Besondere Aufmerksamkeit fr die fremdlndischen Adoptionen ausserordentlich relevant; Beispiel Rumnische Adoptivkinder

Ren A.C. Hoksbergen, Ph.D., Cor van Dijkum, Ph.D., Felicia Stoutjesdijk, M.S.W.

Einleitung

Wenn wir uns mit den fremdlndischen Adoptionen beschftigen ist zu beachten, da8 wir es mit zahlreichen Entsendestaaten zu tun haben. Die fremdlndischen Adoptivkinder kommen aus vierzig bis fnfzig verschiedenen Lndern und aus allen Kontinenten. Diese Folgerung ist fr alle europische Lnder - auch fr die Schweiz - gltig.

In den Niederlanden sind die Daten ber eine lange Periode genau bekannt (Tabelle 1).

Tabelle 1

Die wichtigsten Herkunftslnder der platzierten fremdlndischen Adoptivkinder in den Niederlanden, 1995 - 1999 und alle Herkunftslnder seit 1959.

_______________________________________________________________________

HERKUNFTSLNDER ADOPTIVKINDER IM JAHRE: INSGESAMT

Quelle: Justizministerium und Hoksbergen (2000).

Die Konsequenz dieser vielfltigen Hintergrnde der abgebenden Eltern von fremdlndischen Adoptivkindern ist, da8 es unmglich ist, allgemeine Folgerungen daraus zu ziehen. Es handelt sich nicht um eine homogene Gruppe. Also, wenn wir hiernach die Ergebnisse unseres Studiums der Rumnischen Adoptivkinder zeigen, muss diese Bemerkung in Betracht gezogen worden.

Seit 1990 bis 2000 wurden 161 Rumnische Kinder in den Niederlanden adoptiert (Tabelle 2).

Tabelle 2 Adoptionen von Rumnischen Kindern in den Niederlanden, 1990-1999.

Jahr           Jungen                                   Mdchen          insgesamt

Quelle: Justizministerium und unsere Untersuchung

In 1989 and later years television pictures from Romania's children's homes shocked the world. The total number of children kept in institutions like Nazi concentration camps was not even known, but was certainly more than 100.000 (Battiata, 1990). This article deals with these institutionalized Romanian children, now adopted in Dutch families), mostly (91%) via two recognized adoption agencies. However, first we will say something more about the adoption situation and practice in the Netherlands.

Adoption studies in the Netherlands

In the Netherlands the first adoption law was passed in 1956. Between 1956 and 1960 the adoptions involved mostly Dutch children (500 to 750 children yearly), but soon children from other European countries such as Greece, Austria and Germany were adopted as well. Towards the end of the sixties important demographic, social and cultural changes in the Netherlands took place.

Firstly, between 1970 and 1977 the birth rate declined significantly, from 240,000 to 173,000 live births, which compared with other European countries was unparalleled.

Secondly, television brought the hopeless circumstances of children in Third World countries to the public's attention.

Thirdly, abandonment of children became much less popular for unmarried women. In 1970, 747 abandoned children were placed for adoption in a population of 12,9 million people, only 142 in 1977 and 40 in 1998 (Hoksbergen, 2000).

Since 1975 in the Netherlands inter-country adoption was by far the most common way to adopt a child. Domestic adoptions are rare, since 1982 less than one hundred children per year and since 1995 only 40 to 60 children annually, and mostly from mothers not born themselves in the Netherlands.

Each year 700 to 800 inter-country adoptions take place (Hoksbergen, 2000). Due to the adoption of a large number of China born children, in total 271, in 1999 a total of almost one thousand children (993) have been adopted in the Netherlands.

Adoption oriented research in the Netherlands focuses primarily on inter-country adoption. The first large study on inter-country adopted children was published by Hoksbergen. (1979). Then, several descriptive, longitudinal and experimental studies resulted in a large number of publications (Geerars, Hoksbergen & Waardenburg, 1996; Hoksbergen Juffer & Waardenburg, 1987; Hoksbergen, 1997; Hoksbergen, 1999; Hoksbergen & Walenkamp, 2000; Juffer, Rosenboom, Hoksbergen, Riksen-Walraven & Kohnstamm, 1995; Ligthard, van de Voorde & de Keyser, 1995; Oord van den, Boomsma, Verhulst, 1994; Versluis-den Bieman, 1994). The present study examined the psychosocial situation of children adopted from Romania.

From what is known regarding the Romanian child care history, there were reasons to suppose that this group of adopted children would show more and special kinds of problem behaviors compared to other groups of inter-country adopted children (Marcovitch, Cesaroni, Roberts & Swanson, 1995).

