The caretakers told ABC News they were overworked and often overwhelmed. There are just two nurses for the boys during the day and just one at night. They admitted to giving the boys injections to make them sleep. At times the boys have been restrained with shirts and sheets.
Glazov and Vasilieva know exactly how bad these children have it. But even Vasilieva was stunned when she first saw the conditions.
"First time I came to mental institution and I saw the children I was shocked," she said. "Because I live in Ukraine and I did not know about these children."
Though Vasilieva had been visiting children with Down syndrome for years, it was only recently that she realized they were capable of being educated.
"We thought they cannot study, they cannot have education and we knew that they're life is real hard, but we did not know we could help them," she said. "We thought they understand nothing."
The myth that Down syndrome is a severe mental illness and a scourge on society is an overwhelmingly common one.
Oksana Filipyshyna, Ukraine's deputy head of the Unit for Child Adoption and Child Rights Protection, sat down with ABC News and admitted that more needs to be done to educate Ukrainians about children with special needs, especially Down syndrome.
Before the Americans started coming for them, Ukrainian children with Down syndrome were rarely, if ever adopted.
"The thing is that Ukrainian citizens want to adopt little and healthy baby," Filipyshyna said in Ukrainian, speaking with the help of a translator.
She spoke of the need for rehabilitation facilities and other services that would help Ukrainian understand Down syndrome. But she repeatedly denied that children with Down syndrome were sent to live in mental institutions alongside adults.
"I'm not aware of such facts," she said. "They are not being treated in the mental institutions."
When told about the children that were covered in sores and bruises and left in cribs for years, Filipyshyna said this was not the type of care she wants for the children.
"If this kind of situation is existing of course it is shocking. There's no way to explain it," she said. "And we have to fix it. To fix it as soon as we can."
But when pressed about how the government will fix a problem she was seemingly unaware of, she became nervous and asked to stop the interview.
After a few moments, she continued and spoke of how she would someday like to see more families keeping their children with Down syndrome -- children she called "sunny."
"The country's not as responsible as it should be," she said.
Mia Comes Home
After 32 days in a cramped apartment in Donetsk, Kris and Kecia Cox left for their daughter's orphanage for the last time.
They exchanged some new girls' clothing to be able to take home the dress Mia was wearing when they first met her as "Kareen."
After changing Mia into a new outfit, they told her to wave good-bye to her caretakers. Then Kecia carried her out of the orphanage doors. She was now part of their family.
"She smiled a little when we first met her," Kecia said, "but after only a couple of days she had a sparkle in her eyes that she did not have before."
As Kris and Kecia walked with her through the orphanage gates, Mia stopped to look behind her. She never looked back again.
For the next several days, as her paperwork to travel to America was finalized, Mia was flooded with all the "firsts" she had missed out on.