Families For Russian and Ukrainian Adoption |
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| FRUA is pleased to provide you with a table of contents and sample article from the current issue of The Family Focus© | |
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Internationally Adopted Children: Issues and Challenges
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Fifteen years ago, when my family became involved with international adoptions from Korea and were awaiting our first adopted child, friends told us that children who were adopted during the toddler years would not experience any problems with learning a second language and that older, school-aged children would acquire functional English within six months. Were we in for a surprise, as were the teachers and speech-language pathologists who became involved with our adopted children during the years following their arrival. Meghann arrived at our home when she was just seven months, after a lengthy adoption process involving a myriad of requirements, including a home study, foster care license, criminal background check, physical exams, reflective essays, character witnesses, and financial statements. Although she was considered a special-needs, high-risk baby because of her low birth weight and complications following birth, she appeared to be thriving. However, as time went on, it became increasingly obvious that she had delays in all areas of her development. At age four, she failed an early childhood screening and was subsequently given a full evaluation by the school district. The source of her difficulties could not be found. Even though problems associated with learning English as a second language (ESL) were not viewed as a feasible explanation because of how young she was when she arrived, it was the only one available. Cory arrived at our home when he was two and a half years old, and like Meg, was a special-needs adoption. He was significantly delayed in all areas of development and only spoke four words in his first language. Cory also failed his early childhood screening at age three and was referred for a full evaluation. Because of the many challenges he faced, it could not be determined initially whether he had a specific language problem or whether the lack of language was due to other factors, such as the possibility of low cognitive functioning concomitant with mild cerebral palsy. During the first year post-arrival, however, it became apparent that Cory was functioning at age-level or higher cognitively, and that he was rapidly developing comprehension skills in English. He just wasn't speaking. Meghann and Cory both presented challenges to their early childhood teachers and speech and language pathologists (SLPs) because it could not be determined what was holding back their language development, especially the production aspect. Given their backgrounds, it is tempting to consider Meghann and Cory as special cases of internationally adopted children, but, in actuality, they are not as atypical as they would appear. In the early 1900's, when orphanages were still common in the U.S., significant language delay was a frequent characteristic of institutionalized children. With the current trend toward international adoptions, we are again seeing a high proportion of language delay in orphaned children who have been institutionalized. The severity of this delay is further compounded by the introduction of a second language -- English. Approximately 12,500 overseas children, many of whom come from institutionalized settings, are considered for adoption by prospective American parents each year. Many of these children exhibit severe developmental delays, including a refusal to chew in the younger children, a lack of muscle tone needed for speech production, and language delays. These delays can persist for several years or more after placement in the adoptive home. Studies have found that although 20% of such children thrive upon placement in their adoptive home, 60% experience continuing delays with only partial improvement. A further 20% do not improve at all. Language Delays in Older and Younger Children Language delays are of particular concern because they have such a forceful impact on literacy development. This is especially a problem for older children who arrive at school age. Older internationally adopted children present many complex issues, with many factors and many interactions. The children often are delayed in their first language, have little or no exposure to English upon arrival, have had little or no schooling, and have often experienced trauma, neglect, poor nutrition, lack of health care, and few positive emotional bonding opportunities. All of these factors, and others, will influence the child's ability to learn ESL. These children are not typical immigrants or refugees who have a known family to provide support. All ties to the adopted child's first language and culture have been terminated abruptly, often in a 24-48 hour period. Further, their new families may have little information to share with teachers and SLPs about the child's development, and may themselves be confused. Because of these factors, it can be very difficult to determine whether the language problems the children exhibit are due to adoption and/or psycho-social issues, slower (albeit, normal) ESL development, language processing difficulties, or broader cognitive challenges. In the past, it was thought that adopting very young children would ensure against having a child with language problems because of the amount of time that would be available for the child to learn English before starting school. Typical ESL development is known to progress in a similar sequence to first language development in English, though at rates that account for individual differences, again as with first language development. Silent periods are known to occur that last on average from two weeks to two months. It is also known that young children learning a second language use a variety of cognitive and social strategies to help them learn the new language. We need to keep in mind, however, that most internationally adopted children are not typical children. Because of the trauma and neglect they have experienced, they may not have the capacity or resources to use the strategies that more typical children employ. Also, as noted above, institutionalized children frequently are delayed in their first language, which can affect their second language development. It has been estimated that for every three months spent in an institution, a child will experience a one-month delay in development. Since many children are institutionalized for prolonged period of time, years in some cases, this is a critical concern. Currently, researchers in communication disorders are finding that young internationally adopted children who have been institutionalized before placement not only exhibit delays, but also display unusual language learning patterns because of the simultaneous loss of the first language while learning a second. In attempting to meet the language needs of internationally adopted children, one of the most difficult areas for parents is accepting a multitude of