Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Tuesday, October 9, 2012

Starving and Beating Adoptees in Allegheny County: Some Speculations


Has everybody breathed a sigh of relief that the State Department has got everything fixed for Russian adoptees? No more starvation, no more restraint? Great, let’s move along to the Ethiopian children. No Ethiopian Pavel Astrakhov has yet appeared on the scene, but one is needed.

Last  week, adoptive parents of two young Ethiopian children were arrested in Allegheny County, PA (http://pittsburgh.cbslocal.com/2012/10/04/deputy-attorney-general-wife-charged-with-abusing-adopted-children). One child, a boy of 6, was badly malnourished, and an 18-month-old girl had skull fractures that may leave her blind. The children, who were adopted through a church organization, had been since March in the home of the adoptive parents, Douglas and Kristey Barbour. Mr. Barbour is a Pennsylvania deputy attorney general.

What was happening here? Very little has been revealed so far. I’ve seen considerable Internet speculation that the elite adoptive parents were deliberately cruel to the black children, and although I acknowledge that the children’s ethnicity did not stop the parents from abusing them, there are too many cases of “white-on-white” abuse for me to think that the parents were especially motivated to abuse by the children’s skin color.

There are other possible explanations---  and I don’t bring these forward in an attempt to excuse the Barbours, but because understanding these situations can help us to prevent them from occurring again. Neither do I suggest that a single explanation can do the entire job, so more than one possibility needs to be considered here.

  1. The first possibility I want to consider is that the Barbours were in fact encouraged to use certain “tools” in dealing with the children, and that this encouragement gave them permission to go much too far. There are groups like the “No Greater Joy” ministries that advise physical punishment for disobedience for children as young as 4 months (yes, months ). There have been some deaths associated with that sort of treatment, but they have involved shock from being whipped severely, rather than the skull fractures in the Barbours’ case. The key to understanding this will be to find out whether the Barbours were committed to the idea that instant cheerful obedience must be obtained at all costs, and failing to achieve this easily, they turned to blows.
In addition to the physical punishment “tool”, there are various sources for the recommendation that a child’s diet be restricted in order to display the authority that these people claim is the cause of emotional attachment (see the beliefs of Nancy Thomas, for instance). I have discussed this before at http://childmyths/blogspot.com/2010/12/federici-v-mercer-story-behind-lawsuit.html.  To the best of my knowledge, practitioners do not advise parents not to feed a child at all, but just as a mild spanking can turn into a beating when an adult feels the need to escalate, so can food restriction become a starvation situation.

  1. A second possible explanation for the Barbours’ abusive behavior is the Post Adoption Depression that has recently been discussed on this blog. Depression in many adults involves irritability and shortness of temper as well as the characteristic sadness. Irritability adds to the potential for physical lashing-out against a child whose normal behaviors are found annoying, who perhaps does not go to sleep as instructed or who drops food by accident. Although maternal depression has often been attributed to hormone changes following pregnancy, it’s pretty clear that it can also depend on the challenge of life with young children. (A reader recently pointed out that adoptive parents tend to be older than biological parents and may have life difficulties associated with their greater age--  perhaps responsibility for care for elderly parents rather than a younger person’s expectation that their own parents may be helpful. Adoptive parents may also have very high standards for themselves and feel depressed at their failure to live up to an unrealistic level of performance.)

  1. I have no explanation to offer for the battering of the little girl, beyond what I’ve said so far. But I have to wonder whether starving the boy was associated with poor understanding of the eating habits and nutritional needs of children from other cultures. A 6-year-old is old enough to have strong habits and expectations of what food should be like and how you eat it (hands versus forks, plates versus a communal pot). Adults from the United States suddenly shifted to an Ethiopian diet (delicious but spicy by our standards) might well suffer stomachaches and be reluctant to eat. What was this child’s experience? How did he respond? Did the Barbours take his reluctance as disobedience that had to be nipped in the bud? For other adoptive parents dealing with this kind of situation, I’d like to point out the enormous help that the SPOON foundation (www.spoonfoundation.org) can be in understanding what a child’s past diet and eating habits probably were, and how to make a dietary transition and ensure that nutritional needs are met.

I am hoping that information about these points will emerge in the course of the trial. I would not be surprised to find that all the points mentioned above worked together to cause the terrible outcome. If any reader knows more about this case than has so far appeared in the news, I would like to hear from you.



15 comments:

  1. I know that it's important to try to understand all the post adoption issues in order to try to prevent this horrible treatment of children, but my instincts keep telling me, it's not depression, it's not bad advice, it's not cross cultural food issues. it's that people who abuse child like this are mean, cruel and smart enough to hide it from any reasonable home study that could be done.

