"Thank God for Dr. Ronald Federici. In 2008 my son turned 3. I kept thinking the terrible two’s would phase out. I even named our adoption playgroup The Terrific Two’s and Three’s in hopes of a future life without screaming meltdowns and temper tantrums with fists. I had learned to expect the unexpected with my son adopted in Russia 1.5 years prior. Yes, he’d been sick frequently, and yes, he took medications that had ugly side effects. But I would never have been able to admit then that he had a permanent problem, a disorder that might be jumbling up his mind.

After attending several FRUA conferences, that is Families for Russian and Ukrainian Adoptions, I had heard many other stories of adopted children from the far Eastern European orphanages that struggled with many of the symptoms my son had—only his seemed more severe. He could not make eye-contact with me, but he could with others. He wouldn’t be still long enough to let me rock or hold him much without becoming very agitated and throwing a fit to get away. He broke all his toys and played so rough that he hurt other kids. He locked onto other boys in a vise-like grip and couldn’t seem to let go even when they would wail. He had an hour long meltdown when told no. He flat refused to hold my hand even to cross the street.

Even though my boy was very much loved, he could not return any affection. I thought he had a very hard shell around him and likened him to a feral cat that could not be domesticated. I was so disappointed that I would probably never be able to have a normal relationship with my son because he might be autistic or beyond help.

At a little of 3 years old he was kicked out of the 2nd mother’s day out program. He’d bitten a bigger boy on the face and left a huge wound. I quit my job and decided to do whatever it would take to get my son professional help. My first call was to a professional child therapist and attachment specialist referred by several families in our FRUA group. My second call was to a well-known child psychologist in our city who worked with adopted children’s issues also. I had both doctors do independent evaluations on my son to determine what plagued him. Both doctors came back with the exact same diagnosis in their reports-Fetal Alchohol Effects or Syndrome, Post Traumatic Stress Disorder, Reactive Attachment disorder caused most likely by the PTSD and possibly ADHD.

One doctor was a man and one was a woman. The woman suggested that my son would need to be medicated to make it through a treatment program. Since my son had such great rapport with men and not women, mainly me, and since he’d been passed around in the orphanage mainly by women caretakers, he had a much more severe reaction the the woman therapist. So I decided to go with the man for therapy. We started attachment therapy to help him learn to self-soothe and work on the preverbal trauma first. Every week we went and sometimes twice a week. Things were always calmer for a day or two after the doctor had had a session of holding time with my son-with me right there next to him-to allow an entire cycle of rage to complete. JJ always had a full body shutter after a cycle, and that was one way to know he was done. This cycle would take an hour to go through with screaming, biting, flatulating, kicking and flailing all over the doctor. The screaming could be heard through the office walls for at least a floor.

After the cycle the doctor would ask JJ to go sit on my lap. He would do that, and he would look at me. He would make eye contact. We started to see shorter rage cycles and more mommy holding time with JJ. It was hopeful. Then the rage would come back within a few days and never for any main triggering reason. Nothing would make the child happy.

I read every book I could get my hands on regarding bonding and attachment disorders in adopted children, early childhood trauma and sensory integration disorders. I tried everything I could to try to help my son short of medication.

At some point my misery won out and I started asking to see a psychiatrist. I was then told JJ had conduct disorder and possibly Aspergers. I got a second opinion, and that time I got pervasive developmental disorder and severe ADHD diagnosis. Since his case was so complex and overlapping in so many symptoms, I really wanted the doctors to take into account the orphanange situation. JJ had rickets from malnutrition. His medicals from the orphanage said he was weened from the bottle at 6 months, toilet trained at 13 months out of necessity and that he’d been moved from hospitals to several orphanages in a short amount of time due to overcrowding and poverity in his village. He had been neglected, very possibly abused physically since he flinched and ducked when I’d first met him and came near him with my hands, and he rocked and head banged in his crib every single night at bedtime. He woke up early but never ever called out from his crib. He’d been adopted at 19 months old. His first year and 7 months were not a picture of health or nurture. He lived in a survial of the fittest environment.
I heard about a doctor, a neuro-pscyhologist who worked exclusively with adopted children and had 7 little JJ’s of his own. I called him, and was put through to him on my first call! He was in Virginia, and I was in Texas. I told him my situaion and asked if he was qualified to do an evaluation on my child. He said, “just get to my office as soon as you can.” I worked with his secretary to get an appointment for the following week. I had to fly my wildchild to Virginia to see Dr. Ronald Federici. I couldn’t afford it. I was scared to death of taking him on the plane-after he’d screamed bloody murder all the way home from Moscow for 10 hours on our last plane ride. But I was desperate for professional help by someone who was competent about adopted children’s issues.

Dr. Federici came out and said hello to me and JJ, and then promptly took JJ by the hand and went into his office to do some testing for everything from auditory processing to Asberger’s. They took breaks and came out, we went to lunch together, and walked around the office building. Dr. Federici wanted to see JJ in action. He wanted to see JJ’s attitude toward me. I’d been asked to bring all my Russian medical records and video to Dr. Federeici for a review. I had copies made and had sent them a few days before we arrived. That evening after an all day appointment, Dr. Federici asked JJ to wait in the play area so he could give me the rundown on what he thought.

