[sak9645]

By asking about the frequency of "serious attachment issues", I presume you mean the sorts of behaviors that the sensationalist TV shows portray. I'm talking about the conscience-less kids who attack their adoptive parents with carving knives, molest their siblings, throw the cat out the window, set fire to their home, tell their teachers outrageous lies about being beaten by their grandfather, and so on.

These are the children who cannot live within a family, because no family can spend 24 hours a day on high alert, making sure that a child does not harm himself/herself or others. These are the children who must live in a therapeutic facility that can provide round the clock vigilance, as well as intensive counseling, often for many years.

There are such children; I won't deny it. And some, though not all, come to their families via international adoption. But the numbers are minuscule, when compared against the numbers of children who are adopted internationally each year. And in many case, these children have risk factors that parents and agencies should have noted before adoption took place -- older age; history of severe physical or sexual abuse and/or neglect by birth family; history of placement in a notoriously bad institution; history of multiple orphanage, foster care, or adoptive placements in a short period of time; excessive friendliness on first meeting; and so on.

Unfortunately, because of sensationalist stories, people now hear the words "attachment issues" or "attachment disorders", and associate them solely with children like the ones I just described. And that is a huge mistake.

Attachment issues ARE common in internationally adopted children, but they are NOT the kinds of issues that people who have seen these shows are envisioning.

There are many children who are adopted internationally, who have never learned to give and receive hugs and kisses. They have never learned to enjoy being held. They have never learned to communicate via eye contact. These are attachment disorders.

Many of these children don't need formal therapy. They need lots of love and attention, and a parent or two who will take the time to teach attachment skills. A few may need some sessions with an attachment expert, who will work with them and their parents on strategies to promote bonding.

There are many children who are adopted internationally, who have lost their birthparents and have a hard time believing that they will not lose their adoptive parents. They won't let the adoptive parents out of their sight. The new parents can't even go to the bathroom in peace. They don't sleep well unless they are in the same room as their new parents. They get separation and stranger anxiety in bigger doses than most homegrown kids. These are attachment issues, too.

Again, many of these attachment problems will resolve with time, patience, and love. Some children, however, may need professional help, but we are talking about a few months, not years, and we are not talking about heavy duty pathology.

There are many children who are adopted internationally, who come home and appear wonderfully social. They run up to the crossing guard and give her a hug. They don't object when the neighbor picks them up. They charm the socks off the waiters in the restaurant. Some of these children have attachment issues, because they can't distinguish between what is appropriate behavior with a parent and what is appropriate behavior with a stranger.

Once again, many of these children won't need formal therapy. They'll need a parent who doesn't think the child is "cute" when he/she hugs a stranger, and who knows the difference between social and attachment disordered. They'll need a parent who is willing to tell non-family members NOT to pick up, feed, or do other things for their child, because the child must learn to go to the parent to have his/her needs met. But, again, some families may choose to do therapy to make sure that they are doing everything possible to promote attachment.

There are many children who are adopted internationally who don't cry when they fall down, and don't seek help when a nosebleed starts. In some cases, these children have attachment issues, too. Many institutionalized or street children think that they have to be brave all the time, and take charge of their own problems. They don't realize that it is perfectly normal to cry and to ask for help from a parent.

These children, too, may not need therapy. These children may just need a Mom or Dad who rushes to help them with even a minor problem, and who teaches them by example that it is a parent's job to make them feel better. But, again, some children may need a little therapy as an adjunct.

I would call the above sorts of things mild attachment issues. They are things that do not "look" all that abnormal, and that can be remedied fairly easily.

Some children come home with what I would call "moderate" attachment issues. These are harder to deal with, and could have the potential for turning worse as the child grows bigger and stronger. These are the children who may rage and have terrible tantrums, far beyond the normal "terrible twos" stuff. These are the children who may not develop empathy easily -- who may not understand that you will hurt if she bites you. These are the children who may withdraw from you and others into a fantasy world or just plain apathy. These are the children who will have extreme fears, or who cannot "change gears" from one activity to the next without becoming extremely upset. These are the children who will have problems with impulse control, lying, failure to complete tasks, or head-banging. And these are the children who are defiant or aggressive.

Some of these behaviors may moderate over time, without therapy. However, it is likely that you will need to get professional help with some of them.

There are times when it won't be clear whether a particular problem is attachment related or not. Even therapists may disagree, for example, about whether constant chatter or hyperactive behavior is related to attachment. It really doesn't matter, of course, whether you label the behavior attachment-related. You will do what you can on your own, and get help if you need it.

To get a sense of the spectrum of attachment issues, you may want to look at a website such as attach-china, or to read books by attachment therapists like Greg Keck. But don't let the websites and books scare you too much. Many adoptive parents don't see even the minor attachment issues. I certainly didn't with my daughter.

Sharon