Half a Million Abandoned Kids; Moving Forward From South East Europe’s History of Shame

One Baby Abandoned Every Six Hours In Romania.

Report on Child Protection by Ioana Calinescu. Photos by Petrut Calinescu.

Looking at results in child protection can show an “X-ray of regional mentalities”, says Andy Guth. Child Pact.

“There is so much more to do for the children of Romania, but you need to know where we started from,”  Daniela Buzducea, World Vision.

“When the Police find a new child on the street, they call me first,”  Zini Kore, All Together Against Child Trafficking.

“These youngsters are so hungry they would eat the corner of the table,” Mariana Ianachevici, Child Protection NGOs Federation, Moldova

Hoping to increase the age that children in Romania are institutionalised, from three to six years old, Daniela Gheorghe, FONPC

Half a million children were left abandoned in eastern Europe following the collapse of Communism that began in the 1980s.

After more than 25 years of democracy, many of these countries’ record on child protection is now mixed. 

In 1997, while global concern focused on abandoned children in Romania, 1.66 per cent of the country’s kids were separated from their families.

By 2013, this had dropped to only 1.52 per cent.

This means 60,000 children have been recently cut off from their parents, according to the new Child Protection Index, a cross-border instrument launched this week in Brussels.

Most southeast European nations – including Romania – are fast to reform their laws, but changes are slow to improve the life of every child.

 

Belgrade, 2016. A tiny conference room, packed with civil society activists who have fought for children’s rights from the wider Black Sea and Eastern Europe since the fall of Communism.

Armenians, Georgians, Bulgarians, Serbians, Moldavians, Romanians, Albanians, Bosnians and Kosovars look at the findings of a comparative study as though they were the pass, dribble, tackle and assist of a football match.

A whisper rises up from the Bulgarian delegates.

“Romanian really undid us on this one,” comes a voice.

Despite the collegiate atmosphere among the members who all put the needs of children way above national interest, there is a still time to entertain rivalry between the EU’s two poorest countries.

The study has been developed in nine nations and shows how the lives of these “invisible” children changed over the last twenty-five years.

Romania was the country with the largest problem – with its abandoned kids running into the 100,000s.

The images of abandoned children after the fall of its Communist regime remain scars on the European collective conscience.

To stop the population decline in Romania in the 1950s, due to more working women and a fall in living standards, the Communist Party aimed to boost the numbers of Romanians from 23 million to 30 million.

In 1966, in a move to raise the birth rate, Romanian dictator Nicolae Ceausescu de facto declared abortion and contraception illegal.

This resulted in parents abandoning children in hospitals after birth. The state then placed the kids in overcrowded institutions.

With the break-up of communism in 1989, the doors opened to a humanitarian crisis.

Today ChildPact is the only regional alliance that includes more than 600 child rights organizations. For the ten national members, ChildPact is the friends they grew up with; with whom they shared the same playground and the same stories. They know the group dynamics, the pacts and rivalries, the sensitivities and small victories.

Romanian doctor Andy Guth pours over comparative charts showing which child protection reform models  worked in spite of the east European national systems, and which tend to be corrupt and underfinanced, with low levels of economic development, bad laws and zero methodology of implementation.

 

Child outside block in Ferentari, Bucharest (copyright: Petrut Calinescu)
“At the back of the institution: an image that still haunts me”

Spring, 1990, in Romania. Guth was a recent graduate from medical school and fledgling director of an orphanage in Onești. Here he was signing two of the first transfers to a hostel for ‘irrecoverable’ children, the official term for mentally or physically disabled minors.

These children were clinically healthy when they were admitted.

“Two weeks later, we received the first death certificate,” he says. “I immediately went to the hostel. The first thing I saw when I got out of the car was the graveyard behind the institution. They had their own graveyard!”

For Guth, this was ground zero – the initiation point for the child protection renaissance that would follow seven years later.

“It’s an image that will haunt me for the rest of my life,” says Guth.

Guth was one of the doctors on the frontline of humanitarian convoys in the nineties, facilitating the programs drawn up in offices abroad. They were known as ‘The White Guard’.

Many became civil society activists, who still play an active role in the reform of child protection.

Why did doctors take on such a role?

