Therapist’s Quick Guide to Working with Children Who are Newly Adopted
Posted by pchays on Mar 30, 2016I am an adoptive mother of a beautiful, goofy girl from China.
I am also a pediatric occupational therapist.
Before experiencing adoption personally, I would have said that I was competent as an occupational therapist at working with children who were adopted.
- I knew the developmental concerns related to adoption, for example the potential sensory, motor, language, feeding, social, and emotional concerns.
- I knew the effects of sensory deprivation and inconsistent caregivers has on development.
- I knew how to engage children that had a hard time trusting adults.
While I knew all the facts, risk factors, and possible interventions, I didn’t really understand how to best work with families during their adoption journey.
After my experience as an adoptive parent of a child who needs therapy services, I felt I could share some important knowledge and my perspective to other speech, occupational, and physical therapists who are working with children who are newly adopted.
I know many therapists are short on time. Here is a one page summary for physical, occupational, and speech therapists. I encourage families to print this off and share with their therapists!
1. We are still getting to know our new child. It is really hard to face all the questionnaires and interviews about your adopted child’s history when all you can answer is “I don’t know.” We desperately wish we knew all our child’s history, but in reality we are just getting to know what foods, toys, and TV shows our new child likes. We worry about what our child’s past held and feel like we have to prepare for all the possibilities (trauma, abuse, malnutrition, or maybe a loving care-giver), but we often just don’t know. 3. We trust you and value your opinion, but
our priorities might not be the same. You are a professional who has expertise that we need to help our child. Adoptive families usually limit who interacts with their child when newly home, so know that if we are choosing to come to therapy, it is because we trust and value your services. However, we have a different perspective given our child’s unique story, and we know what is best for our child. We know that all the developmental goals you propose are important, but those goals may not be the top of our priority list. We are working on showing our child that they are safe, loved, and in their forever-family. Sometimes learning to self-feed, walk up and down stairs, or following one-step directions may have to wait. However, some issues should be addressed right away, such as a positioning need that will lead to further damage, severe sensory seeking that needs to be managed, or an oral motor need that is preventing adequate nutrition. Adoptive parents didn’t have the chance to figure out all the little things as our children grew-up, instead it was all thrown at us at once. We want everything possible for our new child, but first we just want to be a family. 5. Our lives at home may be chaos. Bringing home a newly adopted child of any age is similar to bringing home a newborn. It can be emotionally and physically exhausting. Our days are filled with sleep issues, feeding issues, and constant supervision and care of our new child. We are trying to give as much time and attention as we can to our new child, which means that many other things in life get put on the back burner. Be really considerate when asking a parent to do homework for therapy. Sometimes it needs to be done, but make an extra effort to find ways to make it practical. I would encourage any therapist who may work with children who are adopted (or children in foster care, or children with any history of trauma) to spend an hour or two online looking at resources on adoption and attachment. Here are some high-quality resources:
2. We want our child to like you, but not too much. We are focused on learning to be a family. We need your help, but please respect our boundaries and roles as a parent. Please play with our child, give high-fives or fist bumps, but leave the snuggling, hugging, and bonding to us. Many adoptive children continue to “parent-shop,” even after being with their new families for a significant time. On the other hand, if our child trusts you, be respectful of that relationship and know it means a lot to our child (please don’t disappear or switch therapists on us!).
4. Use a team approach, but keep it simple. Many children who are adopted have multiple medical and developmental needs and would benefit from the expertise of many professionals (OT, PT, ST, etc). We want all the resources and help that is available, but sometimes it is too much for children newly home.
. Ask a parent for advice, such as what their child’s atypical behavior might mean. Ask permission if you are unsure before attempting new tasks, demands, or interactions.
What is attachment? It is a bond between two people (that has a physiological component in neural development). For most children, it develops between an infant and a primary caregiver. For adoptive children, this natural process is often disrupted. Adoptive families need to re-create this experience through daily interactions that allow attachment to develop. The goal is to develop secure attachment (where the child trusts a caregiver and can feel safe both with and without the caregiver present). Attachment is a process with skills that need time to develop. A child first has to feel secure and safe with a new caregiver and family, then learn to explore his or her world from this secure foundation.