Below are some terms used and brief definitions regarding children and adoptions. If any word used to describe a child or the adoption process is unclear to you, please do not hesitate to ask for an explanation.
Abuse: Many of the children waiting for adoptive families are victims of abuse. This includes sexual, physical and emotional abuse. The degree of the abuse, when in the child's life it occurred and its duration have varying levels of impact on the child. Sometimes children hide that they have been abused and may not reveal it until later. Abuse affects children differently and may cause emotional and behavioral problems that require the help of counseling and flexible parenting techniques to help the child heal. The abuse is never the child's fault.
Attention Deficit Disorder (ADD): Children with ADD usually have short attention spans and marked difficulty with concentrating. The child may seem to "zone out" often. Some may have learning disabilities also. Medication is sometimes used to manage the symptoms in order to help the child with school.
Attention Deficit Hyperactivity Disorder (ADHD): Similar to ADD in that the child with ADHD has difficulty concentrating. In addition, a child may also demonstrate disruptive, overstimulated or aggressive behavior and have trouble controlling impulses. This impacts school performance and makes it very hard for the child to stay on task. This disorder is typically more common in boys than girls. A child with ADHD can be challenging to parent. Medication and therapy can help to manage the symptoms. A specialist and not a teacher must do the diagnosing of ADHD.
Anemia: A symptom (not a disease) in which the blood is unable to provide adequate oxygen to the cells. There may be no obvious signs, but fatigue, drowsiness, headaches, dizziness and shortness of breath are common.
Anxiety: A feeling of apprehension, worry, uneasiness or dread. Excess anxiety interferes with a child's ability to function normally. This is common in children who have been abused and neglected. Treatment can include medication and/or therapy. Almost all recently placed adoptive children will have some degree of anxiety (so will the parents!).
Asthma: A chronic respiratory condition in which the child experiences repeated episodes of wheezing and breathing difficulty, usually caused by exposure to pollen, tobacco smoke, mold spores, animal dander, dust, pest residue and certain food or drugs. Many waiting children come from environments with these pollutants. Medications are used to treat and relieve attacks. Families with members who smoke would not be best for children with asthma.
Atrophy: Degeneration of tissue, such as muscle or nerves.
Attachment: The emotional connection that infants and children develop toward their parents and others who care for them. It is crucial in the child's emotional, cognitive and even physical development. Children who have experienced abuse and neglect, especially when very young, will have more difficulty forming meaningful relationships with others. Symptoms include controlling behavior, lack of eye contact, lack of cause and effect thinking, chronic lying, lack of remorse, low self-esteem, indiscriminant affection and superficial relationships. Attachment problems can range from mild to very severe. These children have learned not to trust adults, conversely, they can also learn to attach to their new adoptive parents.
Autism: Autism is a form of pervasive developmental disorder with an unknown origin. It can range from high functioning to severe in nature. Symptoms are a marked lack of awareness of the feelings of others and little or no social interaction or communications with others. Children with autism are often described as "within themselves" and may seem to avoid affection and love. Many children with autism will not talk, are self-isolating and self-stimulating. Routines are important because many children with autism cannot easily handle changes in their environment. They can be taught self-care, social skills and language skills.
Bonding: Is the process of developing emotional attachments and is used synonymously as attachment. Bonding is actually different and occurs automatically, without thought or effort. Types include genetic bonding, birth bonding, traumatic and transference bonding.
Cerebral Palsy: A condition characterized by paralysis, weakness, in coordination and/or other motor dysfunction caused by brain damage or birth trauma. Therapy and/or surgery can help the child minimize and sometimes overcome the difficulties of walking and being active.
Child: Any person under age 18. Must be under the loving care of at least one healthy and caring parent.
Cleft Palate or Cleft Lip: Conditions in which there is a rift or split in the palate or roof of the mouth or lower lip. Can cause delays in speech if not treated by surgery.
Club Foot: A congenital condition in which one or both feet are turned at the wrong angle at the ankle. Surgery is used to correct the defect to enable normal walking and activity.
Cocaine Exposure: Caused by the birthmother's cocaine/crack use during pregnancy. Many exposed children are born prematurely. After birth, the infant can be addicted and are often frail, easily overstimulated and stiff. These symptoms may disappear if there are no other complications. Long term effects may include learning, behavioral or medical issues. Early intervention can mitigate these problems. Training on parenting these infants is available.
Cognitive Delays: Delays in learning and thinking compared to other children of the same age. Mental retardation, attachment issues and drug exposure are some of the causes. Special education programs can help.