During Communism, medically-trained personnel were tasked with raising deserted children in unheated buildings that served as town hospitals. This abandonment was seen as a public health issue.

Twenty-five years later, Guth is presenting the results of the Child Protection Index, an international instrument whose development he dedicated four years to, coordinating the collaboration of 71 child protection experts from nine countries. He has worked on the project together with Jocelyn Penner Hall, World Vision’s Policy Director.

This has some disturbing information.

 

“One baby abandoned every six hours”

In Romania, the number of children separated from their families in 1997 was in the range of 100,000 for six million kids.

By the end of 2013, the number hovered around 60,000 for a total population of four million.

Taken together this amounts to a statistically insignificant change, from 1.66 per cent in 1997 to 1.52 per cent in 2013.

One reason for this is a gap between reforms on paper, and those on the ground.

For instance, between 1997 and 2007, Romania was pressured by the EU integration process to accelerate reforms. Now – according to the Index – Romania scores highest when it comes to public policies and legal framework, but still hosts the greatest number of institutionalised children in the region.

Armenia and Moldavia follow closely behind. At the other end of the spectrum, the Index results show that of all countries surveyed, Kosovo has parents who are least likely to abandon their children.

Meanwhile, in Romania today, a baby is abandoned in a maternity hospital every six hours.

What does the tiny decrease in infant abandonment say about child protection efforts over the last twenty-five years?

“This says that one cannot change the mentality of the public by responding to EU pressure alone,” says Penner-Hall.

“It’s been said that the year Romania joined the European Union marked the burial of [child protection] reform. With no external pressure, nothing remarkable happened. However, I believe that after 2007 smaller, more meaningful things occurred. The worst day ever was the first day of democracy in Romania; it was that day when the public conscience started to blossom.”

Guth also believes that the Index can also be seen as an X-ray of regional mentalities.

“For instance, the results prove that in Armenia 97 per cent of disabled children are taken care of by the state, while only three per cent grow in real families,” adds Guth.

“The Index also shows that in Georgia the exploitation of children through labour is not considered an issue. They think it is normal for some children not to go to school.”

 

Romania: number of kids in rural areas going hungry “doubled”

Back in the conference hall, Guth cautions that the results he is about to present are not part of a competition.

But he knows that the moment he opens the diagrams comparing the nine countries, the Romanians will look at where the Bulgarians stand, the Albanians will check Serbia’s scores and the Armenians will want to know if they have outrun the Georgians.

According to overall Index country scores, Romania is placed highest, followed by Bulgaria and Serbia. At a continental level, Romania has some of the most efficient child protection legislation. “The law is built upon the structure of the UN Convention on the Rights of the Child,” says Guth. “In theory, Romania rocks.”

But in practice, the Eurostat data shows is that, as of 2013, the child poverty rate in Romania exceeded 48.5 per cent.

A 2014 World Vision report stated that eight from 100 children in Romania face extreme poverty, living on less than 3.5 Euro per day. The same study testifies that one out of eight children in rural areas go to bed hungry.

This percentage doubled between 2012 and 2014.

“There is so much more to do for the children of Romania,” says Daniela Buzducea, Executive Director of World Vision Romania. “Then again, to see how far you’ve come, you need to know where we started from.”

Daniela is part of the first “free” generation of social workers in Romania. Only in 1994 did Post-Communist Romania have its first graduate promotion in this field. Before this moment, this occupation did not exist.

In the 90s found Daniela in the homes of some of Romania’s most vulnerable children. She was trying, on her own, to prevent the separation of children from their families.

“To me, the Romania of those years is HIV positive children who got infected in hospitals,” she recounts.

In the late 1980s, thousands of children in Romanian institutions contracted HIV due to blood transfusions from syringes infected with the virus.

“The real moment the reform started is encompassed in a scene when I was visiting a young mum with an infected baby,” says Daniela. “She had no form of support whatsoever. She was going through hell. I also had a small baby at home, and apart from visiting this woman just to reassure her that she was not completely alone, there was not much else I could do.

“One day, she was diagnosed with cancer and lost her hair because of the treatment. When I went to see her, on the wall of her house was written the word: ‘AIDS’. She had locked herself inside. She could not even take her child to the hospital because people would throw stones at them. In reforming its social protection system, this is the point from which Romania started.”

