ChatSpace Transcript for Room DrJane
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Dr. Jane Aronson's Chat Transcript
March 8, 2000
Developmental Issues in Kids
Adopted from Abroad 03/08/00 08:59:24 <orphandoctor> Dr. Jane is here
03/08/00 09:02:26 <Guest14> Good Morning. I understand the young children do a lot of catch up after they are brought home to their families. Is there any information on what types of problems with development are more irreversible? Do children from orphanages tend to catch up with kids who have not been in orphanages?
03/08/00 09:03:25 <orphandoctor> Although we don't have a lot of research in this area, we know from long-term experience that most children catch up.
We know that most of the delays are in the language area.
Kids frequently have transitional developmental delay in gross motor, fine motor, and personal -social development and they catch up quickly in the first few months in these areas. More sustained delays are in the area of language.
Also kids often have a honeymoon period where they actually catch up and then a few years later they actually have difficulties in school with learning. I believe that kids adopted from abroad do not have any more problems with learning than the normal population which is about 10 %. Obviously, kids who are very young at the time of adoption will do better long-term because they have had less time in the orphanage. Although there is a caveat and that is that some kids who stay a short time are exposed to very harsh conditions and may end up with as much delay as a kid who stays for years.
It is amazing how some kids can actually be in an orphanage for years and do well and others who stay a short time do not do as well as we might presume.
03/08/00 09:08:51 <Guest14> If kids adopted from abroad do not have more learning problems, do you think that suggests that the malnutrition and lack of nurturing in the first 24 months does not lead to a significant change in whatever the child's learning and intellectual potential was at birth?
03/08/00 09:08:56 <orphandoctor> There are issues that go beyond the scientific. The inherent resiliency of each individual is so varied and dependent on unknown factors
It is hard to say. I firmly believe that kids just are very resilient. We have history to prove this. Malnutrition has been studied since the turn of the century and we still don't know why some kids who have little exposure to harsh conditions may not do as well as those who have longer exposure. There are magical factors at work. Generally though we know that after two years in an institution there are more opportunities for more sustained delays.
There may be very specific kinds of learning problems in kids from orphanage backgrounds that we have not yet defined.
So although the numbers may not differ with the normal population, the style of the learning problems I think will probably be very different than non-orphanage kids.
03/08/00 09:15:01 <Guest14> Does exposure to lead result in specific difficulties in learning or a loss of overall intellectual ability? Does it take months (or years) for significant long term effect?
03/08/00 09:15:38 <orphandoctor> High lead levels for very sustained periods of time do cause learning problems and damage to many organs of the body including the kidneys and the brain.
Low lead levels are inconsequential as long as they are of short duration
Overall intellectual ability could be affected by long-term high lead levels
15% 0f children adopted from China in my practice have elevated lead levels. None of them have been affected adversely
03/08/00 09:18:33 <Guest14> The information parents get in the referrals from China seems to be very minimal? Is it really useful in determining the physical health of a child?
03/08/00 09:19:14 <orphandoctor> Although the referral from China is slim, there are meaningful factors...
The growth points and the photograph can be used to at least have a baseline
If the child's growth is plotted on a standard Chinese growth curve and they are on that curve, that is a good sign...although, we never know how reliable the measurements are.
03/08/00 09:23:22 <Guest14> There are many Gotcha stories about children who are very malnutritioned and seem extremely delayed--and then blossom with the love and attention of a family. How would a parent be able to decide from a referral if there were concerns to warrant not considering going ahead with the adoption. It seems an impossible decision.
03/08/00 09:24:12 <orphandoctor> It is an impossible decision. I agree. The growth points being on the curve is a good indicator of future health. Sometimes there are no predictors.
The referral is a leap of faith, but you know even if you have a child biologically, there are no guarantees
The good news is that the vast majority of kids do adapt and do well long-term.
03/08/00 09:27:45 <Guest14> I appreciate your willingness to share your time and expertise. One more question-Do you usually find that problems with rickets are mild enough to be reversible in most kids?
03/08/00 09:28:29 <orphandoctor> Rickets is reversible except in rare circumstances. The shape of the head does stay boxlike if you have rickets, but the brain is not affected and as the hair grows, the face fattens up and the head doesn't appear as unusual in its shape. Legs that are bowed straighten because they grow so much in childhood.
Also, the bones and muscles strengthen within a few months of renourishment upon adoption.
Well, it's 12:30 p.m. and I have a little one to see. Just back from China See you all next week. Why don't we open the topic to tuberculosis in kids adopted from abroad!
03/08/00 09:33:02 <Sandy> Thanks so much for sharing your knowledge and wisdom with us...I will make sure we have a copy of the transcript up on your site by tomorrow! See you next week for information on tuberculosis.
03/08/00 09:33:14 <orphandoctor> Thanks Sandy
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