Dr. Federici first brought out my medical records that were in Russia and had English translations. He asked if I knew that JJ had been a preemie baby? No. Did I know his record from the hospital say he was born in withdrawal from opiates? He had alcohol in his system. His birthmother had had also tested positive for drugs and alcohol. The combination of problems had caused JJ to have a stroke of some type in his first few days, and he’d been on a breathing machine. “No-this is not what the medical said,” I told Dr. Federici. So Dr. Federici read to me word for word what the medical statements said, and it was all in there. It just had never been translated. The orphanage nor judge, not my agency, not even the caregivers ever said a word about any of these things that had made JJ a very special needs baby. But there it was in black and white. Thank God, Dr. Federici could read the Russian chicken scratching. Later I would send those pages off to a Russian-American physician who would fully translate all of the record for me and tell me he was so sorry for my very sick child.

Dr. Federici gave me the bad news first-the medical record information and the results of the low low scores on all the testing. The only good news he said would come the next day as we made a plan for treatment for JJ. All the information I had gotten from the day made me very sad, but it also validated my deepest intuition that the severity of JJ’s rage and fear had not been coming from simply a behavioral problem. He truly was brain damaged by his birth mother’s in utero choices to drink and do drugs and the hospital and orphanange neglect and trauma after birth.
On day 2 of our intervention with JJ we had a session called intensive family therapy. Dr. Federici showed me how to make a safety plan for JJ, a daily visual schedule. At one point Dr. Federici was giving me some private information and asked JJ to wait right outside the door. I knew that was a shot in the dark and after two minutes of total quiet had gone on, I said I needed to check on JJ. He was no where to be found. We finally found him running into the street on the busy road in front of Dr. Federici’s office building! This was a perfect example of what I meant about me feeling that I couldn’t keep him safe for even a minute if I wasn’t watching him closely. We found out that through an auditory processing dysfunction, JJ had interpreted “stand outside the door for one minute” as GO STAND OUTSIDE THE DOOR-AS IN THE OUT-SIDE DOOR-OUT SIDE THE BUILDING. So he did what was asked of him except that there were so many interesting things going on in the streets that he wandered off that way.

Dr. Federici and I put our hearts back into our chests and proceeded with putting together an applied behavioral analysis system based JJ’s problems and my parenting style for us to take home and immediately put into action. He put the 7-8 part plan on large poster boards for me to tack up to my walls and follow to the letter. He wrote out every piece of the plan for me, and told me to call him when I got home after a week for a consultation.

I have done exactly as he told me to do. Retraining my son has taken bundles of patience, medication, occupational therapy, ABA therapy and work within our home to provide him the proper type of attention for attachment. JJ started sleeping on a futon in my room, earning all privilages and repeating with me daily-over and over our safety plan, our home rules, our good words list, our privilages list, doing chores….and slowly but dramatically over one year’s period of time, I truly met my son’s real personality for the first time. He was more smiley than pouty. He obeyed out of respect and felt proud of himself for earning his likes. The longer we are on this journey into the solution, the closer we have gotten in attachment.

Since attachment had not truly taken place by JJ when we met Dr. Federici, it started when the program started. It took on a life of its own. And the more attached, trusting and open JJ can be the happier he is. We continued with the local attachment doctor who worked with us on our treatment goals with Dr. Federici. The last time we were in the doctor’s office, my son got up on his lap with not even a frown and said he’d rather sit with mommy. At that point I saw a boy who’d come full circle with attachment. The RAD is gone, and my son was considered a severe case. The PTSD symptoms are gone-except for the insecurity of abandonment which may always be a part of JJ’s emotional baggage. He tried to fake a temper tantrum the other day-and we both laughed.

Dr. Federici has never not returned an email or phone call within 12 hours to me-ever. He has never not given me his honest opinion even when he knew it was going to hurt. He has offerred to fight for us with the school board to get JJ the special services we thought he’d need (and now doesn’t require). He’s offerred to see JJ for free. He’s kept in touch and put me in touch with many professioanls who are following our case and hoping for JJ’s continued success. Dr. Federici took pity on this single mom and gave me a discount on office fees. He changed the quality of our lives. He gave to me and to my son hope and tools to find the way out of the darkness out into the light. We both will always be so grateful to Dr. F for his dedication to his work and clients. He has been an excellent role model for both my son and me. In our last talk, he asked when I was going to get on my my own work as a pediatric counselor….I’d already done the time….and other kids need the kind of experience I now have lived through. So now it is me who is rising to the challange to meet the great expectations of a wise doctor, Dr. F.

Karasel Kid
AdoptionHarmonyBlog@blogspot.com

"I would like to thank you for seeing my daughter, but more important for sitting down with me and listening and explaining things to me. You are the first doctor who actually explained what is going on with Barb. You are God sent!!! I do not have enough words to thank you. As painful as it was for me, at least I know what is going on. Thank you so much. I know that Barb thanks you too. She is a good person and my daughter - I will go to the end of the world to help her. Again thank you."