 

“If I had not been there, the kid would have been lost”

Albanian Zini Kore represents the national child rights network “All Together Against Child Trafficking” (BKTF). For almost twenty years Zini earned respect on the streets of his country’s capital Tirana. Not just with the homeless kids, but also with the cops.

“When the Police find a new child on the street, they call me first, to pick him up and only after that do they contact the authorities,” says Zini.

Kids know they may not have much in this life, but at least there is someone fighting on their behalf until the end, no matter what kind of end that may be.

Zini never drives. No matter where duty calls, he always crosses town on foot, searching through the labyrinthine streets, scanning for homeless children.

There was a time when his phone rang incessantly – at day and night. The terrified voice of a street child on the line. No one knows the magical and subterranean paths his phone number travels to reach the kids in the city who need him most. He always grabbed his clothes and left.

“Had I not been there the exact moment the Police accosted a child,” he says, “the kid would have been lost in the inferno of the correctional institutions. From there, there is no way out.”

Today, his phone rings less often. Thanks in part to Zini and his organisation, who work hard to compensate for the state’s lack of involvement, the lives of street children have improved. But the underlying problems persist. The Child Protection Index shows that only Bosnia surpasses Albania when it comes to neglecting the situation of street children. It also demonstrates that the region has a major problem regarding the involvement of authorities in effective protection solutions.

When asked about his kids, Zini proudly mentions his boy, who is still not legally his son. He will soon turn 18 and then Zini will start the adoption procedures. It’s easier this way because at this age the young man can make his own decisions. He is one of those street children Zini fought for.

Child Protection “Mall” in Sofia

George “Joro” Bogdanov doesn’t talk much and when he does he fishes for the right words in English.

He is not a born public speaker. But he is a man of big ideas. He succeeded in putting child protection on the public agenda with an annual gala event where The National Network for Children in Bulgaria recognize citizens whose work improved Bulgarian children’s rights and prosperity and awarded them with the statue of a Golden Apple.

Now he has a new vision: The Children’s House in Sofia. This will be something like a child protection “mall” with conference and meeting rooms for child protection events and workshops; offices for the coalition’s NGOs; playgrounds for children and an educational centre for children with special needs; accommodation and a restaurant for international and local guests. Following a social enterprise model, he wants to hire disadvantaged young people to run the place.

Everybody has told him that he was crazy to even think he could raise the huge amount of money necessary to carry out his idea, but Joro went ahead and did it anyway.

He is now building the House.

 

“How am I supposed to feed a teenager with one Euro a day?”

Among the group gathered in Belgrade, Moldovan Mariana Ianachevici’s laughter is the loudest. It’s contagious, the kind of laughter you want to cling to in the midst of a large and unfamiliar gathering.

If one can still laugh like that after twenty-five years of helping victims of trafficking and abuse, and if one can still talk about taking home the last ten unwanted teenagers from a closed orphanage in Chisinau, there must be a parallel world better than the statistics suggest.

Mariana Ianachevici is a three-time President – she is President of ChildPact, the President of the Child Protection NGOs Federation in the Republic of Moldova, as well as the President of her own NGO, which has assisted more than 1,200 children over twenty years.

“The future President of the country,” she laughs, before relating stories about surviving the winter with canned vegetables and frozen fruits harvested from her NGO centre’s tiny orchard.

“How am I supposed to feed a teenager with one Euro a day? This is all the state gives me. When they sit down… these youngsters are so hungry they would even eat the corner of the table!”

And the story continues, about Valentina, the Centre’s long-time accountant, who never comes to work without a homemade cookie. Just to have something nice to give the kids.

About another lady, Rodica, an older employee of the center, diagnosed at infancy with polio and brain paralysis, of whom all the children are so fond, because she hands out gifts of pretzels, nuts and kind words.

 

“If only every child had an adult to protect them”

Daniela Gheorghe is executive director of the Federation of NGOs for the Child (FONPC). Blonde, tiny and delicate, Gheorghe wrote history by strengthening the role of civil society in Romania. Her eyes brighten when she adds that “in all these years, we mostly fought the Government.”

