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Coping with the Effects of Deprivation Coping with the effects of deprivation Development and upbringing of Romanian adoptees in the Netherlands This research project was financially supported by: the Faculty of Social and Behavioral Sciences of Utrecht University, the Dutch Ministry of Justice, Stichting Kind en Toekomst, de Gasunie, Stichting Pro Juventute and Stichting Janivo. © Catharina Rijk, 2008 No part of this book may be reproduced in any form, by print, photoprint, microfilm or any other means without the prior written permission from the author. ISBN/EAN: 978-90-393-4822-2 Printed by: Print Partners Ipskamp BV, Enschede. Coping with the effects of deprivation Omgaan met de effecten van verwaarlozing (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof.dr. J.C. Stoof, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op vrijdag 13 juni 2008 des ochtends te 10.30 uur door Catharina Huberdina Antonetta Maria Rijk geboren op 13 april 1978 te Eindhoven Promotor: Prof. dr. W. Koops Co-promotor: Prof. dr. R.A.C. Hoksbergen Contents Introduction 7 Chapter 1 19 Adoption of deprived children: Co-morbidity in Dutch children adopted from Romania Chapter 2 35 Parents who adopt deprived children have a difficult task Chapter 3 57 Development of behavioral problems in children adopted from Romania to the Netherlands, after a period of deprivation Chapter 4 73 Parenting of deprived children: Romanian adopted children in the Netherlands Chapter 5 93 Education after early-life deprivation: Teachers’ experiences with Romanian adopted children Chapter 6 113 Parents’ and mental health workers’ perception of therapeutic needs, and experiences of services for Dutch children adopted from Romania General discussion and conclusions 131 Samenvatting (in het Nederlands) 143 Dankwoord 149 Curriculum Vitae 151 INTRODUCTION Adoption is a longstanding practice, which has changed much in the last four, five decades. In most European countries, domestic adoption is the most common form of adoption no longer. In the second half of the twentieth century, the number of international adoptions increased strongly (Selman, 2000). Children who could not be raised by their natural parents due to cultural factors, war or poverty were, and are, adopted by families in other countries. Families hoping to give them a better life than they would have had in their country of origin. Adopting a child that is not biologically related to the family may bring about specific psychosocial problems. If a child is not genetically related to the adoptive parents, the adoptive parents do not know the genetic traits, which may be highly different from their own. In addition to these differences, the early-life history of the child may also cause specific challenges. The biological parents of the child were unable to take care of him (for reasons of legibility, we speak of children in the male form when referring to both boys and girls). Circumstances surrounding conception and pregnancy may have been stressful, and the child has already experienced at least one significant loss (of the biological parents) before adoption. Most children have also spent some time in a children’s home before they were adopted, institutions where they may have experienced (severe) neglect and deprivation. Adopted children may experience difficulties in their identity formation due to factors such as being abandoned by the biological parents, and differing racially and culturally from the adoptive parents. Once adopted, the children may find themselves in three different upbringing situations: they are educated by the parents at home, by the teachers at school, and often also receive guidance from a mental health worker, since professional help is relatively often engaged for adopted children and their families (Peters, Atkins, & McKernan-McKay, 1999). The circumstances of deprived adopted children make the upbringing of an adopted child a challenge for the adopted parents, which demands much of their parenting skills. The same applies for the teachers and mental health workers of these children, who are also confronted with the specific psychosocial problems of (deprived) adopted children. In this thesis, we will describe the children’s problems, and attempt to take a step forward into gaining more insight into the way in which those directly involved cope with these specific psychosocial problems. The triptych of parents, teachers and mental health workers will be approached to relate their 7 Coping with the effects of deprivation experiences. We will focus on children adopted from Romania. These children have often experienced (severe) deprivation in the Romanian children’s homes (Ames, 1990; Federici, 1998). Their complex background makes their upbringing extra challenging for parents, teachers and mental health workers. The central theme of this thesis will be how to deal with the psychosocial problems of (severely) deprived adopted children. Adoption from Romania Adoption from Romania started almost immediately after the fall of Ceauşescu in 1989. His regime left thousands of children in orphanages, under very poor conditions (Ames, 1990). When the media started to pay attention to the circumstances of these children in 1990 and 1991, thousands of couples in the USA, Canada, the UK, and the Netherlands expressed their wish to adopt a child from Romania. In 1990, a stream of adoptions of Romanian children started that wouldn’t stop until 2002. Romania, pressured by the European Union, placed a moratorium, ending possibilities for international adoption of Romanian children (U.S. Department of State, 2004). This moratorium became a permanent law in early 2005 (Graham, 2006). Despite this law, international adoption remains a subject of discussion in Romania. Reasons for this can for example be found in a recent letter by several Romanian orphans who were in the process of being adopted by foreigners, but whose adoptions were halted due to the moratorium. They claimed to have suffered severe neglect, deprivation and abuse because they stayed in Romanian orphanages (Graham, 2006). Adoption as a natural experiment When studying adoption and adopted children, two aspects are of importance. Firstly, how children, often from depriving backgrounds, develop in caring adoptive families. It is relevant for adoptive parents, but also for professionals caring for deprived children, to see the possibilities these children have to overcome the developmental delays they may have as a consequence of their deprived early childhood. Secondly, how adoptive parents and others involved are able to optimally stimulate the development of the child, optimizing their possibilities for recovery. While it is by no means meant to be an experiment involving the child or the adoptive parents, to researchers these circumstances can be seen as an interesting natural experiment (Haugaard & Hazan, 2003; McGuinness & Dyer, 2006). A child is deprived in his early childhood in Romania, and is subsequently placed in a healthy and caring environment. This offers a unique possibility to study the influence of these experiences on the development of the deprived child. The “experiment” may also help to shed light on the traditional question of the importance of nature and nurture on the development of the child. A natural experiment, however, has its limits. Unlike a clinical experiment, the environmental circumstances of a natural experiment cannot 8 Introduction be completely controlled. This makes it harder to discern the specific roles of different environmental factors. The effects of pre-adoption influences Adopted children experience different influences in the period before they are adopted. These may affect them in different ways and through different processes: Genetic One of the limitations of adoption research is that there is often a lack of information about the genetic makeup of the biological parents. It is conceivable, however, that psychosocial problems occur more frequently among parents who are not able to care for their child (Peters et al., 1999). Therefore, certain congenital vulnerabilities may occur more frequently among adopted children. Conclusive evidence of the mediating role of genes in vulnerability to the effects of deprivation is, however, not (yet) available (Taylor & Rogers, 2005). Prenatal The influence of prenatal circumstances on the functioning of children is becoming clearer due to relatively recent developments in research. Nutritional deficiencies of the mother during pregnancy can lead to developmental delays in children (Taylor & Rogers, 2005). The same is true for substance abuse and excessive alcohol intake by the mother during pregnancy (Peters et al., 1999; Schoenbrodt, 1999). The psychological condition of mothers during pregnancy may also affect the functioning of the child at a later age. Stress and fear during pregnancy lead to a higher prevalence of behavioral problems in children (Gutteling, de Weerth, Willemsen-Swinkels, Huizing, Mulder et al., 2005). The biological mothers of adopted children most likely struggle during their pregnancy with their decision to give up the child, and sometimes even have to hide their pregnancy. It is conceivable that this stressful situation influences the unborn child as well. Early life deprivation A large group of the Romanian adopted children experienced deprivation during their stay in a Romanian children’s home or hospital (Ames, 1990;
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