International Adoption: A Health and Developmental Prospective

Abstract

Adoptions from international countries have become an option for many US families, with over 150,000 children adopted in the past 14 years. Typically, internationally adopted children present with a host of medical and developmental concerns. Issues such as growth stunting, abnormal behaviors, and significant delays in motor, speech, and language development are likely directly related to the prenatal and early postnatal environment experienced prior to adoption. The new family and its health-care team must quickly work to identify and address these issues to aid the child's integration into his or her new family. This article will examine potential issues seen in children who are being adopted, including the impact of early environment on subsequent development. We will summarize early and long-term medical issues and review the extent of developmental delays seen in children adopted internationally. Finally, we will discuss possible mechanisms leading to the observed delays, including the impact of stress on subsequent development. By understanding the extent of expected delays and the mechanisms likely causing the issues, the health-care team will be in a good position to quickly identify and develop intervention protocols that will foster the child's assimilation into his or her new family.

Early Puberty in Internationally Adopted Girls: Hormonal and Clinical Markers of Puberty in 276 Girls Examined Biannually over Two Years

“…Internationally adopted children constitute 1–1.5% of the childhood population in some European countries [1,2]. Although the majority of adopted children are healthy and thrive well, some specific health problems, including precocious puberty, have been identified over the last decades [1,3,4]. An increased frequency of early sexual maturation in adopted girls was first reported from Sweden in 1991 [5], and subsequent retrospective studies from Europe and the USA have substantiated this observation [5,6,7].…”

Language Learning and the Internationally Adopted Child

“…Provided with social, emotional, and physical stimulation they were previously denied, IA children have been shown to flourish and grow rapidly. A stable, attentive home makes all the difference for these children (Glennen, 2002;Judge, 2003;Kinder, 2003;Mason & Narad, 2005;Morison et al, 1995;Narad & Mason, 2004;Roberts et al,2005a). What form, exactly, does this language growth take?…”

“…Health concerns for infants housed at these institutions can include various levels of inadequate nutrition, exposure to infectious diseases and intestinal parasites, physical abuse, neglect, inconsistent care taking, and sexual predators. Inadequate health care leads predictably to global developmental delays as well as marked arrested growth-both of which are noted in the majority of these children upon reaching their adoptive homeland (Glennen, 2002;Judge, 2003;Kinder, 2003;Mason & Narad, 2005;Narad & Mason, 2004).…”

“…The World Health Organization reports that among these countries there are high incidences of poverty among the mothers placing their children up for adoption. Such circumstances may mean limited access to proper prenatal care, poor overall health, communicable diseases, poor nutrition, a history of drug or alcohol use, and even a background of abuse and neglect (Kinder, 2003;Mason & Narad, 2005;Narad & Mason, 2004).…”

Speech and language development in six infants adopted from China

“…IA children face a unique language learning situation that provides a "natural experiment" (Cicchetti, 2003) in which to study children's language learning capacity. Johnson, Albers et al, 1996;Albers et al, 1997;Fisher, Ames, Chisholm & Savioe, 1997;Sloutsky, 1997;Rutter et al, 1998;Johnson & Dole, 1999;Ames, Morison, Fisher, & Chisholm, 2000;Miller & Hendrie, 2000;Mason & Narad, 2005).…”