There is a new documentary touring the country right now called STUCK. The film explores the many reasons that orphans in developing countries get stuck living in orphanages. Of course, ideally all children in impoverished countries would be able to grow up with their biological parents. But for some children, this is not an option, and a lifetime in an institution becomes a likely future for them. International adoption is a solution for children who have no other option. It seems like an obvious solution: there are children who need families . . . there are families who want to give a child a home. Yet a myriad of political, cultural, and bureaucratic forces make international adoption difficult, if not impossible. I will be seeing the movie this week, but in a post called Failure to Thrive, Brandon Hatmaker describes on of the most disturbing parts of the film: the developmental difficulties that institutionalized children face:
One segment of the film highlighted my new least favorite phrase: “Failure to Thrive”. While there are significant and often lifelong emotional and mental impacts of a child being orphaned and institutionalized, the thing that most miss is the measurable physical impact it has on a child. The longer a child is institutionalized and away from a healthy family environment, the greater the impact. This is very telling.Failure to thrive indicates insufficient growth, weight gain, or inappropriate weight loss. It covers poor physical growth of any cause and can subsequently be a cause of abnormal intellectual, social, and emotional development. It’s nearly impossible to tell the age of many orphaned children at most international orphanages. Evaluating height, weight, emotional maturity, or even thought development all lead to inaccurate conclusions. All can be impacted negatively.This is often most noticeable post adoption… and once the child is in a healthy family environment. As an adoptive dad, I’ve seen this first hand. After spending nearly three years in one of the best orphanages in Ethiopia, our adopted son grew more than two inches in under three months after coming into our home. He began to thrive in his new environment. I heard just yesterday a report of an adoptive child who grew three inches in two months and was able to move from below zero-percentile on weight to just above average. In TWO MONTHS.
This documentary is deeply personal to me because we were a family that was “stuck”.We turned in our application to adopt a little boy when he was 6 months old. We were approved by both the US and Haiti within that year, and yet a number of factors led to it taking THREE WHOLE YEARS for our son to come home. Our son was orphaned – his dad died before he was born, and his mother died shortly after. He had no other option. We were approved and ready for him. And yet he had to spend three of his formative years in an orphanage, with no mother or father looking after his emotional needs. This was a GOOD orphanage – and yet he still deals with the effects of growing up without a primary caretaker. When I look at my son, I think about how different his life would be if he had been able to join our family at a younger age. So many attachment-related and behavioral issues could have been avoided. And again, he was at a good orphanage. I’m afraid good orphanages are rare in some developing countries. I hope that instead of clicking away, you will watch this documentary. It’s painful, but it’s real. I’ve said it before and I will say it again: this is not an issue just for adoptive families to take up. I met a gal this weekend who told me she was interested in advocating for orphans, but she felt she couldn’t because she hadn’t adopted herself. If there is one message I wish I could impart to everyone who reads here, it’s this: kids without family need advocates. ALL OF US should be advocating for them. Yes, even you. Whatever your situation. A child without a family, growing up in an institution, is the most vulnerable human in our society. We should all be working to change that. We should be seeing what we need to do to get children out of orphanages and back into their families. We should be wary of building more orphanages and dumping more kids into them. An orphanage should be a triage situation, not a lifetime sentence. We should figure out how to reunited them with their families, and if that’s not possible, place them in a new family. If you are in Orange County, there is a showing of this documentary WEDNESDAY NIGHT at 7pm in Rancho Laguna Niguel. You can buy tickets here. Tomorrow night, it will be showing in San Diego at Gas Lamp Cinema at 7pm. The movie is playing nationwide. You can see when it is coming to your area here. If this is a cause that you care about, please sign the PETITION and share this with others.
Jeannett is no stranger to philanthropy through blogging, Her blog is a regular host of guest posts that are matched with giveaways benefits a charity of choice. Last Christmas, she set her sights on something that could change one person’s life forever – a pretty lofty goal. Many bloggers joined Jeannett in sharing Cliff’s story and last Christmas, $5 at a time, readers made a difference for Cliff and raised almost $9,500 for his adoption. Cliff is now Joshua and has a mama, a daddy, three brothers and a whole host of grandmas and aunts and uncles. He lives in a safe home with a loving mom and dad where he gets love and attention and the medical care he needs. He’s learning sign language and flourishing. Jeannett wasn’t kidding when she talked about changing a life. This year, Jeannett is attempting to fund the adoption of a little boy named Xander. He has Down Syndrome and lives in a country where children with special needs who have been abandoned by their families are relegated to life in a mental institution upon turning three. She learned about Xander through Reece’s Rainbow – an organization that tries to help place special needs children into adoptive homes.
The following are Jeannett’s words about Xander and her desire to fund his adoption. I hope you will read and consider helping.
Hello my sweet friends.
