Season 1, Episode 18: Dr. Monica Dalen discusses her work on academic outcomes among adoptees. She emphasizes the variability in outcomes and the challenges that emerge when trying to make general statements about adoptees as a group, given the variety of trajectories that adoptees follow. She adds complexity to the understanding of common predictive factors, such as age at adoption, and then outlines language development and executive functioning as important mediating factors that could serve as targets for intervention.

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Routledge Handbook of Adoption

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Dr. Emily Helder: Hello, I’m Dr. Emily Helder and I’m here with Dr. Monica Dalen. Who is a professor at the University of Oslo in the Department of Special Needs Education and the co-author of a chapter in the Routledge Handbook of Adoption entitled “Academic performance and school adjustment of internationally adopted children in Norway.” So thanks so much for being here.

So I wanted to just start and ask you a bit about the focus of your chapter, because you started by saying that academic outcomes and school adjustment have been an area of focus among adoption researchers in Norway for quite some time, even before it was an area of focus for other research groups in other places.

And I wondered if you could say a bit about why that was, you know, what, what led you to, and your team to focus on that area in particular?

Dr. Monica Dalen: Okay. When I started with being interested in international adoption, I found, it was in the eighties, it was a lot of focusing on the, how the children adopted from abroad manage the transition, the first time in the new adoptive family, how they attach to the new parents. And when you look at the researchers in the field, it was mostly psychologists, psychiatrists, and some medical doctors. They were interested in the children’s condition, both psychologically, but also medically.

And then when we started, we were a group of a researchers at the University of Oslo, mainly in the field of education and special needs education. And we have been very interested in communication, language development, we collaborated with many preschool teachers and teachers, and we were very interested in how, how are these children doing when they have to switch their communication pattern, their language into a quite different family surroundings. And because we all were into education, we were really interested in cognitive development and then further into school achievement. So we started in quite other direction and we found, didn’t find too much interest in that field in the beginning, but then it has exploded and everyone is very interested in cognitive development and especially language development, communication, but still, I think the academic achievement, not too many have really focused on that and I think understood how important it is to manage in school and to manage higher education, to get a job later on in life. And the group of international adopted children are very, it’s a very interesting group in that manner, and maybe especially to have something to have with language, too, which we can come back to.

Dr. Emily Helder: Yes. Yes. I’d love to touch on it. Yeah and one of the things that you do in your chapter is you do review sort of what research is out there, as well as talk about some of your own findings and it seems like one of the things that emerged from that is, is just a high degree of variability that kids have in terms of their outcomes. And I wondered if you could speak a bit to how that impacts your ability to make more general conclusions about how international adoptees are doing academically as a group.

Dr. Monica Dalen: Yeah. I think that’s a very good point because what struck me and has been so obvious in all the years during all the years I worked in the field, it is the variability and heterogeity in a group of children, you find such great disparity in performances, in different areas, not only in academic achievement, but all over. So it’s so unfair to think of them and to look upon them as one group. And the, in all the research projects I have been in, we have a group that can perform very well on top.

And we always have also within the same cohort, a group that’s doing very poorly and have problems. So when we started in this field, as I said in the beginning, we got lots of feedback from school teachers. They were worried about some of the internationally adopted children because they, they really did not do very well.

But then as a group, they disappeared because when you have this normal level or you look at the median and the mean of a group, you disguise the disparity or the variability. So I think that’s, it’s so important that we don’t talk about them as one homogeneous group.

Dr. Emily Helder: Yeah, this monolithic group. So one way, maybe to understand a bit about why there’s that variability is, is maybe identifying some predictors for, you know, which kids are going to maybe fall in which group and one of the predictors that’s used often is age at adoption.  I wondered if you could say a bit about what you see as, you know, the usefulness of that predictor, but also some limitations of that.

Dr. Monica Dalen: Yeah. Well, I think I said, we said in the chapter also that age of adoption is a classical variable in all adoption research.

And in the beginning, everybody said, Oh, if the child is coming as early as possible, it will be for sure that the child would do very well. And then you suddenly got some research outcome that showed that a late adopted child could do very well, too. And if you look into the research literature, you’ll find very complex outcomes. There’s no clear main result of this and it’s not always the researcher are using the same, the same point for what is an early age and what is the late age. Some are saying six months, before six months is early, and everything after is late. And some say two years, three years.

So using age at adoption as a single variable for predicting outcomes, I think it’s very wrong, because you have to look at the surroundings, the environmental surroundings, where the child is growing up and maybe also the pre-natal, peri-natal and post-natal evironmental condition in the country of origin.

