Commission on Security and Cooperation in Europe

Testimony :: Dr. Dana Johnson
Director - International Adoption Clinic, University of Minnesota


Thank you, Mr. Chairman, Commission members and representatives, for inviting me to address you today and for convening a hearing on the pressing topic of the impact of Romania’s restrictions on domestic and international adoption on the well being of abandoned children.

I appear before you to offer three perspectives on this issue. I am first a physician who counsels thousands of families each year throughout North America and Western Europe as they prepare to adopt children from abroad and after they bring their children home. I am also a researcher who has spent the last fifteen years studying the effect of institutionalization on child health and well bring as well as the outcome of post-institutionalized children adopted internationally. The majority of this research has been conducted in the context of Romanian orphans. I was the director of the team of professionals that first published information on the medical status of Romanian adoptees in the United States; I have participated in a number of deinstitutionalization programs in Romanian neuropsychological institutions and camine-spitals under the direction of Christian Tabacaru, former head of child protection and the Romanian Adoption Committee. I serve as consulting pediatrician to the Bucharest Early Intervention Project, the first randomized, controlled study of the effects of foster and institutional care on early brain development and I am a founding member of the Bucharest Institute of Child Development.

Finally, I offer my experience in my most satisfying role, as the proud adoptive parent of Gabriel James Sunil Sai Johnson. Once a fragile three-pound baby abandoned to die by his birth mother in Calcutta India, twenty years later he is a successful college student who can easily lift me off the ground. In summary, I am intimately acquainted on both a professional and personal level with the profound deterioration that occurs in abandoned infants and young children within orphanages and hospitals, the intense desire on the part of potential adoptive parents to provide homes for these children and the extraordinarily positive effects that nurturing, permanent families play in insuring normal brain and personality development.

In the context of today’s hearings, there are three main groups that share an interest and have played important roles in determining the fate of abandoned Romanian children; the government of Romania, the legislative bodies of the United States and the European Union and families who desire to adopt abandoned Romania children both domestically and internationally. All three groups would enthusiastically agree that the rights and well being of those abandoned should be our principal concern and all would agree that institutional care is utterly inadequate. There would be no disagreement that children are best served by remaining in their birth families and if that is not possible they should remain in competent, permanent families in Romania. As signers of the Hague Convention on Intercountry Adoption, the government of Romania, the countries that form the European Union and the United States have all accepted the statement that adoption abroad “may offer the advantage of a permanent family to a child for whom a suitable family cannot be found in his or her state of origin [1].” However the means to achieve these goals differ which is why we face the current crisis.

Two viewpoints can be distilled from the controversy defining the “best interests” of children deprived of parental care, particularly in the realm of international adoption: advocacy for children and advocacy for one child. Those who advocate for children as a group, represented by such groups as UNICEF and Save the Children UK, hold many aspects of international adoption to be in direct conflict with the articles of the UNCRC [2-4]. From this perspective, sanctioning practices that downplay the value of birth family and culture and weaken legal protection for the parties involved undermines legal protections for all children. Those at the opposite pole are motivated by one of the most fundamental drives shared by humans: protecting and nurturing the individual child. From this viewpoint, the right of a single, identifiable child to grow up in a permanent family outweighs virtually every other consideration. While these viewpoints appear to be at odds, they are both centered in the well being of children, and within this arena there is considerable room for thoughtful compromise.

Current adoption laws in Romania are an outgrowth of inadequate restructuring and implementation of child protection legislation in the post-Ceausescu era. Reports by the European Union [5] in 1999 and the United States [6] in 2001 highlighted a system in crisis and in need of a substantial overhaul. The process of Romania’s accession to the European Union that began early in this decade provided the European Parliament the opportunity to examine child protection policy in Romania and bring it into compliance with accepted European standards. However, the resulting legislation, which we are discussing today, essentially eliminates international adoption and concentrates on birth family reunification as the solution to child abandonment.

Superficially, the focus on reunifying an abandoned child with his or her family is consistent with both the United Nations Convention on the Rights of the Child [7] and the Hague Convention on International Adoption [1]. However, the length of time an abandoned child spends outside a permanent family is not a factor considered in either document. Contemporary child development research has unequivocally shown that in infancy, hospital or orphanage care for longer than 4-6 months can cause permanent alterations in cognitive, emotional and behavioral development [8]. A reasonable estimate is that an infant looses about 1-2 IQ points/month, and sustains predictable losses in growth as well as motor and language development between 4 and 24 months of age while living in an institutional care environment. The second finding is that placement in a permanent, nurturing home in early life can immeasurably improve outcome [9]. Finally, though foster care can prevent the deterioration in growth, cognition and emotional development seen in institutionalized children, it is at best a stopgap measure as it does not provide the permanent, committed caregivers that are need to optimize development. We need only look at the problems in our own foster care system to realize that our goal should be permanence [10-13]. Therefore the duration of time when reunification is the priority must be informed by scientific evidence. Failure to do so will violate a child’s right to develop normally.

The virtual elimination of international adoption as a option for child protection in Romania is particularly surprising since countries such as Norway, Sweden, Denmark, France, the Netherlands and Spain have the highest rates of international adoption in the world [14] and all members of the European Europe aside from Greece and have signed, acceded or ratified the Hague Convention on Intercountry Adoption [15]. The ban on international adoption in the current Romanian legislation directly reflects the personal views of Lady Emma Nicholson the Rapporteur of the European parliament to Romania from 1999-2004. Charged with overseeing the progress of Romania towards membership in the European Union, Nicholson devoted much of her effort to reforming the child protection system. Within that context, Nicholson spent an inordinate amount of energy promoting an outright ban on international adoption in Romania by tarnishing the character and motives of those involved in the process [16-19]. Central to her campaign to end international placements was an effort to characterize parents seeking to adopt internationally as unfit, having been denied the option of adopting in their own countries, as well as the frequently articulated, though never substantiated, charges that international adoption was an “international trade in children” controlled by criminals not only for “pedophilia, child prostitution or domestic servitude” but for organ transplantation as well.