Her mission has been to forbid the institutionalisation of children under three years old, and she now hopes to increase this age to six.

The Index shows that institutions taking on children under two years old occurs most often in orphanages in Bulgaria, while the countries most protective of this age group are Kosovo, Georgia and Serbia.

Gheorghe earned her psychology degree in the nineties when the humanitarian convoys opened the doors of the Romanian orphanages.

She enrolled in salvation missions, and was part of the first teams to work with abused children in orphanages. At that time, she had no idea she was joining a battle that would change her life.

“After five years, I fell into a depression that would last for six months,” Gheorghe recalls. “I couldn’t distinguish colors anymore, I was seeing only black and white.”

She was representing abused children in lawsuits with the aggressors and, during her last trial, Gheorghe experienced a miscarriage. She was never able to have another child.

Nevertheless, she developed a bond with three of the girls whose own trauma of abuse she helped overcome, and today she considers them her daughters.

“I am not a mum, but I am some sort of a granny,” she says, as she flicks though pictures of the beautiful girls on her Facebook page.

One of them is a hairstylist and has two children of her own, another is studying physical therapy and the third is working with children diagnosed with autism.

Gheorghe has found joy in seeing the girls develop into independent women.

“It’s no big deal,” she says. “I just fought for them. If every child had an adult to protect him or her, we would change the world.

The State Of Orphanages In Eastern Europe and the Post-Institutionalised Child

This article talks about four key areas-  The Physical Effects on the post-institutionalised child

The Effect on socio-emotional intelligence.

The Effects on Linguistic Development

The Legacy of Institutionalisation on Mental Health.

The Effects of Institutionalization on Children

Introduction

Institutionalization of orphaned and unwanted children has been a long-standing Western tradition, and only in the last century has society begun to realize the damning ramifications of the practice on children. This form of care still remains common in a few former Soviet countries, tragically condemning children to a life of stunted development. This article, then, will tackle the effects of institutionalization of children in former Soviet countries in particular, starting first with the history of institutionalization practices the typical institutionalization experience is like in former Soviet orphanages, and then its profound effects on physical well-being, intelligence, and socio-emotional development.

The State of Orphanages in Eastern Europe

Historically, orphanages in Western cultures have followed the “medical model” approach to childcare—namely, that good caretaking consists of meeting a child’s basic physical needs, with little emphasis on caregiver affection and the attachment needs of children. Most developed Western countries moved away from this model in the 1950s, after the pioneering work of John Bowlby’s attachment theory and Harry Harlow’s work with monkeys showed that healthy attachment is essential for normal development. However, both institutionalization and the medical model approach remains prevalent in former Soviet countries, with several hundred Russian orphans still living in orphanages. Infants in these orphanages are fastidiously kept for, well-groomed and well-fed, but human interaction is minimal. Infant-to-staff range anywhere from 8:1 to 35:1, meaning that infants receive only a bare minimum of human interaction. Frequently, they are frequently left in cribs for a good majority of the day and only receive interaction with staff when their basic needs, like feeding and bathing, are met at predetermined times, and the rest of the time, they must lie in their own feces and urine. Staff members rarely hold or cuddle infants, and they routinely ignore crying, both due to policy and due to the sheer number of other children they must attend to. With so many children to manage, individual needs are ignored, prompting a report by Case Western Reserve University to call the orphanages “warehouses.”

The actual orphanage environment is no more stimulating. Groza, Ileana and Irwin described typical orphanages as “colorless, shockingly quiet and devoid of any of the usual visual or auditory stimulation,” and recalled one orphanage in which the 4-year-old children there had never once left the room assigned to them. Many orphanages lack proper schools and provide no educational or entertainment material for the children to peruse, meaning they must provide their own stimulation. Punished for being “hyperactive,” many children end up simply doing nothing at all. The sight of children staring blankly into space for lack of anything better to do is tragically common.