Adoption of children from Romania

In December 1989, the 24-year regime of Nicolae Ceausesu came to an end, and Romania was abruptly opened to Western communication channals. A large number of press officials, in particular from American television and broadcasting systems, visited the state-run orphanages. It was soon obvious that living conditions of 120,000 to 150,000 abandoned children living in the 600 to 800 orphanages were dreadful (Battiata, 1990). Romanian pronatalist laws from the seventies and eighties compelled women to have children. A main result was that the Romanian orphanage system became a repository not only for diseased, severely damaged children, but also for a large number of normal children of poor parents. The poor economy and the law against abortions led to the abandonment of tens of thousands of children (Johnson, Miller & Iverson, 1992; Groza, Ileana & Irwin, 1999). However, the precise numbers of children in care are unknown.

Almost immediately after the collapse of Ceausesu's dictatorship a large number of institutionalized children were adopted in American, Canadian and other Western countries. Romanias borders were opened to inter-country adoption (Groza et al., 1999). Between 1990 and 2000 almost 10,000 Romanian children were adopted by Western adoptive parents (Federici, 1998). It soon became obvious that many of these adopted children showed several kinds of behavior problems. Therefore, researchers in the U.S.A., Canada and United Kingdom became involved (Ames, 1997; Benoit, Jocelyn, Moddemann & Embree, 1996; Castle, Groothues, Bredenkamp, Beckett, OConnor, Rutter & the E.R.A. Study Team, 1999; Daunhauer, 1996; Federici, 1998; Johnson, 1998, 1999; Johnson et al., 1992; Marcovitch, Goldberg, Gold, Washington, Wasson, Krekewich & Handley-Derry, 1997). Data were obtained through interviewing parents, using Achenbach's (1991, 1992) Child Behavior Checklist (CBCL), the Autism Screening Questionnaire (Rutter, Andersen-Wood, Beckett, Bredenkamp, Castle, Groothues, Kreppner, Keaveney, OConnor, 1999) and other standardized instruments. In summary, all these studies focussed in some way on the causes, effects and mediations of post-institutionalized problem behaviors and conduct disorders of adopted children from Romania (Hoksbergen, 1999; Stoutjesdijk 1999).

In 1998, the authors started a longitudinal study on Romanian children adopted in the Netherlands. The adoptive parents will be approached twice, in 1998-1999 (dieser Artikel) and in 2000. A few parents of these children experienced a large number of intense medical and psychosocial problems with their Romanian children. They were not able to find adequate professional support and help. The two recognized adoption organizations have an official obligation to give aftercare to the adoptive families in which they have placed an adopted child. However, they are not able to do so. For the regular organizations of professional care, the psychosocial problems of Romanian adopted children were often too complex. In 1998 the decision was made to study this natural experiment with children who experienced severe early deprivation and who were placed into favorable circumstances at various stages of their development, compared with other groups of inter-country adopted children.

The purposes of the first part of our study were: 1) to get an overview of the medical and psychosocial problems of Romanian institutionally-reared children adopted in the Netherlands at two periods: at arrival in their adoptive families, and some years later; 2) to observe the experiences of the adoptive parents, their evaluations of their childrens adjustments and their mediations with the two adoption organizations involved.

METHOD

A retrospective longitudinal study consisting of parental interviews.

Sample. Seventy four families with 83 children adopted between 1-1-2026 and 1-5-2026 from Romania (response 86%) participated in this study. Only parents with one or more Romanian children, living at least one and a half year in the Dutch adoptive family, were considered relevant for our study. Using the so-called snowball effect we came to know about two third of all parents with one or more Romanian children. Secondly, the authors asked the two adoption agencies to send letters to all remaining adoptive parents with a Romanian child. This letter explained the purposes, methods and need to cooperate with the study.

Procedure. The survey consisted partly of questions used in other questionnaires for adoptive parents (Hoksbergen et al., 1987). There were four sections: 1) demographic information about the family and background of the adoption; 2) the psychosocial situation of the child at placement and at the time of research; 3) comparison of the child with the peer group or classmates, with respect to developmental and behavioral aspects; 4) the need of the adoptive parents for adequate professional help, support and after care from the two adoption agencies.

The first and third author interviewed the adoptive parents. A research-assistant noted down the responses. The questionnaire consisted of structured questions, using a five-point scale, and semi-structured questions. The judgements and opinions of the adoptive parents were the central source of information. The interviews lasted 1 hours and longer. Copies of medical information received by the parents in Romania or from the adoption agency were asked for or sent back by return envelope.

