I don't share many details about my daughter's health history or health issues because she, to date, is far more private than I am. Plus, she's still in her childhood. But, I am continually learning about early adversity, loss, transition, trauma, malnutrition through first-hand experiences and through research because stuff that happened fifteen and sixteen years ago when she was in utero, in another country as well as in an orphanage. All of those things still impact her and our family as does her race and my own.
Adoption is an ACE though it wasn't listed as one in the original ACE study. It's an adverse childhood experience for a child though to be sure. All children who are adopted experience traumatic loss. Loss of first parents, sometimes siblings, extended family, birth language, culture and customs too. Children who are adopted are often raised by parents who have different skin color, religious traditions, class backgrounds as well as different styles and experiences with parenting than they did or would have experienced with birth family. That means kids who are adopted often experience adverse community experiences as well, such as racism, except sometimes those experiences happen in the home and family as well in the wider community.
It's not easy to find research, information, guidance and support about how malnourishment, SARS, or orphanage care impacts babies, toddlers, teens and adults. So, when there's anything that might be helpful to other parents and families that I run across - I'm happy, willing and even eager to share (see below)! Let's help educate and support ourselves, each other and others so we can be and do better as parents and as people because this isn't relevant only for adoptive parents but for those who care about kids, families, parenting, and ACEs.
It's harder to find research on the impact of that at least to date about what it's like for kids to grow up as a minority in a family setting, in the home and to have different life experiences and ACEs than maybe parents and siblings.
Maybe that will be more available in the future. Please link and share what you know about or what might be relevant.
Adoptive parents are often (though not always) whiter, wealthier, and older than the general parenting population. That's not usually true of the children who we adopt though. Our children are not always from the same race, class, birth country as the one/s they will be raised in. All children who are adopted have endured extreme stress. Sometimes it is only related to loss of birth family and culture, sometimes it's from living through several disruptions, changes in care and caregivers as well as war, hunger, poverty, neglect while in birth families and/or in orphanage and/or or foster care homes - or all of those things.
For many adoptive parents, especially those of us who have had every or many privileges, adoption is a wake-up call. For many of us, the adoption process wakes us up to larger social issues such as race, class, war, poverty and maybe even ACEs. Sometimes, we have to learn more about these things in order to better understand and parent our own children. Sometimes we have to confront our own ignorance and bias as well. Maybe there are things we have never had to even think about even though they are consequential and have impact every single day for our kids.
ACEs. Race. Poverty. Hunger. Neglect. Loss.
One of these things or many of these things or all of these things and how they intersect.
This is another part of parenting with ACEs, not just the ACEs we have as parents but the ACEs our children have that may be different than what we've experienced, navigated or understand.
There's lots we're all still learning about each other, about these experiences when they do and don't intersect and what happens as well for children who are adopted and later surrounded by love, nurturing and therapeutic or attachment style parenting?
What happens for children who have these experiences and who join families where maybe no other ACEs happen?
What health and social issues arise when there's love, attunement, attachment but still early loss and trauma? Plus, how is attachment and attunement, on the part of the parent impacted by race, or when loss of birth culture and language losses or transitions isn't acknowledged or addressed?
There are lots of important questions, issues and possible areas for more research and understanding. There's not a lot of research. But this morning I came across a study I'd not heard of that can help us start looking a little bit at some questions and issues relevant for families who adopt internationally.
The importance of the ecobiodevelopmental framework in which a child develops has recently been highlighted.77–79 Within this context, the devastating, long-term effect of early childhood adversity and consequent toxic stress is helpful in understanding adverse outcomes in international adoptees. In adoption, the assumption is that a positive developmental environment is established upon entering a nurturing family but stress likely persists if sensory deficits impair a child’s perception of the world. Sensory impairments should be added to a growing list of factors that contribute to the pathogenesis of developmental, cognitive and socioemotional problems in children experiencing severe deprivation in early life.33, 34
While the children screened by an eye specialist or audiologist in MnIAP and HVS may have represented a select group with suspected problems, the prospective vision assessment of Eastern European adoptees found a similar high rate of eye problems when examined by a vision professionals.18 These findings suggest that the true prevalence of hearing and vision problems may be even greater than rates reported using data from all screening providers. Evaluation by specialists in these areas is the best option for children who join their families through international adoption given the number of risk factors in this group of children. In addition, the age of arrival for most international adoptees (74%) is <36 months of age.42 At this age, vision screening in pediatric offices is particularly challenging80 because children are often adjusting to the English language for directions and hearing screening requires equipment and a recommended screening protocol 81 more likely available in a specialist’s office.
Summary
To our knowledge, ours is the first study to report the rates of hearing and vision screening in a geographically defined sample of international adoptees in the US and demonstrate that international adoptees are at significant risk for hearing and vision problems undiagnosed in their country of origin. Our findings show that children with these sensory deficits have a higher probability of a variety of problems including attention and social problems as well as diagnoses of speech and language delays, developmental delays and cognitive impairment. Primary care practitioners should arrange screening through vision and hearing specialists within the first few months after arrival to insure timely diagnosis and proper treatment. The importance of identifying vision and hearing problems cannot be overstated as they are risk factors for long term development and behavior problems where ready screening and correction are available in the immediate post-arrival period.
Full abstract. If you know of more or newer studies, more complex and nuanced studies or reports, please share as a blog post or in the comments.
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