ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Monday, March 18, 1996 TAG: 9603180082
SECTION: NATIONAL/INTERNATIONAL PAGE: C-4 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: Los Angeles Times
Sara was 22 months old and like a child in shock when an American couple adopted her and brought her home from a Romanian orphanage in 1991. She couldn't walk or talk, and she would not eat solid food - not even dry cereal.
She would rock and bang her head or just stare, her tongue hanging out, her large dark eyes wide with unspoken fears. She suffered night terrors and tore her room apart. She tested at the developmental level of a 6-month-old.
``For the first two years, I didn't get any sleep,'' recalled her mother, Lily Romine of Lakeland, Fla. ``It was a very difficult time.''
Romine's experience with Sara has been repeated across the United States by many families who have turned to the former Soviet Union and its satellite nations in Eastern Europe in recent years to adopt children.
To be sure, many of the estimated 10,000 children who have arrived here from the former East Bloc since 1990 have adjusted easily to their new lives. But a large number - particularly those old enough to have spent several years in orphanages before being adopted - are showing the effects of years of physical, social and emotional deprivation.
In addition to predictable physical health problems - malnutrition, gastrointestinal ailments and infectious diseases such as hepatitis B - the children also bring a host of developmental and behavioral disorders ranging from mild to severe.
``In general, the longer ... a child is in an orphanage, the more the cognitive abilities decrease and the greater the risk,'' said Sharon Cermak, a Boston University professor of occupational therapy who has made several trips to Romanian orphanages to study the children.
Some adopting families, ill-equipped to cope, have given up their children, a process known as ``disruption.'' Others have filed suit against their adoption agencies, asserting they were not warned in advance about what to expect.
Although the problems associated with institutionalization are not new, ``we have had this absolute explosion in agencies involved in international adoption who come to this with no historical background and no appreciation of the issues involved,'' said Clyde Tolley, executive director of Families Adopting Children Everywhere, a Maryland-based support and education organization for adoptive families.
Most parents are determined to stay with it once their children are home, regardless of the challenges.
The possibility of such problems ``is just one factor in what is a very complex, personal and major life decision,'' said Deborah Hopkinson of Walla Walla, Wash., mother of 10-year-old Dimitri, adopted four years ago from a small town about two hours north of Moscow.
The post-adoption roller coaster has propelled most families into searching for the right kind of help for their children, help that is sometimes hard to find. Schools, day-care centers and pediatricians often shrug off the behaviors or misdiagnose them. And once parents find the right support, they often then must battle their health insurers for coverage.
Insurers often label the problems developmental delays. While many are developmental in nature, many children will not overcome them without intervention.
Sensory integration dysfunction can affect development. It is a condition in which the brain cannot properly process information received through the senses. Many professionals regard sensory integration dysfunction as neurological, but the environment can heavily influence whether a child will experience problems.
Some children with this syndrome cannot tolerate touch and react defensively to certain textures, particularly in food and clothing.
Others display the opposite extreme: Known as ``crashers,'' they crave touch. They bump into things, throw themselves on the floor and often cannot keep their hands to themselves.
For months after his arrival one Russian toddler covered his ears when he heard a toilet flush. A Romanian girl refused to wear clothes until the tags were removed.
Sensory integration dysfunction is treated with occupational therapy. Gains are often steady, but the process can be lengthy, often several sessions weekly for a year or longer.
Teachers and other school personnel often confuse sensory integration and other effects of institutionalization with attention deficit disorder and urge parents to consider medication, such as Ritalin.
Food also can create major problems for unsuspecting families.
``Many of these children won't let spoons come near their faces, and they spit everything out,'' Cermak said. ``They had never eaten solid food. Caregivers would mush it up and put it in bottles, even for older kids. They're not used to different textures; it's a whole new experience for them.''
Sara Romine, like many such children, showed indiscriminate affection to total strangers. In addition to being dangerous - many parents worry that their children will simply walk off with anyone - this tendency is a classic sign of attachment disorder, the inability to bond with a parent.
Children with attachment disorder are often superficially charming - a phony kind of charm - and fail to make eye contact. Control is a big issue for them; they always want to be the boss. Many lie, or show no conscience. Others display abnormal speech patterns, learning lags and a preoccupation with cruel, destructive or violent behavior.
``When we'd go out in public, Sergei would just crawl into the laps of strangers,'' said Laurie Holtz, a medical technologist from Seattle. She and her husband recently adopted Sergei, age 3, from Georgia. They also have a biological son and a daughter from Russia.
After some months, his mother says, Sergei has become ``a completely different child,'' able to trust a single primary caregiver. In general, younger children can overcome attachment disorder more easily than older ones.
Most families are determined to find solutions for their children.
``I never considered disruption,'' said Lily Romine. ``I never felt like I had to give up. I always felt I would find an answer for her.''
She found it from occupational therapists and speech therapists who worked with Sara on her own level.
Today, at 6, Sara is thriving.
``She's doing great. She's very social,'' Romine said. ``Other children love her, and she loves them. She's a wonderful, happy little girl who's getting along just fine at school, learning how to read. The teacher says she's the best listener. I don't think there's a little girl anywhere who tries harder than Sara.''
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