Sunday, April 25, 2010

International Adoption, Fertility and Child Trauma


International Adoption and Reactive Attachment Disorder (RAD) prevalence needs to be looked at in the context of occurring within the adoption community Vs outside the community Vs within the context of foster care.

Although I am sure there are parents parenting children with RAD and the parents don't know that RAD or Developmental Trauma Disorder is an issue.  Often RAD and DTD (Developmental Trauma Disorder) or PTSD (Posttraumatic Stress Disorder) is misdiagnosed or not diagnosed at all.  I remember reading posts on various lists from parents who described in detail the behavior of their child. These descriptions read like a check list for RAD/DTD/PTSD. Then others on the same list would call their child strong willed and/ or head strong and everyone would virtually pat them on the backs and say it was a phase, love is enough, love conquers all yada yada yada. Those of you who have been around and have these kids living with you know the drill.  There is way too much "support" to explain away trauma in a child within the adoption community (as just some typical behavioral issues) or a strong willed child or most commonly pathologizing of the adoptive parents. This way of operating is a self-perpetuating problem fueled by "adoption experts" and agencies and supported by many perspective and adoptive parents.



One of the big problems is that there really isn't much in the way of valid research available that looks at these issues and problems. It's hard to do research when many admit to no issue.

In China all children are "supposedly" abandoned. That means that all children adopted from this situation HAVE been traumatized because leaving an infant or any age child and never coming back then sending them to an orphanage IS trauma. If every agency started from that point maybe the word "trauma" might be mentioned in the process of getting perspective adoptive parents ready to receive a child. NO ONE from the agency we used EVER mentioned trauma.  Show me an agency that doesn't understand or recognize that concept and I'll show you an agency that should not be allowed to be in the child placement business! If they do understand and do not try to prepare perspective parents then they shouldn't be in the child placement business either!

Adopting is not about the perspective parents no matter what they have "been through" before they adopt. It is about the child -- the child -- the child. It doesn't matter what the parents want, whether or not they are unhappy about extra requirements for placement, or whether the parents feel it's an intrusion. The ONLY relevant factor in an adoption  is about the needs of a child. Don't get me wrong, I am not saying there can't be compassion for parents who have been through a lot to build a family. But their struggle isn't a need adoption agencies should be addressing.

Parents who have decided to build a family due to infertility primary or secondary need to have first resolved their fertility issues and if those issues are not resolved, they should not be allowed to adopt until they are resolved. The child has be been put first. The needs of that child have to be put first. Adoption is a complex issue but I think it is way too easy to adopt. I think anyone could pass a home study and I think adoption is marginalized because of this

Of paramount importance is to put the child and that child's needs first.


The InterNational Council on Infertility Information Dissemination (INCIID – pronounced "inside") is a nonprofit organization that helps individuals and couples explore their family-building options. INCIID provides current information and immediate support regarding the diagnosis, treatment, and prevention of infertility and pregnancy loss, and offers guidance to those considering adoption or childfree lifestyles.


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What Wall Street and Medicine Might Have in Common!

What do you think about this doctor - Doctor tells Obama supporters: Go elsewhere for health care
Dr. Jack Cassell, a Mount Dora, Florida urologist, lets present and future patients know to go elsewhere if they voted for Obama.


I found an interesting article by Stephen Hudak in the Orlando Sentinel. The article is about a urologist who put this sign (on the left) on the door of his practice. "If you voted for Obama, seek healthcare elsewhere."  The attitude of this doctor is, however, not surprising to me. Personally,  I do believe that if a physician turns away patients (whether that be directly or indirectly) due to personal or  political feelings, race et. al., his actions are unethical.