I’d like for you to meet Xander. The squishiest, sweetest, most delicious little face you ever did see. Xander lives in an orphanage in Eastern Europe with no Mommy and no Daddy. Those almond eyes, a sign of Down Syndrome…and likely much needed medical care. Once when Henry was a bitty baby, I found myself in his nursery in the wee hours of the morning consoling his whimpering and kissing his feverish little forehead. I remember thinking: of all the people in the entire world, I’m the only one who can make him feel even remotely happy. All he wants is his mama. No one else will do. And suddenly, out of the blue, in the glow of a new mom’s overwhelming love for her first baby, I was crushed at the thought of the orphan crisis. How, if my life were different…if one of millions of things weren’t exactly the same as they are now… I was devastated at the thought of a feverish and sick child whimpering in a crib alone. No mama to stay up and whisper sweet nothings and coo in his ear. No daddy to chase him around the house and throw him high into the air for no reason but to elicit squeals of delight. No cherry flavored Tylenol and cool washcloths for his head. In that moment, in the middle of the night, sitting in a gliding rocker, in a perfectly decorated nursery, I sobbed. And truth be told, I’ve never really stopped sobbing over it, you know? Something happened that night, or really the moment I became a mother, that made me look at the entire world differently. The world is a much smaller place the moment you have children. I think we all break in some way for the orphan crisis…but we have no idea where to start or what to do. After all, little Xander is only one of 143 million orphans. Read that number again. Roll it around in your brain. Horrific. And let’s not forget all of the other issues of our broken world. The cancer, the poverty, the dirty water, the child trafficking, the abuse, the wars, the AIDS pandemic, the….name it. I’m tempted to shut down in an overwhelmed panic. Because the truth is, we can’t save the world. We can give and give and advocate and try, and it still won’t be enough. Right? But you know what? It doesn’t mean we shouldn’t try. It doesn’t mean it’s a good reason to sit back and do nothing. We must try. We must do our part. We must. Do not buy into the lie that your portion does not matter.Do not allow yourself to believe that you cannot make a difference.Do not give yourself permission to throw up your hands in frustration and then cover your eyes with them. Because today my friends, we will do something. It may not be much, but we will do our part because it’s the right thing to do. Because God calls us to do it. After all, last Christmas, $5 at a time, we made a difference for Cliff and raised almost $9,500…Cliff who is now Joshua and has a mama, a daddy, three brothers and a whole host of grandmas and aunts and uncles. I know your heart breaks for orphans. I know it does. And I know that it may not be possible for you to adopt. But a family out there would love to. And you can help. Together we will combine our portions for Xander’s adoption fund. So that when a family steps forward to adopt him, a gift of funding will be awaiting them. International adoption is expensive. And is hands down the biggest deterrent to would-be adoptive families. Not desire. Not extra bedrooms. Not politics. Just stupid, awful money. So let’s bless a family today. Let’s bless Xander. Let’s make this Christmas be about more than wrapping paper and twinkling lights. Consider making a tax deductible donation to Xander’s adoption fund through Reece’s Rainbow. I know life is expensive and times are tough. I know. But ask yourself this: Can you afford not to? Read HERE to find out more about an incredible matching grant and some absolutely MASSIVE giveaways. You’ll love it.
From time to time, I will get an email from someone asking me for advice about running a children’s home or an orphanage. While I have a background in psychology and a definitive heart for orphans, I really can’t claim any expertise on best practice. I certainly have opinions, and there is a lot of research available that suggests some of the negative effects of institutional life. But in terms of finding the elusive handbook for doing it well? I don’t know that it’s out there. Do you? Am I missing it? If you know of any resources that detail best practice for orphanages, would you leave a link in the comments? I would love to hear about it. I know there are many books that outline the orphan crisis, the need, and ways people can help, and there seem to be many books that look at the theological call to care for orphans. But I’m talking about a research-based guide to day-to-day orphan care – a book looks at how children can best be nurtured into healthy adults in a group setting. I would love to read more about that. My friend Phil Darke is currently undertaking research of this kind. He is working with a ministry called La Providencia. They are working in Honduras, providing family-based care for orphans there, but a part of Phil’s role is also to research and design a model for family-based orphan care that they can then share with others working in the same field. He wrote this post on his website recently and allowed me to share it here.
Last Thursday, we visited an orphanage in San Pedro Sula from where four of our Providence Children came. The experience was even more eye-opening than I thought it would be and it confirmed that there is a huge need to improve orphan care in Honduras, which is what we are working on through the La Providencia model. The experience also confirmed to me that something is not always better than nothing, particularly when the "something" is terrible, yet gives the illusion that something positive is being done for the kids. Here are some snippets of the issues we saw:
The bedrooms had holes in the ceiling because the kids were trying to “escape” (word used by the orphanage worker).
The inside courtyard windows had bars on them because the kids were trying to get out.