RESULTS

Demographic. Seventy four families with 83 Romanian children (36 girls and 47 boys) were interviewed. In 35 percent of the families, there was at least one biological child. This composition of the family was found in other Dutch adoptive families as well (Hoksbergen et al., 1987). Age of the child at adoption ranged from 1 month to 6.7 years (M= 2. 9). At the time of research, their ages ranged from 3.5 to 14. 6 years (M= 6. 8). On average, the children lived 4. 1 years in the adoptive family. The large majority of the adoptive fathers and mothers were between 35 and 42 years of age. Compared to studies of other samples of adoptive parents (Hoksbergen et al., 1987; Verhulst & Versluis-den Bieman, 1992) families with high socioeconomic status were underrepresented. However, compared to the Dutch population in general families with high socioeconomic status were overrepresented. The level of education of mothers and fathers were similar. Mothers' education was much higher than the general population (28% vs. 16% on highest level of education).

Medical and psychosocial situation of the adopted child. All adoptive parents went to Romania to escort their child to the Netherlands. To finish the whole adoption procedure they needed to stay in Romania two or more weeks. According to the information the parents had received, the general health situation of 47 percent of the children should have been without any problems. However, after medical investigation in the Netherlands within two weeks after coming home, only 28 percent of the children did not show any medical problems. Eight of the 83 children were infected with Hepatitis B (see also: DeVoid, Pineiro-Carrero, Goodman & Latimer, 1994). In a separate study we will report more detailed information about medical data.

At placement only 11 children (13%) did not show any psychosocial problem. Among the other 72 children, besides other problem behaviors, 53% showed indiscriminately friendly behavior, 50% had sleeping problems, 39% had eating problems, and 38% showed stereotyped behavior. At the time of the interview, on average 4.1 years later, indiscriminately friendly behavior and stereotyped behavior persisted. A few more parents (33% vs. 28%) mentioned ADHD as important problem behavior. With 44 of the 72 children (61%), the mentioned psychosocial problems still occur and with 34 other children a number of different problem behaviors were raised. Nine children gave reason to think that they suffered from semi-autistic behavior.

Sixty seven percent of the parents needed professional help. Compared to groups of adoptive parents of children born in countries like Thailand and Greece, this number is very high (Hoksbergen et al., 1987; Storsbergen, 1995). For 54 children (65%) a total of 188 different professional caretakers have been approached. A quarter of the parents are not content with the professional help they received. Not enough knowledge of the behavioral effects of extreme deprivation was an often-heard complaint.

Parents perception 4 years after placement. We have asked the parents to compare their child(ren) with their class mates at school.

Half of the Romanian adopted children still lagged with their general and emotional development. The delay in physical development has vanished with the majority of the children. In spite of the difficult circumstances these adopted children had lived in. A few seem to think that their children made developmental gains since placement (Tabelle 3).

Tabelle 3

Entwicklung von Rumnischen Kindern, durchschnittlich 4.1 Jahre in der Familie, nach dem Urteil ihrer Eltern (N=83),

      Entwicklung          positiv                         negativ          kein Unterschied

The lag in development decreased with the time the adopted children stayed with their adopted parents. When children stay five years or longer with the adoptive parents, we see a significant decrease in all five aspects of development. The general and emotional development is still uncertain for a third part of the children (Tabelle 4).

Tabelle 4

Anzahl von Jahren in den Niederlanden, und Rckstand in Entwicklung nach dem Urteil der Eltern, am Moment der ersten Untersuchung.

Rckstand in:                  Total(83)        1-3 Jahre(34)      3-5 Jahre(28)       5-9 Jahre(21)

                     N %         n %         n %        n %

Erluterung: 4 Kinder waren im Moment der Untersuchung 1-3 Jahre in Holland. Zwanzig von diesen Kindern zeigten noch immer still ein Rckstand in ihrer Entwicklung = 59%. Von den 21 Kindern die schon 5-9 Jahre in Holland sind zeigten nur 7 = 33% noch immer einen Rckstand in ihrer allgemeinen Entwicklung.

Je lter die Kind sind, je mehr Rckstand in ihrer Entwicklung diese Kinder zeigen (Tabelle 5).

Tabelle 5

Ankunftsalter und, nach dem Urteil der Eltern, Rckstand in Entwicklung, im Moment der ersten Untersuchung.

