Vision and Hearing Deficits and Associations with Parent-Reported Behavioral and Developmental Problems in International Adoptees

Abstract

Objectives To determine the occurrence of vision and hearing deficits in international adoptees and their associations with emotional, behavioral and cognitive problems. Methods The Minnesota International Adoption Project (MnIAP) was a 556-item survey that was mailed to 2969 parents who finalized an international adoption in Minnesota (MN) between January 1990 and December 1998 and whose children were between 4–18 years-old at the time of the survey. Families returned surveys for 1906 children (64%); 1005 had complete data for analyses. The survey included questions about the child’s pre-adoption experiences and post-placement medical diagnoses, and the Child Behavior Checklist (CBCL). Multivariate logistic regression assessed associations between hearing and vision problems and problems identified by the CBCL. Information on hearing and vision screening and specific vision and hearing problems was also collected via a telephone survey (HVS) from 96/184 children (52%) seen between June 1999 and December 2000 at the University of Minnesota (U of MN) International Adoption Clinic. Results In both cohorts, 61% of children had been screened for vision problems and 59% for hearing problems. Among those children screened, vision (MnIAP=25%, HVS=31%) and hearing (MnIAP=12%, HVS=13%) problems were common. For MnIAP children, such problems were significant independent predictors for T-scores >67 for the CBCL social problems and attention subscales and parent-reported, practitioner-diagnosed developmental delay, learning and speech/language problems, and cognitive impairment. Conclusions Hearing and vision problems are common in international adoptees and screening and correction are available in the immediate post-arrival period. The importance of identifying vision and hearing problems cannot be overstated as they are risk factors for development and behavior problems.

Early impoverished environment delays the maturation of cerebral cortex

“…Since the pioneering studies of René Spitz on the genesis of psychiatric disturbances in hospitalism 109 it has been shown that early institutionalization has adverse influence on child development 19 . A large number of studies reported that children raised in orphanage, hospital or foundling home show marked delays in cognitive development, poorer physical growth, visual and hearing impairments 47 and considerable deficits in social competence 19 , 110 – 112 .…”

“…Thus, our investigation is not concerned with the effects of juvenile social deprivation, but it is targeted to understand how early impoverishment of rearing environment, including the pre-weaning period, might reverberate on the developmental trajectories of neuronal networks. We used the visual development as a model of brain maturation not only because it is a paradigmatic example of experience-dependent development and is profoundly affected by early EE, but also because it is increasingly evident that impoverished developmental conditions such as those of institutionalized children can lead to delays and deficit in sensory development 47 .…”

Differential DNA methylation in peripheral blood mononuclear cells in adolescents exposed to significant early but not later childhood adversity

“…It has been shown that concordance between blood and brain is variable between CpGs sites, with some showing greater similarity than others (Davies et al, 2012;Farré et al, 2015). In addition, the many genes with multiple functions related to morphogenesis of the eye and heart may be consistent with vision problems frequently noted among children reared in institutions (Eckerle et al, 2014) and may suggest the potential for cardiovascular disease as these children age.…”

Comprehensive Health Evaluation of the Newly Adopted Child

“…A study involving the Minnesota International Adoption Project survey reported approximately 30% of international adoptees screened had vision problems. 74 Diagnoses included myopia, hyperopia, astigmatism, