Is my child likely to have problems?

In studies done in the late 1960s, researchers found that adoptees were more likely than non-adoptees to have psychological, behavioral, and academic problems. Later analysis of these studies pointed out a large flaw: The studies grouped together children adopted in infancy with children adopted as teenagers. Children adopted in their teens have generally suffered neglect and/or trauma — that’s why they’re available for adoption. Subsequent, better-designed studies show a more nuanced picture.

The Sibling Interaction and Behavior Study at the University of Minnesota, which has followed children in 600 families since 1999, concludes that by mid-adolescence, adoptees are no more likely than their peers to engage in negative behaviors like delinquency, substance abuse, or aggression. Their relationships with their brothers and sisters (also adopted, or the biological children of the adoptive parents), were as close and loving as those between bio-siblings, and they reported feeling just as attached to their parents as did biological children.

However, the SIBS study also finds that adoptees are “moderately” more likely than their non-adopted peers to suffer emotional or behavioral problems like anxiety, depression, oppositional defiant disorder (ODD), and attention deficit/hyperactivity disorder (ADHD). Children adopted domestically are at slightly more risk than those adopted internationally; researchers do not know why. Overall, though, the SIBS researchers emphasize that “most adopted adolescents are psychologically healthy.”

Curiously, the SIBS study notes that while the risk of disorder is small, adoptees are more than twice as likely as non-adoptees to be referred to a mental-health professional. The researchers theorize that adoptive parents are better educated or have greater economic resources than non-adoptive parents, have had previous interaction with social services, and “may have a lower threshold than the parent of a nonadopted child for reporting behavior as problematic.”

Which children will need extra support?

Children who have spent significant time in an overseas orphanage may not have had sufficient stimulation, and may arrive with poor language skills in their own language, which can lead to later learning problems. A child over the age of two should be evaluated in his or her native language, so that any delay can be addressed as soon as possible.

Children who are of school age when they are adopted should be screened for potential learning disorders. Public schools are legally required to provide a free assessment if there is any suspicion of a risk for later learning problems — even if the child in question attends a private school. You can also request testing for your preschooler if he or she shows language delays, poor coordination, or other hints of a problem.

What happens if my child is diagnosed with a learning disorder?

If your child is found eligible for special education services, you’ll meet with school officials to design an “individualized education program” (IEP). The plan may include special attention from remedial reading teachers, speech or occupational therapists, or other specialists. It will list accommodations to help your child compensate for his or her weaknesses — extra time on written tests, for instance, or a copy of the class lesson. It should also arrange for assistive technology devices, if needed, such as audio books or computer software to help children organize their thoughts.

What do I do if my child has emotional or behavioral problems?

Sometimes even the best parenting can’t overcome everything a child and his family faces. Most children’s difficulties can be chalked up to normal childhood development, rather than to problems stemming from adoption. But if you’ve tried different parenting and discipline methods and your family’s difficulties persist, a professional can give you the tools you need to parent successfully. There are no hard and fast rules for when to seek professional help. Before you do, consider these options:

• Your child’s behavior may well be normal for his developmental stage. Read up on child development.
• Consider the family situation. Is there a change in the household (conflict, new siblings, divorce, a move) that may be prompting the behavior?
• Seek out parenting classes or advice from a parenting expert.
• Make sure your child knows that it’s easy to talk about adoption. Watch an adoption-themed movie or read adoption books together. Show your interest in talking about adoption and your availability to address any concerns.
• Make sure your child has a chance to interact with other adopted kids by joining a support group, attending a workshop, or taking part in summer camps.
• Join a support group yourself.

How do I know if a problem is adoption-related?

The therapists who support our families say that, in their experience, adoptive parents are too ready to assume that a child’s emotional or behavioral problem is about adoption rather than a normal developmental stage of childhood — and too quick to sign a young child up for one-on-one therapy.

Is there such a thing as “adoption trauma”?

If you troll adoption-related websites, you are likely to trip over discussions of “adoption trauma” or “the primal wound.” This is the theory that all adoptees, even those adopted as newborns, are permanently scarred by being separated from their birth mothers. (The theory has been expanded to cover children born to surrogate mothers as well.) While there is no doubt that people who say they suffer from adoption trauma are genuinely suffering, there is absolutely no objective evidence that the primal wound is a real psychological phenomenon. The SIBS study doesn’t directly address the primal wound theory, but its findings directly contradict the idea that adoptees are automatically troubled: The adoptees in the SIBS study were no more likely to be depressed than their non-adopted peers.

Anu Sharma, a psychology professor and a lead researcher on the University of Minnesota’s Sibling Interaction and Behavior Study, says: “Adoption is often a subtlety in children’s problems — a part of who they are — but not usually the main issue.”

When should we try therapy?

If your child has emotional or behavioral problems, whether adoption-related or not, and isn’t making any progress, you may want to consider therapy. When searching for the right therapist, you’re looking for someone who neither overemphasizes the effects of adoption nor ignores its influence. The ideal therapist should have knowledge of and experience with adoption, and should encourage you to take an integral role in your child’s treatment. Use local adoption resources. Start with referrals from your adoption agency, lawyer, or parent support group. Some states have post-adoption offices that offer referrals. Contact your local mental heath association for referral to therapists who have indicated an interest in adoption. Don’t limit yourself to psychiatrists and psychologists. Clinical social workers, family therapists, and licensed counselors may also be able to effectively treat an adoptee. Once you’ve compiled a list of therapists, arrange interviews and ask the following questions:

• What is your experience with adoption?
• What issues do you  believe may affect adoptees and can be helped by therapy?
• Are you comfortable talking about adoption?
• Do you believe adoption always has a negative impact on a child? (Steer clear of any therapist who says “yes” to this.)
• What do you need to know about our family? (Parents are critical to a child’s treatment and should be included in the plan.)
• What experience do you have in dealing with situations like ours?
• For children in open adoptions: Have you ever worked with a family involved in a birth parent search? Have you ever included a child’s birth family as part of treatment?
• If yours is a multiracial family: What experience do you have of working with people of my child’s culture?
• How does your practice work? Who covers the practice when you are not available?
• What are your fees, and have you worked with our insurance company?

Are support groups for adoptees helpful?

Social workers encourage adopted children to take part in adoptee support groups. Our families often say that their children resist the idea of such groups, but, once they have taken part, find them extremely rewarding.