Elena M Duarte

"Hi, Dr. Federici! It’s hard to believe that it was a year ago I first sent you an email regarding a family consult. I hope you and all of your family are doing well. From some of the listserves, it sounded like you went ahead and moved your office? If so, I hope that all went well for you too. I’m in the middle of opening a larger ABA center here in Southern Indiana, so I can appreciate the challenges!

Your help has proven invaluable with the children. While we continue to work through some issues with several of them as would be expected, they’ve all made huge strides forward this past year, in a large part because of your guidance and direction. Here’s a quick update on each child, plus a request below:

Kris is like a completely new person. He seems like a weight has been lifted and he’s doing extremely well. We’ve not seen the dark days for a long time from him and he’s worked through a lot of stuff with us. He just returned from his first mission trip (Jamaica) and that also has had a very positive impact, it seems.

Will’s change is incredible. We were able to explain to the school that we all had been operating under a misdiagnosis and convinced them to build him, Cary and Adam a language-based program within their existing school, customized in many ways for their specific needs based on your recommendations. Will went from starting the year reading at pre-K levels and nearly zero math ability to now reading at 80% proficiency on 3rd grade sight words, and large improvements in occupational math capability. Cary and Adam both had their best years ever, though both have a long way to go. Cary’s just so extremely hyper, it still it drives folks around him batty, plus he has a hair-trigger temper and has gotten a lot more mouthy. But it happens less frequently and in between, he’s actively trying to do things to improve his behavior and relationships. Thankfully, the darkness has abated quite albeit though it still shows up periodically. Adam still struggles, but the med trials on the Abilify didn’t go well, though the Welbutrin seems to help some. The local doc is trying him on a low dose of Risperdal, but we’re being very cautious given his earlier unusual reactions. It seems like his development – physically, mentally and emotionally has just stopped for the most part. It’s worrisome, as he seems totally out of touch with other people and is adamant his view of the world is accurate.

Ava is a pretty moody 13-year-old, but seems to be doing well most of the time. We try to get her out and involved in other things so she gets a break from the stress around here, but she still prefers to be a homebody, so we’ll keep working on that.

Kristie’s anxiety continues to be a major source of issues for her, but that seems to be improving some. She deals with some paranoia now too and the morning mania continues to be a major issue, but I’m doing some behavioral interventions with her that she finally seems to be responding to most days. We’re also seeing a lot more smiles, conversation and interest in what other people are doing, so that’s positive.

So that is the update. Again, I can’t really adequately express how much I appreciate all you’ve done for our family. You gave us the window we needed into our children so we could help them more appropriately and for most of them, it seems to be working. You also helped Jim and I take a very hard look at what was going on with us and that situation has improved dramatically over the past year also.

Thank you again for everything and may God bless you and your family…

With appreciation,"

Kim Derk

"Dr. Federici: It seems that we have an agreement with the school board, thanks to your expert opinion which the could not challenge. I think that we have an agreement and that they will pay for my daughters private LD School, Brehm. I told you that I would fight them to the very end with your help. If all works, I do want to thank you for all that you have done. You are a wonderful man, who have helped so many people and God has to bless you all of the time. You deserve it. I think that you are the best and without your evaluation, I would have never succeeded. You are an Angel. Thanks a lot. "

Elena

"Dr. Federici: I’m pleased to report that we reached a settlement agreement with Elena’s school district yesterday. The district agreed to place Elena at The Cove School, pay Cove tuition and transportation, reimburse us for tuition paid after the unilateral placement earlier this year and reimburse us for some of our expenses related to testing. We are exceedingly pleased, because Elena has made the transition very well to The Cove School, demonstrating progress, even in the relatively short time she attended this year. In fact, she was awarded the President’s Award, singled out among all six graders for her eagerness to learn and help others.

We’ve come a long way in just a short time but so much of this we owe to you. You have helped us understand more about our daughter after our visit with you than in all our searching for the past 11 years. Your insights and recommendations have now given Elena the best possible chance to recover what was missing and what she lost, while in the public school system. You must experience an enormous sense of gratification when you can help someone—and a family—as much as you’ve helped Elena—and us. We will never forget what you’ve done. As Elena grows older and can better understand what you’ve done, you can be sure she will hear it from us.

I hope that we will have the opportunity to visit with you again in the not so distant future, so that you can reassess her, after she’s had some remediation at The Cove School and the opportunity to work with new members of our therapeutic team. This morning, we just added a child psychiatrist, Dr. Hirsch, who is following your suggestion to revisit Elena’s prescribed medication. Also, pediatrician Todd Ochs, who specializes in foreign adoptions, is helping us connect the early medical diagnoses we received from the adoption agency and the diagnoses you made in your assessment.

Again, thank you for giving us so much hope."