There were 143 kids in a 120 capacity place.
The budget is $3,000/month, 80% of which goes to payroll; so they put $600/month to care for 143 kids. That is about $3.50/month per kid.
The “nursery” had about 25 cribs in two small rooms with many cribs holding two children who were severely malnourished and lacking in love.
There were also special needs children in the nursery. One awful situation had a 10 or 11 year old kid just sitting in a crib, Indian-style, staring into space.
Most of these kids aren’t living – they are simply there. It broke my heart, but also confirmed the importance of what God is doing at La Providencia to improve orphan care and change the paradigm of orphan care around the world. Hopefully we can together see the day when places like this orphanage cease to exist. I truly believe that the situation in San Pedro is not better than nothing because it gives the illusion to the world that something is being done to care for the orphans in Honduras — in reality, these kids are simply in a prison (surrounded by a two story high wall and guard tower) trying to escape. Most of these kids are not being cared for at all – this is not the fault of the loving and well-intentioned workers. It results from the lack of resources and a society that, on the whole, simply doesn’t care about orphans, treating them as sub-human, as trash. While they appear to have school, food, and "helpers," they are lacking almost everything they really need — families, touch, a real education. medical care, and real hope. They are kept from the world, behind the walls. It is tragic and hard to see. Especially when you contrast it with La Providencia and what loving orphan care can look like. And when you know that the only thing standing in the way of loving care like LP is money and a true belief that these kids are human beings, the same as all of us. Lord, help us to have wisdom and discernment to know how to develop La Providencia and share the model so that we together can improve orphan care. Then, we won’t have to see orphanages like the one in San Pedro Sula any longer. That is my prayer.
I’ve been wanting to post my notes from the workshop I did at The Idea Camp, but I’ve struggled with how to present it, because it really was more of a conversation. What I’m sharing below is really just an outline – there was so much more meat in the discussion that took place in that room full of people who cared passionately and deeply about these issues. But here is a general overview of what what discussed in relation to the psychological ramifications for orphaned children:
The Orphan Archetype:
First we looked at the dichotomy of presentation in the “orphan achetype” (in plainspeak – the stereotypes and oversimplified ideas we hold of orphans) We talked about the idea of the orphan as a plucky, happy child whose only issue is a need of parents (i.e. Annie, Oliver, Newsies, Meet the Robinsons) and how this may affect idealized notions, especially for prospective adoptive parents. Then we talked about the presentation of orphans as troubled, damaged goods with inevitable attachment disorders and problematic behavior, and how this may deter the adoption of older children. The reality in both of these stereotypes is that orphaned children are complex human beings with unique strengths and needs.
The Psychological Needs of Orphans
If we want to help orphans become fully functioning adults, we must address their psychological needs along with their physical needs. Adoption into a loving family can be a solution to healing the wounds of abandonment, but prospective adoptive parents must have an understanding of the psychological effects of abandonment. Too often, parents are simply looking to add a child to their family and then shocked, disappointed, and resentful of the unique psychological needs of a child adopted from a difficult place. Orphanages and those working in in-country care must adapt the caregiving to address the whole child: physical, spiritual, and psychological. It is not okay to assume that Christian education or academic prep will erase deeply ingrained developmental or psychological issues.
Orphans and Loss
At the base of the orphan experience is loss. The loss of parents is probably the most significant loss any child can experience. How and when that loss occurred will likely affect a child’s development and ability to attach. A child who was cognitive at the time of loss or relinquishment may deal with severe abandonment issues. At the same time, a child who received the nurture of a consistent caregiver in the first three years of life may fare better than a child relinquished at birth into an orphanage setting. While a child who was placed as an infant may not have a cognitive memory of abandonment, they may also not have had the benefit of individualized care during the critical first two years of life. By nature of being orphaned, a child’s psychological needs will be greater. Simultaneously, by nature of being orphaned, that child is likely to receive less attention into their psychological well-being, especially in an institutionalized setting. This is the tragedy for most orphans: high psychological needs, deficient psychological care. Thus, problems are compounded. Specifically, institutionalization compounds the effects of abandonment.
Both anecdotally and empirically, we see a subset of behaviors that tend to emerge in children who live in setting where there are multiple children and multiple caregivers. (This is often due to the combination of low staff-to-child ratios +the revolving door of shift-working caregivers, and most orphanages have this. Even the best. It is extremely expensive and difficult for an orphanage to create a family environment with consistent caregivers. The behaviors that emerge from this setting may indicate reactive attachment disorder, but most kids will fall short of that diagnosis and yet still struggle behaviorally and relationally. This is what prospective adoptive parents need to understand: there is a huge spectrum between a typically developing child and a child with reactive attachment disorder, and most children coming from orphanages will fall somewhere in the middle. Therefore, parents should still be prepared for attachment challenges and transitional issues, which may include:
· Superficially charming behaviors · difficulties with eye contact · indiscriminant affection with strangers · destructive tendencies · hoarding or gorging · manipulation · lying and deceitful behaviors · fear of abandonment · difficulty making decisions or veering from routings · aggressiveness · entitlement issues · power struggles (lord of the flies) · self-soothing behaviors · sexual acting out or sex play with other children
(There was quite a bit of discussion from the participants about how these behaviors manifest, in both orphanage and home settings. To respect privacy, I won’t go into detail, but there was definitely a consensus that these issues are prevalent for institutionalized children).