    Better post placement supervision, or some sort of required monthly playground with the home study SW in attendance and handing out tips? Maybe this would help spot problem situations better. I don't know.

    It just makes me so mad and sad it's hard to look at it objectively.

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  2. I know, it just makes us feeling like attacking the parents. But that won't keep it from happening again, and that's why it's important to figure out what's behind the cruel behavior, that could be detected before the adoption took place.

    Much better post adoption supervision would certainly be a good idea, especially when more than one child is adopted at a time. But-- and here's where we get down to brass tacks-- this will only work if SWs pay attention, refrain from making a premature alliance with the parents, and don't fall for the "bad advice" (some of which has actually appeared in SW textbooks). Have a look at the Florida grand jury report on the death of Nubia Barahona and you'll see what I mean.

    Unfortunately, placing a child for adoption is seen as an accomplishment-- whereas in fact some children would be far better off in long-term foster care or even in an institution than
    with the adoptive parents they get.

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  3. But to what degree do we also see these same types of problems in long term foster care or institutions? Without data, there is little way to know which situation is higher risk for the children. Do we have any data?

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  4. There are certainly records kept on these things, at least where it's official foster care rather than an informal arrangement. While no one could accurately say that abuse never occurs in institutional settings, their advantage is that it's much more difficult for an individual to abuse one child repeatedly without anyone else noticing. If you're a staff member and you come on your shift and see that a child has been injured, acts strange, or is unusually hungry, you know that any abuse occurred on the previous shift and you know who worked that shift. What's more,you're a mandatory reporter, and although you might want to protect your co-worker, you know that you will be implicated if you don't report.

    The real problems in institutions probably arise when a senior administrator is involved-- as in the "pindown" scandal in Britain 20 years ago.

    As for foster care, the children's safety and well-being should be monitored by caseworkers regularly, and this in theory should provide some surveillance, although not as frequent attention as would occur in an institution. A current problem seems to be the use of private firms who supply caseworkers for this purpose, and in a number of cases have not made sure that the caseworker actually saw a child-- with several child deaths as a result, as in the Nubia Barahona case I mentioned before.

    It's also important to remember that biological parents sometimes abuse their children. Much as we would want to imagine a system without any abuse, we need to face the fact that at present, child abuse is one of the things human beings do. Handicapped children are more likely to be abused than those with typical development, and parents in some circumstances are more likely to be abusive than others.

    To protect adopted children, we seem to need serious supervision of the family through at least some months of the adoption, especially if more than one child is adopted at a time, if the children's language is not the same as the adoptive parents', and if there are physical or mental handicapping conditions. The U.S.- Russia adoption treaty allows for ongoing surveillance of Russian-born children in the U.S. and regards those children as retaining their Russian citizenship-- but the mechanism for the surveillance has not been publicly spelled out. We'll see whether it's effective.

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  5. I completely agree with the majority of your response. My one disagreement is with the conditions of Institutions. IMO we have to compare the data on instance of child abuse and neglect of international adoptive parents to the child's institution of origin where inadequate nutrition, inadequate medical care and vaccinations, inadequate stimulation may be more common and the structure for preventing neglect and sexual, physical abuse perpetrated by workers is lacking.

    In the city where my daughter was adopted from there were children in orphanage uniforms, runaways who would rather live on the streets in winter than in the orphanage. Those children have a right to better care AND the children in this article have a right to better care than they got from their AP.

    But, that leads me to completely agree, better post-placement supervision may be an answer, at least in part. Of course, what's better and what's good enough could be a lengthy discussion in itself.

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  6. Oh-- the institution of origin-- I'm sorry, I didn't understand the point you were making. Naturally that's a completely different thing, with all the inadequacies and dangers you mention.

    I was trying to compare U.S. institutions, foster homes, and adoptive homes.

    By the way, I don't know whether you've seen the work of Michael Rutter and others comparing outcomes for children in Romanian foster homes vs. institutions. They concluded that foster homes had a very positive effect, relative to the institutions.

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  7. I have not. I should check it out. It seemed that China was moving in the foster home direction, but then pulled back for some reason. I'm not sure now. I haven't kept up on it. Very thought provoking discussion, thanks!

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  8. In U.S. foster/adoptions in Massachusetts, there is a mandatory "waiting period" of 6 months prior to finalization (and it's often much longer than that if termination of parental rights has not occurred) where the pre-adoptive family is seen by a social worker at least once a month---or at least once a week in intensive foster care programs (where many of the most damaged children are placed). And that provides a tremendously important point of oversight, education, and support when a child has first moved into a new home. It's not foolproof, for sure. But it's far more support and attention than the vast majority of internationally adopting families receive---pre- or post-adoption.

