We had a call today from our socialworker's supervisor. She lives in Chicago. She was reviewing our homestudy and called about some "red flags." When she said this, I got a little worried. I know Chance had a rocky childhood, but I didn't know what she wanted to address. To our surprise, she wanted to go over N.'s report with us. She had red flags because she thought we didn't understand what it meant to adopt a child with special needs.
She personally has a child with autism so she has a very "real" perspective on life. I was thankful she called, but it was also very discouraging. She made it sound like the only good and successful adoptions were with children who were involved in "healthy-child" adoptions.
I realize that she is the person who has to deal with disrupted adoptions (adoptions where the child placement does not work out). I know she's probably seen couples get in over their heads, but she all but diagnosed N. with autism. It was interesting too because we told her some of the things our doctor pointed out in N.'s report and she seemed to discredit all of them.
After the phone call, I told Chance that I appreciated her honesty and her realism, but I've also worked with parents who have autistic children. Many of them end up over-diagnosing kids onto the spectrum. For example, I work with another therapist whose son is autistic. The first child we saw together had a mild speech and cognitive delay - probably from lack of exposure and interaction. His parents had some mental disabilities and weren't parenting in the most effective ways.
This therapist automatically asked if I thought the child had autism. The therapist said that he believed the child exhibited many of the same behaviors as his son. I honestly told him that I didn't know, but my first guess was that the child and his family just needed guidance. Sure enough, six months later and he's talking, communicating, and thinking at a much more appropriate level. The therapist has worked hard on getting his parents involved. They've gained a ton of parenting skills from the therapist.
I guess I'm just trying to say that sometimes the parents of autistic kids are overly sensitive to some of the autistic tendencies exhibited in children with delays.
After getting off the phone with this gal (and thinking that we might be crazy for even wanting to adopt in the first place!) I picked myself up and composed the following email:
We just spent 30 minutes on the phone with [our social worker's supervisor]. She had some very realistic questions about N.'s file. Unfortunately many of those questions will go unanswered until he is seen in person. Specifically she raised the question of an autism diagnosis. Chance and I are very willing to adopt a child with special needs, but we are not wanting to take on a child who will need permanent care. We would like for our child to grow to become self-reliant and independent. This leads to my question. What if we were to travel to Bulgaria, meet with N. for two of the five days, and we realize that he is not the child for our family? Would there be a possibility of spending time with another child who needs to be adopted? Would it still "count" as our first trip to Bulgaria?
We have been continually affirmed that God has placed N. in our lives for a reason. We're continuing to trust His plan, but we also are guarding our hearts and preparing for a worst-case scenario.
Any answers you might have would be helpful! Also, Martin, you've seen quite a few Bulgarian files. Is autism regularly recognized and diagnosed in the medical facilities? Have we heard any news about the possibility of an update report and pictures?
Martin (who is the U.S. rep for Bulgarian adoptions) responded with this email:
First, let me thank you and Chance for the lightning response on the paperwork.
The issue of Autism for N. specifically: In the beginning, I had concerns too. What made me think that this is not a case of a child with Autism is the fact that he responds positively to and initiates contact with adults. Also, from the report, I see that he shows a range of emotions.
I still have concerns about him demonstrating stereotypical movements and playing alone but these could be attributed to the overall orphanage influence: lack of stimulation (children tend to self stimulate, which might result in stereotypical movements), lack of intentional teaching of social skills - this can result in children having social/emotional delays. Attachment issues that are common for children in an orphanage can also manifest themselves in isolating oneself from the rest of the children, difficulty with building relationships etc.
When we spoke on the phone, I shared with you that what I see in the report leads me to believe that this is more of an "institutionalization syndrome" rather than some specific diagnosable condition. This has been my experience with a lot of children living in BG orphanages and they were not classified as having a special need either. It is difficult to say by looking at the report only.
A key thing to look for will be: can he maintain eye contact, how well does he initiate contact or attempt to engage others. His language skills are a concern: again, it is difficult to say whether the delay is due to lack of stimulation or to some medical/psychological condition.
To answer some of your other questions:
Psychologists working with children in BG orphanages are able to and have diagnosed children with Autism in the past. I have not seen too many differentiations between PDD, Aspergers, Rett's, or CDD but have seen Autism diagnoses.
As I told you on the phone: You are not committing to adopting this child. After seeing him, you can make any decision you feel is best for your family.
I did already pose the question: If you and Chance could look at other children while you are there. We were told "no" by the Minister Of Justice (they pretty much referred us to the procedure for receiving permission to see a child - your application has to be approved by the MOJ first).
I also asked for an updated report on N. including permission to contact the orphanage staff and take some pictures and/or a video.
As part of the process of extending N.'s placement with NBA, the MOJ must provide us with updated health information and pictures too.
I understand your trepidation and even fears. Like we discussed on the phone: both you and Chance should approach the referral of N. with love and care but also should try to remain objective and gather information, as well as opinions from people you trust. And, Yes, you should "guard your hearts" against disappointment.
Since you mentioned "the worse case scenario", let me reiterate what I shared with you on the phone: the Child Reports we get from BG tend to be quite critical of the children's abilities and achievements. While that does not sound like a humane and loving thing to do, it gives me some reassurance that what's on the reports is "the worst case scenario". I hope that I am correct and that you will be positively surprised.
I will try to get more information on N. and will send it to you as soon as it becomes available.
So, his email at least calmed my heart - for the time being. Please be praying. As Chance said earlier tonight - if God has called us to adopt N., who are we to tell Him "no"? Pray that we can quickly become prepared to make these tough decisions. It sounds like we'll be going to visit N. in about two months. Crazy!