Glenn Brichacek, Ph.D
President/CEO
The Admiral at the Lake

"Dr. F: I had another thought about topic to include in Anna's 'needs/problems' section of report: "She may reach puberty by ___ years of age, and will need direct teaching and hands-on assistance to manage self-care during menstrual periods, and cannot reliably relay menstrual pain due to high pain tolerance/thalamic pathway-sensory nerve involvement, which may create unpredictable moods and behavior", or something akin to this. Hope it's not too late. Off to take in sights with lots of layers to keep us Southerners warm. Everytime we leave hotel or restaurant or Metro stop, Anna announces "Dr 'Rici is CLOSED, Mommy". When we ask if she likes you, she says "Ye. . . . NOOOOOO!". Guess that sums it up. Who really LIKED their drill sergeant, but am sure she has a love spot in her heart for you.
Thank you for everything. You met and exceeeded our every expectation, and we thank God for you. May you have blessed holiday season. Sincerely"

Lyn

"Dr. Federici. Thank you for everything. You met and exceeeded our every expectation, and we thank God for you. We have been to so many "experts" over the years, and you nailed it in two days, and have helped us see hope and a light at the end. We have learned more from you in these past days, than from years of 'therapy".
May you have blessed holiday season. Sincerely"

Jeri H. , Houston, Texas

"You are a life-saver, Dr. Federici! Your quality evaluation and comprehensive parent training has saved our family! We went through so many people, and you are the ONLY one who gets it with post-institutionalized kids. We owe you so much...thanks for helping all the families out there. God Bless!"

Will/Mary V., PA

"Hi. Just want to thank you for finding the time to meet with the Boyle child and the state department family/parents (from Africa). I read the report of your eval and just get blown away. This was the BEST evaluation and treatment plan we have ever seen for one of our state Department kids adopted from Ukraine. Actually, it was the best Neuropsychological Evlautaion we have seen altogether. This is a life long challenge for these parents. Your eval/recommendations was certainly something deeply needed and appreciated by them. Thanks for all the great support to our families serving abroad Thanks again"

D. Supervisor, Exceptional Programs, US Department of State

"May I ask what Dr. Federici does for....assessment?"
"Federici conducted 34 tests, held a diagnostic clinical interview and reviewed seven years worth of reports for my chld. I doubt that most other clinical psychologists are as thoroughly versed in the pre and postnatal challenges that confront Romanian children at least. In my experience, they don't conduct as many tests.

My child was in his office from 8 in the morning until 6 p.m. Some children will receive additional testing; in our case, quite a bit had already been done, so Federici looked those results over and made sure to widen the testing to not duplicate (and/or to corroborate) what had been done before. Federici likes to do a great deal of testing by way of simulating a school day. He discovers what the mentally fatigued child does, what the low frustration child does, etc., what the "give up" child does, what the "dependent" child does...my child found it challenging, just like learning in school...

Within three weeks of our visit, Federici compiled and sent me a highly useful 37-page report. He also revised the few inaccuracies immedaitely when I made the request. Not only did his assessment provide the interconnected aspects of my child's learning, pulled together to show how, for example, short term memory and attention were involved. He made sense of a complicated history, noting subtle and obvious issues in a way that made the report's findings difficult to ignore in public school. Furthermore, because Dr. Federici has the credentials in psychopharmacology, he indicated which medications might help my child. I felt that I had received a thorough, competent evaluation.

I went to Federici because I was frustrated with the ignorance or "sluff off" factor I was encountering locally. .... I chose to go to Federici because of his knowledge base and the awareness that he could deliver a report (and revise it!) much more quickly than a hospital center."

Hi Dr. Federici, sorry it has taken me so long to write back. You may recall I was struggling a couple of months ago with the Adults Only program. I reread your book, watched the tape (Saving Dane), and reread Wendy's program. We got over the bumpy spots and things went relatively well.

Katie is able to be redirected verbally when she engages in body movements or "silly talk." She returned to school in late August and has made a smooth transition to a new school, new teacher, and new classmates. Staff there is also finding her easy to redirect and Katie is now being mainstreamed again in the 3rd grade for math and some of the other subjects.

Katie has also transitioned to a new daycare setting (she is taken by bus to a different school) and has handled the change well. I am very pleased with the results I've seen as a result of implementing your program. I wish I could clone you and move you closer. Once I enjoy the fruits of our labors, I'll be ready for the next steps! Thanks for providing such a wonderful service!"

Pat M.

"My daughter and I would not be where we are with peace in our home, and secure signs of attachment without the intervention and support of this team. My message to anyone adopting an older child is early intervention and consultation with this team of professionals."

P.R., Indianapolis

"A great expert in the field of Child Psychology. We need him here in the U.K and Ireland"

J.R., England

" Extremely talented and skilled Clinician, Presentor and Parent!"

Mental Health Staff and Parents, Iceland

" Always a Professional we welcome here to lecture and train".

Adoption Society, Australia

"Dr. Federici is the only neuropsychologist qualified enough to evaluate and treat the most complex children, especially post-institutionalized children".

T.T., Founder, PNPIC

"Ron Federici and his group were the only ones that could handle my out of control child who had failed multiple treatments. His group has the best treatment team for the family in need".

B.C., California

"This group of professionals evaluated and treated our situation, pro bono, because we were in dire need. The evaluation and program for my son helped immensely."

K.C., New York

"If it weren't for the most professional evaluation and intensive treatment program given our family with our adopted child, we would have been destroyed."

K.J., Fort Worth, TX

"NBC-Dateline "Saving Dane--Saving a Family" which highlighted Dr. Federici's expertise with the most disturbed children was an inspirational show of recovery."

Professional review, NBC Dateline June 2003.