    As the mother of two children who had been in foster care as well as in institutions (residential treatment centers as well as psychiatric hospitals), I would have to say, from purely personal experience, that abuse is rampant in any living situation that is transitory---i.e., where the child does not develop roots and connections in the community that grow strong enough to allow that child to trust an adult enough to report neglect/abuse.

    And, please remember that abuse in institutions is not only (or even primarily) visited upon children by adults, but by other, usually older children as well. And that's extremely hard to prevent, even in small secured facilities with 24/7 awake staff.

    There will always, I believe, be a need for foster care and adoptions for children who cannot remain with their birth families, either for the short-term or the long-term. But the current child welfare programs, which tend to rip children away from all their naturally formed support systems, and drop them, like involuntary refugees, among strange adults is about as dangerous for vulnerable children as we could invent if we were setting out to create a system that would lead children to becoming, quickly "good victims" of abuse and neglect.

    In an ideal world, I would want programs that leave the children in place, and remove/add adults as necessary. Especially with children above the age of 3 or so, who have started, through daycare and preschool, to make some relationships (potentially safeguarding relationships) in the wider community, this could be lifesaving if the new, presumably improved adults in their young, hurt lives are not up to the task of caring for them---and healing them.

    And, finally, let's remember that many, many of the children who enter into formal surrogate care enter as victims of trauma and do, indeed, have healing to do. Often, that's just more than people know how to deal with: good, kind, well-intentioned people, as well as authoritarian, controlling, punishing people.

    I believe that it's only the rarest of cases where something like evil results in the abuse and neglect of children---whether in birth families or any of the many kinds of surrogate care. But ignorance, lack of witnesses, the child's lack of confidence or a voice, desperation, greed, mental illness, selfishness, anger, disgust, disappointment, depression, narcissism, etc.---all of these can combine to result in an outcome that sure looks like the work of evil.

    I don't believe that the "It takes a village" approach to childrearing is always the best approach, but it certainly takes a village of eyewitnesses who care about a child's well-being to ensure that every child who is in danger has a safe adult to lift them out of harm's way.

    Any family or group of families who engage in an extreme form of isolation from the larger community engender my suspicion. Always. Perhaps unfairly. But privacy is the first ingredient for child abuse and neglect, in my experience.

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    1. An eloquent and thoughtful statement-- thanks very much for articulating the ways that banal issues lead to evil outcomes.

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  9. certainly a part of the equation must be that it's the adoption families that are monitored to some degree and therefore the adoption parents are the ones who get caught, and get publicized. Otherwise, I'm back to the idea that these adopted kids are being brutalized for the crime of not being biological kids.

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    1. You never quit, do ya? Always with the evolutionary view!

      Actually, when it comes to severe malnutrition and fractured skulls, I would expect that bio parents are just as likely to get "caught". For milder problems,you may be right that adoptive parents who are monitored may have their actions detected.


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    2. You never read Cinderella? Never heard of people giving preferential treatment to their bio kids (and shitty treatment of the non-bio ones)?
      I fail to see what your three ideas have to do with adoption specifically. Harsh advice, parental depression,and 'he wouldn't eat his boiled vegetables?'
      You might wanna try incorporating a little evolution.

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    3. Oh yes, that literature is helpful. As I understand it,it also says that youngest sons are always the cleverest and best-looking, that trolls live under bridges, and that mice can be turned into horses.

      The ideas I mentioned do in fact have more to do with adoption than they do with bio parenthood. Adoptive parents receive more advice than bio parents, including pre-adoption training sessions, and some of that advice stresses the need to exert authority over adoptive children, and claims that all adopted children are grieved and distressed for life (see N. Verrier).

      Depression among adoptive parents is less likely to be recognized as what it is than when it occurs among bio parents (see the many comments on this blog that deny that it's even possible in adoptive parents).

      And it's not about eating vegetables, but about recommendations of persons like the attachment therapy advocate Nancy Thomas, who has stated that peanut butter sandwiches and milk make a perfectly balanced diet, or others who make the child's food dependent on the parent's approval of his behavior.In the case described above, we had a child who weighed 47 pounds when adopted and 37 8 or 9 months later; that didn't happen because of refusal of carrots.

      Ockham's razor says we have an adequate number of factors here and don't need to appeal to evolutionary concepts-- indeed, if we did stress those ideas, we might well miss the possible causal factors I've laid out.

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  10. This comment has been removed by the author.

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  11. If anyone wonders why I deleted that comment-- it didn't go in the place where I wanted it.

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