Therapist, physician husband thought they could raise a troubled girl. They couldn't

Monday, August 14, 2000

By Cindi Lash, Post-Gazette Staff Writer

In her first meeting with the 4-year-old Russian orphan who was to become her adopted daughter, Anna sensed trouble.

But as a family therapist for nearly a decade, Anna knew about assessing and treating disorders, syndromes and psychological problems. She and her physician husband believed they cou ld cope with the physical and mental ailments that can affect previously institutionalized children.

They were wrong. Fifteen months after Anna and her husband decided to adopt the blue-eyed girl with blond ringlets and a double-dimple smile, they gave her away.

"We were professionals and we thought we'd know how to help her," Anna said. "But she really did things you wouldn't think of [from a child so young]. I don't think a child like this can live in society."

Anna, 45, and her husband are among a small but growing number of parents who have opted to disrupt -- or dissolve -- adoptions because they could not provide the level of care their adopted Russian-born children required.

Experiences like theirs prompted the Russian government earlier this year to suspend international adoptions while it overhauls its adoption system. Anna, who lives with her husband and a 12-year-old daughter in an affluent Western Pennsylvania neighborhood, told her family's story on condition that her last name and details about her family be withheld.

In addition to doing research, Anna talked with other families that had adopted from Russia before choosing to work with Adopt-A-Child, an agency in Squirrel Hill. With her husband and their then-10-year-old daughter, they flew to Russia in July 1998 to formalize the adoption.

Unlike other children in the orphanage, the 4-year-old girl had no apparent physical problems. She was "big and blooming," and exhibited none of the fearful, retiring mannerisms displayed by other developmentally delayed children there.

Anna said her diagnostic antenna went up quickly as she observed how the girl fawned over her husband. To her, that suggested reactive attachment disorder, which often affects children raised in institutions without individual attention or care.

Those children develop without learning to form attachments and, as a result, are often indiscriminately affectionate with strangers.

The girl also balked at doing what others wanted her to do. To Anna, that suggested oppositional defiant disorder -- another syndrome common in children who've been abused and institutionalized and are used to looking out for themselves. The presence of a venereal wart on her tongue was a sign of past sexual abuse.

"From day one, [I suspected] trouble," Anna said. "I had an idea and I should have listened to it, but I thought I knew what oppositional defiant [disorder] was and how to approach it. We so wanted to make this work."

At home, the family's struggles began and intensified. Every morning meant a battle to bathe, dress and feed the girl while she screamed, kicked, clawed and bit.

Despite the efforts of Anna's older daughter to win the girl over, the girl smacked and hit the older sister, then began sidling up and whispering, "I hate you. I'm going to kill you."

At night, the adopted girl delighted in poking her fingers into her mother's windpipe while they read bedtime stories. She choked her dolls, tormented the dog and acted out sexually.

Anna and her husband knew the girl's behavior resulted from having spent most of her life in an orphanage, and they sought to counteract the effects of institutionalization.

The family began treatment with a therapist in Shadyside who'd been recommended as an expert in treating children with attachment disorders. That therapist has since left the region.

The girl was diagnosed as having up to 12 disorders, including reactive attachment, post-traumatic stress disorder, obsessive-compulsive disorder, bipolar disorder and multiple learning disabilities.

The therapist prescribed exercises aimed at helping the girl learn and establish bonds with her family. The therapist also advised confining their older daughter to the second floor of their home until the younger girl felt less jealous of her and her place in the family.

Anna quit working, stopped studying for her doctorate and acquired a library's worth of books and videotapes dealing with the younger girl's disorders. Their older daughter huddled in her room or fled the house to visit friends.

One day in the park, the girl saw a woman cuddling an infant on her lap. Anna was touched to see the girl's face wrenched with longing for the kind of mother's love that she had been denied as a baby.

But in May 1999, the younger girl erupted at the sight of the older girl on the first floor. Grabbing a pole used to open a skylight, the girl beat her older sister bloody and nearly unconscious before Anna heard screams and pulled them apart.

"Who would believe a 5 1/2--year-old girl could do this?" Anna said. "I grieved that whole month of May, when I could see she was really going down the tubes. I felt at times like I'd built a bond with her. But the day she beat my older daughter, I felt I couldn't take care of her anymore."

The family installed a security system to make sure the girl didn't attack them while they slept behind locked doors. Afraid for their older daughter's safety, they sent her to relatives in Boston when school ended.

