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What should you expect when adopting internationally or bringing a child into your home from foster care? Check out our discussion with Dr. Robin Gurwitch a licensed clinical psychologist with close to 30 years of experience in evidence-based treatments and the impact of trauma/disaster/terrorism on children. She is a professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center and the Director of Parent-Child Interaction Therapy (PCIT) and Child-Adult Relationship Enhancement (CARE) Training at the Center for Child & Family Health. She has been a National Child Traumatic Stress Network member since 2001.

In this episode, we cover:

• While there are some distinctions, children adopted from US foster care and children adopted internationally have much in common.
• We say that the vast majority of children adopted through foster care or internationally have special needs. In addition to the medical or physical needs we might see, there are also emotional and behavioral needs, and today, we will focus on those needs.
• What are some of the factors that influence the behaviors of children adopted from foster care or adopted abroad?
  • Neglect (lack of stimulation)
  • Abuse
  • Maternal substance abuse and subsequent prenatal exposure to alcohol and drugs
  • Multiple caregivers
  • Institutionalization (multiple caregivers, neglect, removal from birth family)
    • Does the length of time in the institution impact psychological and physical development?
    • May have entered the institution after having lived in a family first.
    • What different types of care are available, and how do these different types of care impact the child’s behavior and development? 
  • Lack of education
  • Child leaving familiar ties and surroundings
• What are some expected or typical behaviors common in children who have experienced these?
  • Attachment issues
  • Food insecurity-how does that look
  • Sleep issues
  • Attention Issues
  • Post-traumatic stress
  • Impacts of prenatal substance abuse
  • Specific Impact of Institutionalization
    • Lack of understanding of the meaning of family
• Parentified children and not seeing adults as a source of meeting needs
• Impacts of neglect
• Impacts of abuse (often, we don’t have reports of abuse in the child’s file)
• How common is sexual abuse in foster care or children in orphanages or institutions abroad? What are the behaviors that might result from sexual abuse?
• Impact of the child leaving familiar ties and surroundings
• What type of parenting is effective at helping kids adjust?
• Setting reasonable expectations.

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