Severe Neglect in a Six-Year-Old - what to consider before adopting?
March 14, 2015 5:17 AM   Subscribe

We have the opportunity to adopt a 6.5-year-old child who previously suffered from neglect and malnutrition, but does not show signs of trauma or lack of attachment. What do we need to consider, know and act upon right away?

We have the opportunity to adopt a six-year-old (6.5 years to be exact) who, according to the social workers, is a wonderful, happy, healthy child, with no medical or behavioral problems that are of significant concern.

The history is less than happy:
(FYI, there's no criminal history record available to me to validate any of the statements about the family below)

  • The child's biological parents had issues with drugs and violence

  • one of the parent's is s drug addict, him/herself was abused and is the biological parent of multiple children (i.e. 8+) from different relationships, who are "dispersed all over". Also mention of that parent's siblings with children under foster care. There is also mention of an inappropriate relationship between the parent and the oldest child, but this doesn't seem to be proven, and stems from an anonymous e-mail received by the social services agency

  • the other parent is accused of abusing and killing one of their children (more hearsay though there is no police report or mention that this actually happened or that the parent is in jail). There is also no mention as to whether "our" child was present at the time

  • For the first 6 years of the child's life there was a lot of neglect, passing the child from foster care to extended family care and back to the original family, after which the government agency decided to remove the child permanently from the family

  • The child is below ideal height and is believed to suffer from malnourishment and stunted growth

  • The child services agency feels that this child needs a stable environment in which he/she can be nurtured, loved, guided and protected, and as a result is giving us an amazing opportunity to bring him/her into our family.

    The care-workers say that this child is happy, (relatively) healthy, does not have nightmares or behavioral/emotional outbursts, with speaking, social, intellectual and motor skills that match someone his/her age.

    The only medical issue is less-than-optimal eyesight, the malnutrition that occurred from the neglect, and the lower-than-average height which might be a result.
    The only behavioral issue is that this child is affectionate with everyone - he/she does not know boundaries for affection and will go to and hug anyone. Makes sense considering his/her history, but is there any underlying thing we need to think about?

    Our feeling was that this child was able to survive by being under the radar - so while he/she was never noticed, he/she was not targeted by any of the other siblings or parents either.

    We are ready to give everything we have to this child to make sure that he/she feels loved, protected and secure. We're ready to consider professional help, special education, and all that good stuff.

    But we know that love isn't always enough. Wounds take time to heal, some wounds are better healed by other people, and some wounds don't heal at all. We also know our limits in what we can handle, and if someone is better suited to care for this child, then the child should have the opportunity for the best care possible.

    What do we need to consider, do, and look out for as we accompany this child in his/her journey?
    posted by anonymous to Human Relations (21 answers total) 7 users marked this as a favorite
    I have a little insight into this dynamic, but I'm saying this as an educator who works with kids with emotional disabilities, so I'm telling you that I work with kids like this, but these are the kids who have been placed at a therapeutic high school because their levels of need are so severe. I am NOT speaking for all adopted family dynamics. My kids need a LOT of support and have diagnosed attachment disorders.

    Based on this child's history, it's pretty likely they have an attachment disorder (They may not. But they probably do.). They may struggle with affection, be withdrawn, angry, hypervigilant, detached, overly-dependent, aggressive, inappropriately affectionate. The list goes on. This is typical of all the adopted kids I work with.

    So, as concerned parents, prepare yourself for a lot of work. More than raising a neurotypical child. Family therapy, individual therapy, probable special education services, a lot of research for and spending money on healthy activities for exercise and socialization, parenting classes, support groups, and especially the exhausting mental work in raising a child who will be at least, challenging.

    I am not saying it can't be done. And I'm not going to paint this as, "But if you do all the great things, you'll be living a Hallmark-moment." It could be very hard and there may not be a lot of walking into the sunset moments.


    Speaking for those kids who got a really crappy deal at birth, I suggest that you investigate support groups, therapy, do some research on raising an adopted child with a difficult early childhood, and then ask yourself, "Could I change this child's life positively? Will I accept this responsibility to save one life and do good in the world?"

