Dr. Ronald Federici: Noted Expert Witness

An example of expert testimony provided by Dr. Ronald Federici can be found here.

Dr. Ronald Federici: Siret Orphan Reunion

Ron Federici

On June 26, Washington, D.C. will play host to a reunion of the first children rescued from orphanages in Siret, Romania. The horrific conditions of orphans in Siret and other Romanian institutions were brought to light by a 1990 ABC Turning Point report, “The Lost Souls” and a follow-up in 1997 entitled “Romania: What Happened to the Children.” The exposé launched efforts around the United States to help the neglected and abused children.

The Romanian crisis, which has a long history related to communism and economic turmoil, continues today. Dr. Ronald Federici discussed the current state of orphanages in Romania and other parts of the world, as well as the adoption programs in the United States. Dr. Ronald Federici is a psychologist and founder of several American relief efforts for the Romanian orphans.

He first visited Siret’s orphanages in 1996 as a consultant for the follow-up report. Federici, who has adopted two Romanian orphans, is founder of the American chapter of theRomanian Challenge Appeal. He is also the author of Help for the Hopeless Child: A Guide for Families.

Read the transcript below.

Washingtonpost.com: Welcome to our discussion Dr. Federici. To get us started, could you give us some background about this week’s reunion of the Siret adoptees?

Ron Federici: After working in one of the most dismal institutions in Romania known as Siret, our humanitarian efforts were able to extract fourteen children from this place and find families to adopt them here in the States. The event on Saturday, 26 June, will involve American and Romanian specialists and dignitaries working collaboratively in discussing even more aggressive programs for de-institutionalization. This will be the first time the adopted children from Siret will see each other on American soil, which really highlights how a project can come together with the help of concerned people in both countries.

Washington, D.C. : Dr. Federici,

Can you tell us a little bit about how you got involved in Romanian orphanages.

Ron Federici: I have been performing neuropsychological evaluations on very damaged children for 20 years and have seen numerous children from international settings. I was asked to be a medical consultant for ABC News in 1996 in which Tom Jarril wanted to revisit the tragedy of Romanian institutions. When I went over to Romania it really made it clear to me as to how the children I had already been seeing had become damaged. I now continue to work with an international humanitarian group and experts regularly in Romanian institutions, performing evaluations and setting up treatment programs while coordinating activities with the government.

El Paso, TX: Can you comment on the subject of attachment disorder and the Romanian adoptees? Have any longitudinal studies been undertaken? Does consistent nurturing seem to overcome some of the initial problems seen in these cases?

Ron Federici: Specialists in International Adoption Medicine have been collecting a tremendous amount of data about the effects of institutionalization. Psychological experts are now revisiting earlier studies in the 40′s and 50′s on the effects of deprivation from Spitz and Bowlby. For all of the older children, beyond adoption age of 2 and 3, attachment problems are almost guaranteed as these children never lived with any type of positive parental figure, nor are they typically afforded proper care. The child under the age of 2 years old stands the best chance and will benefit the most by intensive nurturing and attachment whereas the older adopted child just does not have the ability to benefit from love and nurturing alone. Actually, those of us working in attachment disorders are finding that parents who try to provide an abundance of love to the older child only wind up with more problems as the post-institutionalized child just does not process or comprehend these emotional concepts. We are now breaking down attachment disorders into children with cognitive problems who lack the innate ability to comprehend human emotions and children who appear to have primarily psychological damage causing attachment disorders.

In my book, “Help for the Hopeless Child; A Guide for Families”, I discussed a very radical but successful treatment program for parents adopting older children in order to rapidly work on the effects of institutionalization and attachment disorders. Again, providing just love and affection can often cause more problems as this is more what parents need to do than what the child can handle. More and more research studies are being published but the current focus continues to be more on medical issues. The psychological data will continue to be available in book form and in subsequent research articles.

Bethesda, Md.: Has democracy in Romania done anything to improve the condition of the orphanages?

Ron Federici: Romania will take years to evolve as they are in a terrible economic crisis. Children continue to enter institutions due to poverty and deprivation with very few funds being channeled to these institutions. International aid is in great demand as the conditions continue to be VERY poor for these children. Democracy has allowed growth, but the country is still in great despair. It is evolving, however.

