Physician: Helping My Post-Institutionalized Child

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What are some strategies that I as parent can implement to help my child rehabilitate from the institutional care setting?

  1. Immediately during the post-adoption period, do not over stimulate the child. Avoid trips to toy-r-us, Disneyland, and large gatherings. When exposed to this type of environment children tend to have meltdown, hyperactive and out of control
  2. Child should be placed in a well-structured routine. Do not allow the child to become the center of attention
  3. Families should stay home with child for as long as possible.
  4. Expose the child only to close family members during the post-adoption period.
  5. One parent should be home with the child for the first couple of months.
  6. Exposure to both parents is optimal as long as it is as financially feasible.
  7. Avoid daycare immediately after arrival
  8. Try to communicate during the first 2-3 months in the child native language.
  9. Do not try to force the child to learn English right away, it will come in it own time.
  10. Child should stay home with a primary parent as opposed to a nanny or babysitter.
  11. If available, have the child socialize with a child from a similar institutional setting and culture.
  12. Older children should be enrolled in school as soon as possible.
  13. Schools usually place these children in “English as second language program” Insist that the child be placed in mainstream classes. Language will develop rather quickly if the child is exposed to the English language.
  14. Post-Institutionalized children tend to become fixated on junk food, such as hot dogs, sweets, chips and soda immediately. Let them eat but not just what they want or like. Set limits. Since they have never had junk food, it becomes an obsession.
  15. Initially try to recreate the diet that the children had in the orphanage. Gradually transition them to your families diet slowly over time.
  16. In regards to television, avoid shows that have aggressive tendencies. Disney type movies are usually calm, have good language are funny and have good moral values. Children tend to imitate things that they see. Having them watch power rangers is almost a guarantee to have a power ranger in your living room wrecking your furniture very soon.
  17. Children need to earn activities and privileges based on their daily performances. Good behaviors need to be rewarded and bad behavior needs to be gently punished by taking away privileges like favorite toys, games for short period of times. Never ever use corporal punishment.

Adopting a post-institutionalized child is a extremely difficult undertaking. If your expectations of international adoption that all that you need to do is to travel overseas to pick-up a child, put him into GAP clothing and expect him to function in our society without problems, then maybe International Adoption is not for you.

Consistency and complete dedication towards the best interest of the child are mandatory. The immediate gratification of the parents to form a family unit needs to be delayed temporarily. This will help to promote a good long-term prognosis for the post-institutionalized child.

by George Rogu M.D.

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The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

This material has been provided by, an innovative adoption medicine private practice and educational service, dedicated to helping parents and adoption agencies with the complex pre-adoption medical issues of internationally adopted children. All medical interactions are performed via, e-mail, express mail, telephone, and fax. There is no need to make a live appointment or travel outside of your hometown. For more information, visit or call 631-499-4114.

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