The Health and Well-being of Adopted Children

Abstract

OBJECTIVE. We compared the health and well-being of adopted and biological children and examined whether observed differences may be a result of differences between these 2 groups in demographic characteristics and special health care needs. METHODS. The 2003 National Survey of Children's Health was funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, and was conducted as a module of the State and Local Area Integrated Telephone Survey by the National Center for Health Statistics, Centers for Disease Control and Prevention. The nationally representative sample consisted of 102 353 children, including 2903 adopted children. We compared estimates for 31 indicators of health and well-being for adopted and biological children and present adjusted estimates that control for differences in demographic characteristics and special health care needs prevalence. RESULTS. Adopted children are more likely than biological children to have special health care needs, current moderate or severe health problems, learning disability, developmental delay or physical impairment, and other mental health difficulties. However, adopted children are more likely than biological children to have had a preventive medical visit or a combination of preventive medical and dental visits during the previous year, to receive needed mental health care, and to receive care in a medical home; they are more likely to have consistent health insurance coverage, to be read to daily, or to live in neighborhoods that are supportive, and they are less likely to live in households in which someone smokes. These differences between adopted and biological children remain statistically significant even after adjustments for differences in demographic characteristics and the prevalence of special health care needs. CONCLUSION. The results suggest that, although adopted children may have poorer health than biological children, their parents may be doing more to ensure that they have needed health care and supportive environments.

Comprehensive Health Evaluation of the Newly Adopted Child

“…1,5,30,31 Care should be used when approaching the newly adopted child, particularly for internationally • Substandard housing, multiple changes in residence • Family members using illegal substances or alcohol, domestic violence ○ Passive tobacco exposure, methamphetamines, other illicit substances in the home environment ○ Other environmental toxins, both in the home and in the surrounding community • Number of prior placements, quality of such care…”

“…For these children, early scores may not be predictive of later functioning, as seen in studies by Rutter et al 40 Several studies have demonstrated significant developmental delays in children as they enter foster care, particularly in speech and language. 2,5,[41][42][43] Likewise, children adopted internationally nearly always demonstrate delays in at least one area of development, with nearly half of the children having global delays. 13,[44][45][46] Children adopted internationally may demonstrate delays in expressive and receptive language that are not solely related to acquisition of a new language.…”

An Adoptive Parental Perspective on Personal Genomic Screening

“…Studies have shown that adopted children, as a population, tend to experience more health problems than nonadopted children as a population. 8,9 Given recent emphases by respected medical bodies such as the US Centers for Disease Control and Prevention on the importance of family medical history, one might argue that because adopted children often lack access to reliable family medical history, the balance of benefits and risks is different. Certainly, the American Academy of Pediatrics has taken a position to the contrary, explicitly recommending that genetic testing for adopted children be approached in the same way as it is for nonadopted children.…”

The Pediatrician’s Role in Supporting Adoptive Families

“…11,16 Many adopted children have complex medical, developmental, behavioral, educational, and psychological challenges. 1,2,7,16,17 In fact, 39% of adopted children were classified as having special health care needs, compared with 19% in the general population. 1 Furthermore, more than half of children adopted from foster care (54%) were considered to have special health care needs.…”