When to Seek Clinical Evaluation

While most internationally adopted children do very well, initial adjustment difficulties are to be expected in most cases (especially in older post-institutionalized children). Normal adjustment struggles, which typically subside over time, must be distinguished from pre-existing developmental or emotional problems, which may complicate child's post-adoption adjustment.

Pre-existing conditions, such as developmental and learning disabilities, depression, anxiety, and psychological effects of abuse or neglect, require prompt diagnosis and treatment in order to allow your child to proceed with the adjustment process.

It is often difficult for family and school professionals to distinguish between child's expected post-adoption adjustment struggles and possible clinical symptoms. If your child exhibits any of the signs described below, s/he may benefit from a careful, specialized, culturally-sensitive evaluation by a trained professional, who is experienced in the area of international adoption.

Signs of Difficulty May Include:

• Difficulties forming healthy attachment (e.g., withdrawn, excessively demanding, or "clingy" behavior)
  
  
• Behavior difficulties (e.g., aggressive behavior, lying, stealing, temper tantrums, or inappropriate sexual behavior)
  
  
• Persistent developmental regression (e.g., acting younger than chronological age most of the time)
  
  
• Persistent problems with peer relationships
  
  
• Evidence of depression, anxiety, low self-esteem
  
  
• Recurrent and distressing memories, nightmares, and hypervigilance