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Beginning Again: Dr. Nelson’s Inspired Expertise on the Growth of Adopted Children

Thursday, November 03, 2016 7:07 AM

November is National Adoption Month; it is a time to increase awareness and start conversations on how to support the youth who are going through this process. NorthShore's Rebecca Nelson, PhD, specializes in adoption within the fields of child and adolescent psychology, and took inspiration from her personal experience to help parents better understand development. She discusses below:

Dr. Rebecca Nelson 
You recently did a webinar covering child development in adopted children – what kinds of questions did you notice parents asking?
The webinar focused on why the standard ages and stages may not be as predictable for adoptive children when pre-adoptive factors can impact development. In this context, adoptive parents asked about schooling, language, behavior, socialization and parent-child relationships. Parents wanted to know what should be considered atypical, and how to help their children when they notice delays or inconsistencies in development.

What factors contribute to the development of adopted children?
Adoption research over the decades consistently highlights multiple findings:

  1. Adoption at the youngest ages results in the most favorable developmental outcomes. This is because increased length of exposure to adversity is associated with increased delays.
  2. Quality foster care serves as a developmental buffer, as it provides individualized care and attention.
  3. Delays are less common for children with more robust growth measurements, which reflect better health in terms of growth, nutrition and prenatal and maternal conditions.
  4. Children impacted by prenatal substance exposure have an especially vulnerable developmental course. Also, adoptive parents tend to possess some characteristics making them well suited to parent children exposed to early life disadvantage. These include preparedness and commitment to parent, lower threshold in seeking professional services relative to non-adoptive parents and greater socioeconomic resources to provide facilitative and supportive living situations.

How has your own personal experience added to your understanding and specialization in child development?
I lived in an orphanage for my first 5½ years. At time of adoption I was very underweight, broadly delayed and had the expected transient medical conditions consistent with institutional care. Fortunately, I was mostly healthy and able to catch-up with time, but wondered about those who could not. This led to my specialization in child development. I wanted to better understand the factors contributing to vulnerability and resilience with at-risk pediatric populations. This included children born prematurely and those with other neurodevelopmental challenges. At-risk children can benefit from developmental monitoring, intervention, and support. The goal is to help all children with a difficult start in life fulfill their potential and thrive.

Do you find there to be any common misconceptions about the psychology of adopted children?  
Unfortunately, it is not uncommon for adoptive children to be asked about their “real” parents. This type of question is intrusive and delegitimizes their adoptive families. Any time “real parent” or “real child” is conveyed an assumption of bionormativity is communicated, that families formed through biological ties are better. A good example is the public controversy that surfaced this year over Olympic gold medalist, Simone Biles’ relationship with her adoptive parents. 

Additionally, popular culture often perpetuate negative stereotypes of adoptees, namely, that adoptees are inherently inferior in some way. This can lead to attribution bias where a person’s undesirable behaviors are assumed to be due to their unchangeable inherited traits, and their positive behaviors are attributed to post-adoption influence instead of having a more balanced perspective. Important, too, adoption research tends to focus on problem areas to help those most in need. However, many adoptees are happy and functioning well. We know parents who listen and are engaged in talking with their children about adoption openly and non-defensively promote positive adjustment. 

If parents of adopted children would like to better understand and work with their adopted children on development, who can they talk to?
Address initial concerns with your child’s pediatrician who knows your child’s health history and your family. Your child’s pediatrician can then provide a referral. Parents should also feel comfortable requesting a specialist if they are knowledgeable about the type of help they need: psychologists, psychiatrists, social workers and allied professionals. The Donaldson Adoption Institute provides a policy document by adoption clinician and educator, David Brodzinsky, PhD, outlining adoption competent professional training guidelines for mental health professionals and reviews adoption competent research-guided therapies. Families with specific concerns about their child’s development can seek my assistance through the ISCU Developmental Follow-Up Clinic.