    Answer yourself honestly. And then please consider adopting this child.
    posted by kinetic at 5:46 AM on March 14, 2015 [16 favorites]

    Good on you for thinking about doing this. Former member of foster / adoptive family here.

    The child is very likely to have evolved coping mechanisms that will be all but invisible, to begin with, and which will seem bizarre and disturbing to you when you discover them. The happiness may be one - happy children get less negative attention. Caching food if they've been neglected may be another. As they settle, anger and hurt will show, so be prepared for storms from a seemingly happy and uncomplicated child. We also saw LOTS of lying over the most innocuous things, small acts of destruction and vandalism, blanking when questioned or told off, on top of which there will be all the emotional scarring that will show itself in the pushing away, the defiance, the kicking out at boundaries again and again - but remember that they're just checking those boundaries are strong enough to keep them safe.

    If you can work through this constantly and supportively for years without losing your temper or yourself, you will have done a positive thing for the world, not to mention the child themself.

    One thing - please do ask for professional advice when things get tough. We didn't and things got too hard at times.
    posted by Martha My Dear Prudence at 5:57 AM on March 14, 2015 [9 favorites]

    The only behavioral issue is that this child is affectionate with everyone

    Just to spell it out, this along with the child's history is a massive indicator that the child has some form of attachment disorder, and may well behave quite differently with adults that are perceived to be permanent caregivers. This doesn't mean you shouldn't adopt them, but you should be aware of this as a strong possibility going in.
    posted by Acheman at 6:10 AM on March 14, 2015 [13 favorites]

    Read up on the ACE study and understand the short and long term results of trauma (even if they don't seem to be poorly affected now, worth being aware of.) Luckily, there are great treatments for kids that can help them rebound from the effects of childhood abuse. (Trauma-focused CBT, EMDR, PCIT and others I'm less aware of.)
    posted by gilsonal at 6:11 AM on March 14, 2015 [1 favorite]

    Purely as ancedata (from my own family and various formerly-foster/now adopted members), I'd say it's almost 100% positive that the child does have attachment issues.

    You describe the child as "A wonderful, happy, healthy child, with no medical or behavioral problems that are of significant concern" --- but the thing to remember here is that while he is presenting himself as happy, kids with attachment disorders often do exactly that.... to outsiders. Attachment disorders usually manifest themselves inside the permanent home, out of sight of other people: the child will act out where he feels safest to do so. So maybe he hasn't displayed any signs in all the various foster homes and extended-family homes and everywhere else he's been shuttled, but that's because he has not felt safe to bring attention to himself: being "under the radar" was the safest thing to do in all those temporary places.

    I'm certainly not saying not to take this child into your home and family, I'm just saying that yes, you'd better expect him to take much more attention and care --- and extensive, immediate and ongoing professional therapy! --- than a child without such a traumatic history.

    Finally, you say the child's care-workers report the child is happy, and does not have emotional outbursts --- to that, all I can say it that unless they are licensed therapists they are unable to tell you for sure if he does or does not have attachment disorders. Being apparently well-adjusted has been a part of his survival kit, and he would have tried to hide his problems rather than get tossed out to yet another unknown environment.
    posted by easily confused at 6:17 AM on March 14, 2015 [10 favorites]

    The only behavioral issue is that this child is affectionate with everyone - he/she does not know boundaries for affection and will go to and hug anyone. Makes sense considering his/her history, but is there any underlying thing we need to think about?

    I missed this. This is the underlying thing. This can be an indicator of disinhibited symptoms of reactive attachment disorder. "The child doesn’t seem to prefer his or her parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. He or she is extremely dependent, acts much younger than his or her age, and may appear chronically anxious..."

    Best thing to do is talk to some therapists, your local school system to find out what supports they offer, investigate what services are available to you and the child therapeutically, and proceed from a knowledge-based position.
    posted by kinetic at 6:21 AM on March 14, 2015 [2 favorites]

    We have the opportunity to adopt a 6.5-year-old child who previously suffered from neglect and malnutrition, but does not show signs of trauma or lack of attachment.

