children.

ONGOING DELAYS

61% of those surveyed reported that their child has NO CURRENT DEVELOPMENTAL DELAY.

The following delays were reported as being present at the time the survey was completed. Keep in mind the average time home was 23 months.

13% of those surveyed, feel that their adoptive child has at present, FINE MOTOR SKILL DELAYS.

10% of the adoptees are reported by the parent as having a GROSS MOTOR SKILL DELAYS.

13% of the adoptive families report that their children continue to have SOCIAL SKILLS DELAYS.

32% of the children continue to have LANGUAGE AND SPEECH DELAYS.

10% of the children have LEARNING PROBLEMS .

ATTACHMENT CHARACTERISTICS

Of the 206 respondents, 63% (130 children) were reported as having NONE of the twenty one characteristics. 16% of the children were reported to have between 1 or 2 of the characteristics. 12.5% of the children were reported to have between 3 or 4 characteristics. 7% of the children had between 5 or 6 characteristics. 98% of the children had 6 or fewer characteristics. 1.5% of the adoptees were reported to have 8 characteristics. The three families reporting eight characteristics identified themselves on the survey and are well known to the agency. Not one of these three children has an attachment problem. They all easily give and receive love!

The most frequently cited characteristic was, OVERLY FRIENDLY, which was reported for 14% of the children. The second most frequently cited characteristic was, CHATTERS INCESSANTLY, which was reported for 10% of the children. The third most often cited characteristic was AGGRESSIVE, which was reported for 10% of the children. FREQUENTLY HYPERACTIVE and INAPPROPRIATELY DEMANDING AND CLINGY, were each cited by 8.4% of the families. NONE of the families cited the following characteristics: PRE-OCCUPATION WITH FIRE, DEPRESSED AND CANNOT TRUST. Only 2.1% of families reported their children to be OVERLY SENSITIVE TO TOUCH. The following characteristics were reported for 1.1% of the children: Poor Peer Relationships, Cruelty to Animals, Not Affectionate, Lacks eye contact, Fearful and Anxious, Inconsolable and Avoids Intimacy. Hoarding was reported for 3.2% of the children and 5.3% for the children were reported to be DESTRUCTIVE and as having CRAZY LYING.

These twenty one characteristics are often used as a screening tool by therapists specializing in attachment when assessing a child for attachment problems. Eight or more of the characteristics would be cause for serious consideration and could suggest the necessity for an attachment evaluation. Social workers providing post placement services to the family would want to be alert to children with the persistent expression of a large number of the characteristics in addition to other observations reported by the adoptive family in the areas of the child's conscience development, impulse control, self esteem, interpersonal interactions, emotional, and cognitive and developmental problems.

WHAT WE CAN LEARN FROM THE SURVEY

We want to emphasize that this survey was designed to solicit feedback from as many adoptive families as possible. We value the opinions of our families and feel that agencies can learn a lot from their adoptive families. This survey does show that according to the adoptive family, 73% of the adoptees were developmentally delayed at the time of arrival. This is nearly three out of four children. After the children had been in the home on an average of 24 months, the delays changed from 73% with reported delays to 39% reported with delays or 61% were considered by the adoptive family to have NO DELAY. While it is helpful to realize that the majority of children were reported as having no delays, it is also important to realize that 39% of the children continued to HAVE DEVELOPMENTAL DELAYS and as such, adoptive parents need to be prepared accordingly for this prospect. It is significant to see that the largest ongoing delay reported for the children is speech and language with 32% reporting this as a continuing problem. We believe that early intervention is essential and that families must be aware that time and practice may not be the best remedy for speech and language delays. Outside resources should be identified before the child's arrival so that should services be needed, they can be sought without added delays.

This survey confirmed that the overwhelming majority of Russian and Eastern European children do ATTACH to their adoptive families and had very few of the attachment resistive characteristics. (91% had 4 or fewer characteristics)

CONSIDERATIONS FOR THE PROSPECTIVE ADOPTIVE FAMILY

There are several things which have emerged from this survey. There seems to be some indicators that suggest the most appropriate or suitable adoptive family for the children available for placement. A family considering an adoption from Russia, as with any other country where the children have been institutionalized, should expect that their child will arrive with delays, which includes physical delays, delays in fine motor, gross motor, social skill/emotional, speech and language and learning problems. While 61% of the children were reported to have no delays after an average of 23 months in the home, parents need to be prepared to accept persistent delays especially in the area of speech and language, ( 32% of the children were reported to have speech and language delays beyond 23 months). Families must be willing to accept this possibility and must be willing to seek help from professional resources. Families should be prepared and willing to deal with a child who chats incessantly, is overly friendly to strangers and one who is often hyperactive and may frequently demonstrate aggressive behavior . Since one in ten of the children was identified as having a learning problem, parents should arm themselves with knowledge about learning disabilities and be willing to be an advocate for their child in the school system. While the majority of families feel they were as informed as possible about the condition of their child prior to the adoption there were at least 34% who encountered undiagnosed problems. The problems cited were: unexpected flu, scabies, eczema, heart murmur, rickets, anemia, hepatitis B, upper respiratory infection, giardia, small stature, hernias, allergic asthma, mild cerebral palsy, hearing loss, horrible teeth, Tourette's disorder, ventricular septal defect, ADHD, impetigo, strep infection, neuro- reflexive delay, and hemiparesis.

Finally, there were many comments made by adoptive parents recommending that prospective adoptive families search for a homestudy agency who is able to help them acquire the knowledge, skills and tools they may need should circumstances require it after adoption and an agency willing and capable of providing support and resource services should they be needed. The lowest fee for the study should not be the primary reason for selecting a homestudy agency.

Rainbow House International believes that these surveys are representative of the children available from Russia for adoption. They are the norm rather than the exception.

POST ADOPTION SURVEY

Name (optional)

Child's City & Country of Origin

Orphanage #

Age at time of Adoption

How long has your child been home?

How long did your child live in an orphanage?

Did child live with birth family and how long?

Child's Sex

Current age

Child's medical diagnosis at time of adoption

Were there undiagnosed problems? (Please describe on back of paper.)

Did your pediatrician concur with the original medical diagnosis? If not please indicate differences on back.

Do you feel that you were as informed as possible by RHI about the condition of your child prior to deciding to adopt? (please explain, if no).

Which developmental delay did your child have? delays in fine motor skills? delays in gross motor skills? delays in social skills? delays in language skills? learning problems?

Does your child presently have any delays in development? If so, indicate in what area(s).

Please describe any significant problems you have encountered both in the delays and in finding help/treatment/ understanding from schools, etc.

Does your child exhibit any of the following characteristics? acts overly friendly with stranger? lacks eye contact except when lying, wanting something or angry? is not affectionate with parents? is destructive to self, others and material things, esp. own things? is cruel to animals? steals? lies about obvious/crazy lying? frequently acts hyperactive? has poor peer relationships? preoccupied with fire? incessantly chatters? is inappropriately demanding and clingy? is passive or apathetic? is defiant or aggressive? is depressed? hoards food or objects? cannot seem to trust? is unwilling or unable to be comforted when upset? avoids close, intimate relations? fearful and anxious? is overly sensitive to touch?