Entering and spending time in an orphanage is a life-changing experience. As an adult, meeting the children who live there, seeing their reality, witnessing the depth of their need for permanency changes you. You can never go back to not knowing. Orphanage life also changes another population, the children who live there. If you have adopted a child out of an orphanage, are in the middle of the adoption process, or are even just thinking about adopting, there are some things you need to know about the effects of orphanage life on children. These are true regardless of whether your child’s orphanage was “good” or not. Even a good orphanage is still an orphanage and is not the optimal placement for a child.

While each child differs in their degree of resilience, they will all be affected to some degree by these five things:

1. Your child will have experienced trauma.

Losing one’s birth family and being placed in an orphanage, regardless of the age it occurs, is traumatic. Scientists have now confirmed that trauma does indeed change a person’s brain neurochemistry. These changes can cause a host of difficulties for the child. They include: Difficulty with emotions (expressing them, identifying them, regulating them), being easily overwhelmed, hyper-vigilance, overwhelming anxiety, disassociation, volatility (easily set-off, rages), hyperactivity (which looks like ADHD, yet is not reached with ADHD medication), impaired cognition and reasoning skills, depression, sense of hopelessness.

2. Your child will not have a sense of permanency.

Life in an orphanage is one of constant change. Caregivers come and go, other adults come and go, children come and go. Unlike a family member moving away where there is continued contact, though from a distance, there is no continuing contact for the relationships in the orphanage. Children quickly learn that people leave and are never seen again.

3. Your child will not have an idea of what to do with free time.

Life in an orphanage is fairly regulated. Because there are so many children and so few caregivers, life happens on a schedule . . . when to get up, when to get dressed, when to eat, where to go, what to do, when to go to bed. The idea of having a room full of toys and the time and permission to play with them is foreign concept. It has taken my children sometimes years, with a lot of demonstration and help, to begin to figure out self-directed play. It is a learned skill and orphanage life doesn’t teach it.

4. Your child has learned great survival skills, but not great family skills.

There are many ways children learn to be successful in the orphanage. Being superficially charming, being stronger, and being sneakier are among a few of the ways children have learned to make life work for them. These skills do not serve children well in a family. It takes time to help your child figure out new ways of having their needs met when they enter your family.

5. Your child has learned that he or she can only depend on him- or herself.

With the impermanency, shortage of resources, and brain changes as a part of orphanage life, it is not surprising that children learn they can only count on themselves. The adults in their lives have let them down too many times. They do not trust others and it will take some time to allow a child to learn to trust the new parents.

For many children the list doesn’t stop there. While the next two are not true across the board, they are a common enough part of orphanage life that parents must be prepared for the possibility their child will have experienced them.

1. Your child may have suffered abuse of some kind.

This abuse could take the form of emotionally damaging words, physical hitting and beating, being tied into beds, and sexual abuse by either caregivers or by other children. These are not things parents want to think about, but it happens all too often. Parents need to be prepared to deal with the aftermath.

2. Your child may have suffered extreme neglect.

While all children in an orphanage have experienced neglect, if only due to poor adult to child ratios, others experience more severe forms. This neglect can result in extreme malnourishment, extremely low muscle tone, and extremely delayed development. Neglect from having even the most basic of needs met can cause physical problems such as feeding issues, skin injuries, and bone loss in the case of extreme malnourishment. The long-term effects of extreme neglect may never be completely overcome, even in the best permanent family.

The list sounds scary, I know. Out of my three adopted children, I have experience with nearly all of these to some degree or another. This is not to say I am Super Mom. I’m not. What I want to tell you is that there is life, abundant life, beyond this list. There will be moments that are terrifying and frustrating and that feel hopeless, but there will be even more moments of joy and wonder and gratitude that you get to be a part of this child’s life, to help redeem it, and to help bring healing and hope to a child who had none.