The hidden risks behind adoption

Peggy Hilt wanted to be a good mother, but day after day, she got out of bed feeling like a failure. No matter what she tried, she couldn't connect with Nina, the 2-year old girl she'd adopted from Russia as an infant.

The preschooler pulled away whenever Hilt tried to hug or kiss her. Nina was physically aggressive with her 4-year-old sister, who had been adopted from Ukraine, and had violent tantrums.

Whenever Hilt wasn't watching, she destroyed the family's furniture and possessions. "Every day with Nina had become a struggle," she recalls now.

As the girl grew older, things got worse. Hilt fell into a deep depression. She started drinking heavily, something she'd never done before. Ashamed, she hid her problem from everyone, including her husband.

On the morning of July 1, 2005, Hilt was packing for a family vacation, all the while downing one beer after another and growing increasingly aggravated and impatient with Nina's antics. "Everything she did just got to me," Hilt said. When Hilt caught her reaching into her diaper and smearing feces on the walls and furniture, "a year and a half of frustration came to a head," Hilt says. "I snapped. I felt this uncontrollable rage."

Then Hilt did something unthinkable. She grabbed Nina around the neck, shook her and then dropped her to the floor, where she kicked her repeatedly before dragging her up to her room, punching her as they went. "I had never hit a child before," she says. "I felt horrible and promised myself that this would never happen again." But it was too late for that. Nina woke up with a fever, and then started vomiting. The next day she stopped breathing. By the time the ambulance got the child to the hospital, she was dead.

Hilt is now serving a 19-year sentence for second-degree murder in a Virginia maximum-security prison. She and her husband divorced, and he is raising their other daughter. She realizes the horror of her crime and says she isn't looking for sympathy. "There is no punishment severe enough for what I did," she told Newsweek in an interview at the prison.

Hilt's story is awful -- and rare -- but sadly it is not unique. Adopting a child from another country is usually a positive, enriching experience for both the child and the parent. Over the last 20 years, foreign adoption has become more popular, and Americans now adopt about 20,000 children from Guatemala, China, Russia and other nations each year. (In the last few years, as restrictions and red tape have increased in some countries, the number of overseas adoptions has begun to drop.) Longitudinal studies show that most of these kids do quite well, but in a small but significant number of cases, things go very badly. Since the early 1990s, the deaths of 14 Russian children killed by their adoptive parents have been documented.

That disclosure was partly responsible for Russia's decision in 2006 to suspend its intercountry adoption program while it underwent review.

Locally, Schaumburg resident Irma Pavlis was sentenced to 12 years in prison in 2005 after being convicted of involuntary manslaughter for the December 2003 death of her newly adopted 6-year-old Russian son Alex.

Pavlis testified during the trial that she struck Alex to reprimand him the day before his death. But the defense argued that the boy had been adopted with an unreported medical condition and self-destructive behavior that made him more than normally vulnerable to serious injury.

Alex's 5-year-old sister, who'd been adopted along with him, was taken from Pavlis and her husband and placed into foster care at the time of Pavlis' arrest.

Cases like these are extreme, but clinicians who specialize in treating foreign orphans say they are seeing more parents who are overwhelmed by their adopted children's unexpected emotional and behavioral problems. And though reputable agencies try to warn parents of the risks, not all succeed. "In the past, agencies were a bit naive," says Chuck Johnson of the National Council For Adoption, which is responding to the problem with a massive education initiative. "Now we're urging them to give parents a more realistic message." Some parents struggle to find effective treatment for their kids. Others seek to give them up. Reports that a growing number of foreign adoptees were being turned over to the U.S. foster-care system recently prompted the Department of Health and Human Services to order its first national count: 81 children adopted overseas were relinquished to officials in 14 states in 2006.

Why do some adoptions go so wrong? Clearly, it's not the kids' fault. Their behavior is usually the result of trauma, mistreatment, malnutrition or institutionalization in their home countries -- problems more common in places like Eastern Europe. But "the country of origin doesn't matter so much as the child's experience," says Dana Johnson, director of the University of Minnesota's International Adoption Clinic.

Some are found to suffer from fetal alcohol syndrome, mental illness or reactive attachment disorder, an inability to bond with a parent. Prospective families undergo an arduous screening process, including home visits, and specify how much disability they can handle. But even families who specifically request a "healthy" child sometimes go home with a troubled one. In some cases, the mismatch is inadvertent. But in others, orphanages or adoption agencies overseas -- eager to find homes for difficult children in their care -- mislead prospective parents or fail to disclose the full extent of a child's problems or personal history.

Emotional and even physical problems can be difficult to detect at the time of adoption, especially in infants, and often aren't diagnosed until months or years later. Hilt says that's what happened to her.

She and her husband decided to adopt after being told she'd probably never conceive. After passing their agency's screening, they brought home their first daughter from Ukraine in 2001, and that went so well they decided to adopt two Russian sisters. But when they flew to Siberia to meet them in May 2003, they were told the sisters were no longer available. Instead, they were told, they could adopt Tatiana, a lively 18-month-old, and Nina, a quiet, withdrawn 9-month-old. They visited Tatiana every day for a week, but officials never let them see Nina again. "They said she had a bad cold," Hilt said.