unknowns. Adoptive parents may have been given very sketchy information or no information may be available if the child had been abandoned. Because of this, it is important to be aware of the large constellation of possible contributing factors that may be influencing all aspects of development, including language. It is also important to be aware that internationally adopted children have a higher incidence of language delay and language disorders simply due to their history (e.g., frequent low birth weight, poor prenatal care, poor nutrition, maternal drug and alcohol use). Assessment Issues Given the characteristics of this population, many factors can influence the results of a speech and language evaluation. In assessing these children it is necessary to remember that they are different from the typical population. Even if assessment materials are available in the child's first language, they have not been normed for this subpopulation's children who may have been exposed to a different dialect of the language, and who may have been institutionalized. There is also a potential for bias in the testing situation. These children's world view and knowledge may be unusual, not only because of different cultural experiences, but also because of their severely restricted experiences in an institutional setting. First-language attrition can also bias assessment results. Little is known about language attrition in this population. These children often experience total loss of contact with their first language and culture within one day's time. Tied into this are also issues of personal identity, which can be either positive or negative, especially in older adopted children. It is not unusual for a child to experience a complete loss of first language in as little as six-months' time. This can occur even with teens, especially if they wanted the adoption and have bonded with their new family. Other factors that can affect the assessment process include hearing loss and semi-lingualism. Hearing must be carefully evaluated because of the high incidence of ear infections and lack of medical care for this population. Semi-lingualism -- the lack of age-appropriate command in either the first or second language -- is also a possibility during the first couple of years. This is a result of learning a second language while simultaneously rapidly losing the first language. It is also imperative that the child be assessed immediately. If there is a possibility that the child can be assessed before arrival, this should be requested. Results, however, should be weighted according to the source. What may be considered a language assessment in the home country may be vastly different from what is best practice in the US Further, it is not unusual for information to be conveyed in a manner that presents a child in the most positive light. Even if the child has been assessed prior to arrival, it is still important to fully assess the child's first language immediately after arrival, before any loss can occur. A dynamic approach, assessing the child's ability to learn language, such as found in Vygotsky's work, as well as the invented morpheme studies done in communication sciences, may give more information than standardized tests. Finally, on-going assessment several times a year can be beneficial in tracking the child's second language development. Intervention Recently, those involved with internationally adopted children have advocated for immediate intervention in most cases due to multiple risk factors in this population, which include prenatal birth factors, effects of institutionalization, and the high incidence of central auditory processing disorder (CAPD) and attention deficit disorder (ADD). Taking a "wait and see" attitude with this high risk population, especially with older children, can lead to greater problems in their ability to communicate, as well as further delay the acquisition of skills necessary for literacy development. Intervention with these children seems to progress best using a team approach, involving the regular classroom teacher, SLP, ESL specialist, school psychologist, and international adoption specialist/psychologist (if available). Since this population presents such a complex set of interfering factors, and since there are such extreme individual differences within the population, a team approach can be most productive. Such an approach allows a pooling of knowledge across several realms: language needed for literacy, second-language development, language disorders, and the effect of emotions and trauma on language. With a team approach, members can capitalize on each specialist's knowledge and strengths and thus better tease apart the issues that are affecting the child's language development. This type of approach, though time-consuming initially, should include joint assessment, joint planning, and coordinated intervention, in order to maximize generalization across situations and settings and to most appropriately provide the array of services these children need in order to remediate problems from the past as they start a new future. It has now been 15 years since the initiation of the process that allowed Meghann and Cory to join our family. They are both teens, both looking forward to their first year of high school. They are each involved in music and sports, and plan on attending college. Meghann has been receiving speech-language therapy since she was four and will continue receiving services in high school. She still struggles with language issues and has sequencing and short-term memory difficulties. Cory has not received speech-language services since he was seven. He has no language problems; it is thought that his delayed language production might have been due to socio-emotional factors caused by adoption issues and early institutionalization. It would be inaccurate to blame the language problems of either of my children on the ESL issue. In retrospect, ESL seems to have played only a very minor role, and, at least in Meg's case, such a view may have delayed her receiving needed services. Though it is certainly important to consider the impact of a second language on children's development, ESL is only one small piece of the puzzle when addressing the problems of internationally adopted children. An awareness of all the issues, careful ongoing assessment, and a team approach to intervention will best serve the needs of this special population. Christen M. Pearson is an assistant professor at Grand Valley State University. Her interests include the interface of second language acquisition and language disorders in children, as well as the special language issues faced by internationally adopted children and the impact of these language issues on literacy development. Contact her by email at pearsonc@gvsu.edu The ASHA Leader, American Speech-Language-Hearing Association, October 23, 2001; Feature Article; Copyright by the American Speech-Language-Hearing Association. Used with permission. Reproduction of this article is strictly prohibited. |
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2005 Families for Russian & Ukrainian Adoption |
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