Urology does fall within the parameters of the work we do in educating the public about infertility issues. Just the infertility "business" is a multi-billion a year industry. This particular doctor's attitude is really a benefit to would-be patients. My advice to a patient seeking care from such a physician would be to run as fast as possible away and to another practitioner who might have his emotions and temper more in-check. A physician who feels this strongly about the "type" of patient he would not help (which includes most of the country as Obama did win the popular vote) suggests to me his professional judgment may be clouded. Could a physician really made an unbiased decision in what might be the best treatment for a patient under his care? What about "leanings" he might have that conflict with the thoughts of a patient under his care? It is a very slippery slope for a doctor who takes the Hippocratic Oath to put himself out there with this kind of political opinion. Or maybe the modern Hippocratic Oath needs to make exceptions in the case of . . . whatever!


As repugnant and unethical as I find the sign, it is really beneficial for perspective and current patients to know they might find better care elsewhere in an environment where personal opinions might not have effect on the kind of care they receive!.

My definition of a good doctor is one who has both the intellectual knowledge and practical skills combined with human empathy and compassion for his/her work with patients. Such doctors can be hard to find but they are around. I understand very well that medicine IS a business. However it  is good business to achieve a "fair profit" without gouging the public and while delivering good customer service and a quality product. Any good business including medical practice can also follow a moral compass! Healthcare for many doctors who have god-like complexes is a huge cash-cow. I do think there are many parallels between "Wall street" and the practice of medicine.


The InterNational Council on Infertility Information Dissemination (INCIID – pronounced "inside") is a nonprofit organization that helps individuals and couples explore their family-building options. INCIID provides current information and immediate support regarding the diagnosis, treatment, and prevention of infertility and pregnancy loss, and offers guidance to those considering adoption or childfree lifestyles.


In April of 2004, INCIID launched the first and only National IVF Scholarship Program for those who have medical need for IVF but who are without financial resources and insurance making the procedure out of their reach. Find out more about the scholarship.


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Thursday, April 15, 2010

We are the Truth no One Wants to Hear: Successful Adoption

My parents were the best. They taught two significant and amazing principles to live by. They told me not to be afraid to fight for what I believe in and that the "truth would set me free". Maybe the love and respect for my parents and my fond memory of their support is one reason why  I was upset when the Joint Council on International Children’s Services (JCICS) put out a mass email and Call to Action called “We Are the Truth” . Their mass emails urged the condemnation and prosecution of parents like Torry Hansen.  In fact, adoptive parents were encouraged to blog today about their successful adoptions.  The call claimed that the truth about adoption was not in children who were prone to set fires or parents who acted unwisely out of desperation, but in successful adoptions. The JCICS says, "You know that families who encounter difficulties do not simply abandon their child.  You know that help is available, that solutions are found and that families can thrive." Well JCICS, I don't know of anyone who really sees "help" as readily available. Readily available predisposes there is mental health insurance without huge deductibles, and that those skilled with young traumatized and attachment disordered children will be "readily available"   ----  "Thrive" The definition of thriving is to prosper; to flourish; to succeed --- I am not sure we fit that successful thriving family (fairy tale) definition either. But we love both our girls dearly!


I have two beautiful daughters, one who grew under my heart after 7 years of infertility treatment including 4 miscarriages and a boat-load full of drugs, and the other who grew in my heart through adoption. I doubt the JCICS is looking for stories like ours though.


After we decided to adopt and be completely done with fertility treatment, we looked for an agency. We settled on America World Adoption Association which at the time (2000) was exclusively doing Chinese Adoptions. Although our story is the type of adoption story that is usually swept under the carpet and excluded, we consider it successful --- not due to any support from the agency (which is typical) but because we dug, scraped and researched to find the appropriate services our daughter needed. Not because there were readily available solutions either -- there were not. But because both my husband and I had backgrounds and resources that enabled us to spent the $50,000 a year in out-of-pocket expenses it costs to find the right kind of therapies and resources.


