These are the findings of Dr. Elinor Ames’ research on the Development of Romanian Children Adopted to Canada. In 1990, Dr. Ames, an adoptive parent and professor of developmental psychology at BC’s Simon Fraser University, began her research on the effects of institutionalization on children adopted to BC from Romanian orphanages. That same year, 1013 children were adopted from Romania to Canada, the single largest influx of intercountry adoptions in Canadian history.

Ames’ research, which began in a Romanian orphanage, compared the development of 46 children adopted in 1990 aged eight months to five years at the time of adoption with 45 non-adopted Canadian children. The youngest 30 were matched to 30 children adopted at two months and, therefore, had minimal orphanage experience. Given that number of intercountry adoptions now exceeds the number of local adoptions, the timing is bang on.

Intellectual development, attachment, medical and behavioural, and social concerns were studied. The purpose was to contribute to our knowledge of the effects of early deprivation on later child development and to provide guidance to future adoptive parents of orphanage children.

Major findings and recommendations

Findings Emotional: Parents adopting children from orphanages were initially most concerned about possible health problems, less concerned about developmental delays, and even less concerned about behavioural or emotional problems. Three years later, 72 percent of these same parents identified behavioural, emotional, or social problems as their child’s most troublesome problem.

Recommendation: Agencies and individuals facilitating international adoptions should provide specialized pre-adoption preparation for parents adopting from orphanages. Such preparation should include information on the characteristics and distinctive problems of children adopted from orphanages.

Recommendation: Opportunities should be provided for prospective adoptive parents to have contact with support groups of individuals who have already adopted from orphanages.

Findings — Medical: Common problems of orphanage children were intestinal parasites, hepatitis B, and anemia. Some children received only a perfunctory check from family physicians, who did not seem to realize that they might have more and different medical problems than Canadian-born children.

Recommendation: All internationally adopted children should receive a thorough medical checkup arrival in Canada. Parents and physicians should be helped by the preparation of Physician Guidelines for Medical Assessment of Children Adopted from Foreign Countries, for each province. A brochure for parents to present to their physicians, which would suggest medical tests that should be done on international adoptees.

Findings — Length of Stay: All orphanage children were developmentally delayed when adopted. The longer they had spent in orphanage, the more delayed they were.

Recommendation: Where possible, those arranging adoptions from orphanages should try to place the youngest children available. When older children are placed, parents must be made aware of the greater commitment and resources that will be necessary to rear these children.

Findings — Learning: Orphanage children who entered the B.C. Infant Development Program made rapid progress. After three years in Canada, 4-1/2 year-old orphanage children had low average IQs; the early-adopted children and Average IQs; and the Canadian-born children had high average IQs. Orphanage children adopted at 2 to 5 years of age had the lowest IQs (“slow learner” range), and only half of them were in the school grade appropriate for their age. The provision of stimulation and support for development in the home was more highly related to IQ in the adopted groups than it was in the Canadian-born group.

Recommendation: All children adopted from orphanages should be entered into infant development programs or specialized preschool programs in order to assist their development.

Findings — Social Skills and Parental Stress: Initial characteristic problems of orphanage children (eating voraciously, making stereotyped movements, and withdrawing form siblings and peers) had mostly disappeared three years after adoption, but orphanage children still had more behavioural problems than Canadian-born children. Their problems were acting-out and poor social interaction with peers. Of these children, 36 percent of them had behaviour problem scores high enough to indicate a need for professional help. Fewer orphanage children than Canadian-born or early-adopted children had formed a secure attachment relationship with their primary caregiver in the three years following adoption, and 1/3 of orphanage children displayed insecure attachment patterns not commonly found in home-reared children. Orphanage children were much more likely to be indiscriminately friendly with new adults than were children in the other groups, even three years after adoption.

Parents of orphanage children reported more stress than other parents; by the second time they were studied, one-third of orphanage children’s parents had stress high enough to suggest the need for professional help.

Recommendation: Agencies facilitating international adoptions should be required to provide post-adoption support for parent adopting from orphanages. Support could be provided in group sessions or individual consultations, and deal with topics such as attachment, social behaviour, and ways of dealing with attention-demanding behaviour, distractibility, hyperactivity, and indiscriminate friendliness.

Findings — Support: More orphanage children than children in the other groups used at least one specialized teaching service. Approximately 1/2 of their parents wanted some services that they had not been able to find, e.g., adoption support groups (especially for parents of older children), advice about behaviour problems, speech therapy, and respite care. There was wide variation in how well orphanage children were doing: 30 percent of them had three or more of four serious problems (IQ under 85; behaviour problems above a clinical cutoff; atypical insecure attachment; continued stereotyped behaviour), while 35 percent of them (and more than 70 percent of early-adopted and Canadian-born children) had none of these serious problems.

Most of the differences in how well the orphanage children were doing were not predictable from the children’s condition at adoption or from the quality of their orphanage experience, but rather were related to the length of time they had spent in orphanage, and to characteristics of their adoptive homes.

In general, children were doing better when they had been in orphanage for a shorter time, when families had adopted only one child from Romania, when mothers were older, and when other family stressors were fewer. Conditions (e.g. lower socioeconomic status) that interfered with parents having large amounts of time and energy to work on alleviating orphanage children’s many problems led to poorer outcomes.

Recommendation: Adoptions of orphanage children should be considered to be special-needs adoptions that require extra commitments of time, energy, expertise, and cooperation with helping agencies.

Recommendation: Parents should be cautioned that the time and energy necessary to rear an orphanage child make it unwise to adopt more than one child at a time, or to bring the child into a family that already has several young children.

Recommendation: Pre-adoption preparation services should help parents in two-parent families to reach an agreement concerning whether family resources are or are not sufficient to meet the needs of an orphanage child.

The views expressed in this report do not necessarily reflect those of Human Resources Development Canada.