"Dr. Ron Federici and his staff are an unmatched resource for families experiencing the challenges of parenting children with complex behavioral and learning problems. As an adoptive parent of a number of post-institutionalized children, Dr. Federici understands the emotional as well as the clinical issues facing each family. His superb diagnostic acumen is paired with an excellent track record of effective interventions."

Dana E. Johnson, M.D., Ph.D., Professor of Pediatrics, University of Minnesota

"Given his extensive professional and personal experience with children of international adoption, Dr.Federici provides families with a uniquely informed and invaluable assessment of each child's cognitive, academic and emotional strengths and weaknesses as impacting children's functioning in home, school and other settings. His comprehensive neuropsychological assessments and expertise with post-institutionalized children, offered in conjunction with practical strategies, provides parents with tools and a much needed and individualized road map to identify the critical educational, medical and behavioral supports known to be essential for the promoting the wellbeing of these often misunderstood children and their families."

Lisa M.H. Albers, MD, MPH, Director, Adoption Program, Children's Hospital/Harvard Medical School

"I have worked with Dr. Federici for 10 years and have traveled with him to Romania on many medical missions. I learned about the plight of orphans from Dr. Federici and he inspires me daily. I send families to him because he knows the intricacies of the mind of an orphan mentally maimed by the harsh and unimaginable conditions of orphanages all over the world. He saves the souls of children. He is a creative and daring psychologist who drains his soul to help the hopeless!"

Dr. Jane Aronson,
International Pediatric Health Services, PLLC

"Hello Dr. Federici and Leslie: I just wanted you to know that we have turned a HUGE corner! I called in desperate need 2 weeks ago and only 1 1/2 days later Michael decided to begin to comply.

I did have an emergency visit with his Psychiatrist, but we only decided to increase his Tenex to 1 mg b.i.d. I am very glad that is the only change we made because the difference in Michael and his behaviors is like nothing I have ever seen!

I have a new analogy for you to use. When I was pregnant people would tell me about their labor and delivery pains, but because I have never been through this I could only imagine. And, of course, my own labor and delivery would be my own personal experience. This is how I perceive explaining "extinction burst". If you have never been through it, or seen it, you can only imagine what it will be like. And, of course, it is different for every child. I now understand that what Michael was doing on that Wednesday (hurting himself and me) was a true "extinction burst" (UGLY) (and perhaps a little something else). He was fighting for his life to try to get his old behaviors to work!

Well, I am happy to say that his old behaviors did not work :)
We are committed to the program and now even more so. The changes are so unbelievable!

Thank you, thank you. The work that Dr. Federici and you do is invaluable to families like ours.

Will keep you posted, and I'm sure have additional questions along the way. We just wanted you to hear some GOOD NEWS!"

Kelly F. (Rick, John and Michael too)

"did they determine over the phone before you traveled which of your children would need the extensive evaluation ?"

We knew that Kat was either on the way out or we needed to do something "really different". When we made an appointment for Kat, we were willing to pay what ever was needed for peace (what price do I put on that).

We sent (our other children) to stay with my brother for the 4 days we were in DC with Federici. When we came home and started to work the Federici program with Kat, our youngest son’s Autistic behaviors were amplified. He displayed very stereotypical behaviors. We decided to take him to Federici for a full evaluation. After it was all said and done; the biggest suggestion was to try and reduce stress in his life and redirect him whenever he displayed stereotypical behaviors and get him around better role models (Kat was not a good role model for him). Our son was diagnosed as above average intelligence and many other positive dx's.

"I'm also wondering if there is any testing that can be done locally through the child's pediatrician that can help to minimize Federici's cost."

We could not face another person that was not willing to believe us. We were not willing to waste another nickel on "She's Cute, She's Adorable".

We had tried local stuff only to be told that "everything was fine" and "she's cute and getting better". This was not the case at home. I video taped what was going on in our home and the therapist was beside herself stating "I had no idea it was like this". We gave up on local's and decided to try something extreme.

The result has been extraordinary. Kat is not a perfect, normal 4 year old however, she is nowhere near the behavior monster she was last year. She can sit and eat dinner, she can play with her brother, she will use the toilet for its intended purpose. This is priceless! We had lost all hope for Kat until we saw Federici.

Many may disagree with his tactics and call it barbaric or something along those lines. They may say that I have violated my child's rights. I can tell you that my child has a right to life. The path she was on was a suicidal path, self mutilation, running into traffic, throwing herself into moving cars, the fireplace, the wall, the doors. We have done all we could do to save her from herself.

She is a different person today. I know this helps. I think very Highly of Dr Federici and his staff because "it worked for us" and "saved our family" on many fronts."

B.D., New Jersey

"Hi Dr. Federici, We thought we would touch base with you and give you an update as to how things are going with W and D since our visit with you two years ago.

We still speak and enforce your level program EVERYDAY. Of course, we have made revisions from time to time to keep up with development, responsibilities and privileges, but the basics are the same. The kids are very used to this in their lives by now. Tracking their token count is a daily part of their lives, much like brushing their teeth! They have had their ups and downs, mostly due to lying - but we seem to have gotten a better grip on that lately.

W has come a long way. He thrives on his schedule and is quite self-directed. He doesn't like bumps in his road or unexpected transitions, but he's doing better at accepting them when they happen.