Our (NSN -- non special needs classified)adopted beauty came to us at 16 months and weighing in at only 13 pounds (having been starved and tied in a Chinese orphanage for most of her young life. Her affect was completely flat and she had a vacant stare. When we saw her, she was totally silent and immediately and completely shut down. The "co-called" caregivers taunted and laughed at her in front of us. She wouldn't eat or drink and then slept for the first 36 hours. We also had some problems getting her out of the country. These problems were not well defined. There was a lot of language exchange between the interpreter (from AWAA) and the Chinese but no real interpretation to us about these exchanges. It was clear from the reaction of the medical personnel when we did their superficial physical that there was concern over her status. Of course there was --- the child had been starved and was the size of a 2 month old at 16 months !  To our benefit however, before leaving for China to pick up our daughter, our friends who had been with the State Department, introduced us to the then  director of Chinese personnel at the American Embassy (in China) who eventually migrated to the US. Thanks to her, we were able to get her out of the country. I'll never forget the words of the American in charge of our final outgoing interview. She said, "Are you sure she is alright?" To which I replied, "Yes, she's just sleeping a lot."  Then the American said, "You know just what to say don't you?" My husband (a teacher) and I (a certified special education teacher) agreed before we filled out one piece of paper, that we would parent whatever child was provided to us. We felt that this child was meant to be our child. I had acquaintances and advocates in the adoption field.


The first year or two home was like being in a fog. Our daughter woke up every 2-3 hours until she was 7. Our post adoption report was late. The agency would call and tell us they needed to do it and actually was upset with us because we didn't jump right in and tell them what they wanted to hear. We were overwhelmed with our daughter's lack of eating, drinking , dissociative state, screaming rages, one of which lasted 4.5 hours, self hurting and aggression behaviors as well as medical problems. We did finally get the report done. I asked for a copy but it was not sent. I had to really badger the agency for a copy of the report. When I finally read it, I couldn't quite figure out whose child they described - it certainly wasn't ours.


Once we navigated the "maze" trying to find appropriate resources for our daughter she has made progress but thee was NO readily available help. Our help came from other parents who went before. There are many parents - too many to count who have children like ours.. Moms who would lay down their life for their children but who are stressed to the max with problems no one ever mentioned. We spent the last 9 years immersed in evaluations, therapist searches and visits, medical intervention etc. At this point our daughter is still so orally defensive that she remains mute. When we take her to the dentist they have to use sedation just to look at her teeth. She remains terrified of running water in enclosed spaces but not the pool. She is terrified of any stranger entering our home too. There are still screaming flashbacks and trauma responses. Aggression is much better but can surface when she is terrified or triggered into a trauma response. The school district where we live retraumatized her and then came after us.One of the things they did to her in pre-school was to withhold food (her lunch) in order to try and make her speak.This is an illegal and immoral form of restraint -- and done to a child who they knew had been starved.  They regressed her to point that we had to start over at 7. Her team of therapists and doctors told us if we didn't get her away from the school personnel as well as any others without the proper experience with trauma and attachment disorder we would lose her permanently to mental illness. The schools do not have programs that are trauma sensitive -- so she is home with me 24/7. And although our school districts brag about the money they spend per pupil (more than $18,000 a year for regular non special ed students) they have exiled us and continue to violate our daughter's right to a free appropriate public education.


My husband can't retire because the therapies and resources needed for our daughter has wiped out our savings. We now have a second mortgage and credit card debt (all medical) and her sister has no college fund. It is not unusual for us to spend $50,000 out of pocket in medical expenses. It took us 9 years to get our daughter anxiously attached to us. Would we ever abandon her -- no way. Are there readily available resources for the thousands of parents who have these issues with their internationally adopted kids -- no way. It is so easy to blame the parents. Don't get me wrong, the parents of the little Russian boy were absolutely WRONG to do what they did. But it deeply disturbs me that there has been a real rally to demonize them.


The sad truth is that agencies do not do justice to any real kind of post-adoption services. Services are NOT readily available. Unless you are well educated on how to manipulate our health care system and really good at it, (and that presupposes you already have a health care policy that even covers mental health)  the odds of finding the right help for a child with trauma and attachment disorder are almost "0%"


I recently asked our agency to stop sending us solicitation emails -- something they have not honored. I tried to speak to them and offered them my list of resources (which our pediatrician readily accepted) but they do not return calls or emails -- they do continue to solicit for donations however. 