Nonetheless, they signed adoption papers for both girls. But when they returned to finalize the adoption in January 2004, they were told that only Nina was still available. The Hilts hesitated. They suspected a bait-and-switch, especially when officials insisted they sign papers testifying they'd spent many more hours with the baby than they had. "The whole process didn't feel right," Hilt said. "But we figured we could love any child. You convince yourself that everything will turn out OK."

But from the start, Nina "literally pushed me away," Hilt said. Over time, Hilt found herself resenting the little girl. "We'd been such a happy family, and then Nina came and everything changed," Hilt says. "I began to realize that we had made such a big mistake."

Tatyana Kharchendo, the doctor in charge of the Little Sun Child Home 1 in Irkutsk, where the Hilts adopted Nina, did not directly answer Hilt's charges, but insisted the child "was absolutely healthy and beautiful."

No one is exonerating Hilt or others like her. But Joyce Sterkel, who runs the Ranch for Kids, a Montana boarding school for disturbed international adoptees, says she's come to see the parents as well as the kids as victims in these tragic cases. "It's a horrible thing, but I understand how some people end up killing these kids," she says. "They have no empathy, no affection, no love. My heart goes out to these parents because they don't know what to do."

When Sterkel, a nurse, first started working with international adoptees in the early '90s, she didn't see many deeply troubled children. But 10 years ago she adopted two Russian boys whose American parents had given up on them. One of them, a 14-year-old boy, had just been released from a juvenile-detention center after trying to poison his mother. Over time, Sterkel was approached so often about adopting other children that she decided to open her camp.

Today it houses 25 to 30 kids from all over the country, and has a waiting list. The overwhelming majority are from Russia, Romania and Bulgaria, but she also has had children from South Korea and Colombia. Some were bullied or raped while institutionalized or were the children of prostitutes, drug addicts or alcoholics. "I have gotten calls from parents who say the child they adopted has killed the family dog, threatened to kill them, and no one will help them," she says.

Emotional, behavioral and physical problems are not unique to adopted children. Biological children can have the same range of issues. But adoptive parents often assume they know what they're getting into because they get the chance to meet their child in advance. That was the case when Kimble and Shellie Elmore of Los Angeles met a 10-year-old Russian child named Tania in 2005. The director of the orphanage proudly described her as an "angel."

But as soon as they took custody of their new daughter, her behavior changed dramatically. "She was completely out of control," Kimble says. Tania would scream for hours at a time, then fall into deep sullen silence. After signing Tania over to the Elmores, the Russian court handed them her file. They were stunned to find that she had a history of violence and had been transferred from one orphanage to another. They called their adoption agency back home, but were mistakenly told that there was nothing that could be done, that Tania was now their legal daughter.

The American Embassy could have helped, if they'd known. Seeing no alternative, they boarded a plane and brought Tania back to California. By the end of the first week, she was admitted to a hospital psychiatric unit. She came home a few days later, but things grew worse. She tried to stab her father with a spike and attacked a police officer who came to the house in response to a 911 call.

Doctors diagnosed Tania with bipolar disorder, post-traumatic stress disorder and attachment disorder, and suggested she be sent to Sterkel's camp. In the past year the Elmores have exhausted their savings and retirement funds trying to pay for private residential treatment. "We know she's just a child and we want what's best for her," says Kimble. "But we don't know how to help her. Adoption is supposed to be a touchy-feely thing surrounded with the glow of new parenthood. But no one says, 'What if the worst happens?' "

Psychologist Karyn Purvis of Texas Christian University, who has done extensive research on troubled adopted children, says many of these kids simply don't respond to stern lectures and timeouts. Lab workups of her patients often reveal extremely high levels of cortisol, the stress hormone. "The children, for the most part, were in safe homes living with safe people," Purvis says, "but those cortisol levels told us that their children did not feel safe with them, even if they'd been living safely with them for years." Children like them are almost constantly in a hypervigilant state, she says. They don't let their guard down long enough to forge affectionate relationships.

Over the past several years Purvis has developed new methods to restore a sense of security and trust to traumatized kids. If a child becomes violent, for instance, Purvis often responds with a "basket hold." She cradles the kids firmly but gently in her lap, facing outward, with their arms crossed in front of their chests. She rocks and quietly soothes until they calm down, then asks them to look her in the eye and tell her what they want. Purvis' assistants have taken to calling her the "Child Whisperer."

Sometimes techniques like these result in dramatic turnarounds. The family of a 5-year-old adopted from Russia thought they had no choice but to seek psychiatric hospitalization after she threw her baby sister down the stairs. But after the parents adopted Purvis' methods, the little girl finally started talking about the serious abuse she'd experienced. The child's behavior changed markedly. But her mother "changed even more," Purvis says, "because now she has hope."

Purvis is quick to say that her techniques don't work with every child, and older kids can take much longer than younger ones. "They have to unlearn what they've learned," she said. The next step, she says, is for prospective adoptive parents to get more training before and after they adopt. "Very few agencies are training parents to deal with brain damage, sensory deprivation, aggression," Purvis says. "A lot of these parents are smitten with the hope that they'll make a difference in a child's life, but they need very practical tools. I consider myself very pro-adoption. But I'm also very pro informed adoption. "

Peggy Hilt wishes she'd heard this message years ago. "If I knew then what I know now," she says, "I would have gotten help for Nina and for me." The best she can hope for now, she says, is that her story will prompt others to seek that help before it's too late.

• Daily Herald staff writer Eric Peterson contributed to this report.