Congenital: Present at birth. Includes conditions arising from fetal development or the birth process that are not heredity.
Cystic Fibrosis: An inherited disease characterized by chronic respiratory and digestive problems.
Depression: A morbid sadness, melancholy or lack of hope. Symptoms include irritability or angry moods that can last most of a day and are present more days than not. Poor appetite, overeating, insomnia, low energy, low self-esteem, poor concentration and hopelessness can accompany the depressed mood. Severe cases can include thoughts of suicide. Treatment depends on cause and severity of the depression. Medication and therapy are usually effective.
Developmental Delays: Any condition or disorder that interferes with a child's normal developmental progress when compared to children of the same age. The delays can be in physical and motor abilities, speech, self-help skills and cognitive or emotional development. The implications for the child can range from mild to severe. Treatment varies based on cause, severity and type of delay.
Diabetes: A hereditary or developmental problem with sugar metabolism. Caused by a failure of the pancreas to produce enough insulin. Juvenile diabetes, or type 1 diabetes, is treated with diet, exercise and insulin. Type 2, formerly called adult onset, is now seen in overweight children. It is treated with diet, exercise and medication. In severe cases, type 2 diabetes is also treated with insulin.
Down's Syndrome: A condition resulting from a chromosomal abnormality characterized by mental retardation and such physical signs as slanted eyes, flattened facial features, short status and tendency toward obesity.
Drug Exposure in Utero: Besides cocaine, other drugs used during pregnancy can increase the risk of damage to the child's nervous system and child's development. Specific long-term effects are uncertain, but these children generally experience some behavioral and learning problems. It is often associated with ADHD. Early diagnosis of the developmental delays and subsequent treatments can reduce the overall effect.
Dyslexia: An impairment of the ability to read. Early diagnosis and educational intervention are essential.
Dystonia: Impairment of muscle tone often associated with cerebral palsy or other motor problems.
Educable Mental Handicapped (EMH): Mental retardation affects children in different ways and in many degrees from mild to severe. Some have educable retardation, meaning the child can be educated and trained for future responsibilities, again in varying degrees. EMH classes and programs are designed to help the child achieve a level of independence as an adult. Roughly 85 percent of all children with mental retardation fall into this category.
Emotional/Behavioral Disorder Classroom (EBD): A special education classroom for children with emotional and/or behavioral problems that interfere with the child's education. These classes are taught by specially trained teachers and generally have a small number of students. Many children eventually are able to return to regular classes.
Emotional Disabilities (ED): A disturbance of mood not due to any physical or mental disorder. Children with ED may exhibit lack of respect for authority, behavior problems in school, inability to cope with change and difficulty getting along with other children. They might also have trouble sleeping, have mood swings, be impulsive and appear unaware or unconcerned about the consequences of their actions. Medication and therapy are used in treatment.
Encephalopathy: A term describing any dysfunction of the brain. The disability may be a combination of disorders or may not be severe enough to define more specifically.
Encopresis/Enuresis: Is also called "soiling" and "wetting" respectively. It is the repeated voiding of feces and/or urine into the child's bed or clothes that may be voluntary or unintentional. Sometimes this incontinence is associated with particular disabilities like spina bifida, muscular dystrophy and cerebral palsy. Often in children with histories of neglect and abuse, especially sexual abuse, soiling and wetting are voluntary. They are expressions of rage. A thorough medical evaluation is necessary to rule out physical causes. Medication can help in some situations. Helping the child learn to control the problem without shame or guilt is most important.
Epilepsy: A recurrent seizure disorder of brain function characterized by a loss of consciousness, sensory disturbance and generalized convulsions. There are two primary types of seizures: petit mal (brief lapses or clouding of consciousness) and grand mal (child loses consciousness, falls, becomes rigid and has involuntary muscle contractions -- less common than petit mal). Epilepsy can be controlled by medication.
Expressive Language Disability: Problems associated with the child's inability to express himself verbally. This complicates parenting as the child can easily be misunderstood when he fails to respond to parental (or teacher) questions. Early diagnosis is imperative. Often exists in conjunction with sensory integration problems.