The photo above is of my beautiful younger daughter and her service dog.


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Tuesday, April 13, 2010

International Adoption: The children are ALL special needs

I hate to be the one to deliver this message but there is little chance any child internationally adopted - both older and younger - is going to be "normal". Knowing what I now know about the physiology of the brain, it is impossible for the neuro connections and the chemistry to be normal with the kind of environments these kids emerge from.

I agree with many other professionals when they say, "All international adoptions are special needs [adoptions]..."
It is probably true that most families don't dissolve [dissolution] (after the child is legally adopted) or disrupt (before the adoption is final) children. However - I do hear people throwing around generalized terminology about dissolution of adoptions when there are no real statistics on this. There are some stats kept on domestic adoptions but no national database and no stats on international adoption. I was involved in the early discussions about the Hague which I don't necessarily agree was the best thing for international adoptions (that's a whole other discussion) and a small group of us hammered home over and over the importance of keeping statistics on adoptions that were disrupted and dissolved  --- no one would  even discuss it. No one wants to talk about what happens when an adoption goes wrong.

I don't know of any agencies who really screen parents the actively the way it should be done. Anyone can pass a home study and even with the 10 hours of "required" education, the education is so passive, there is no way a family has any idea what they could be in for when adopting internationally.  I have a child who could easily be a candidate for dissolution -- not that we would ever consider doing that - no way. But I have been told by many other parents and by professionals who DO "get it" that our child is the kind of adoption that would be disrupted or dissolved. If I had not had the background I did and the resources to fight the fight we are still fighting, there is no way we could have handled the immense magnitude of her problems. I can not tell you how many people who know her story have said, "Thank God she was placed with you." In a way that is quite the insult - because many of those telling us this (are saying under their breath - thank God I didn't get her.) But she is mine and I love her. When we made the commitment to adopt, my husband and I agreed we would be adopting the child we were meant to parent. No one is promised tomorrow and that includes adoptions or "normal children" who could get hit crossing the street tomorrow and suffer a traumatic brain injury.

Bruce Perry, MD (author of The Boy Who Was Raised as a Dog) said it best when he said this, "Once you know what trauma looks like, sadly you see it everywhere."
A young child from a third world country can not come out of an institution with multiple caregivers without have their neuro pathways disrupted. The odds are it's physically impossible.
Before anyone starts up the tar and feathers -- with that said, some children display this in a much more mild mannered way while others who were subjected to extreme abuse and chronic neglect - are like my daughter.

What's important here is to recognize that adoption and in particularly international adoption is a very complex issue which most people never even think about let alone talk about it. Parents need to be taught extensively about the normal way children attach and what happens when that normal attachment is disrupted with trauma (neglect and abuse).



Some Helpful Links
Helping Traumatized Children Learn
The Long Shadow of Trauma
Child of Rage Documentary - Interview with Beth (a child with RAD and trauma history)
Trauma Information Pages - Alan Schore


CHILD OF RAGE the documentary




goku son | MySpace Video





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Saturday, April 10, 2010

Adoptions, the Good, the Bad and the Ugly

Yesterday, the news hit that a 7 year old boy adopted by an US family had been put on a plane and sent back to Russia. The outrage was all over news. The mother had relinquished the child to her mother after she became afraid of the child's behavior. She said she feared for the life of her children. Aghast, outrageous, how could she...the outrage from professionals, from individuals. Yes this is outrageous but anyone with this outrage needs to take a close look at why this kind of thing happens. She isn't the first to act out of desperation and sadly she won't be the last. Take a look at what is happening in Liberian adoptions too.  These are very sad stories and the ugly side of international adoption.

There are few people (including professionals and adoption agencies) who talk about or even understand the cold hard facts and dilemma traumatized children bring to their new families. Children adopted from places where neglect and abuse is commonplace and who have been institutionalized come with huge problems. There is hope these children can heal and lead productive lives but only if those who place them educate parents about the issues BEFORE deciding to bring a traumatized child/ren into their homes.

