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Adopting Again with Prenatal Alcohol Exposure in the Family, Part II

August 8, 2011

This is the second post in a short series on adopting again after bringing home a child who has PAE (prenatal alcohol exposure) and with that, the possibility of a future FASD (Fetal Alcohol Spectrum Disorder) diagnosis.

Often, families begin their adoption journey with some ideas about how many children they eventually want adopt and why. Two very common reasons for adopting again are the desire to have another child of the same ethnicity and/or another child who joined the family via adoption. That is a common theme among adult adoptees: it is isolating to be the only child with those life experiences.

So many parents approach adoption with the hope to eventually adopt more than one child. But sometimes reality intervenes: an adopted child’s actual needs are more challenging than anticipated and parents are left wondering which is the greater good: focussing on the needs of this child or opening their home to another child who needs a permanent family?

In Part I of this post I repeated the professional recommendation that children with known PAE, should be screened for developmental evidence of brain damage between the ages of two and four. Not all children with PAE who are screened will show areas of concern.

An aside: in kids with PAE/FASD, their ability  to conform to expectations and to perform tasks as requested varies widely from day to day. Some kids with FASD also have unusual social charm that can temporarily mask deficits. So if the person  conducting the screening is not a FASD clinician and sees no red flags, but your own concerns are not allayed, trust your gut despite the screening.

We did not have Hope screened as a toddler because we were still unaware that the small amount of alcohol her mother reported could be a problem. Nor did we know that we should seek screening anyway. But we had  multiple areas of concern. Even with no clinical findings for back-up, for the first three years of Hope’s life, God made it mercifully obvious that our plate was too full to adopt again. It was not that we had no desire to adopt again. We simply surrendered the dream because, for all we knew, we were looking at an entire lifetime with that level of challenges. We could tell she was not growing out of her behaviors at the rate everyone assured us she would.

I appreciate now that it was a grace to us that Hope was not our first and only child. Had she been, we may have intuitively created a family environment that enabled and obscured her real needs. With undivided attention from mom and dad and no siblings to provoke, Hope’s God-given charm might have kept us in the dark for a while. It was also a grace that we had not committed to adopting another child right away. At that time, Korean special needs adoptions were taking about 12 months and we would have renewed our home study before Hope turned one, when her manifestations of FASD were still in an infancy honeymoon period. So had we recommitted as soon as possible, the next child would have come home in the thick of Hope’s toddler years.

However, I can also say that Hope’s toddler years were so difficult in part because we, her parents, knew nothing about FASD. We understood nothing about the kind of environment a child with FASD needs to bring out her strengths and support her weaknesses. Parenting her in ignorance, we created a layer of secondary disabilities that exacerbated her FASD deficits.

That’s why it so critical that all parents who adopt a child with PAE educate themselves about FASD. Not because every child with PAE will have FASD.  But so you will have the tools at hand to intervene if necessary in order to prevent secondary disabilities from developing.

Listen to Kari’s description of what happens to families when secondary disabilities go unrecognized and unaddressed:

“Most of us are aware that our children develop “defensive behaviors” when there
is a poor fit between their environment and their needs. For example, a child
who is chronically frustrated in school may start to act out there or stop going

Parents are no different. Adoptive parents of children from
the hard places have additional needs because of our children’s needs. We, like
our children, need to be heard, understood and supported and when we are not, we
can also develop negative defensive behaviors.

When we do not fully
understand or are not supported in understanding the needs of our children, we
can spiral into a toxic consequence cycle. When this typical parenting approach
does not work with our atypical children, we might understandably sink even
deeper in this punitive approach. When the world steps in and sees our behaviors
at that point, they become quite concerned…as they should. But they have no
understanding of how this happened. The needs that brought about this cycle are
not addressed. There is only blame and punishment.

This is exactly what our children experience in this world. We have stepped into their shoes.”

(Kari at Coffee Catharsis, “Guard Your Heart” 8/7/11)

No family with a prenatally exposed child can afford to invest years in ineffective parenting strategies. But families who are trying to plumb the depths of their child’s challenges in order to make an adoption decision can afford to waste even less time. You need to identify the parameters of their true disability, not ascribe the immutability of brain damage to behaviors caused by a mis-fit between your child’s needs and your family’s environment.

While the brain damage caused by prenatal alcohol exposure will always be with us, Hope’s challenges as a toddler are not the same challenges we live with today. Mercifully, God led us to a set of more effective parenting strategies early on, in time to ameliorate the secondary disabilities that had arisen during the two years she and my husband and I were all baffled and beating our heads against walls. With those secondary issues pushed from our family’s foreground into the background (we will always have to work to keep them there), we had a clearer picture of what she (and we) have been given.

And with that appraisal, God blew life into our dream of adopting again.

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