I have heard that many Institutionalized children exhibit many peculiar behaviors shortly after arriving home. Can you described some of these behaviors and what does a new adoptive parent need to do to help over come these behaviors?

Many peculiar behaviors can be observed immediately post-adoption in many internationally adopted children. These behaviors provide self-soothing, self-stimulation and often times are used to attract the attention of the adult caregiver.
For the socially neglected orphan child, the lacks toys, limited human interactions and the lack of loving parent; are the primary reason for this type of behavior. While these behaviors appear to be very peculiar, they are basically a normal response to an abnormal environment in which these children are raised. Some of these self-stimulating behaviors are so disturbing that they mimic the some of the behaviors of the “Autistic child”.

Some of the Autistic like behaviors exhibited by orphan children is:
1) Head banging
2) Rocking
3) Head shaking
4) Swaying back and forth
5) Staring at the hands
6) Hand flapping
7) Biting and hitting others
8) Twirling and pulling hair
9) Smelling object
10) Fascination with spinning objects

In an orphanage environment, getting the attention of the adult caregiver often time is extremely difficult. A well-behaved, disciplined child who does not disturb or bother anyone would never get any adult interaction. Many times, orphan children resort to attention seeking behaviors such as biting, hitting and various other types of tantrums in order to earn some extra adult attention. To a socially neglected and isolated child, even negative attention like discipline is better than no attention at all.

To the new adoptive parent, any of these behaviors can be very disturbing and heartbreaking. I recall a case of a 2-year-old girl from Russia. The parents at the Post-Adoption evaluation described to me a peculiar rocking and swaying behaviors exhibited by their newly adopted girl. I tried to explain that this is a normal response to an abnormal environment. At our next visit, the parent’s video recorded the event. The rocking and banging was so severe, that I as a physician was moved by it. Movements were so violent that it mimicked seizure like activity. The only thing that went against the diagnosis of a seizure disorder was the mere fact that the child was completely alert during this entire event. After a few minutes of this rocking and banging, the child settles down a falls asleep, and the rocking disappeared. This ritual occurred for many weeks. As the child settled into her new family, the intensity of the episode decreased dramatically to the point where it disappeared. The mother did report however that, there are times when the child is under stress or being excessively tired, that the episode does resurface.

While I really do understand hoe disturbing this could be to the new parent’s, I would like to assure you that these behaviors really do go away with time. As new adoptive parents, we must concentrate and reward the good behaviors while ignoring the disturbing behaviors. As parents, it is our responsibility to make certain that the child is always safe, and that the behaviors in no way injure the child. If the child exhibits head bagging as a self soothing ritual, instead of allowing the child to hit his head against a hard wall, place a pillow or something soft to lessen the blow. These behaviors generally take weeks to months to self extinguish, but eventually they do after the child settles into his new environment. It should also be noted that many times in moments of stress, these behaviors might reappear temporarily until the stress resolves.

A particular case come to mind of a 20 month old child that had resolved his head bagging only to reappear after being involved in a car accident. During the care accident, the mother was rendered unconscious while the child was safe in his care seat. He was strapped in and was completely helpless, while his mother was not able to soothe him in the time of need. Lots of lights, sound and commotion just overwhelmed this child. His body rocking and head banging reappeared for a few weeks, but after resettling into his normal family routine, his head banging and rocking have once again disappeared.
To date, the head bagging ritual has not resurfaced.

By Dr. George Rogu of www.adoptiondoctor.com and Adoptioneducationclasses.com

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)William W. Hay M.D. Current Pediatric Diagnosis and Treatment. McGraw-Hill Medical Publishing.

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