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Baby and Toddler Adoptions - Interrupted or Unexperienced Stages of Development

By Patricia Irwin Johnston, author of Adopting: Sound Choices, Strong Families

Developmental interruptions are common in adopted babies who are placed after birth. What causes these interruptions and how can you address them.

Your baby may not join you at his birth. That's an adoption thing. That may or may not result in adjustment problems for either or both of you, but if your baby has a hard time adjusting to change, or if you find it difficult to help her adjust, many tools for dealing with those potential problems were offered in the last chapter. If those don't work, more may be available if you are willing to make contact with an adoptive parent group about your concerns.

Psychiatrist Justin Call's research concerning how babies can be expected to react at certain vulnerable stages of development during their infancy is, unfortunately, not well known among those who are arranging placements. In a 1974 article called "Helping Infants Cope with Change" published in the January issue of the journal Early Child Development and Care, Dr. Call describes how babies of various ages may feel and express distress about a change in environment and caretaker. For example, newborns to three month old infants are described by Dr. Call as being most concerned with having their needs met. One might assume, then, that if needs continue to be met consistently, babies might not be particularly distressed by changed surroundings. Perhaps, writes Call, this is true of newborns. But it's also true that by age one month, babies are alert enough to respond to stimuli but are not sophisticated enough to modify them, so that until they are over three months old they are particularly susceptible to overstimulation and overload. Call believes that babies who are between four and twelve weeks of age are highly likely to be distressed by a change in environment and caretaker.

A more adaptive time for change is when babies are between three and six months of age. These babies, Call says, are more able to respond to and modify stimuli and are physically sophisticated enough to respond more easily to a changed diet. But a particularly vulnerable window again appears for the child between six and twelve months of age. Children who have been given the opportunity to do so have usually formed an intense attachment to a caretaker by this time, and if moved they are likely to experience a full range of typical grieving behaviors, including shock and denial, anger and despair, depression and withdrawal. It's important to keep in mind that because these devastating losses are occurring before a baby has language with which he might be able to communicate more directly and more successfully, it is particularly hard for him to resolve this kind of anxiety.

If you are adopting a child who will not arrive home until he is several weeks or months or a year or more old, I recommend that you use the time before his placement to try to get a sense of what milestones he may have passed and what growth experiences he might be expected to have had before he arrives at home. One way to do this is simply to check out the growth and development books and read the chapters for the weeks and months you will have missed as your child's parent. If you miss time together not because you didn't know about the existence of one another but because you are waiting for some bureaucracy somewhere to free your already identified child to his family, the newsletter Growing Child, which arrives on a monthly basis planned to coincide with your child's age, provides an even better way to "keep up" with your child

It's important to be prepared for the possibility that your later-arriving infant-even if very healthy-may not have achieved all of the milestones the books have described as "average" or "normal" when he arrives home. Sometimes those delays are a result of the child's not having had enough one-on-one stimulation in previous environments. In orphanages, babies often have many caretakers in one day (and some of these caretakers may be older children rather than adults). Orphanage kids may have come to expect few interactions each day and may not have learned that there can be a cause/effect relationship between expressing a felt need and having it met. Some later-arriving infants may never have experienced comfort and so do not know how to. If he has never felt full of food before, never felt comforted by cuddling, your child may have real difficulty understanding these new feelings and accepting them. And if he has been deprived of this kind of early caregiving, he may be operating mostly in "survival mode," having become so fearful and stressed as to be hyper-vigilant. Sometimes developmental delays are traumatically induced regressions that have to do with Baby's fear and discomfort about this move or a series of moves.

Every parent wants her child to be as smart as he can be. Adopting parents often worry that the things they've had no control over-a birthmother's poor diet or ingestion of toxins such as chemicals or alcohol during her pregnancy, poor nutrition or a lack of stimulation during the period before we become his caregivers, trauma from neglect, abuse or separation-will affect his intelligence. Though basic intelligence is innate, parents who provide appropriate stimulation can offer their babies optimal intellectual support.

In the first year babies' brains develop more synapses (electrical connections) than at any other period in their lives. The first year of life is a crucial one for cognitive development. It behooves you to learn as much as you can about where a well-cared for baby might be expected to be by the time he is the age of your baby at arrival, and to learn as well just how much stimulation a baby of that age can handle. Then use this information as you interact with your baby.

Because babies are so sensorially focused, stimulating all the senses will help the baby learn. New sounds, tastes, touches, and sights when offered by a trusted caregiver engage a baby's brain. Mobiles that flutter above a crib, fathers who talk while they change diapers or give baths, songs sung while the bottle is being warmed, a variety of textured items placed on a tray all help Baby to learn. In order to learn, babies need to do things over and over again, and yet intellectual growth requires a balance between familiarity and novelty. So change those mobiles occasionally, find new songs to sing, give baby different textures, and set his chair so that he has a different perspective on the room.

By the middle of the first year of life, babies who have been well-stimulated yet not over- stimulated and who have experienced consistency while being exposed to new things, have been steadily growing cognitively and are able, on a rudimentary level, to understand that their actions have an effect on the world. At about age eight months, children have sophisticated enough motor control as well as cognitive ability to deliberately reach out to ring a bell on a toy and understand with real delight the cause and effect relationship in a game of peek-a-boo.

By the end of the first year, most children who have experienced a steady relationship with a trusted caregiver are communicating very well with signals, body language, coos and grunts, and most have begun to use a few words. Cultural differences and changes of language can create interruptions in this growth, and sometimes these interruptions can trigger regressions. If you child is not with you during some or all of this first year, his progress in these developmental stages may very well be delayed.

Progress in motor skills can be delayed as well. Babies whose early months are spent in group care facilities have few of the opportunities for developing motor skills that children cared for by skilled foster parents or reared from the beginning in their adoptive home have. Babies must be unswaddled and given space in order to learn to kick and to roll from side to side. Children who spend little time being carried--spending hours in a crib and then strapped in a seat--have few opportunities to test their motor skills. If there is nothing colorful or interesting to bat at or try to pick up, a child may not have learned to grasp a rattle.

Developmentally interrupted babies who are given consistent, careful and attentive care, love and stimulation should be expected to catch up within a matter of weeks or months. If your child does not catch up within a half year of his arrival, talk with his doctor about your concerns and elicit help in screening for less common health problems which may have gone unidentified. These could include fetal alcohol syndrome or fetal alcohol effect, lingering effects of institutionalization, or undiagnosed post traumatic stress syndrome. You may also find helpful advice from your adoptive parent group.

Pat Johnston is a well regarded publisher, prolific author, and adoption advocate. This article is excerpted from her book, Adopting: Sound Choices, Strong Families, a thoughtful guide to adopting and adoption. Excerpted from Chapter 15 "Adjustments in the First Year Together" (Perspectives Press, 2008).
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