    As others have said, this is not a good assumption. Inappropriate attachment is an attachment issue, and neglect is starting to be recognized as often more traumatic than physical abuse. Losing siblings, especially to homicide but even to the foster system, is traumatic. Having parents who are addicted is traumatic. Bouncing around foster homes is traumatic. And I've worked with adults who had been adopted as infants immediately into loving supportive families, and those adoptions are still traumatic.

    A lot of times, people (children and adults) aren't capable of processing trauma until they're in a place that's safe. The lack of nightmares and acting out now does not mean that it's going to be smooth sailing going forward.

    Which, again as others have said, does not mean you shouldn't adopt this child, and you do sound like you realize that you want that supportive army of therapists, educators, and specialists, which is awesome. If you work from the assumption that this child is not dealing with trauma, however, I think you'll end up having a much harder time of it than if you go in understanding that while they may be holding it all together now, they're dealing with major major major traumas with only a six-year-old's brain (and, really, given the situation, they likely don't even have the emotional development of an average six-year-old yet), and they need you to be as understanding and supportive and pro-active as possible in teaching them how to deal with that, which is generally more about "absolute unconditional love no matter how much you act out" (though keeping yourself safe) and less about "tough love" or "setting limits" or even really "loving boundaries," at least for a good six months to a year. This child's brain is going to need to reset into a deeply accepted understanding that you are not going to leave them, harm them, or neglect them even if they do (temporarily) become a "problem child."

    This child has learned that parents may kill their own children. Of course they're acting perfectly. They quite literally need to find a way to trust that you won't kill them if they misbehave. You need to understand that's what's going on, and get all the help for yourselves (therapists, supportive friends, supportive family members) as you can during this process so that you have safe places to vent your frustration in ways that don't retrigger the child's traumas.

    Again, I think everyone here is offering warnings and urging caution because everyone you talk about in your question is acting like this child will be easy. This child will likely be easier than many other children in the system, because it does sound like they've got some good coping skills in place, but that's not the same as "untraumatized." I do hope that you and your partner are able and willing to take that on -- I don't think it means there's necessarily people "better suited," as long as you do the research and get the support you need -- but it's important not to go into it totally unprepared.
    posted by jaguar at 7:33 AM on March 14, 2015 [23 favorites]

    Memail me - I have adopted kids from similar backgrounds with malnutrition issues. Your agency/caseworker is underplaying the child's issues to get them adopted, and you need more info from them not just to make the decision about adopting, but if you do decide to, you will want more info to parent this child well.
    posted by dorothyisunderwood at 7:36 AM on March 14, 2015 [17 favorites]

    Have you actually met this child? You can't really know anything about them or whether you would want to raise them if you have not, no matter how much information the agency gave you. Certainly this child will have emotional problems given the history, but be very careful of therapies for "Radical Attachment Disorder", many of which are unproven, unscientific, and abusive in and of themselves. Visit Dr. Jean Mercer's blog "Childmyths" to get a sense of which therapies help and which to avoid. ( sorry, I don't know how to highlight so you can click on links)
    This could work, but only if you and your partner are clearheaded enough to know what you might be in for and deal with it in a way that will not further hurt an already traumatized child.If you think this will be easy, or you have really serious doubts, don't do it. Look into the concept of "rehoming," you do not want to go in that direction if things do not work out. It is great that you are questioning now before making a permanent comittment. I hope this can work out for both of you and the child.
    posted by mermayd at 8:18 AM on March 14, 2015 [1 favorite]

    As an educator I've seen lots of adoptions like this, and you need to carefully read everything that's been said and linked to here. I've seen lots of kids who only start to show the effects of their abuse after they realize that their new parents aren't going to take them back to the foster home.