Alexandria, VA: Doctor Federici, we’ve had cases in the U.S. of parents putting their children up for adoption and then changing their minds and wanting to regain custody of their children. Do situations like these ever complicate your efforts in Romania?

Ron Federici: It is a tragedy that children are adopted and then relinquished. This is due directly to the fact that adoptive parents are typically not well prepared, trained or informed by their adoption agencies. Families have one opinion that the child will just fall in place, but when the damage surfaces, many ill-prepared families are overwhelmed and disappointed to where they want to give up the child.

The Romanian Department of Child Welfare is very troubled regarding this situation and feel that there should be a much better family assessment and binding contract to where families are not able to quickly relinquish their child. this is the importance of an IMMEDIATE and thorough assessment of the child’s needs by proper specialists and to provide vast support to the families in order to prevent relinquishment. If it continues, in these cases, the Romanian Government will most likely require more stringent contracts between agencies and their government in order to insure the best interests of the child to remain in the home.

Washington, DC: Is it true that the older children get, the worse the conditions are in orphanages? I have visited orphanages in Russia and this is the case — abuse gets much worse as the children get moved from a small kids to an older kids orphanage.

Ron Federici: As children grow older, they continue to be channeled in any available institution where the range can be from 4 years old to 25 years-old. This is a huge problem as children become more vulnerable and more abused and more emotionally damaged by being even further lost in a hopeless system. This is the tragedy of Eastern European institutions which have a long history through Communist times. This is the importance of trying to find a way to prevent more children from entering the institutions, as once they get in, they may never leave

Arlington, VA: Dr. Federici, are you and your colleagues trying to close down Siret or reform it? What is the response-reaction of the Romanian government?

Ron Federici: We have had tremendous support from the Romanian government regarding our humanitarian efforts in Siret. We now have a full-time group of volunteers from all disciplines working in Siret and they have allowed our medical team to set up pediatric, psychiatric, medication, and educational programs . We have built two group homes and have used Siret as a model for de-institutionalizing children. Our ultimate goal is to provide new training and models on ways for institutional children to leave the place and become productive Romanian citizens but they need a great deal of guidance from outside experts. We have total support from the government, and, I believe, Siret will stay open as they are very proud of our accomplishments, and often reference our work to other sections of Romania. We travel around Romania evaluating institutions. There may be some that close, but at the current situation, chidren will just remain in the institutions as there is no other place for them to go.

Rosslyn, VA: In the wake of the Columbine shootings, can the ideas in your book be applied to older children? Also, how is the traumatization of older children different than that of younger children?

Ron Federici: Columbine was a tragedy but reflects how damaged children can become – the epitome of an unattached child. Families must use principles of aggressive reattachment and demanding that their child get back in the family, comply with requirements, but also learn and practice how to relate at a deeper level. While sections of my book may seem aggressive and unconventional, what choice do we have when children are slipping away into deep despondancy and rage?

We must find ways to aggressively to hold them in the family ,train them and recondition their thinking and behaviors. While there still may be failures, aggressive attempts on the part of parents of the older child stands a much better chance of success than allowing the damaged child to drift away into tragic outcomes.

No. Virginia: What happened to the Romanian children who came to the U.S. and then started to have severe psychosocial problems. Were some of them sent back to Romania or did they go into new foster homes?

Ron Federici: So many of the children have chronic problems and have overwhelmed the families to where the families have given up even trying. Some have gone to foster homes or residential care, which is like another institution for them, and promotes a deeper attachment disorder. We are trying very hard to train mental health professionals on more proper and aggressive treatment models for the post-institutionalized child as opposed to the “wait-and-see or let them adjust” model. These children have gone through so many experiences that we cannot comprehend and need experts who truly understand children and the effects of deprivation. Treatment has to be unconventional as the child with an attachment disorder can often be smarter than the therapist or the parent. We are setting up international adoption clinics across the country with the Parent Network for the Post-Institutionalized Child (e-mail: pnpic@aol.com), setting up training for families at least three to four times per year across the country.

Washington, D.C.: Do the orphans tend to have psychological damage before entering these orphanages or does it come from living in them? How do you -or other professionals in this area- address these youngsters psychological problems?