D struggles with many thinking errors as well, especially when it comes to relationships. She will continue to be a handful, for us and for whoever else in her future!

Overall they (we) are doing wonderful compared to where we were two years ago. On your 50-80% improvement scale, we give W a 75% and D a 60%. We expect more...still lots of room for improvement.

They even get themselves up with their own alarm clocks, get dressed, make their beds, feed our pets, get their own breakfast all on their own! Sounds a tad different from their experience in your waiting room two years ago!

Thank you again for all you did for us. We still hope to come back some day so you can see the progress for yourself. I'm sure you could put W's anger control skills to a mighty test, but hopefully he would show improved survival skills! Sincerely,"

TJ & K., Boise, Idaho

"When we brought home our daughter Grace from Ukraine in March of 2004, we wondered if we would be able to parent her. She was 17 months old, 13 pounds and one big bundle of nerves. Grace has fetal alcohol syndrome, a disorder prevalent in the Eastern European orphan population. We are so grateful to have had that diagnosis which is necessary to getting her the proper help. Giving her love and time was not going to unwind the condition she was in.

It wasn’t just FAS that brought Grace to this level of stress, but a combination of unfortunate life stunting scenes. She was the 6th child born to a 26yr old alcoholic in Crimea. Born full term she weighed 4 pounds and micro cephalic. At three days she was taken from the hospital to the orphanage where she lay wrapped tightly swaddled in a blanket. Over the course of the following year and a half she would experience a constant set of illnesses including acute bronchitis, pneumonia, chicken pox, measles, salmonella poisoning as well as malnourishment that kept her too ill to be kept with the healthy orphans. Her main stay would be in the infirmary, a small dim room with a few cribs, no toys, and no stimulation day after day.

When we met Grace for that very first time we could hardly hold her because her body literally didn’t want to bend. It’s like picking up a wet, mad cat out of the bath tub- legs stick out everywhere. While she didn’t scream at us, she didn’t really look at us either. She had been deprived of so much that she couldn’t understand people. And deprived as she was, she was most content to be left in her crib where she could rock and bang her head and flick her fingers on metal screws. That was how she knew the world. So imagine her reaction when we took her away from that existence.

R and I were sure that she would thrive and be excited at discovering her new world. We couldn’t have been more wrong. Her behavior deteriorated more so upon our arrival home. She wanted to be able to continue what R and I termed “zoning out.” If she could sit and gaze or stick her finger in a hole and stare at it all day, she would have. We tried everything you could imagine. We left her alone to do it; in the case she might feel comfortable enough to enter our world. That didn’t work. We put socks over her hands so she couldn’t cram them up her nose anymore but then she’d only gaze or enter into another activity with her feet. Pretty soon, we realized there was no chance at bonding because we were so focused on how to get her into our world.

Looking back we were beyond clueless. While we had the diagnosis of fetal alcohol syndrome, there was nobody in our community to train us in how to parent her. And even if we found someone who understood FAS, we needed someone who would also understand the type of conditions she existed under in the orphanage. Love alone would not heal this little girl. As the first months passed, R and I were becoming the bundle of nerves that Grace was. Admittedly, I wondered if I could do this parenting thing with Grace and more selfishly, I was exhausted.

A friend of ours gave us some information about Dr. Federici and his practice in Alexandria, VA and we contacted them. By then I had been on all of the adoption forums on the internet and was convinced Grace had reactive attachment disorder as well as a host of other disorders. I had contacted a few different therapists through email explaining our situation only to be encouraged to disrupt the adoption. We felt at the end of our rope. What Dr. Federici and our occupational therapist, Wendy Schmidt were able to explain to us is why Grace was this way and what we needed to do to help her.

The severe lack of stimulation and neglect from her stay in the infirmary in addition to her malnourishment caused her to enter into a pseudo autistic state; a dissociative state where she used these maladaptive self soothing coping behaviors to exist. Dr. Federici has written on the subject calling it institutional autism. In order to bring her out of these “basement” behaviors, it would take minute to minute daily structure with me, her mom by her side. We needed to recreate a new world and in order to do that she needed consistency and repetition. And further, I would have to stop her “zoning.” Life in our home for those months was a bit like the movie Groundhog Day. Each day was a replicate of the day before. For a few weeks I think I must have cursed Dr. Federici and our therapist a few times a day. Each time she withdrew into her “zone,” I held her in my arms in what is called a “settle hold.” This is not to be confused with holding therapy techniques. I simply held her in a cradle like you would a small baby so that she couldn’t continue the maladaptive behaviors. She screamed and screamed. Days went by like this. I seriously questioned if any of this was working. Slowly she stopped the screaming and then began to look around, still refusing to look at me. Eye contact was particularly difficult. I wanted to put her down on the floor so many times and to be able to go on with my life.

I admit that I became so frustrated, I wondered if this was going to be what life would be like forever. If only I could set her down on the floor. She would have been happy to have been left alone to continue her “zone” and I could be sure of some quiet time. Isolation was setting in for me. Not only was I staying home everyday with a screaming child in my arms, but most of my community didn’t understand what it was I was doing or why I was doing it. I was tired of the explanations and the strange looks. I know they meant well but the best thing friends and family can do is be a support and not offer advice based on the normal healthy child they are raising at home.