    One particular little guy was all smiles and joy up until this point, and then he started heavily testing the relationship, like he was trying to make his mom give up and take him back. Screaming that he hated her and hitting and calling out for help in public areas and everything. He was still the happiest guy in class, though, you wouldn't know at all.

    That said, his mom is amazing with him, and he's getting better with lots of therapy, and he's being officially adopted and taking her name next month, and her life is totally fulfilled because of him. So if you're aware of the possibilities and sure (as sure as you can be anyway) that you can handle them and are willing to take all the help you can get, go for it! The right family will literally save him.
    posted by Huck500 at 8:40 AM on March 14, 2015 [3 favorites]

    If this were a sitcom and I were your wisecracking but warm-hearted best friend, I'd rhetorically ask you to consider how well you can handle raising a child that is six but acts like a three year old. If you have rigid expectations, then I think the emotional roller coaster might break you, especially if you care much about what other people think and are bothered by interfering parenting "tips" from bystanders. I believe you are going to need to be very flexible and adaptable.

    Yes, I think it would be great for the child in question to be adopted into a caring and stable family. But I think it's possible that, for admirable motives, the social workers are selling you this kid as aggressively as they would sell an unreliable used car. The child is clearly a deserving human being who needs care. I'm just suspicious that things will not be as rosy as the caseworkers are trying to suggest.
    posted by puddledork at 9:01 AM on March 14, 2015 [3 favorites]

    The only behavioral issue is that this child is affectionate with everyone - he/she does not know boundaries for affection and will go to and hug anyone.

    This can be a hallmark symptom for not just attachment disorder, but also fetal alcohol syndrome as well. Even if your prospective child does not have FAS, familiarizing yourself with resources around that disorder as well may be helpful.
    posted by blue suede stockings at 9:07 AM on March 14, 2015 [2 favorites]

    Missed the edit window, but vision problems can also be a symptom of FAS, though they could just as easily be a result of the early malnutrition or just plain genetics.
    posted by blue suede stockings at 9:15 AM on March 14, 2015

    Everyone has given you great advice and perspective so far.

    I worked in a residential therapeutic treatment center as a "mentor" for two years. Personal negative feelings about these places aside, many of the young (12-18) people I worked with had similar backstories to the one you're describing. Unhappy and abusive childhood, foster care, name it. The parent's adopted the children, many only a few months after birth, and trauma behaviors manifested themselves as they got older.

    If you do this, you need to be prepared for the worst. The worst might not happen, but you should be ready for it. What will you do when your child starts manifesting feelings from the extreme neglect they experienced and starts cutting, drinking/using drugs heavily, develops an eating disorder, or acts out sexually? Obviously, a lot of that is stuff atypical teenagers go through, but as a parent of a trauma survivor, you'll need to be more prepared because it's more likely. A lot of the kids I worked with did not think their adopted parents wanted them, that they only adopted them out of pity, and that they were just trash that would eventually be thrown back away when the parent realized their mistake.

    It's hard. I've worked with the parents and their kids and it is rough on everyone. It's worth it if you can manage your own emotions well. Don't go into this imagining a perfect happy family because that's going to lead to a lot of heartache. If you've got endless patience and good resources, go for it. Like someone said upthread, the right family situation can save a child like that.
    posted by Marinara at 9:23 AM on March 14, 2015 [2 favorites]

    The only behavioral issue is that this child is affectionate with everyone - he/she does not know boundaries for affection and will go to and hug anyone. Makes sense considering his/her history, but is there any underlying thing we need to think about?

    Yes. Attachment disorder. Which is only to say that you and this child will need professional support, because the flavour of the behaviour you describe is pretty classic, and typically changes flavour at puberty and then in the teenage years.
    posted by DarlingBri at 9:50 AM on March 14, 2015 [1 favorite]

    One of my close friends adopted a girl with an almost identical history - down to the family homicide and everything.

    They have had her for almost a year, and it's been brutal. So, so much harder than anyone had warned them or they even anticipated. They are the best parents I know. And even with financial and emotional maturity, an amazing support network of friends and family, and a rock-solid marriage, they are struggling with the depth of the need their child has.