Fetal Alcohol Syndrome/Fetal Alcohol Effect: Also known as FAS and FAE respectively. Both are caused by alcohol use during pregnancy by the birth mother. The amount of alcohol and the timing of use required to cause these disorders vary from individual to individual. Babies born to alcoholic mothers may show signs of alcohol withdrawal and have low birth weight. Their heads may be smaller than normal (See microcephalus) and they may have facial abnormalities. FAS can cause a variety of birth defects, including mental retardation of some degree, and prevent the child from processing information quickly or easily. Children with FAS or FAE often have trouble developing good judgment and a strong moral system. FAE children generally have fewer physical abnormalities and may have average intelligence, but are troubled by behavioral and educational challenges.
Firm, Consistent, Able to Set Limits: Parents with these skills lovingly insist that children follow family rules and routines and set consequences for undesirable behavior. Firmness and consistency are the antidote for children who come from chaotic, inconsistent and sometimes dangerous environments. Children feel more secure and safe when they know their new parents will and can protect them. Ironically, limits are liberating.
Grief: Deep, prolonged mental anguish over a loss. All foster and adopted children must grieve the many losses each has experienced. Adoption only can happen after a loss for all involved: the birth parents, the child and even the adoptive parents, who must grieve for the child they would have had without infertility or the child they thought they were getting through adoption. There are five stages of grief: denial, anger, guilt, sorrow and recovery. Children often get stuck in one stage, and without successful grieving, the child's developmental progress will also get stuck.
Heart Murmur: Sounds from the heart other than those normally present. A murmur is caused by the blood passing over a rough-ended valve, flowing through a constricted opening, a defect in a heart valve, or by the backflow of blood through an incompetent valve. In children, many are not serious and do not restrict the child's activity.
Hemophilia: A rare, inherited blood disease of males characterized by defective coagulation and an abnormal tendency to bleed internally and externally.
Hydrocephalus: A condition characterized by enlargement of the head due to the increased accumulation of fluid in the brain. When children with hydrocephalus are not treated promptly, they will have below normal intelligence, physical disabilities and a variety of other medical problems. The most effective treatment is the surgical insertion of a shunt, a flexible tube placed in the brain which diverts the flow of fluid from the brain to another region of the body where it can be safely absorbed.
Hyperactivity: A higher degree of inappropriate motor activity than is considered typical for a particular age group. See Attention Deficit Hyperactivity Disorder.
Individual Educational Plan (IEP): A plan developed for an individual child who through educational testing is determined to have learning disabilities. By law, the child's educational plan is modified to accommodate the child's unique learning requirements. Approaches include placing the child in a self-contained classroom with a special education teacher, to having the child use the special education classroom for some subjects and be mainstreamed or in regular classes for other subjects. Sometimes the student is in all regular classes but receives help from a collaborative teacher and modifications on requirements for certain subjects. The child is to receive educational services in the least restrictive manner. Services also include speech and physical/ occupational therapies. See learning disabilities below.
IQ (Intelligence Quotient): A measure of intellectual functioning determined by the Wechsler Intelligence Scale for Children. It contains two subscales: a performance scale and a verbal scale. The performance scale measures the ability to solve problems without the use of words, to think rapidly in visual images and to quickly interpret visual materials. The verbal subscale measures verbal comprehension, which includes applying verbal skills and information to the solution of problems. It also includes the ability to think with words and the ability to process verbal information. The two subscales are combined and the IQ is referred to as the Full Scale IQ. Many factors can influence the test results, and unless the child has scored essentially the same over several tests, the results may not reflect the child's true ability.
Juvenile Arthritis: A chronic, inflammatory disease that affects the whole body and may cause joint or connective tissue damage throughout the body. It affects children before age 16, causing joint pain and discomfort. Juvenile arthritis can be helped by medication and physical/occupational therapy.
Language Disorder: A lag in the child's ability to understand and express ideas that puts linguistic skills behind the child's development in other areas like motor, cognitive or social development. Most are described as expressive and receptive language disorders.
Learning Disabilities (LD): Some children find learning in regular classrooms difficult. It does not mean they are not intelligent; it means they learn differently. Children with learning disabilities may be average or above average in intelligence. They have trouble sorting and storing information because of language disorders, sensory integration problems or expressive and receptive language disorders. A difference of 20 points or more between a child's verbal score and performance score on the IQ test generally indicates a learning disorder.
Children suspected of an LD should be tested as soon as possible. An inability to perform well in school typically is followed by behavioral problems resulting from the child's frustration level and embarrassment in the classroom. Schools are required by federal law to test the child and develop an individual education plan (IEP) specific to the child's needs which typically involves special education classes. These classes allow the children to reach their potential in a nonthreatening environment. Some students attend only the LD classes, which are referred to a self-contained. Some students only go to the LD class for specific subjects and are mainstreamed for other subjects. These are referred to resource classes. Some students take mainstream classes with modifications made on the coursework and have the LD teacher in the classroom to help. This is the collaborative model and allows the student with a learning disability to feel like a regular student.
