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Behavior Interpretation Comments
Oral Defensiveness
It was a heartrending shock to see that my newly adopted son would not put a cracker to his mouth and gagged at the sight of any food he could not drink.

These behaviors may all be understood as manifestations of oral defensiveness. This is a very common description in post-institutionalized children and can be explained in part by the feeding practices and lack of play opportunities. In many of the orphanages, children are only fed from a bottle until they are almost 2 years old. Pacifiers are not used. There are few toys for the children to play with and mouth. As a result, children are not used to having things in their mouths. Their mouths become overly sensitive and food and other objects produce an uncomfortable feeling.
It is interesting to note that premature infants who have been tube fed show a similar response when a bottle is introduced and have marked difficulty with beginning feeding. Because of this, current practice has been to provide the infant with non-nutritive sucking while being tube fed.
He doesn't like to eat. At age 2 he couldn't tolerate a Cheerio. He still gagged on some food at issue age 4. He eats only when he is starving or else made to eat. He sucks on his fingers, coat, and shirts. He used to suck his tongue when anxious, and mouthed toys until age 5. Since many children from the institutions are already poorly nourished, feeding can be a major chore and the child's refusal to eat may present major stress to the family.  
She screamed and cried at getting her teeth brushed or having anything of size or texture in her mouth (she spit out all food that required chewing). For some children, oral defensiveness subsides with patience and slowly introducing different foods and textures. For other children for whom the problem persists, more active intervention is recommended.  
Tactile Defensiveness
She disliked being bathed but, as with other behaviors, we felt it was because she wasn't used to it.

Discomfort with bathing, with having fingernails and toenails cut, and with having tags on clothing are all examples of tactile defensiveness.
She does not like to be hugged or kissed--it is still not natural to her. She screeched at any attempt of a sibling to touch her. She had an aversion to children. It is possible that this child is showing tactile defensiveness. Her "screeching" at siblings and "aversion to children" may reflect her awareness that light touch is "hurtful" to her; it may be her way of avoiding having this happening. Unexpected touch is more likely to produce a defensive response than is expected touch. Children are more unpredictable in their behaviors than adults.  
Auditory Defensiveness
He was terrified of vacuum cleaners until recently. We supposed that he's remembering some archaic medical equipment from the orphanage.

It is possible that, rather than remembering medical equipment from the orphanage; this child was showing auditory defensiveness and was bothered by the high-pitched noise of the vacuum cleaner.
Reduced Sensory Awareness
My daughter was adopted at age 4 from an orphanage where she lived since birth. She did not cry for3 months, even when having stitches or blood tests.

Lack of response to pain has been a very common description from parents who have adopted the first institutionalized children. These examples reflect an under reaction to sensory input.
An alternative explanation is that in the orphanage, no one responded when the child was uncomfortable and so the child "learned" not to show a response to pain.
Sensory Defensiveness
This is the easiest category to recognize. It occurs when certain types of normal sensory inputs are experienced as uncomfortable or threatening.


From THE HANDBOOK OF INTERNATIONAL ADOPTION MEDICINE by Laurie C. Miller. © 2004 by Oxford University Press, Inc. Used by Permission.


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