Physician: Transition from Orphanage to Home

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After arriving home how can I help ease the transition from orphanage life to family life?

After an adoption the stress that a child can experience is difficult to describe. Just imagine, this child is taken out of his usual environment by complete strangers, forced to go on a terrifying plane, and now live in a completely unfamiliar home setting with people that he can not even understand. This type of experience can certainly causes severe psychological and emotional turmoil in any one.

The transition between the orphanage and the child's new home can be eased if the parents are aware of a few simple measures.

Post-institutionalized children do best in a highly structured environment. By starting out with a highly organized home life; this will minimize regressive behavior in the child. Children vary in their ability to tolerate change and uncertainty and when it occurs, it needs to be structured.

Another important situation is over stimulation. Where not enough love is definitely in the detriment of the child's emotional health, too much love right away can lead to emotional turmoil and stress. Post institutionalized children have a limited ability auto regulate themselves or their behavior. Activities which can be viewed as a normal family routine (example: a trip to the mall, Toys R’ Us or Disneyland) can lead to total decompensation and meltdown in a internationally adopted child, especially during the first six months post placement.

It is imperative during the first few months to maximize parent child interactions. This can be done by reading, holding, and playing with the child. Constant reassurance that the parent will always be there must be made. The child should also be encouraged to have interactions with other children, but only when the parent is present. This helps to foster appropriate attachment between the child and the mother.

Unfortunately, many children exhibit bizarre behaviors such as rocking, and head banging. These behaviors are self stimulating and soothing activities that help the child to auto regulate himself. These behaviors may appear disturbing to the parents, but as long as they do not pose a safety issue to the child, parents should learn to tolerate them. Most of these behaviors will diminish what time but may reemerge only when the child is tired or stressed.

The final piece of advice that I have is for easing the transition to family life is for parents to seek help early if needed. Parents have a tremendous emotional investment in their child and often have a strong need normalize abnormal development or destructive and dangerous behaviors. Parent should avoid making excuses to explain delays or problems. I encourage parents to seek help early because prompt intervention usually results in a better outcome.

Additional information and references: 1) Miller, L. (2004). The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers. Oxford University Press, Cary, NC. 2) Federici, R. (2001) Raising the post institutionalized child: Risks, Challenges, and Innovative Treatment.

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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