Leveling: For determining which living environment is most appropriate for a child with behavioral problems. A combination of testing, parental and worker evaluations are used to assign a level to the child ranging from one to five. Children with higher levels generally need more structured and even restrictive living settings commonly found in therapeutic foster homes or residential treatment facilities.
Medically Fragile: A designation for children with a physical condition, as documented by a physician, which may become unstable and change abruptly, resulting in a life-threatening situation. Conditions can include children with nasal, gastric or gastronomy tubes. A child may have a tracheotomy that requires frequent suctioning. Drug dependence, apeana, diabetes, neurological or physical impairments that require 24-hour care are included.
Meningitis: A bacterial or viral infection of the linings of the brain or spinal cord.
Mental Retardation or Mental Handicap: Mental handicaps affect children in different ways with varying levels of severity. Mildly Mentally Handicapped (often covered by Educably Mentally Handicapped) means that a person can be educated and trained for some level of future responsibility. Special classrooms and programs can help these individuals to gain a level of independence, self-care and learning basic academic subjects. EMH generally refers to an IQ between 55 and 69. Trainable or Moderate MH children have IQs ranging from 40 to 54. The educational emphasis is on self-help and vocational skills. Severe MH is used to specify individuals with an IQ between 25 and 39. Basic communication and self-help skills are where the educational process is concentrated. Profound MH is for people with an IQ under 25. They require total care.
Microcephalus: A condition causing a small head with a sloping forehead that prevents normal development of the brain, resulting in a mental handicap.
Muscular Dystrophy: A hereditary disease characterized by progressive weakness caused by degeneration of muscle fibers.
Neglect: A term used to describe the absence of a proper, healthy nurturance of a child. Children who have experienced neglect may have some degree of emotional problems and developmental deficiencies. Neglect can be emotional, medical, educational, a lack of supervision or failure by the parent(s) to provide the basics of food, shelter and protection. Chronic, severe neglect can cause attachment problems up to reactive attachment disorder, and is especially damaging to infants. In many cases, neglect is far more harmful to the child than some abuse.
Nystagmus: A condition in which there are rapid involuntary movements of the eyes. It may indicate a brain malfunction and/or inner ear problems.
Oppositional Defiant Disorder (ODD): Many neglected and abused children are defiant given their lack of trust and anger over their mistreatment. ODD is more than that. It is behavior that lasts for at least six months and includes five or more of the following: loss of temper; arguing with adults (on just about everything); refusal to obey; deliberately annoying others; blaming others for his own mistakes; being touchy and easily annoyed; angry; resentful; spiteful and vindictive; swearing and using obscene language; and impulsive. Parents of these children must be firm and consistent. Family counseling is imperative.
Organic Brain Syndrome: A cognitive impairment to varying degrees which may include disorientation, impaired memory recall, distorted perception and emotional problems. Some of these are depression, anxiety and irritability. Behaviors can be affected with poor impulse control, acting out and aggression. Treatment is based on the underlying organic disease. Psychiatric care and a thorough evaluation are needed.
Paraplegia: A condition in which both legs are paralyzed.
Pervasive Developmental Disorder (PDD): An impairment in the development of social skills. Children with PDD have limited activities and interests that are frequently stereotyped and repetitive. They may also have delays in developing intellectual skills, comprehension of and using language, posture and movement, eating and drinking or sleeping patterns and responses to sensory input.
Poor Impulse Control: A lack of ability to control behavior or a lack of awareness of the consequences of a behavior. The behavior "happens" before the child is aware of what he is doing. A child with poor impulse control may be sneaky and manipulative, which makes it really hard for the parent to determine if the behavior was purposeful or an impulse. It is common in children with ADHD. Medications can be effective.
Post-Traumatic Stress Disorder (PTSD): A syndrome caused by re-experiencing traumatic events while being unaware of or unresponsive to current events or, in other words, a "flashback." A child may experience sleeping problems, nightmares, intrusive thoughts, have difficulty concentrating, self-destructive behavior, hyperactivity or anxiety/panic disorder. Therapy is crucial in managing PTSD.
Psychosis: A major mental disorder exhibited in seriously disturbed behavior and lack of contact with reality. Psychosis can be emotional or organic in origin. It can include delusions, hallucinations, regressive behavior and a disintegration of the personality. Many mental illnesses may have psychotic features. Immediate psychiatric care is required for the safety of the person and others.