When a child is neglected severely (no nurturing, multiple caregivers etc), there is a chemical shift in their brains chemistry. These children's brains stay in the primitive or reptile brain. The children live in a state of hyper vigilance and go into fight/flight/freeze mode in a desperate attempt to live and survive. There is a huge struggle going on internally. Most are very physically and emotionally dysregulated. They can't even cope with how they feel in their own skin let alone function in the world. Without proper handling, children with severe attachment disorder and early trauma can't empathize. They don't develop a conscience or relationship with their caregivers or families. They can become sociopathic and their only focus is survival.  Early childhood (developmental trauma disorder) trauma is devastating to not only the child but also his entire family. The entire family is at risk and need a great deal of outside support just to sustain themselves. Add to this parents who are clueless and have no education about this process and agencies who promise sweet children with no issues and you have a complete recipe for disaster.

As I watched Dr. Phil berate the boy's  mother and grandmother (on CNN with Anderson Cooper) and mention in a fleeting comment there maybe some children who might possibly have attachment issues, I became angry. This young boy was adopted at 6 years of age. Even in a best case scenario there was neglect in a Russian orphanage. Alcohol abuse in Russia is also common. While I am not saying what the grandmother did was right - it was reprehensible in many ways - I can understand an invision that desperation, a complete lack of adequate mental health services and no insurance covering mental health  - can lead to desperate acts. If you thought a family member was going to kill your family, set fire to the house and kill everyone inside, and you had no where to turn, your thinking might be cloudy too.

We have a horrible and growing problem in this country. We are still in the dark ages as far as the way we approach and treat mental health issues. This family was obviously in crisis. There are way too many questions and the focus should be on what happened to make this mother and grandmother so desperate. This is a very complex issue. It is not black and white but many shades of gray. Before you jump on the "off with their heads" mentality, I think we all need to look at what happened to make this family take such an outrageous and desperate action.

For more information on Attachment Disorder

 Parent support of an attachment disordered child or a child with a trauma history

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Saturday, March 20, 2010

BRAVO BRAVO Maria Cross - IVF with Donor Eggs


So many women make the mistake of waiting too long to try and conceive. It is heartbreaking to speak to the numerous women who think they have time to put off  building their family that --  trying to conceive can just be put on a back burner for a while. These smart, talented educated women point the finger at many of the celebrities who conceive in their 40's as proof it's OK to wait. And it is OK to wait if as long as you know the realities of conception over 40 and the distinct possibility that in order to conceive and go to term later in your reproductive life, you will NEED to use a donor's eggs costing anywhere from $20,000 - $40,000 and which is a procedure not covered by insurance (in 99.9% of cases).


A woman in her late 20's and early 30's has only about 2 out of 5 eggs that are normal (chromosomally speaking). By the late 30's and early 40's only 15-20% of the remaining eggs are normal and by the mid 40's that numbers decreases to 10%. To make matters worse, IVF and the media used for the procedure can be harsh on already fragile eggs. So the chances of a successful IVF for 40+ are extremely low - less than 1% (if that).( See Geoffrey She, MD's IVF Authority Blog.)


Just look at the list of "STARS" who are having their bundles of joy in their 40's and even 50's. Just to name a few: Jane Seymour, Emma Thompson, Susan Sarandon, Madonna, Annette Bening, Cheryl Tiegs, Beverly D'Angelo and the list goes on...Does that mean the experts don't have the stats right? Or that maybe these "beautiful people" just don't have the same kind of biological function the rest of us experience?  Though I am not privy to the information behind the closed IVF clinic doors, I do know that a number of celebrities (statistically speaking) have used a donor to get pregnant and carry their child to term. Otherwise, there should definitely be clinical trials to see how these celebs do what other's biological ticking clock can't.


Maria Cross has really stepped up to the plate (IVF dish if you will) and has done a great service to women everywhere by telling the world she needed to use a donor's eggs in order to have her twins. So BRAVO Maria.


Have questions about using a donor - log onto INCIID Forums and ask an expert here.


