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Advice for Parents of Post Institutionalized Children

Older Child Adoption Bonding & Attachment Medical

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  Written by George Rogu M.D on 01 Jan 2006

Adopting a post-institutionalized child is a challenging undertaking. Though there are techniques and tips that work best with particular age groups, there are a number of general practices that have been proven to help children of all ages adapt more readily to their new families, culture and environment. The following tips have been comprised to guide families during the crucial time period immediately following adoption.

The most critical advice adoptive parents of older children MUST absorb is this: Your desire for an instant-happy family is unrealistic. The entire focus must be on the needs of the child. With patience and consistency over time, the family will come together as a cohesive unit.


•  Immediately during the post-adoption period, do not over stimulate the child. Avoid trips to toy-r-us, Disneyland , and large gatherings. When exposed to this type of environment children tend to have meltdown, hyperactive and out of control.

•  Child should be placed in a well-structured routine. A chore-list (photos of duties posted in a bathroom are good), consistent times for meals, play, and school are all vitally important.

•  Families should stay home with child for as long as possible.

•  Expose the child only to close family members during the post-adoption period. Parents and siblings ONLY are preferable.

•  One parent should be home with the child for the first couple of months.

•  Exposure to both parents is optimal as long as it is as financially feasible.

•  Avoid daycare immediately after arrival

•  Try to communicate during the first 2-3 months in the child native language. Finding an interpreter and learning basic phrases before the child arrives home is essential.

•  Do not try to force the child to learn English right away, it will come in it own time.

•  Child should stay home with a primary parent as opposed to a nanny or babysitter.

•  If available, have the child socialize with a child from a similar institutional setting and culture.

•  Older children should be enrolled in school as soon as possible.

•  Post-Institutionalized children tend to become fixated on junk food, such as hot dogs, sweets, chips and soda immediately. Let them eat but not just what they want or like. Set limits. Since they have never had junk food, it becomes an obsession.

•  Initially try to recreate the diet that the children had in the orphanage. Gradually transition them to your families diet slowly over time. Food is the language of love for these children. Withholding the foods they are most familiar with can be damaging to the initial bonding.

•  In regards to television, avoid shows that have aggressive tendencies. Disney type movies are usually calm, have good language are funny and have good moral values. Children tend to imitate things that they see. Having them watch power rangers is almost a guarantee to have a power ranger in your living room wrecking your furniture very soon.

•  Children need to earn activities and privileges based on their daily performances. Good behaviors need to be rewarded and bad behavior needs to be gently punished by taking away privileges like favorite toys, games for short period of times. Never ever use corporal punishment.

Consistency and complete dedication towards the best interest of the child are mandatory. The immediate gratification of the parents to form a family unit needs to be delayed temporarily. This will help to promote a good long-term prognosis for the post-institutionalized child.

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) Federici, R. (2001) Raising the post institutionalized child: Risks, Challenges, and Innovative Treatment.

by George Rogu M.D.


The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship. is an innovative International Adoption Private Practice dedicated to helping parents and adoption agencies with the complex pre-adoption medical issues of internationally adopted children.



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