Ever so slowly, as we inched ahead day by day, we began to see the unraveling of this tightly wound bundle of nerves we met that first day. She began to look at my face, only to glance away if our eyes met. And then she began touching my face while I held her. I began to add something new to our schedule as she was ready for it. Nearly three months passed before I left the house to take her out to public places. I realize now how vital that time was for her to be able to feel safe. She began to giggle and understand “silliness.” She no longer reached for strangers as if they were equal to me.

We even had to teach Grace what it meant to feel pain. For all of the times she felt pain and cried as an infant and nobody came to soothe her, she ceased “feeling” the pain. Crying and acknowledging hurt for her was useless. We taught her this by each time she fell we ran and scooped her up and made a big deal about what happened and told Grace she was hurt and cried with her. Basically the exact opposite of what we did with our two biological boys. But it worked! She needed to have her feelings validated and to be able to once again connect her physical pain and appropriate emotional response. This was key to helping cure the “zone out” periods. Grace learned that Mommy and Daddy fixed pain not gazing, hair pulling, eye poking or any one of her other coping mechanisms.

Today Grace is three years old and we have had her with us for 18 months. In that period of time she has truly blossomed reaching more goals than we ever imagined for this short period of time. For a child that had to learn to suck from a bottle when we brought her home, she is now learning to chew solid foods. A child that couldn’t walk until 21 months is now running and jumping a year later. A girl that didn’t understand what a Mommy and Daddy was, now calls out to them for hugs and kisses. A babe that didn’t know what smiling was for, now laughs heartily at a tickle or the cat’s tail brushing across her skin.

There is no greater joy than watching the emergence of life in a child that was in many ways lifeless. She only existed and now she is exuberantly alive! And you know what, I wouldn’t change a thing. It’s easy to say now of course, but in many ways her special needs humbled me, carving in me, a new patience and a whole new compassion for what many children experience in the orphanage setting.

Grace will never be cured of fetal alcohol syndrome and the secondary effects of it. She is frustrated easily with not being able to talk and to communicate her needs and wants. She will slowly achieve more goals as the time passes but she will forever have to live with the brain damage that cannot be reversed and we her family will need to adjust with her. R and I never set out to adopt a child with special needs, we only trusted that God would take us to the child He wanted us to have. And in doing so, we have received His grace and our Grace."

T&R, Arkansas

Hi Dr Federici: Just a quick update on Kristina: Heavy metals (blood and urine) were negative. Risperidol is GREAT! We now have a child psychiatrist managing the meds and doing fine at 0.25 BID. Her voice is not as loud, less  rocking, crashing, banging, less agitation, staying on task/focused, especially at school. Unfortunately last weekend, we had 4 days of hell (she acted like she did pre-risperidol). I called child psych and she upped the dose to 0.25 TID (8 am- 4 pm/ after school- and bedtime). Things are better now.

Child psych ordered a fasting lipid panel which was abnormal. Note it was ordered/drawn 3 weeks after starting drug. Kristina must have crappy genes as she is not diabetic or obese. Her cholesterol is 197.  Her HDL is 38 (low) and LDL is 145 (high). As you know, the HDL should be high and the LDL low. Hers are reverse and indicative of "moderate CHD risk". Child psych doubts it is from the risperidol as she has not been on it long enough. We are redrawing labs in 6-8 weeks, if lipids are higher, she will pull her off resperidol and try another drug. Any thoughts on abnormal labs and/or drug effect?

Peds endo at Childrens Mem'l Hosp won't see Kristina unless she is off the growth chart. She is at 10% now.

Peds neuro at Childrens is admitting her next week for a 24 hour EEG and comprehensive neuro exam, per your recommendations. Do u want results?

By the way, liked your commentary in PEOPLE mag last week. Both Kristina's teacher and principal stopped to tell me they recognized your name in the magazine.

IEP implementation meeting is Monday with the whole team. School district has ABA trainer that will work with Kristina's school and us to put behavioral program in place (finally). They are following your recommendations and for that we are eternally grateful to you. Feel free to use us a a reference for other families. We think you are terrific! Regards,

Karen J.

Hello Dr. Federici, I just wanted to say thanks again a million times for your help with Irina. We took your advice on the Risperdal and kept her on it. It has been 2 weeks now on the medication and 1 month out of school and she is like a different child. She is so much better. She is sleeping good and her mood swings, hyperness and anger have greatly improved. We can see some hope now! Just wanted to share with you the good news about her and say thank you so very much for doing what you are doing for the kids.

Lori and Mike, VA Beach, VA

Hello Dr. Federici! I am writing you to share good news about a former patient -- D.S.. We visited you in August of 1999 from Cleveland, Ohio ... and have corresponded several times since them. D. was selected to be the valedictorian of his confirmation class at our synagogue. Today he delivered his speech in front of the congregation. It was a moving and meaningful experience. The entire congregation was crying ...the cantor said it was the most powerful confirmation speech she had heard in her 25 years at the synagogue. We thought you might enjoy reading it. And ... you should know ... that you were included in his first version of the speech as one of the reasons why he has reached the point he has. (the first version of the speech was more like a book ... and needed editing). Thank you again for your guidance and expertise.

