Internationally adopted (IA) children often have delays at adoption and undergo massive catch-up after adoption. Before achieving developmental catch-up, however, delays at adoption present a risk for IA children's adjustment, but it remains unknown whether such delays foreshadow IA children's outcomes after catch-up development has completed or ceased. In the current analysis, we utilized menarche as a practical marker to indicate the cessation of developmental catch-up. We investigated how delays at arrival predicted long-term outcomes in 132 postmenarcheal teens (M = 14.2 years, SD = 1.7) who were adopted from China at 16.6 months (SD = 17.1). In 2005, adoptive parents provided data of medical evaluation results on their children's delay status in gross motor skills, fine motor skills, social development, emotional development, and cognitive development. Six years later in 2011, data on parent-child relationship quality were collected from parents, and data on the adoptees' academic competence and internalizing problems were also collected from both parents and adoptees. We found that gross motor delay at arrival predicted academic performance (parent-report: b = -.34, p < .01) and internalizing problems (self-report: b = .26, p < .05; parent-report: b = .33, p < .01). Other delays were not significant in predicting any of the outcomes. The impact of early nutritional deprivation on gross motor development was discussed.

In this chapter, we first review the research on internationally adopted (IA) children’s experiences with birth families. Then we focus on literature related to institutional care and its impact on young children’s development, as well as the impact of pre-adoption adversity on IA children’s post-adoption development. We aim to highlight the challenges facing adoption research in linking pre-adoption adversities with post-adoption outcomes. We emphasize that the challenges are mainly due to two methodological barriers: challenges in prospectively identifying and studying children who will be abandoned, institutionalized, and later adopted, and the lack of standardized post-adoption measures that can be used among IA children from different countries. Notwithstanding such limitations, findings point to the links between prolonged and severe pre-adoption deprivation and neurobiological impairments, post-adoption cognitive delays, attention problems, and learning disabilities. Finally, we emphasize that despite pre-adoption adversity, IA children demonstrate considerable resilience in recovery and developmental catch-up.