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Ask the Older-Child Expert: Timing of Services

By Gregory Keck, Ph.D.

Q:"We're about to adopt a seven-year-old. Does he have to start school right away? What about medical care? What can wait until we've bonded?"

A:Congratulations on your upcoming adoption! The first months after your child's arrival will be busy, exhausting times for everyone in the family. First and foremost, keep in mind that you've probably spent months, or even years, preparing to welcome a child, but the child you're adopting has probably had little or no preparation to become part of your family. You can't anticipate how successfully your child will manage the transition, but you can do much to smooth the journey.

Before the arrival
Adopting an older child isn't a decision anyone makes without a great deal of thought. Continue to research and read about adoption and parenting. Many social welfare and adoption agencies offer support groups or can connect families to those with similar experiences. Solidify these relationships now to ensure a solid support system after your child comes home.

You'll also want to identify the service providers you'll be working with. Older children often need occupational therapy, physical therapy, attachment therapy, or sensory integration work. If you're adopting from foster care and your child received services, ask your social worker if he can continue with the same professionals.

When your child comes home
What will you need to consider as you welcome your new addition into your family?

  • Medical care. Evaluating your child's health and securing any necessary services can't wait. Don't worry that doctors' appointments will interrupt bonding. The risks of delaying catch-up immunizations or therapeutic programs far outweigh any benefits from "cocooning." Take advantage of the car rides to and from the appointments as one-on-one time with Mom or Dad.
  • School and daycare. A child adopted from foster care, who has attended school all his life, can be enrolled in school immediately. But a child who has spent most, if not all, of his life in an institution should probably not be placed into yet another group-care setting. When children have multiple caregivers throughout the day, they have a harder time figuring out your role as parent.

    I recommend that one parent stay at home for as long as possible, spending time with the child until he begins to connect with you. (If there are legal concerns about not sending the child to school, explore a short-term, homeschooling arrangement.) How will you know an attachment is forming? He'll come to recognize you as having "standing" in his life. He will rely on you, approach you, ask for things, and request permission to do things.

    If staying at home isn't practical, see if a family member might be able to care for your child while you and your spouse are at work.
  • Rules and routines. Parents frequently try to help the new child by making few demands on him. Expectations, rules, and chores are put on hold. But this only makes it more difficult for the child to accept a role of responsibility later on. Structure and routine help a child feel safer. A child who has experienced chaos and instability needs to know that the adults in his life are in control.
  • Social situations. Spurred on by excitement--finally he's here!--some parents plunge the child into the family's life, introducing him to extended relatives, neighbors, friends, church members, and so on. The child may seem to accept and welcome these interactions, but he may be resentful internally, and wait until later to act out. Limit visitors, and expose your child to as few new faces as possible in the first weeks. Give him an opportunity to accept you before throwing him into unfamiliar experiences.

Family first
The most important factor in facilitating secure attachment is time. Forget about quality time--go for quantity time. Enjoy your child, and take advantage of any situation that will allow you to spend time with him. Play simple games, cuddle, laugh, have a regular family-movie night, and serve his favorite foods for dinner. The relationship you form now will be the foundation for your child's development throughout childhood, adolescence, and adulthood.

Preparing the Children at Home
How can you help your new child's soon-to-be siblings adjust?

  • Include them in the preparation. It's not enough to say, "You're going to have a new brother." Tell them what you know about your child's background. If you anticipate developmental or medical needs, assure the siblings that they won't be responsible for their new family member. They need to know that you will be taking care of everything.
  • Ask them what they most look forward to--having a new playmate, getting to be a big (or little) sib. Let the siblings help decorate his room, paint a sign to hang in the living room to welcome him home, or make a special meal on the day he arrives.
  • Discuss how things might change--household routines, after-school activities, family time--and be honest with them. You'll have more demands on your attention, but reassure them that each child will still be able to spend time alone with Mom and Dad.

GREGORY C. KECK, Ph.D., the founder of the Attachment and Bonding Center of Ohio, in Cleveland, has been working with adoptive families for nearly two decades. He's the coauthor of Parenting the Hurt Child (Pinon Press) and Adopting the Hurt Child (Nav Press), author of Parenting Adopted Adolescents (NavPress), and the adoptive father of two boys.

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