And I think everybody would say that if a child, maybe three years old has been very, very bad surroundings, nurturing, neglect, everything. We will say that well, every year counts not a good development, but then you can have a child six months of age having fairly bad experience and cannot manage to overcome it.

So, I mean, and you can have a child being in a foster home, a wonderful foster home being six/five years and do well when after adoption. So I really think we have to look into that much more differently. And I think, a main difficulty here is that we have so, in many cases, we have very limited valid information on how a child has had it in the country of origin, because we don’t know. And we don’t know if we can rely on information from orphanages, from foster families or from actually the people that have taken care of the children in the country of origin. Because it’s, I’ve seen so many places that this doesn’t always fit. I have been into orphanages in China and what we heard about what the, how they handle the children it wasn’t what we saw. So, I mean, it’s really, you have to be careful. I think Michael Rutter is one of them or maybe some other researchers has really has gone in to do valid evaluation of the conditions in orphanages and can compare, then you can rely on it for sure.

Dr. Emily Helder: Right, right. Well, and with so many unknowns, it becomes so difficult to really make those kinds of comparisons and really study it in a systematic way. Yeah. Yeah.

Dr. Monica Dalen: So I will be, I would be critical if you only use age of adoption. But then again, I can, I can agree that you have to find ways of evaluating conditions and children’s development, and some, some researchers are doing great jobs on that.

Dr. Emily Helder: Yeah. As you think about you know, other factors that predict outcomes, one of the things that you wrote about in your chapter was these mediating factors.

So things that are impacted by the pre-adoption adversity and then contribute to some of the school adjustment. And so I wanted to ask you about a couple of those: language to start. You know, I encounter this quite a bit clinically where it’s very difficult to disentangle the impact of language learning for international adoptees, especially in the first couple of years that they’re home, to disentangle that from learning disabilities or learning difficulties that are present and it’s very hard to assess that clinically because, you know, the tests that we have are maybe not in a, the language that they are, you know, most acquainted with. And in the US the way our special education system can work, it can make it difficult for kids to access services for learning disabilities, because we have to document that the learning disability isn’t caused by a lack of exposure to English. And so it just becomes very challenging to get access to services. So I was curious to hear from your perspective, how is this handled in Norway? Do you have advice for clinicians who are in the same spot?

Dr. Monica Dalen: Well, I think Scandinavian researchers were quite early in focusing on language development among international adopted children just as, because we started with education or aspects related to that, then language and communication started earlier.

So at our, at my department, we have had courses, we have really focused on how to, to understand the language situation for international adopted children and early, I think we pointed to that international adopted children are not bilingual or monolingual. They have to switch their first language because either they’re very, very young or a little bit older, they have to switch their first language into the language in the adoptive family.

And they start very, very early to do that. And it’s, one would say maybe too early, because it’s so important to communicate with the people who are taking care of you and are getting you and are being your new parents. So what we have discovered is that sometimes it goes too fast and they can communicate on a day to day language base.

But if you’re, and that can sometimes, they are so good in that. So you can sometimes disguise that they don’t really get or grasp the concepts behind the word they use and many of our preschool teachers and teachers have discovered this and we discovered this, and it’s so important that you early check out by all kinds of help you can have in materials to see does the child really understand what they are saying and what it means, and then try to help to develop the conceptual background. So we have worked very much on that and you can see when you start in school, this is really so important because if you read the texts that you don’t really understand, then it’s much harder to read. And that’s what many of our teachers have sent us feedback that they have, they feel they have a need for more help in this. So I think it’s very important to start early checking out what, where the level of the child’s cognitive development is, and then start to have intervention  programs for helping them to really understand, especially when you go over to reading. I mean, so I think that’s a very great field in Norway for researchers. I’m not actually in a language research, but I have colleagues in my department who are very, very interested in this field and I think they’re doing a great job. But it’s very important.

Dr. Emily Helder: Yes. Yeah. That transition from learning to read, you know, in early elementary to reading to learn as kids get older. That’s often when I was seeing families clinically start talking about some challenges. Yeah.

Dr. Monica Dalen: They have to handle the language on a more abstract conceptual level.

Dr. Emily Helder: Yeah. Yeah. As we’re thinking about some of the other mediating factors that your chapter talked about, I’m wondering if you could reflect a bit on how understanding what those mediating factors are helps us understand targets for intervention. If we want to improve academic outcomes, like kind of what can we target upstream to really impact academic outcomes?