Ron Federici: Many of the children who enter institutions have been damaged either medically or psychologically simply by poverty and deprivation. Many of my Russian and Romanian colleagues tell me that “why do you think we place the children in the institutions – because they are healthy?” Poverty is certainly the number 1 reason for children to be placed in institutions, although given the severe medical, nutritional, environmental, and economic hazards, the mothers and children are clearly at risk which results in either cognitive or emotional impairments when the child enters the institutions and gets worse as the years go by.

Washington, DC: How long does the adoption of foreign children take today? Because of the Romanian Challenge Appeal, is adoption of Romanian children quicker than children from other countries?

Ron Federici: Families wanting to adopt must go through an international adoption agency which can take anywhere from 8 months to two years depending on the problem. Most people want infants, which is smart. Older children are more readily available with an abundance of handicapped children.

Our Romanian Challenge Appeal focuses only on institutionalized children who clearly have emotional damage and need a very strong familiy. We have the strong support of the Romanian government to expedite handicapped adoptions as this has been the priority of the Secretary of State, Dr. Tabacaru, who sees the handicapped child as the most vulnerable and in quickest need of a family who can handle them. We have had wonderful families taking on our children from Siret, with the adoptions being done within 4-6 months and at virtually no cost aside from basic requirements (e.g., translations, INS, court fees, etc.).

Arlington, Virginia: Dr. Federici, I read the recent Washingtonian article about your work. How have your boys recovered from their surgery since the article’s publication? I hope they are well.

Ron Federici: Our children were almost dead when we found them and are now very much alive. They have defied all odds and are walking and at the top of their classes. They are an amazing pair and show how a strong brain and a strong soul can prevail. it too tremendous medical and psychological work to get them to this point. Tom Jarriel, from “20/20″ ,will be seeing them this Saturday, as he and I saw them at their worst condition years ago. Thank you for your kind words.

Arlington, VA: In 1990 Romania was seen at the forefront of the problem orphanage scene. Where are troublespots around the globe for this problem today?

Ron Federici: International adoptions are a real risk, as we just do not know genetic backgrounds, accuracy of records, the amount of care provided or how the older child really is. People are still adopting in volumes but I think families really need to be prepared for potential problems and hope that they will be able to find a healthy child or at least be able to aggressively deal with problems as they surface. Think of it this way, how would you function if you lost everything, had poor medical and nutritional care and had no one to take care of you and you had these experiences for years? Would you be healthy? And how long would it take for recovery to occur? Some do much better than others, with the goal being to get out of the institution as early as possible.

Herndon, VA: Have you heard evidence of similar problems with children adopted from other places under similar circumstances?

Ron Federici: Problems are not only in Romania. In my work in evaluating over 2000 internationally adopted children, there are problems in any country having institutional care. There is no such thing as a good institution – only some that do better than others. Whether it be Russia, Romania, Poland, Central and south America, the Far East, or even China, there are going to be problems if children remain in institutions. It is just not the place where children need to remain. Again, families must become more educated regarding the effects of abandonment and neglect, and that recovery takes a long time. it will often need more than love and a good home.

Garland, TX: Earlier, you mentioned the Parent Network for the Post-Institutionalized Child. What other types of support are available for adoptive parents once they’ve brought these orphans home?

Ron Federici: There are more support groups forming, such as Friends of Russian and Ukranian Adoptions (FRUA). The Parent Network does the most trainings and has satellite branches across the country. There are also international adoption clinics, and international adoption specialists across the country providing support and services. The Parent Network is centered in Dallas, TX, under the direction of Kathieseidel@juno.com, or you can e-mail PNPIC@aol.com to get the exact location. There are also support programs in Fort Worth, TX, at the Child Development Program at TCU, which is now doing a summer camp program for intensive rehabilitation of the post-institutionalized child. I trained their staff.