The psychological impact of being abandoned does not end in childhood. If children do not form healthy attachments it is very likely they will struggle into adulthood as well. This is one of the reasons we see a statistical cycle of abandonment – children who were abandoned are more likely to abandon their children (and former foster youth are more likely to have their children removed). Some of the issues abandoned children may face in adulthood:
· difficulty in relationships
· legal problems
· occupational problems
· depression and anxiety
· abandoning children
· sexual acting out
· drug/alcohol addictions
· poor coping skills
Again, there are many orphanages that are attempting to raise “future leaders” in their country of origin, but this is unlikely if psychological needs are not met. Academic and spiritual education are valuable, but there needs to be an intact psychological foundation for children to succeed.
Adoptive parents must prepare themselves for the unique needs and traumas their children may hold from being abandoned and from orphanage life. Orphanages and homes for children need to set up a family environment with consistent caregivers. Directors need to be trained in best practice for attachment and pass that training on to the staff that is working directly with the children. (We also spent a good deal of time talking about the impact of short-term mission trips on orphans and I will talk about that more in another post).
In conclusion, I shared the findings of The St. Petersburg – USA Orphanage Research Team (a huge thank-you to Megan who gave me this information). I think the findings here are really important for anyone doing orphan care:
This research group is looking at best practice for group care. In the study, the made the orphanage more family-like by integrating groups by age and disability status, changing caregivers’ schedules and assigning two "primary caregivers" to each group, and training caregivers to care for the children more like they’d care for their own children (sensitive, responsive care). Children who experienced the intervention showed improvements in every domain of development, including height/weight (even though their diet/nutrition never changed). I think this intervention is a good demonstration that orphanages *can* be made to be more family-like, and these kinds of changes might help to ameliorate some of the problems that are typical of children adopted from orphanages. Notably, this intervention can be sustained on the same budget that the orphanages already get from the government. Of course, it’s important for there to be a dedicated orphanage director and staff for the intervention to work. From a practice and policy standpoint, because orphanages aren’t likely to disappear any time soon, this type of intervention might be a direction to go in the future. Some other things to think about– 1) Our research shows that most of the problems experienced by children adopted from orphanages stems from their experience during the first two years of life. This is *not* to say that experience beyond that age is not important (it clearly is). But we’re finding that the rate of problems that these children have is greater for children adopted after two years of age, but the rate of problems does not continue to go up with even later ages at adoption. The specific age when this "shift" in levels of problems occurs does vary depending on how depriving the orphanages are–the orphanages we study show the shift around 18 months of age at adoption, whereas the 1990s Romania orphanages show that shift closer to 6-12 months. 2) We’re thinking that a lot of the problems that children adopted from orphanages have can be traced back to very basic interactions that would tend to happen quite frequently for children in a typical family (but, are relatively rare in an orphanage environment). One thing we’re thinking about is the degree to which children experience contingently responsive care. So, when baby does X, a specific caregiver always or usually does Y. When the same caregiver interacts with a child over time, responding to the child’s needs (instead of just providing care according to a predetermined schedule), patterns begin to develop, and children develop understandings of basic, fundamental concepts like contingencies (if X happens, then Y happens) and social cues (this facial expression means X, this tone of voice means Y). If a child doesn’t have these experiences early on, and doesn’t learn these fundamental skills at those early ages, its very likely that the child’s brain development is affected, and its perhaps not surprising that parents report that their adopted children have some difficulties in social situations and with logic/science understanding. 3) Indiscriminate friendliness or disinhibited social behavior is often reported in children adopted from orphanages. There’s no doubt that some of this behavior is reinforced in the orphanage environment, but it seems like it stems from things even more fundamental than that. The early experiences children have in orphanages often produce deficits in children’s executive functioning skills (things like planning, organization, decision making, inhibiting responses, etc). It’s quite possible that this superficial social "charm" that children show is actually showing their inability to inhibit social responses around strangers.
This is by no means a complete representation of the conversation that happened at Idea Camp. There was so much good feedback shared from those present and this is just a small snapshot of all that was discussed. I will be talking more about orphan culture and the transition to family culture at the upcoming Together for Adoption Conference in Phoenix. If this is of interest to you, think about attending in October.