From the moment that the au pair arrives in the United States, she will be faced with the enormous challenge of figuring out how to live with Americans in a country that may be very unfamiliar to her. The adjustment tools that she has used in the past may no longer work for her now because her surroundings are so different, and the "ground rules" have suddenly changed. While some au pairs adjust quickly, most au pairs go through a noticeable period of frustration, confusion and feelings of homesickness.

The symptoms of culture shock include difficulty sleeping, mental fatigue, preoccupation with minor discomforts, a delay or refusal to learn English, feelings of hopelessness, or a desire to go home. Complaints about the host family, America, and Americans often dominate conversations of au pairs going through the worst phase of culture shock. It normally occurs several weeks after the au pair's arrival, when the initial excitement has worn off, and she realizes that she will have to deal with the new environment for a long time to come. Recognizing these symptoms for what they are will reduce the problems they cause for the au pair and the disruption to the family.

As the initial stage of culture shock passes, the au pair begins to adjust to life in the U.S. Her language ability will gradually improve, and she will be able to better communicate basic ideas and feelings.