Whether we give birth or adopt, we never really know what we are getting ahead of time, and if we are healthy and stable, we will be able to accept the child we are given, and if we are lucky we will be able to find the answers to problems we will encounter as we try to help the child to reach his or her potential.

It is important to know that of all the children who come through the foster/adoption system, 90% come from families where alcohol is abused.  At least half of all children in foster/adoptive families have Fetal Alcohol Spectrum Disorders (FASD).  This is a high risk for both domestic and international adoptions.

There are a few basic rules about expectations when it comes to adopting children who are prenatally exposed to alcohol, who either do not have the physical symptoms of Fetal Alcohol Syndrome (FAS) or if it is too early to notice symptoms of Alcohol Related Neurodevelopmental Disorders (ARND). These rules are suggestions really, based on the experience of hundreds of other adoptive parents:

1) There is no way of knowing for sure if a child without obvious symptoms has been adversely affected in ways that might show up later, around puberty or adolescence. If the child is found later to have FASD, there is a 90% chance the child will need long term support throughout adulthood. (This figure will change as we learn how to better prepare the way in the future.)

2) There is a very wide spectrum of effects ranging from full FAS to so-called "milder" ARND, and the children with the milder effects are actually at greater risk of having serious problems later - because the symptoms are not visible, the expectations of others are unreasonably high (normal) and set the child up for failure and frustration that can lead to depression or aggression.

3) There is also a very wide spectrum of behavioral disorders among the kids who are exposed and/or affected. More than half of kids with FASD have ADHD, some have ADHHHHHHD, and some are not hyperactive at all. More than half of the adults with FASD suffer from clinical depression, some of them become suicidal, and some of them cope and adapt very well to the stress of living with FASD.

4) There is another breakdown of kids with FASD - that is the mental health issues. Some of the children have mental health diagnoses that are directly related to the FASD, such as the ADHD and depression mentioned above. Other children who have FASD may also have a serious mental illness such as Bipolar disorder or Reactive Attachment Disorder (RAD). (I almost typed reactive detachment disorder, which would almost be more accurate, wouldn't it?) While most people with FASD have some mental health issues, most do NOT have serious mental illness. However, there seems to be a higher rate of mental illness among FASD than the general population, due to the fact that women with hereditary mental illness are at high risk of self-medicating with alcohol, and are likely to pass on the genes for the mental illness to a child who is affected by her drinking during pregnancy. There are some articles about the serious mental health issues like RAD and Bipolar on my web site (do a search): http://come-over.to/FASCRC/

5) Expect the worst, hope for the best, pray for guidance, seek support of others, and plan on spending a lot of time and energy looking for solutions to problems as they pop up along the way. If the child does not have a serious mental illness, the chances are becoming greater and greater that he or she will be able to live away from home, as long as a good support system is built up over the years, and as long as the child is able to accept the reality of the FASD and the limitations and restrictions that will be necessary to maintain success.

I bring the mental illness issue up because there are sometimes some misunderstandings about the behaviors of teens and adults with FASD. Some of them, only a small percentage, have serious disorders like Bipolar and RAD, but we hear a lot about them because their behaviors are so alarming, and the parents seek out help on the FAS lists, and are often helped by the support and advice from other parents whose kids have similar problems. I just want everyone to remember this: Most kids with FASD do not have serious mental illness, and most kids with FASD are not violent or aggressive or hateful or anti-social. Most of our kids are very sweet, friendly (overly so), sociable (without social graces) and would not hurt a bug, they are so loving. The children with FASD who show signs of anger toward mother or show violent behavior with pets or siblings are most likely among the small percentage who have a serious mental illness. These kids need an entire different set of intervention strategies and medication regime than what we suggest for kids with classic FASD.

Here are some links that might be helpful to families thinking about adoption:

FASD among children in Russian Orphanages by Claire Coles, Ph.D.

Price of Adopting a Child with FAS by Dianne Yee, an adoptive mother of a young adult with FAS

Thoughts on Adoption by Kris, an adoptive mom with lots of experience

Are You Ready to Adopt? Questions to ask yourself, from Lori

FAS: Implications for Adoptive Parents - from Roots and Wings

Here is an article by an adoption specialist who recognizes and understands the hidden disabilities like FASD that occur so frequently as part of the adoption experience: Adoption: What to Expect - How Does Pre-Natal Exposure to Alcohol Affect the Likelihood of Mental Health Diagnoses

Here is an article about international adoption (pdf file): International Adoption: New Kids, New Challenges by Dr. Dana E. Johnson

Looking for insights into adopting a child exposed prenatally to alcohol or other drugs? This new book by award-winning author David Gerrold about adopting this troubled little boy will warm your heart and will help you understand a little more about the adoption experience.

The Martian Child

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FAS Community Resource Center