The Physical Effects of Institutionalization

The physical effects of such a deprived environment have been long noted. The noted nineteenth-century pediatrician Henry Dwight Chapin, for instance, discovered that there is a significantly higher infant mortality rate in institutions, even when infants were otherwise healthy, and this mortality rate was so high in 19th century orphanages that the term “hospitalism” was coined to describe the common plight of orphaned babies. At one Romanian orphanage, most children were below the 20th percentile for height and weight, rendering them more vulnerable to disease. Officials there estimated that mortality rates in the winter could be as high as 40%, and on any given year, about half of the children died within the first 24 months after arriving at the orphanage. Children who do manage to survive typically suffer stunted growth, generally at a rate of one month’s delay for every three months spent in an orphanage. Growth stunting for some children is so severe that they can be diagnosed with “psychological dwarfism,” a phenomenon in which emotional or abuse disrupts the secretion of growth hormones and stunts normal growth. It is not unheard of for such children to grow three to four inches in just a six-month time span after being adopted. While most health problems resolve within a year of adoption, children nonetheless remain smaller than their non-adopted peers throughout childhood. The longer the orphanage stay, the shorter the child tends to be for their age.

Complementing this physical stunting are motor skill development problems, like possessing low muscle tone and not demonstrating age-appropriate motor skills. One study found gross motor delays and fine motor delays in 70% and 82% of Russian children, respectively. Like the other physical effects mentioned above, these motor skill problems resolve themselves in more stimulating environments.

The Socio-Emotional Effects of Institutionalization

Of course, the effects of institutionalization do not limit themselves to merely physical development. Indeed, the greatest legacy that institutionalization leaves is on children’s socio-emotional development. Perhaps the most well-documented effect is on attachment. John Bowlby noted that all children need a stable, responsible caregiver to attach to; without one, a child is set up to have difficulty with relationships later in life. By definition of being institutionalized, however, children in orphanages do not have a caregiver to attach to, as staff members work on shifts, may switch jobs, and have other children to care for—there is no one dedicated long-term to an individual child.

Generally, children who are institutionalized after the age of two and have had quality care during their infancy are not terribly affected by this indifference, but children who enter institutions before the age of one tend to do quite poorly. These children realize early on that no one particularly cares about them. Infants in nurseries are eerily silent, a direct result of learning early on that their vocalized distress will never be rewarded with attention. They frequently fail to attach to anyone, and, unused to physical contact, are highly sensory and tactively defensive and recoil from human contact if it is given. Unlike normal children, they become even more upset when someone tries to console them and prefer to “cry it out” by themselves, as that is how they are accustomed to doing.

Infants who present ambivalent and avoidant attachment to caretakers often go on to present characteristic disordered attachment styles later in life. The most common relational style seen in institutions is known as “indiscriminative friendliness.” Starved for affection and used to an ever-changing rotation of caretakers, these children seek affection inappropriately from everyone and anyone, including complete strangers. However, other children completely give up on soliciting affection from unresponsive caregivers and cease to be social altogether, instead developing what is known as “institutional autism.” Although not actually autistic, these children develop stereotypically autistic behaviors, like rocking, head-banging, stereotyped behaviors, and bizarre rituals, seemingly as a way of providing some stimulation in their own, otherwise sensually barren lives. Unlike autistic children, they stop this sensory-seeking upon placement in a more enriched environment.

These disturbed attachment styles, unfortunately, frequently persist after adoption. A full third of adopted Romanian children demonstrated avoidant attachment to caregivers, and an even higher percentage had only ambivalent attachment. Often, the most indiscriminately friendly children violently unravel in a post-institutional environment and become aggressive and controlling, deregulated by the lack of structure and the constant showering of warmth and affection they were denied for so long. Many attachment disordered children do eventually recover, but a significant minority of cases is eventually diagnosed with reactive attachment disorder. The prognosis for reactive attachment disorder is generally fairly poor, especially for older children. After a certain critical point of development, it seems, children simply cannot develop the capacity for normal, warm human relationships.