Recognizing that poverty was the root cause of child abandonment and that EU membership offered the best hope for economic well being, Romania was forced to placate Lady Nicholson and the European Parliament by passing the current highly restrictive adoption legislation in June 2004. Economic pressure to retain these laws continues. Nicholson, responding to the BBC’s question on her views if Romania re-asserts international adoption said, “If Romania were to go back to the selling of children (her stated view of international adoption), then I believe she will be delaying her entry into the European Union for a long, long time to come.” [20]. With the current statutes, children with handicaps or who are members of ethnic minorities who are difficult to place in Romanian families but readily placed abroad, currently have little hope of a permanent family [21].

Romanian is a sovereign nation and should be permitted to craft its own solutions to child protection problems that are evidence- rather that tabloid-based. In doing so, Romania should be able to rely on the financial and technical assistance of the United States and the European Union. While we must work towards the ideal of all nations caring for their own children, we must also acknowledge current realities. We must not penalize the children abandoned in Romania today as poverty remains the standard for much of the population, the physical and professional infrastructure of the child protection system remains inadequate and adoption perspectives in Romanian society do not permit timely in-country placement of all abandoned children in competent and committed families.

I once again emphasize that this issue is not merely a matter of law that can be resolved at the agonizingly slow place of most legal or legislative proceedings. If an infectious disease or release of a known toxic agent threatened the future of thousands of Romania’s children, there would be no hesitation to intervene. Development outside of a nurturing family during the first years of life leads to catastrophic loss of brain potential. Unfortunately, this epidemic of maldevelopment is as silent as the hospital and institutional wards where these children vegetate.

The clock is ticking. If an infant abandoned today in Romania remains outside of a family by the end of next summer, his or her IQ will have dropped an average of 15 point. By the end of summer of 2007, IQ will have permanently dropped an average of 30 points and be close to the mentally retarded range. The present laws in Romania leave children in institutional or temporary family care for an unacceptable period of time. Placement of these children in adoptive Romanian families and if this is not possible, in families abroad will prevent this deterioration. A child’s brain is a delicate and perishable entity, I challenge you to consider how many IQ points do the abandoned children of Romania need to loose before action is taken?


1. Convention of 29 May 1993 on Protection of Children and Co-operation In Respect of Intercountry Adoption. Hague Conference on Private International Law. Available at: Accessed September 11, 2005.

2. Intercountry adoption. UNICEF International Child Development Center. December 1998. Available at: Accessed September 11, 2005.

3. Position on international adoption of children from Bulgaria. Save the Children UK. October 2003.

4. Dillon S. Making legal regimens for intercountry adoption reflect human rights principles: transforming the United Nations Convention On the Rights of the Child with the Hague Convention On Intercountry Adoption. Boston University International Law Journal. Fall 2003; 21(2):179-257.

5. Ad hoc Report on Child Protection in Romania A/RO/SOC/99003, 22 July 1999, OMAS Consortium.

6. Ambrose MW and Cobun AM. Report on Intercountry Adoption in Romania. January 22, 2001. Available at: accessed September 11, 2005.

7. Convention on the rights of the child. UNICEF. Available at: Accessed September 11, 2005.

8. Johnson DE. Medical and developmental sequelae of early childhood institutionalization in international adoptees from Romania and the Russian Federation. In: Nelson C, editor. The effects of early adversity on neurobehavioral development. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.; 2000:113-162.

9. Johnson, DE. Adoption and the effect on children’s development. Early Hum Dev 2002;68:39-44.

10. Halfon N, Mendonca A, Berkowitz G. Health status of children in foster care: the experience of the Center for the Vulnerable Child. Arch Pediatr Adolesc Med 1995;149:386-392.

11. Takayama JI, Wolfe E, Coulter KP. Relationship between reason for placement and medical findings among children in foster care. Pediatrics 1998;101:201-07.

12. Simms MD, Dubowitz H, Szilagyi MA. Health care needs of children in the foster care system. Pediatrics 2000;106:909-18.

13. Murphy Garwood M, Close W. Identifying the psychological needs of foster children. Child Psychiatry Hum Dev 2001;32(2):125-135.

14. Selman P. The demographic history of intercountry adoption. In: Selman P, editor. Developments, trends and perspectives. London: British Agency for Adoption and Fostering (BAFF); 2000:15-37.

15. Status table. Hague Conference on Private International Law. June 16, 2004. Available at: Accessed on September 11, 2005.

16. Nicholson N. Red light on human traffic. Guardian Unlimited. July 1, 2004. Available at:,8146,1250913,00.html Accessed September 11, 2005.

17. Mitu F. Interview granted by Baroness Emma Nicholson. TELE7ABC Italy. February 19, 2001. Available at: Accessed September 11, 2005.

18. Nicholson has proof on children abused by adopting foreigners. ZIUA. March 13, 2004. Available at: Accessed September 11, 2005.

19. Damian G. Romania has been destroyed by internal corruption. ZIUA. March 29, 2004. Available at: Accessed September 11, 2005.

20. Interview with Baroness Emma Nicholson MEP. BBC News. September 18, 2004. Available at: Accessed September 11, 2005.

21. Richards SE. Dispatches from Romania: the babies left behind. December 1, 2004. Available at: Accessed September 11, 2005.