Week One

Kendall Eckenrod was born in the Philippines on July 2, 2009 as a result of an unplanned pregnancy.  Her birth parents were both 18 years old, uneducated and unemployed.  They have one son at home who is 13 months of age.   Kendall weighed 4 pounds and 2 ounces at birth; however, she was born prematurely at 35 weeks gestation.  The birth mother acknowledged having poor nutrition during the pregnancy and was a smoker.   Shortly after delivery, Kendall was placed for adoption because her parents were both financially unstable and felt that they could not support another child. She was placed in a facility for two years before a final adoptive family was found.  Identifying concerns noted are her premature birth, poor gestational nutrition, mother smoking during pregnancy and mother’s two pregnancies in short period.

As a newborn, Kendall appeared to be a very healthy baby. She reached her milestones relatively on time. She was rooting, sucking and grasping at age appropriate expectations. However, Kendall had episodes where she was a very agitated baby. She would cry and fuss a lot and was difficult to comfort.   This resulted in an obvious need for immediate attention. She was often placed in a swing to sooth her agitation because the placement facility was understaffed and crowded.     A problem Kendall faced was that she was unable to develop a caregiver bond, which is crucial to development. The way we are treated determines our life long mental health. In addition, our early experiences with caregivers shape our adult love. Because of Kendall’s unique situation, she was unable to experience that bond which has resulted in her constant need and want for some type of attention, which sometimes results in Kendall acting out. In addition, because the adoption agency is short staffed, her bonding time with the individuals working there is limited and sometimes inconsistent. This may result in some future problems, behaviorally or psychologically. 

Developmentally, Kendall’s language seemed to be on point. At 3 months, Kendall was reacting to loud sounds, recognizes specific voices, cooing, cries depending on specific needs, and is smiling. The only issue Kendall seemed to be facing was a lack of attention and more frequent crying. At 6 months, Kendall was able to follow specific sounds with her eyes and respond to changes in tones of a voice. She also frequently noticed toys that made sounds and often would get very distracted from these toys. Kendall was babbling with bilabials (/p/, /b/, and /m/) and often babbled more than the typical child.  Often she would babble louder than another child who was also babbling. Again, this seemed to demonstrate her persistent need and reassurance of attention.

At 1 year old, Kendall began to take her first steps. However, it is important as a caregiver to the child that the caregiver is close when they begin walking. This was a difficult task in an adoption facility. She however developed all her gross motor skills on time. At this time, Kendall however showed signs of difficulty following simple commands and would become distracted with outside stimuli resulting in Kendall no longer paying attention. She would also move very quickly from one activity to another. This posed a serious concern for some signs of ADHD. Her constant need for attention, consistently distractibility, difficulty paying attention, and some behavioral issues seemed to indicate that she was showing signs of Attention- Deficit Hyperactivity Disorder. The adoption agency noted this in their files however, they were tentative and thought she was too young to make an official diagnosis.

Kendall’s speech developed normally, she was pointing to pictures when named in books, was acquiring new words on a regular basis and was using some two- word combinations when speaking. Kendall’s undiagnosed ADHD signs continued up to her official adoption when she was 2 years old.

Kendall was officially adopted at 2 years of age from a couple from San Diego, California in the United States. Leroy and Susan Eckenrod were respectably 39 and 37 years of age. They tried to have children for years however were unable to so they began the adoption process. Susan is a science teacher at Mt. Caramel High School in San Diego and Leroy in a police officer. The couple was very excited to finally become proud parents. The adoption process went through Bay Area Adoption Services in California. Kendall arrived in the United States and met her new caregivers in August of 2011.

Leroy and Susan reported that Kendall seemed to be a relatively happy baby; however seemed to have some emotional and behavioral problems that occurred. Still, they assumed that this was to the sudden change in atmosphere and the overwhelming attention of new faces. They also noticed Kendall having a difficult time attaching to them but they also felt that is could be a possible result of the adoption process. Nevertheless, at 3 years of age, Kendall was talking much more and becoming more comfortable but they started to notice more signs of ADHD. Kendall was having a difficult time paying attention, she wasn’t listening, was very distracted, would fidget a great deal, talk a lot, would not take turns when playing with other kids, would blurt out answers, interrupt other kids, and couldn’t stay in one place which also resulted in her moving from one activity to another very quickly. These signs and symptoms had both Leroy and Susan concerned however, they love Kendall very much and want to provide her with the support and proper care she may need.

Decision Point

Do Leroy and Susan take Kendall to the physician to get a confirmed an official diagnosis of ADHD to potentially start behavioral therapy or do they wait until Kendall starts school to see if it is going to actually affect her or impact her in any way?

Questions:

1.     What are common signs of attachment difficulties at birth?

2.     What role does the adoption play on Kendall’s attachment and behavioral problems?

3.     What is the average cost of an adoption?

4.     Because Kendall was born premature, does that have an impact on her potential official diagnosis of ADHD?