Quadriplegia: A condition in which all four limbs are paralyzed.
Reactive Attachment Disorder (RAD): An inability to form normal relationships with others, especially the child's caretaker. RAD begins before age 5 and requires marked pathogenic neglect in the first three years of life. Children with RAD exhibit three specific problem areas: 1) They are unable to form attachments; they form relationships only on the basis of need with little or no regard for one caregiver over another. 2) They exhibit developmental retardation in that they have difficulty with conceptual thinking (lack of cause-and-effect thinking). 3) They show poor impulse control and are especially aggressive. The most disturbing feature is their total lack of remorse. These children do not allow themselves to be parented; they need to be in control.
Most children in the system have attachment problems, but few actually have a RAD diagnosis. Attachment is a learned behavior. Children with RAD need very specific counseling to overcome it and often also require residential or psychiatric care.
Receptive Language Disabilities: Difficulties that derive from a child's inability to understand spoken language. This can cause major problems in school and complicates how a child is parented.
Residential Treatment: Some children need a structured out-of-home placement for their behavioral/emotional problems. Residential treatment facilities provide 24-hour care with counseling, therapy and trained staff. Children are placed in residential treatment only after their families have unsuccessfully tried other ways to help the child. A child may need residential treatment for his own safety or for the safety of others. Residential treatment works best when the family is involved through family counseling.
The use of residential treatment is not a sign of failure of the parents. It generally reflects on the severity of mistreatment the child experienced before being placed for adoption.
Schizophrenia: A mental illness manifested by psychotic behavior and loss of contact with reality, bizarre thought processes and paranoia. Schizophrenia can usually be managed with medication.
Scoliosis: A curvature of the spine, either congenital or acquired by very poor posture, disease or muscular weakness due to certain conditions such as cerebral palsy or muscular dystrophy. If caught early it can be easily treated.
Seizure: A convulsion or sudden alteration of consciousness, which is usually accompanied by motor activity and or sensory phenomena, caused by an abnormal discharge of electrical energy in the brain. Two common types are petit mal and grand mal seizures associated with epilepsy.
Sexual Abuse: It is estimated that 90 percent of special needs children have been sexually abused in some fashion. This includes boys, girls and even infants and toddlers. Sexual abuse ranges from children witnessing adult sexual behavior, fondling, sodomy and intercourse. The child's relationship to the perpetrator, the method by which the perpetrator gained the child's trust and the type and duration of the abuse result in varying reactions from the children. Many suppress it for years, but the behavioral ramifications may indicate sexual abuse is indicated; some children who have been sexually abused may act out sexually in a variety of ways. The abuse may surface at later time, for example, when puberty starts. Children will need therapy to reduce the impact of sexual abuse, and parents will need additional training and a willingness to work with professionals for the child's sake.
Sickle Cell Anemia: A severe, chronic blood disease that is hereditary in origin. The abnormal gene produces a crescent shaped red blood cell, which causes the hemoglobin to crystallized within the cell and form painful blood clots and many other medical complications.
Spasticity: A condition in which there are sudden, involuntary contractions of the muscles making voluntary movements more difficult and inaccurate. Spasticity is common in children with cerebral palsy.
Speech Disorder: Oral communication that exhibits poor or abnormal use of the vocal apparatus, is unintelligible, or so inferior that it draws attention to itself and causes anxiety, feelings of inadequacy or inappropriate behavior in the speaker. Stuttering is an example. Speech therapy can be helpful.
Spina Bifida: A congenital midline defect resulting from failure of the bony spinal column to close completely during fetal development. Spina Bifida causes major physical complications.
Termination of Parental Rights: The voluntary or involuntary court action, which removes all rights and responsibilities of the parent and frees the child for adoption.
Tourette's Syndrome: A disorder characterized by involuntary, sudden, rapid and recurrent movement or vocalization. Common motor tics are eye blinking, neck jerking, shoulder shrugging and facial grimacing. Vocal tics can include repeated coughing, throat clearing, grunting. sniffling, snorting, barking and swearing. If not diagnosed, these behaviors can cause a child to be misunderstood with major ramifications. Certain drugs have allowed dramatic improvement in some patients.
Waiting Child: Any child who has been freed by the courts in order to be adopted. This is a child that could not return to the birth family and was not adopted by the foster parents or by any of the families who are approved to adopt special needs children. These children are faced with the reality that no one wants them...every day.