High Risk Kids


Hi Dr. Laura,
My husband and I are seriously considering assuming permanent guardianship for 3 young children, and particularly the youngest. Their mother is a foster-sister. Here are details:

Children are 16 months, 2½ and 4.
Their mom is a little slow mentally.
She breastfed each to age one or so.
The children have been shifted around once they hit toddler age.
There is obvious developmental delay.
They don't mind going with unfamiliar people, but do panic if you put on your coat. It is as if they're afraid you will leave without them.

We've been asked to take the youngest. I'll be talking with a non-traditional adoption lawyer soon.

Could you tell me what steps we should take to give her the best chance to catch up and live a happy, productive life? Could you recommend a developmental specialist? We live in the Seattle area.



Congratulations on becoming a parent to a 16 month old! Your question is how to help your little one catch up and live a happy, productive life, and how to find a developmental specialist. As I am sure you know, you and your husband also have some catching up to do, to learn how to meet your daughter's unique needs.

I live in NY and don't know any developmental specialists in Seattle, but the best resource in most places is the local University. The University of Washington has a Child Development Clinic that has an Infant Mental Health Center (206-543-8453). I don't know the folks there, but they offer direct service to families and would be a good place to start.

How to help your daughter catch up depends a lot on what she's experienced in her first 16 months, as well as on her genetic inheritance. But here's my advice:

1. As you probably know, the most powerful healing force in the world is love. Loving your daughter may not be enough, but it is the only place to start and end.

2. Since your daughter is coming to you when she is preverbal, she will not remember her early life, but that doesn't mean it hasn't had a profound effect on her. She is likely to have attachment issues, which will include self-worth doubts and abandonment fears. Be aware that her "terrible twos" might be particularly difficult because she will be "testing" you to see if you abandon her too. A good book to read on this topic is "Attaching in adoption, practical tools for today's parents" by Deborah Grey.

3. When a child has a history of unreliable caretaking, her brain development suffers. Kids who are not comforted literally don't develop the nervous system's full capacity that allows them to comfort themselves. For that reason, they can be hard to parent. A terrific book on this process is The Science of Parenting by Margot Sunderland. If your daughter has challenges in calming herself, it's particularly important that she receive empathic parenting that allows her to learn to manage herself emotionally.

4. The best book I know on helping kids who already feel bad about themselves (and a 16 month old may) is
"Smartlove" by Carolyn Heineman Pieper and William J. Pieper. They may have it at your library, but it's so good you will probably want your own copy.

5. As far as her intellectual development goes, what will help your daughter advance most quickly is engaging with her. If one of her parents can stay home with her and interact, converse, involve her in housework, take her on adventures, be with her while she plays with other kids, etc., she will make up for lost time. A daycare center would not be likely to nurture her mental development.

6. Having your daughter evaluated by a developmental specialist will point you in any other necessary directions. For instance, if her verbal development is delayed, it is a good idea to intervene early with a speech therapist.

The clinic that evaluates your daughter may well refer you to a therapist on their staff who is experienced in working with kids with attachment issues. It may be you won't need that. However, if you should encounter any issues that feel challenging, I encourage you to seek professional consultation. You are doing the work of the angels, but you don't have to do it unassisted.

I wish you and your family every blessing.

--Dr. Laura

Laura Markham

As both a mom and a Clinical Psychologist, Dr. Laura Markham offers a unique perspective on raising kids. Her relationship-based parenting model has helped thousands of families across the U.S. and Canada find compassionate, common-sense solutions to everything from separation anxiety and sleep problems to sass talk and cell phones.

Have a question about parenting your child? Ask Dr. Laura on her Pregnancy.org Forum, Chat with her live on the Pregnancy.org chat on Wednesdays, or Tune in to her radio show and ask her in person! She takes calls every Wednesday at 9am Pacific/ 10am Mountain/ 11am Central/Noon Eastern at MyExpertSolution.com.

Dr. Markham is the founding editor of www.AhaParenting.com, where she regularly takes on a wide range of challenging questions from parents who struggle with "the toughest, most rewarding job on earth." In private practice, and as a speaker and presenter at parenting workshops and seminars, she enjoys connecting face-to-face with parents to help them transform their relationships with their children, regardless of age.

She is the author of an upcoming Q&A e-book series, Ask Dr. Markham, which will have editions for all ages from birth to teens, and of the soon-to-be-released, The Secret Life of Happy Moms, which lays out her relationship-based approach to raising kids who turn out great.

Dr. Markham received her Doctorate in Clinical Psychology from Columbia University in New York. She's held many challenging jobs, including running publishing companies with 100 employees, serving on corporate boards and coaching business leaders, as well as counseling families and children. Bottom line, she says, "Raising children is the hardest, and most rewarding, work in the world." Dr. Markham lives in New York, with her husband, 14-year-old daughter, and 17-year-old son.