Recommendations for the First 6 to 9 Months
Our list of recommendations is based on the collective years of experience of our team of adoption health care specialists and has evolved over time. In presenting these recommendations, I would like to acknowledge the collaborative contributions of my clinic colleagues, Dana Johnson, MD, PhD, Angela Sidler, MD, Stacene Maroushek, MD, Kay Dole, OTR, Sandy Iverson, RN, CNP, Mary Jo Spencer, RN, CNP, and Maria Kroupina, PhD. "
- We recommend a low-keyed arrival scene as you return home from your child's country of origin. It is usually best to avoid having a large crowd greet you. Your child should stay in your arms and should not be passed to others.
- Develop daily routines and rituals, and stick to them as much as possible. In keeping mealtimes, bedtimes and playtimes consistent, your child will begin to feel that each day has a predictability and structure to it. This is comforting for the child who is experiencing a period of incredible change and transition from orphanage to adoptive family.
- We recommend that parents, as much as possible, be the only persons to feed, change, bathe, dress, rock to sleep, or comfort their child. We think it is helpful for your newly adopted child to practice having needs consistently met by you, the parent.
- When extended family members or friends bring gifts for your child, we recommend that you have your child sit with you and that you hand the gift to your child or assist your child in opening the gift. You may want to say something like "Look, Annie. Grandma brought you a present. You may open it now."
- In the beginning, you may want to advise relatives and friends ahead of time that they should ask your permission to pick up your child or do an activity with your child. Each time they ask permission, your child is hearing them reference you as the important decision-maker for activities that involve your child. This may provide your child with practice in referencing you before embarking on a new experience.
- In large group gatherings, like adoption shower parties, let guests know ahead of time that you will be holding your child and that you will not be passing your child around from person to person. Overall, we advise avoiding large group gatherings during your child's first few months home. A previously institutionalized child does not need trips to Disneyworld or a day of shopping at the mall. What he or she needs more than anything is lots of concentrated one-on-one time with a warm, loving and sensitive parent.
- Spend as much one-on-one time with your child as possible. Your child does not need to be surrounded by lots of toys. In fact, being surrounded by too many toys and an overly stimulating environment may be overwhelming. Instead, choose one or two toys and get down on the floor with your child, and play with the toys in an interactive manner with your child. Use lots of facial expressions and face-to-face gestures like peek-a-boo or rubbing noses together. Watch your child for cues that he or she may be getting overwhelmed or tired, and then switch to a soothing, comforting activity such as rocking your child.
We believe that all of these steps may assist your child in seeing you as the essential "gatekeeper(s)" through which all good things in life come. The goal is to help your child realize that you are the one(s) to meet his or her needs, to be trusted, and with whom to seek close contact.
Sometimes, despite undertaking the above recommendations, parents may notice their child is having a difficult time in developing an appropriate attachment relationship. If you feel you and your child are experiencing difficulties, you may want to seek the help of a trusted professional, hopefully someone with lots of experience in working with internationally adopted children. Unfortunately, a flurry of mass media reports has highlighted problems with a number of "attachment therapists" who are recommending therapies that are not only untried and unproven, but may be potentially dangerous or lethal. We at the International Adoption Clinic encourage parents to seek reputable therapists. If a treatment or therapy is recommended for your child that you, as a parent, feel is abusive or questionable, we urge you to trust your instincts and not condone or allow such treatment. We encourage you to seek a second opinion from a trusted and experienced physician, nurse practitioner or child psychologist.