One day at summer camp, Anna found the girl holding a child's head underwater in a stream because that child had supposedly taken her milk carton.

"The other girl's mother came running and she looked at me like I had a monster," Anna said. "I knew that, but I didn't make the monster."

Desperate for help, Anna and her husband contacted Dr. Ronald S. Federici, an Alexandria, Va., developmental neuropsychologist who is internationally known for his work with once-institutionalized children. Anna said Federici assessed the girl later that summer, then bluntly told her and her husband that the girl would try to kill their older daughter if she came home.

Federici suggested that Anna and her husband try methods he's detailed in his book "Help for the Hopeless Child." His intervention plan calls for families and their adopted children to remain together in their home for weeks or months, shunning outside stimulation until the child becomes part of the family circle.

Federici's program also includes therapeutic holding, in which parents immobilize their rebellious, violent child on the floor until the child stops resisting them. While the therapy can appear to be abusive to the untrained, Federici and his supporters say it has been successful with many children.

Anna said Federici offered no guarantees about how much the girl's behavior could be modified. Still, she and her husband decided to try, at least for a few weeks.

Not long after they went home, Anna said, the girl asked her for a hug before bedtime, then choked and nearly strangled her during the embrace. As Anna coughed and gasped after breaking free, the girl grinned and asked in a falsely sweet voice: "I'm not trying to kill you, am I, Mommy?"

Anna walked downstairs, dialed Federici and said, "Find another place for her."

Federici referred them to a couple in another state who work with severely disturbed, formerly institutionalized children. They were interested in taking in and perhaps adopting such a child.

In October, Anna and her husband told the girl they loved her but believed that she'd be better off with another family that better understood how to help her.

"OK, cool," the girl responded. "Is my new mommy a good cook?"

During the 15 months that the girl was with her family, Anna said, she contacted Adopt-A-Child repeatedly for advice about how to handle her. She said agency workers initially told her, "It'll get better," and offered few suggestions about modifying the girl's behavior.

She said she felt the agency offered no alternatives for finding a new placement for the girl, telling her, "She's your child."

Adopt-A-Child Clinical Director Laura Ellman said Anna and her husband met with agency officials twice in the fall of 1998 and again in May 1999. Agency workers also had several telephone conversations with them.

Ellman declined to discuss the specifics of what was said in those talks. But she said the family's comments about the girl were positive for nearly a year.

Ellman said Anna and her husband did not express concerns about the girl's behavior to Adopt-A-Child until their third meeting, May 1, 1999. Ellman said agency workers referred the family to professionals who, they believed, could help the girl.

"The end of the report [from that meeting] says Anna was very, very pleased to have [the girl] as part of their family," Ellman said.

Around that time, however, the family concluded that the girl was "deteriorating," Ellman said. The family telephoned the agency six times between June 4 and Sept. 15, Ellman said, and the agency provided additional referrals and suggestions about addressing the girl's behavior.

At the family's last meeting with agency workers Aug. 5, 1999, Ellman said, the family again raised questions about the girl's behavior. But she said they also completed a questionnaire on which they wrote that they had discussed their concerns and believed they were "on the right track."

"It appears that things deteriorated quickly after that from the parents' perspective," and the family broached the idea of disrupting the adoption, Ellman said.

Adopt-A-Child recommended agencies and physicians who could advise the family on disruption. In September, Ellman said, Adopt-a-Child was contacted by the family's attorney, who said the family had found an option and wished no further contact with the agency.

"We've placed more than 600 Russian children since we began [in 1992] and we have hundreds of people who can attest to happy outcomes," said Ellman, who added that Anna's case was one of two adoptions arranged by the agency that later were dissolved.

"I feel professionally very responsible about what went on with that family. Adopt-A-Child was as involved with them as they agreed to let us be," she said. "We certainly cannot guarantee the happiness of our folks, but we certainly try to support them through the process."

Today, the girl's new family is preparing to adopt her. Anna and her husband are paying the legal bills for that process and have taken out a home-equity loan to cover those costs, as well as nearly $100,000 in medical and other bills.

Although the girl has been gone for nearly a year, her photographs still hang on the walls and her Winnie-the-Pooh-trimmed bedroom sits intact. Her things won't be packed away until her next adoption is final.

"After she left, my husband and I couldn't talk, we were so sad," Anna said. "Now I'm starting to feel like I had a terminal illness and the family that took her gave me my life back. Those people are saints, and I can't bless them enough for helping us, and for helping her."