As a defense mechanism, in order to maintain the child’s own inner well being, neglected children generally shut out all environmental and interpersonal contact that could cause them harm. There is sometimes a component of learned helplessness. It is this type of behavior that often gets labeled as Institutional Autism. Once this pattern of regression occurs, it tends to be insidious and progressive.

The following is a list of characteristics that children with Instititutional Autism exhibit:

1. Loss of physical height and weight. These children look much younger than their chronological age.
2. Severe language delay which can regress to infant babbling
3. Lack of eye contact, aloofness
4. Failure to orient to child’s name
5. Lack of interactive play
6. Lack of interest in peers
7. Failure to use gestures to point or show
8. Sometimes there are severe issues with bedwetting and soiling
9. Behavioral control issues and lack of social development
10. Attention and concentration problems. Example: ADHD-like behavior
11. Deficient in learning and memory
12. Institution-acquired autistic behaviors

Some of the most worrisome and disturbing characteristics of children afflicted with Institutional Autism are that when they have complete regression, they resort to self-stimulating behaviors in order to fill the lapses regarding loneliness, deprivation and despair.

Examples of these behaviors are:

1. Rocking and head banging
2. Uncontrollable outbursts of rage and aggression
3. Body thrusting into inanimate objects such as walls
4. Self-mutilating behaviors such as hair pulling and picking at the body

During the adoption process many parents are faced with the dilemma of acquiring a child who exhibits some or all of the above mentioned characteristics. Parents become saddened when the child does not come running or show any type of emotion towards them when they arrive to meet the child. During the first hours to days for these children to be withdrawn, exhibit lack eye contact and lack of communication with the families. Observation over time is the best means to differentiate adjustment problems versus more severe conditions.

After the adoption process is complete and the child returns to the United States, some of these children continue to display some quasi-autistic behaviors learned from in the institution for a period of time after the adoption is completed.

It must be remembered that all orphan children have significant impairment in both communication and their social skills. These children cannot be expected to come home, put on a pair of blue jeans and function immediately in our society. There is a great deal of work that is required to rehabilitate these children. In contrast to true Autism, Institutional Autism tends to improve with time and proper interventional services. It has also been found that some children who arrive with severe mental impairment upon arrival have a dramatic improvement in their IQ points in the first years post-adoption.

I must once again stress the importance of rehabilitation, education and a great deal of work on behalf of the parents in order to obtain these results.

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.

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© George Rogu, M.D.