Oakland, California: Dr. Federici: Many people who have escaped from or are familiar with Rumania believe that orphanages in that country are -or were- a tool of “ethnic cleansing.” Are there any statistics available as to the ethnicity of the children in orphanages, i.e., Rumanian, German, Hungarian, Sekler, Gypsy, etc.? Thank you.
C. Rekay

Ron Federici: I agree that there was probably some “ethnic cleansing” during the Communist years. I do not know if anybody knows the statistics. What we do know is that any child with ANY type of deformity, medical, intellectual, or even suspected anomaly, went into the institution. Caucecscu did not like anything but perfection and mandated that women have many children to increase the work force. But, when the conditions were bad, sick children were born. This was how the institutions became so overcrowded. A real human tragedy which continues. However, this new government, particularly Secretary of State, Dr. Tabacaru, who is in Washington DC at this moment having many meetings with governmetn officials, is trying his best to get as much medical and economic support as possible.

Rosslyn, VA: Do many people still adopt Romanian orphans? I remember a number of American families adopted needy babies after political changes in Romania about 10 years ago or so.

Ron Federici: People are still adopting Romanian children. But it is slower because it is harder to find healthy infants. The older children have problems and many people choose not to adopt them as their problems are quite evident. If families work with a good agency and a good Romanian foundation, good adoptions can be done. I know for a fact that the Romanian government wants to continue working with the United States. The Romanian Secretary of State is meeting with the head of international adoption agencies in Washington on Tuesday to discuss these matters.

Chevy Chase, MD: Nearly a decade has passed since the ABC report. You have been their many times–how has Siret changed over the years?

Ron Federici: The only reason Siret has changed is because of the Romanian Challenge Appeal, groups both here and in Great Britain. This is a terrible institution but we have been able to maintain the best group of volunteers imaginable to work with the children. Now that the government and the institution allows us to intervene we have been making some real improvements but it is a very difficult task. There are so many children. If we can help ten or 20 % then we have done well.

Washington, D.C. : Did the television coverage of the Romanian orphanages in the early 1990s help to improve conditions there?

Ron Federici: The first TV show brought awareness but then everybody flocked to adopt these damaged children only to be ill-prepared for the effects of institutionalization. Media coverage certainly put pressure on Romania to allow other concerned parties to help, which is what we are doing.

I can’t say enough positive things about this new government. The Department of Child Welfare is really trying to do good things but they often struggle with older ideologies. It is an evolution that requires many outside consultants that can work with the Romanians at their level of transition.

Arlington, VA: How would you address criticism of Americans rushing to adopt Romanian -and other European- children over the thousands of orphans in their own country?

Ron Federici: Families adopt internationally because it is quicker, cheaper, and avoids contact with the biological parents. We have a tremendous amount of children here from families, that are also abused. But it is interesting that families here do not want to adopt children from “our system” as they feel the child is damaged when the same type of damage is possible or probable for the institutionalized child in Eastern Europe. It gets back into families being better prepared for a child’s problems. Also, many families go internationally as they view these children as cute and attractive and not having the problems of our abused children here in the States. This is so incorrect. Children everywhere need a family.

Garland, TX: Where can I send a financial contribution to help these kids?

Ron Federici: Thank you very much. The Romanian Challenge Appeals office is at 400 South Washington St., Alexandria Va 22314. Phone number – 703 660 6079. Donations should be clearly marked to the Romanian Challenge Appeal. You can also ask for our entire programs available.

Washington, D.C.: How would you characterize the local adoption system?

Ron Federici: The local adoptions systems in the States tend to be very quick if you adopt from Social Services. If you use international adoption agencies you must interview them and make sure they provide you with all the necessary training and information, which includes potential risks and resources if problems occur. Don’t go with the person who says “love and a good home will make it better.” This is certainly a very important intervention but commonsense must prevail as these children often need a lot more than love and a good home. With proper understanding and interventions, the goal is to bring the child to their optimal potential.

Washingtonpost.com: We’re out of time now, so let’s bring this discussion to a close. Thanks to Dr. Federici and to all who participated today.

Dr. Ronald Federici: Offering Independent Adoptions in Russia and Ukraine

Dr. Ronald Federici is one of the world's experts in the diagnosis and treatment of institutionalized children.

To assist families, he has established the Russian and Ukrainian Private Adoption Project.

Private adoptions offer more flexibility, and more information, especially medical, is available. The Project also has the resources to conduct in-country examinations.

Dr. Federici is the proud father to seven adopted children of his own, and oversees each adoption himself.