During the last decade, nearly 190,000 children from outside the United States have been adopted by families in the United States, and many of these children have experienced orphanage care. These children are vulnerable to a complex constellation of deficits crossing behavioral, physical, educational and emotional domains. Parents and schools are often unprepared for the needs of these post-institutionalized adopted children. School counselors are in a unique position to help educators and parents develop appropriate interventions for these children. This article contains a brief review of the literature on post-institutionalized adopted children and implications for school counselors in interacting with these children, their parents, and their teachers.