Related to the problem of attachment is social skills development. According to John Bowlby, if children are institutionalized for too long, the child will lose the ability to interact with other humans in a normal way. In one study of Romanian children, it was reported that while most parents were concerned that their children were too withdrawn and avoidant within the first year after adoption, after a few years, children’s greatest social problems were externalized. Parents frequently complained of aggressive, manipulative behavior and difficulty getting along with peers. The longer children had lived in an orphanage, the greater parents reported their difficulties to be, and the worse the impairment in intelligence, the worse the child’s social skills tended to be. Another study on Romanian children found that an astounding 55% of preschool-aged children were unable to demonstrate developmentally appropriate social skills like meaningful eye contact. Some children are so profoundly deficient in social skills that they arguably lack any sort of conscience or feelings for others at all and instead present symptoms of sociopathy.

The Effects of Institutionalization on Intelligence

Yet another well-documented, deleterious socio-emotional effect of institutionalization is intellectual disability. By school-age, a majority of Russian children living in orphanages are diagnosed with “oligophrenia,” a vague descriptor in Russia for “general mental deficiency,” and a study of internationally adopted children showed that upwards to 50%-90% of preschool-aged children had developmental delays upon arriving in their new country. Many children had multiple delays, usually in motor and language skills. Similarly, in another study of Romanian children, every single child in the study was developmentally delayed upon arriving in Canada and frequently tested into the borderline mentally retarded range. The more time a child spends in an orphanage, the more profound the intellectual impairment; for every year that a child spends in an institution, his cognitive development will be delayed by about six months.

Some of this damage is observable at the biological level. Total brain volume is significantly negatively correlated with time spent in an institution. The hippocampus in particular shows markedly decreased volume, which research has demonstrated is due to overproduction of cortisol, a hormone released in stressful situations. Repeated release of cortisol in stressful situations, like that of neglect in orphanages, destroys the hippocampus, which is central in learning and memory. Damage is not limited to the hippocampus, however; FMRIs of formerly institutionalized children have revealed that the prefrontal cortex tends to be both immature and reduced in volume, which leads to problems with impulse control and decision making. Accordingly, then, children do particularly poorly on tests measuring visual memory and attention, learning visual information, and impulse control.

Fortunately, most children usually make rapid gains in intellectual development upon removal from the institution environment. However, the legacy of institutionalization often lingers, as the precipitous drop in intelligence institutionalized children experience is not entirely reversible even after being placed in an optimal adoptive family environment. Three years after adoption, children in one study had only very modest gains in intelligence, and most scored in the low average IQ range. The longer a given child lives in an institution, the worse his intelligence tends to be, especially if the child has lived there since infancy.

Linguistic Development in Institutionalized Children

With no one talking to them, it hardly comes as a surprise that linguistic development is severely retarded by institutionalization, too. Language delays, in fact, are the most commonly diagnosed problem in post-institutionalized children. Children learn from interacting, not from passively hearing others, but this is exactly the opposite of what institutionalized children doing. Glennen discovered in an observation of a Russian orphanage that when language was spoken in the presence of children, it was usually between caregivers, and on the seldom occasion a child was spoken to, it was typically in the form of simple commands. Most activities, like meals, were conducted in almost complete silence. Accordingly, with no opportunity for actual practice, about 60% of 2 1/2 institutionalized children in one study had no expressive language whatsoever, and at age 3 1/2, only an astounding 14% were capable of speaking two-word sentences. Nonverbal communication skills are often no better; children’s skills tend to be either minimal or negative in nature, like hitting. Deficient language development is one of the hardest effects of institutionalization to undo; after certain critical linguistic periods are missed, no amount of intervention will ever fully remediate a child’s language deficits. A child’s rate of acquisition, then, literally determines his capacity for language later in life.

The Legacy of Institutionalization on Mental Health

Finally, institutionalization leaves individuals with a significantly hiked risk of mental illness and disturbed behavior. So common is disordered development that a specific mental disorder has been suggested specifically for post-institutionalized children, known as Developmental Trauma Disorder. This disorder is hallmarked by what is known as “mixed maturity,” in which children demonstrate normal maturity in some areas, but act like a much younger child in other areas. Academic skills, depth and appropriateness of relationships, and social skills tend to be more representative of those of a younger child. Frequently, these symptoms will mimic those of ADHD and PTSD’s, with poor social skills and hyperactivity. The stress of repeated traumatic events, such as institutionalization, changes the make-up of the central nervous system in such a way that children are biologically conditioned for a heightened fear/stress response. Children are maladaptively hypervigilant as a result, and because they frequently misperceive totally innocuous events as threats, they present immature, aggressive, and socially inappropriate behavior. The inability to pay attention and the hyperactivity is directed related to the degree of neglect, and is unrelated to low birthweight, nutrition, or intellectual disability.

