Post Traumatic Stress in Adopted Children

This video by Dr. Ronald Federici is a short lecture on this important topic.

Insights Into Institutional Autism

By Dr. Ronald Federici

Over the past decade there has been a tremendous influx of children coming from post-institutionalized settings in various Easter Bloc, South American and Far Eastern countries. These children have often been placed in hospital-based or classic institutional settings following illnesses or even death of the biological parents or the parents general inability to care for the child’s emotional needs. Children from Eastern Bloc countries in particular have been rapidly placed in institutionalized settings due to the demise of the communist systems which have rendered many people poverty stricken and homeless with a subsequent inability to care for an of the medical, physical or psychological needs of their children.

Children having any type of medical problem (even mild) are often placed in hospital settings or institutional care programs which are state run. For example, children who have been described as being somewhat “slow” or even suspected to have mental retardation (i.e. the Russian word Oligophrenia) are often called morons, imbeciles or some other term pertaining to mental deficiency. These types of children are often placed in neuropsychiatric facilities in great volumes.

Additionally, children with even mild medical problems such as orthopedic damage or some other type of crippling pattern in which they are not able to walk (but could be walking with adequate surgical interventions and physical therapy) are also placed in hospital-based institutions.

Children with somewhat more complicated medical problems such as hepatitis, hemophilia, congenital malformations and deformities, mental retardation or classical autism are often placed institutions for the rest of their lives.

The principal problem with this situation of placing children in hospital-based or institutional settings for a defined “problem” is that many of the diagnoses are typically incorrect or over exaggerated. Once the children are placed in institutional settings, particularly those in the Easter Bloc countries of Romania, Moldovia, and various sections of the former Soviet Union, they are destined to remain there for life without appropriate medical or psychiatric/psychological interventions.

In particular, many of the children who are placed in neuropsychiatric facilities have been termed mentally deficient or Oligophrenic. More often, the child’s mental delays are the direct result of very poor pre and post-natal factors, nutritional and medical neglect, in addition to a child having a situation such as simple speech and language delays in their own native language which have been misconstrued as mental deficiencies.

Once children are placed in these types of institutional settings, they are often moved repetitively. For example, infants are often placed in some type of hospital or nursing setting for the first 1-2 years of their life and then transferred to another setting which can often last from 2-5 years. It should be emphasized that, during these critical years (birth through 4-5 years old) these institutions typically lack any and all type of stimulation, language and intellectual-cognitive development, early school-based programs or even appropriate medical diagnosis are care. So often, children are starved, neglected, and isolated to their cribs.

It has been well documented that many of these children have been found to be tied to their cribs or isolated and sheltered from human contact. Combined with profound medical, nutritional and often physical neglect and abuse, these children regress to very primitive states to where any and all type of sensory-motor, speech and language, and even intellectual abilities have become stagnated and, over the course of time, typically regress and deteriorate to levels where they appear truly mentally deficient when this was not the starting pattern in their lives.

As the institutional child continues to “transfer” from institutional setting to institutional setting, the level of deprivation often increases. Very often, children are “warehoused” in the institutional settings to where there are up to five children in a bed with literally dozens of children per on caretaker who is often completely oblivious to their physical and psychological needs. It has also been documented that there is often a “medical director” assigned to the facility who rarely shows up. The children often receive medical care when they are in an acute or life threatening situation, and the medical care is often very poor and can sometimes cause even more problems in the actual illness of the child (i.e. the treatment can sometimes be worse than the actual illness).

It has been this writer’s experience based on visiting multiple institutions in Easter Bloc settings that the profound levels of neglect intensify with each year the child is alive. Basic physical and nutritional needs are not provided which results in the child’s brain and physical development slowing to where it is almost impossible to actually detect the age of the child. There have been many children observed who have the appearance of a 6 to 7 year old when in fact they are actually in their early or mid-teenage years. Additionally, many children have been literally tied down to their cribs for days, weeks and even months at a time, with even their feedings being given while they are in their cribs. Over the course of time, there is a literally no movement and many of the children lose many and all previously acquired language.

Additionally, many of the children who have some level of physical problem, particularly orthopedic problems in which they are not able to mobilize around the institution, become targets of physical and sexual abuse which further causes post traumatic stress disorder features, profound depression and a “regression” to a stage of early infancy in which they are literally “shutting out” any and all type of environmental and interpersonal contact. More simply, children look for any type of safety and security when they are being totally deprived and neglected.

What tends to emerge in the child who has received multiple institutional placements combined with profound neglect and abuse on a wide scale level is the “regression factor” or the child who “disintegrates” and loses motor, sensory, speech and language, and intellectual skills. Once this regression occurs, it tends to be insidious and progressive.