Lag in:                        total               jnger als 2            2 Jahre und lter

                        N %             n %         n %

Twenty eight percent of the children, younger than two years of age at placement, showed elay in emotional development versus 67% of the children which were two years and older; the comparable figures for general development were as follows: 25% vs. 72%. This runs counter to the findings by Moore and Fombonne (1999) but is in accordance with findings of Verhulst et al. (1992).

Discriminant analysis (Tabelle 6) reveals that two variables predict, in 72 percent of the cases correctly, whether a child will have no lag (not so well predicted in 53% of the cases) or will have a lag (very well predicted in 84% of the cases) in development. The number of reported psychosocial problems at placement predicts 69 percent correctly. This is the most important variable for the prediction, whether a child will have a lag in development. The age of arrival adds up to 72 percent. Nonparametric tests (Kruskal-Wallis, p < 0.05) support this finding.

Tabelle 6

Diskriminant Analyse auf Adoptivkinder: Was kann der Rckstand in Entwicklung erklren?

Kein Rckstand RckstandStandFunctCoef M SD M SD

Mediation and aftercare by the two adoption organizations involved.

Eleven adoptions were privately done; 72 children came via two adoption organizations. Only 42 percent of these placements were perceived by parents as satisfactory. An important complaint was the absence of any sort of aftercare and the lag of useful and correct information about the adopted children from Romania.

Discussion

The information we received from the parents is relevant for answering the main purposes of our study: 1) the high response (86%), much higher than in other studies with children adopted from Romania; 2) the quality of the cooperation of the parents; 3) the fact that a number of parents asked us to do the study.

Dutch adoptive parents of a child from Romania differ partly from other parents. Motives for adoption are comparable but the SES-level is somewhat lower than we usual see with groups of adoptive parents. Often the reason to adopt a child from Romania was that the parents were able to collect the child themselves. Later on it would be much easier to go back to Romania to search for the roots of the child.

This study found the rate of problem behaviors of adopted children from Romania extremely higher than in other Dutch adoption studies (Hoksbergen et al., 1987; Verhulst et al., 1992). According to the parents a majority of the children (87%) show problem behaviors and mostly the kind to be expected with orphanage children: indiscriminate friendliness, stereotyped behavior, sleeping and eating problems.

Concerning the information about the children received from Romanian institutions or the Dutch adoption organizations, the medical and psychosocial situation was even worse than expected.

The degree of physical (20% vs. 5%), language (42% vs. 10%), and motor (37% vs. 14%) catch-up among Romanian adopted children after five years was impressive and much higher than with other aspects of development: general development (49% vs. 33%), and emotional development (48% vs. 33%). However, the catch-up in physical and motor development was not complete for all children.

The catch-up of other aspects of development was slow. The children needed five and more years to recover and even then seven children were, according to their parents, still behind in their general and emotional development.

It is remarkable that the variable, number of reported psychosocial problems at placement, predicts most of the lag of development. This indicates that, according to the judgement of the parents, the simultaneous presence of different (perhaps entangled) psychosocial problems makes it difficult for parents to overcome a lag of development. A conclusion worthy to be explored in further research. In this regard age at arrival is also a relevant variable.

These adoptive families much more often needed professional help (67% vs. 22%) than other adoptive families (Hoksbergen et al., 1987). However, because almost a quarter of the parents are not content with the help of adoption agencies and other institutes for professional help, the psychiatrists, psychologists and social workers involved need more knowledge about the treatment of problem behaviors of severely deprived children.

Abstract

Since 1975 in the Netherlands intercountry adoption is by far the most common way to adopt a child. Each year 700 to 900 intercountry adoptions take place. Quite a few large studies on the evaluation of these adoptions have been done. In 1998 the authors started a longitudinal study of 83 children (response 86%) adopted from Romania. Average age at placement 2.9 years, at the time interviewing adoptive parents, 6.8 years. At placement, 67% of the adoptive parents needed professional help. Ten percent of the children were infected with Hepatitis B. Only 13% did not show any important psychosocial problems. The number of reported psychosocial problems at placement by the parents predict 69% of the lag of development observed four years later, the age of arrival add up to 72%. Four years after placement most problems still exist. However, no disruptions of the adoption have taken place yet.

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Ren A.C. Hoksbergen, Ph.D., Adoptionspezialist, Universitt Utrecht, Heidelberglaan 2, 3584 CS Utrecht.

Cor van Dijkum, Ph.D. , Statistiker, Universitt Utrecht.

Felicia Stoutjesdijk, MSW, Entwicklungspsychologe, Universitt Utrecht.