Unsurprisingly, the prospects for children who are not adopted from these institutions is often grim. Of the approximately 15,000 children who grow out of Russian orphanages every year, the Russian Interior Ministry University estimates only about 20% are successful post-institution—10% commit suicide, 30% end up in jail, and 40% end up homeless. The cycle of child institutionalization tends to repeat itself, with many orphanages reporting that they have children who are the third or even fourth generation to have been institutionalized.

Adoptees do better, but still struggle, as these problems follow them even after they leave the orphanage. In her landmark study on institutionalized Romanian children, for instance, Ames noted that children frequently try to apply maladaptive behavioral strategies learned while in the orphanage to their post-adoption lives. Many children, for instance, engage in behaviors like stealing, manipulating, fighting, and lying, because doing so earned them extra attention or food in orphanages. Similarly, as testament to their highly regimented, unstimulating lifestyle, children can be highly dependent on others telling them what to do, often for years after adoption. Many cannot determine for themselves when to stop eating, and one study recounts that some children will lie in bed quietly for hours until prompted to get up.

Although many of these behaviors disappear as children acclimate to a stable post-adoption life, many other behaviors persist. Even in the best of adoptive environments, adoptees suffer a rate of mental illness about 70% higher than the general population. Their difficulties are not necessarily due to poor genetics, either; adoptees from China and Korea, which eschew institutions in favor of foster care, experience mental illness at a rate three to seven times lower than adoptees from former Soviet countries, which use institutions. Indeed, 72% of parents in Ames’ study of Romanian children cited their biggest concern with their children not to be anything physical or intellectual, but socio-emotional. More than a third of the children in the study needed professional help for behavioral problems several years after adoption. Children who are older at the time of adoption, who experience abuse, and who have multiple changes in caregivers were more likely to have problems. The most common problems included conduct disorder, antisocial behavior, poor relationships, and affective disorders.

Clearly, as has been demonstrated, institutionalization has a profound impact on every aspect of a child’s functioning. The gross amount of neglect, both physical and emotional, causes severe damage that is not always possible to undo, and the longer the time spent in the institution, the worse the effects. The vast majority of children never get adopted, meaning they languish in stunted emotional, cognitive, physical and social development forever. While there is hope for those who do get adopted, the effects of institution more often than not leave a damning legacy.

References

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Delaine, L. (2000, May 1). The plight of Russia’s orphans. Retrieved fromhttp://www.russianlife.com/blog/plight-orphans/

Federici R. (2007, July 18). The neuropsychology of bonding and attachment disorders. Retrieved from http://www.rainbowkids.com/expertarticledetails.aspx?id=57

Federici (2008). Raising the post-institutionalized child risks, challenges and innovative treatment. Retrieved from http://www.drfederici.com/raising_child.htm

Gindis, B. (2005, December 23). The second glance at institutional autism in internationally adopted children. Retrieved fromhttp://www.adoptionarticlesdirectory.com/Article/The-second-glance-at-institutional-autism-in-internationally-adopted-children/81

Gindis, B. (2011). Navigating uncharted waters: School psychologists working with internationally adopted post- institutionalized children. COMMUNIQUÉ, 27(1), Retrieved from http://www.bgcenter.com/communique-article.htm

Gindis, B. (2012, March 12). Internationally adopted child: Navigating between PTSD, ADHD, and DTD. Retrieved fromhttp://www.adoptionarticlesdirectory.com/Article/Internationally-Adopted-Child–Navigating-Between-PTSD–ADHD-and-DTD/184456

Groza, V. (1999, October). US policy promotes institutionalization of children in Romania. Retrieved fromhttp://msass.case.edu/faculty/vgroza/international/adoption/uspolicy.htm

Groza, V. (n.d.). Interview by A Martin [Web Based Recording]. Adverse impacts on children living in orphanage institutions. , Retrieved fromhttp://www.adoptvietnam.org/adoption/health-institutional-impacts.htm

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