H.S., Ohio

Dr. Federici, I was very moved by the Episode of Dateline "Saving Dane" I think your program is wonderful, and I can't tell you how wonderful I think Dane's parents are. I can only hope that all parents would be so patient with there children. They were amazing. Please if you are still in contact with them. They did a wonderful job on Dane. I couldn't get over what a happy little boy he was towards the end of the show. I'm just hoping that his road has gotten easier and that he is just as happy if not happier these day . . . .

My name is Allison, i'm from Tracy, California and I was very moved by this story.

Dr. Federici: On behalf of Debbie and myself and especially little Miss Kelly, thank you not only for attending today's meeting but for using your expertise to make the meeting a done deal in our favor before it even started. Today was the polar opposite of the meeting 3 months ago, which was a done deal against us before it even started, and the chair of the meeting was even condescending and rude, refusing to even consider your test results. But when the meeting started today I sensed a change in attitude within the first five minutes. The "educational establishment" was in our corner after looking at the data and wanted to work with us "in good faith," as they put it. As I told Debbie after today's meeting, when the odds are stacked against you, it is time to bring in superior firepower: Dr. Ronald Federici. Cordially,

Stuart

Just a note to say that Mihaela is doing really well since we started Sensory Processing Therapy and implemented all your recommendations. We have been in therapy for almost a year and the change in her is unbelievable. Can you tell me is Sensory Processing something that needs to be continued for a long time with children from Romania? I am sure that it depends on the child. What books can you recommend on the treatment at home for SPI? We have also seen an endocrinologist for her as well. I don’t know what we would have done without your help with Mihaela. You have been a life saver to us Dr. Federici and I just want to tell you THANKS!

Mihaela's Mom

Dr. Ron: We want to tell you that Dane continues to excel all around since we completed the "program" featured on "DateLine NBC" over 4 years now. NO MORE rages and uncontrollable episodes! Never a dull moment at our house! On a happy note, the kids are doing great!!! Megan is making A's in her honors college program and enjoying her new apartment and roommates nearby. Dane is a speedy cross country runner (carrying the team's first place trophy) on the JV team at his new high school. Both love us at this point in time, Praise God!!! Our family is blessed and has been restored thru so much.

Dear Dr. Federici, Four years ago I contacted you about my then 9 year old son, Joshua. Although I had to modify your program due to Josh being my foster son at that time, your program still worked. Josh is now happy & healthy and learning to enjoy life after being abused and neglected for the first 8 1/2 years before he came 'home' to us. He still suffers permanent brain damage (FAS/E) but he is completely mainstreamed now and last quarter he made the honor roll! And today Josh won three out of his four of his wrestling matches and won 2nd place in his division! Not bad for a kid I was told may never heal who used to bite me, kick me, spit on me and try to kick the windows out of the van. THANK YOU, THANK YOU, THANK YOU!

Again, I can't thank you enough for helping us save Josh. I need another miracle now to save Justin. Thank you so much for helping our family, again.

Carol

HI DR FEDERICI
DAVID IS DOING GREAT. HE HAS HIS MOMENTS BUT HE IS LISTENING AND FOCUSING BETTER. ON MONDAY I AM MEETING WITH THE SPECIAL NEEDS SCHOOL TO SEE IF WE CAN BYPASS THE WAITING LIST. AS WELL I AM SPEAKING WITH POTENTIAL ABA THERAPIST RECOMMENDED BY THE SCHOOL BOARD. DO YOU WANT TO SEE US IN MARCH. IF SO, DAVID HAS SCHOOL BREAK THE WEEK OF MARCH 5. LETS US KNOW. DR FFEDERICI IT IS GREAT HAVING A SON NOW INSTEAD OF AN ANIMAL.

STANLEY

Dear Dr. Federici, We really enjoyed the opportunity to work with you and we both sensed a genuine desire on your part to help children. What you do for children and their families is amazing and your strength of character and knowledge was truly apparent throughout our visit. Your perspectives on parenting Andrew were insightful and we can clearly see benefits in the short period of time we have tried to implement the techniques. In a sense, the methods you taught are liberating in that we now understand that it is not necessary to constantly cater to Andrew's wants and needs. Best Regards,

J & D from Connecticut

Hi Dr. Federici and Nadya, We wanted to follow up with you and inform you on how our son, Sam , is doing. We had met with both of you back around May 2007. Dr. Federici, after all your testing, your conclusion was that Sam had depression and you recommended that we put him a low dosage of an anti-depressant. Well we finally found a child psychiatrist in New Jersey which was no easy task. We showed her your report and she acceded to prescribe a very low dosage of Prozac, which she recommended.

Well we are so happy to tell you that is exactly what Sam needed. He is a completely different boy now. He's generally happy and acts like a normal boy. His self esteem has markedly increased and it has had an incredibly positive impact on the whole family!

We are still working on bonding issues, but after dealing with four years of his depression, we feel the bonding will come in time. We are trying to incorporate some of Nadya's recommendations regarding this issue.

We do thank the Lord that he is doing so much better now.

Thank you and may you continue to assist so many families that are in such difficult situations.

God Bless,

Paul and Vicky B