    Have the biological parents have their rights terminated yet? If they haven't consider that they may still have visitation, and will get choice over school placement, etc. The visitation has been the worst part of it with my friends' child. It's heart-breaking.

    I don't want to dissuade you, because I think adoption is a wonderful thing. But it's not easy. In any, ANY way.
    posted by guster4lovers at 11:50 AM on March 14, 2015 [4 favorites]

    I used to work in a program with 'at-risk' teenagers and many of them were adopted. A few things that I saw a lot of, was parents who had a bit of a martyr complex, saying (more than once) "But I saved them!!" and being mad that the kids didn't appreciate it more. If you adopt, go in with the understanding you are not a martyr, you are a parent. And that means that you will get pooped on as much as other parents, and maybe even more.

    Also, keep in mind that the social workers probably don't know everything. If you move forward, get an independent child psychologist who specializes in these issues for an evaluation. Not necessarily to tell you whether to adopt, but to get an independent evaluation of the challenges ahead.
    posted by Toddles at 3:54 PM on March 14, 2015 [4 favorites]

    As the commenters above have eloquently pointed out, there are a range of issues that may arise in the future, so on a related note, there may also be a variety of ways to maximize the financial resources available to help cope with these foreseeable challenges.

    The child may be entitled to benefits from the state and/or federal government to support their special needs, even if those needs become apparent after the adoption. Please keep careful and complete records of everything spent to investigate and address any special needs, and please consult with an attorney (and tax professional) about how to maximize the resources available for the child.

    The American Academy of Adoption Attorneys may be a helpful place to start, and this organization notes that "[i]t is important to consult with an attorney prior to beginning your adoption journey so [...] your questions can be answered particularly about the laws in your State."
    posted by Little Dawn at 5:58 PM on March 14, 2015 [1 favorite]

    Transitions are always very tough on people who carry trauma with them.
    It is possible the kid will bring a genetic propensity to anti social personality disorder/similar and the 'acting out' will happen later. What such a kid would need would be the 'unbreakable container' and consistency to truly move on from the wreckage of the past.
    posted by tanktop at 1:27 AM on March 15, 2015

    I want to add; I choose to work with this type of kid and my work is painful, difficult and occasionally rewarding.

    Having said that, I also know that I am not capable of raising or adopting one of these kids. I could not do it. So think about this very seriously. There's no shame in knowing that you're not up to the challenge.
    posted by kinetic at 1:51 PM on March 16, 2015

    My cousin could be the child you're describing. My aunt was a Special Education teacher and he and his biological brother were her students. I don't know the whole story of the adoption, but I do know that it's been a struggle. The inappropriate affection, the smiling on the outside, all of it. My cousin started out as a shy, reserved, malnourished little boy but quickly grew into a normal sized, aggressive teenager who threw temper tantrums that shook the house. More than once my uncle had to be able to physically restrain him from attacking my aunt.

    My cousin is not mentally handicapped, but he is. I don't exactly know how to describe it. He's not handicapped, but he's not normal either. He's socially stunted. He has been in therapy for the last 13 years, but he still doesn't know how to act appropriately in most situations. He probably won't ever hold a job that involves more than menial tasks. He isn't dumb, but he has a very hard time following direction and submitting to authority. He will probably never be able to live on his own. I don't know what my aunt and uncle have planned for when they die, I don't know if my other cousins are planning on taking him in.

    I guess what I'm trying to tell you is that even if the only thing that happened to your child is that they were bounced around foster care there are still scars there. We know that's not all because the child is undersized and had been malnourished. So there are going to be scars, issues, and lots of unknowns. Are you ready for not just a damaged child but one who in six years will be a damaged, pubescent teenager? In twelve years will be a damaged adult? You have to be in this for the long haul. Not just until this child should 'normally' be an adult and go to college or move out, but for their entire life and the lives of any children they bring into the world.
    posted by TooFewShoes at 5:36 PM on March 16, 2015 [1 favorite]

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