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Friday, March 19, 2010

Don't Crash and Burn - Planning Your Infertility Journey

In the world of infertility treatment - a multi-billion dollar a year industry, the media often paints a picture of rich couples trying to create designer babies. You and I know from our own infertility journeys that nothing could be farther from the truth. But how does someone know when the time has come to get off the infertility super highway before another truck hits us...Everyone who merges onto the fertility highway  exits with some dents and fender benders. The key is not to crash and burn in the process. Some couples get lost and lose each other and sometimes  themselves in the process. But many others are successful in their endeavor to build a family even if the way they do it leads to adoption or a child free life. The key to successfully resolving fertility is open communication and planning.


When starting out on the treatment road, couples should discuss their long and short term goals. Before setting foot into the office of a fertility specialist, together you should decide how far to take your struggle, whether or not you might go to all lengths or stop short of using a donor for both sperm and eggs, if you'll need a surrogate and how much time or how many years you will give medical treatment. Open communication with your partner and collecting your thoughts on when and what you want to do will go a long way in your infertility journey. Success may be different for each individual. Success can be full term pregnancy, remaining child free or possibly moving to adoption. There is a great deal to learn and careful planning before you leap can save you from crashing and burning.



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Thursday, March 18, 2010

Infertility EGG Raffle - what do you think?

According to wordnetweb.princeton.edu/perl/webwn a raffle is a way to "dispose of in a lottery as in "We raffled off a trip to the Bahamas." A lottery in which the prizes are goods rather than money!

Why would anyone hold a raffle --- any raffle? Lots of organizations, usually nonprofit organizations, hold raffles in order to fund their missions. Raffles for goods to raise money for charities are a tool to better enable them in providing services to consumers who need their help. So the charities who hold raffles are the beneficiaries of the raffle. The reason an organization holds a raffle is to raise awareness and make money - a good thing for charities. But why would a "for profit" organization hold a raffle? A company would hold a raffle as a way of advertising their product and services, raise more awareness of what they offer and to enhance their bottom line. Just what we need within the infertility industry!

In concept the more valuable an in demand a product the more publicity. But what do you think happens when products and services offered are human gametes? At one time a number of years ago INCIID (pronounced "inside") board members  thought and discussed at length, the possibility of an IVF cycle as a raffle in order to fund the mission and promote awareness of the plight of infertile couples. The idea was discussed at length and abandoned as very bad.

Why you ask?  Why not help one couple and raise awareness? Because although we leave the concept of when life begins to the religious scholars and individual consumers, we still think it's wrong to objectify human gametes. We believe that conception and creating a family is a very personal and individual choice - not a commodity. In the world of corporate greed, this concept is not well understood.

INCIID and its board didn't want to "depersonalize" something so private and so personal.  Instead what we did was to gather together a group of doctors who also felt as we do at INCIID. These "Heart Docs" or doctors with heart, donated their time, their facilities and services to the IVF Scholarship Program. Instead of a raffle, we found a way to regularly give away not just one cycle of IVF but many every year.

A raffle for human gametes is just a bad idea. Instead of a raffle to draw attention to an individual company or clinic, why not donate a cycle to a consumer through a nonprofit organization like INCIID?  You could still draw attention and in helping a charity. By following a moral compass to help consumers in reality the company also helps itself. Not only does INCIID raise infertility, pregnancy loss and adoption awareness  but it also provides scholarships for those who can not afford them. Okay, now what do you think?

The InterNational Council on Infertility Information Dissemination (INCIID – pronounced "inside") is a nonprofit organization that helps individuals and couples explore their family-building options. INCIID provides current information and immediate support regarding the diagnosis, treatment, and prevention of infertility and pregnancy loss, and offers guidance to those considering adoption or childfree lifestyles.

In April of 2004, INCIID launched the first and only National IVF Scholarship Program for those who have medical need for IVF but who are without financial resources and insurance making the procedure out of their reach. Find out more about the scholarship here:

Follow the link to find out more about INCIID's  IVF Scholarship Information and Application


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