Dr. Monica Dalen: Yeah. And I think language is one of the very, and then over to reading, oral language reading, writing, and check out programs to help them to develop this field. Then you have another field also mentioned in the chapter, which is hyperactivity/ADHD symptoms and that’s a complicated field and there are lots of experts in neuropsychology and in that field and medical doctors, also.

So, but I think that’s a big development here also. And for me, and what my experience is, that if a child has real problems to concentrate, to control impulses, you’re talking about effortful control, and you are  talking about executive functions, that lots of new concepts to really put a focus on. You have to manage to stay concentrated and to fulfill at that target, if you are going to develop in your learning. And that is very difficult if you are distracted either by thought or impulses from inside or from the outside. So I think some of the intervention programs we already use with a child who has had brain injury, to shelter them to really try to reduce the impulses coming from outside also could be used here, but I mean, this is a very big field and we also have all the medical treatment, which are very much discussed, but sometimes you can understand adoptive parents if they have a very hyperactive child and cannot get anything out of a school situation and they get advice that maybe you should have a medical treatment, that they do that to help the child.

And I have seen children that really then started to focus and to start to get into a very positive developmental circle. So I’m not an expert on that, but I think there will be lots of things happening here in this field. They start very early with practicing, practicing effortful control and things like that.

So, I mean, everything here we can learn from.

Dr. Emily Helder: Yes. Well, and those executive functioning pieces are coming up so often in relation to other areas, too, in terms of emotion regulation.

Dr. Monica Dalen: Yeah. Emotional regulation, because that’s another field that you also find in international, among internationally adopted children, you have a higher percent of hyperactive behavior.

You also have externalized behavior. So, I mean, when you go deeply into this and you really get mixed up a bit for executive functions, externalizing behavior, effortful control. I mean, this is a big, new, not a new area, but it will expand, I think.

Dr. Emily Helder: Yes. Yes. I hope so. Especially in terms of targets for intervention and really supporting kids.

Yeah. As your study has progressed, you, so far, at least in the chapter you’re reporting outcomes through third grade. And, overall  again in terms of group means things are looking very positive for the kids. And, but at the same time, there’s that variability in your sample that seems to be increasing just as we talked about earlier. And so I was curious what kind of future research is planned with these children as they enter adolescence. And do you have any thoughts about or expectations about what you might find?

Dr. Monica Dalen: Yeah, actually we try to, to get funding for continuing our study to follow this group of about 90 children,maybe not that much in all grades, up to the primary school or maybe secondary school, but we didn’t manage. And then two of us have retired. So, I think we had to say stop there. And I would remember the children in that group were not the most vulnerable international adopted children.

They were all under two years when they arrived and no medical, really medical diseases. But I, I am, I would love to see more research on these children into high school, further education. I think you will find the great disparity continuing, and some of them will get more challenges than others.

So, and actually we are, Norway is joining into a European study which, it started to be the focus of children from, adopted from Eastern Europe countries, because we don’t have them in this study. And it’s going on Italy, France, Spain, Norway, and that is children in high school age, 17 years old, I think, but it’s not focusing only on academic achievement.

It’s more broader, but, we’ll see how that will work. It’s difficult to cooperate in this corona time to meet and to, to, to have everybody’s, I think they have a, it hasn’t had that much progress because of everybody being in a special situation.

Dr. Emily Helder: Yes. Yes. I know that the same thing is happening with my own research.

So, so it is very challenging. Yeah. I’m excited to hear about that study. I’ll look forward to following that and, and looking for outcomes related to that. Yeah. Well, thank you so much for both for writing the chapter and also for meeting together.

Dr. Monica Dalen: Okay. Could I just add, because I think you also mentioned that, something about if we don’t find the children, if you can’t help the children that we now have this problem with reading and cognitive development.

What will happen with them when they get up in this age? And I would say I would thinking of that because I think you can see two groups here. You can see one really will be dropping out of school, having big problems, being isolated and cannot come into the job market. Well we don’t know how much, we know that adoptive parents are very supporting and helping, but still, but then you have another group which I could call the late bloomers.

There are some of the adopted children that are coming. They are coming and they’re developing, but they are developing in a little bit more slowly. And then suddenly they can really manage more. I have seen that this group of children, too, which I call the late bloomers and they can do very well, although they didn’t manage so well at first. So there’s hope.

Dr. Emily Helder: Yeah. Well, I’m so glad to end on that note. And also just to recognize how many different trajectories there are for, for these kids. Yes, yes. Yes. Well, thank you so much,

Dr. Monica Dalen: Very nice talking to you and good luck with your work.

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