Question: I have heard that many institutionalized children exhibit many peculiar behaviors shortly after arriving home. Can you described some of these behaviors and what does a new adoptive parent need to do to help over come these behaviors?

Answer: Many peculiar behaviors can be observed immediately post-adoption in many internationally adopted children. These behaviors provide self-soothing, self-stimulation and oftentimes are used to attract the attention of the adult caregiver.

Some of the behaviors exhibited by many adopted orphan children include:

  • Head banging
  • Rocking
  • Head shaking
  • Swaying back and forth
  • Staring at the hands
  • Hand flapping
  • Biting and hitting others
  • Twirling and pulling hair
  • Smelling object
  • Fascination with spinning objects

For the socially neglected orphan child, the lack of  toys, limited human interactions, and the lack of loving parent experienced in an orphanage are the primary reason for this type of behavior. While these behaviors appear to be very peculiar, they are basically a normal response to the abnormal environment in which these children are raised. Some of these self-stimulating behaviors are so disturbing that they mimic the some of the behaviors of an autistic child.

In an orphanage environment, getting the attention of the adult caregiver is often extremely difficult. A well-behaved, disciplined child who does not disturb or bother anyone would never get any adult interaction. Many times, orphan children resort to attention-seeking behaviors such as biting, hitting, and various other types of tantrums in order to earn some extra adult attention. To a socially neglected and isolated child, even negative attention like discipline is better than no attention at all.

To the new adoptive parent, any of these behaviors can be very disturbing and heartbreaking. I recall a case of a 2-year-old girl from Russia. The parents at the Post-Adoption Evaluation described to me a peculiar rocking and swaying behaviors exhibited by their newly adopted girl. I tried to explain that this is a normal response to an abnormal environment. At our next visit, the parent’s showed me a video recording of the behavior.  The rocking and banging was so severe that I, as a physician, was moved by it.  Her movements were so violent that it mimicked seizure-like activity. The only thing that went against the diagnosis of a seizure disorder was the mere fact that the child was completely alert during this entire event. After a few minutes of this rocking and banging, the child would settle down and fall asleep, and the rocking disappeared. This ritual occurred for many weeks. As the child settled into her new family, the intensity of the episodes decreased dramatically– and finally the behavior mostly disappeared. The mother did report, however, that there are times when the child is under stress or being excessively tired that the behavior does resurface.

While I really do understand how disturbing behaviors like these can be to the new parents, I would like to assure you that these behaviors really do go away with time. As new adoptive parents, we must concentrate and reward the good behaviors while ignoring the disturbing behaviors. As parents, it is our responsibility to make certain that the child is always safe and that the behaviors in no way injure the child. If the child exhibits head banging as a self-soothing ritual, instead of allowing the child to hit his head against a hard wall, place a pillow or something soft to lessen the blow. These behaviors generally take weeks to months to self-extinguish, but eventually they do after the child settles into his new environment. It should also be noted that many times in moments of stress, these behaviors might reappear temporarily until the stress resolves. A particular case come to mind of a 20-month-old child who had resolved his head-banging only to reappear after being involved in a car accident.  During the car accident, the mother was rendered unconscious while the child was safe in his carseat. He was strapped in and was completely helpless, while his mother was not able to soothe him in the time of need. Lots of lights, sound, and commotion just overwhelmed this child. His body-rocking and head-banging reappeared for a few weeks, but after resettling into his normal family routine, his head banging and rocking have once again disappeared.  To date, the head banging ritual has not resurfaced.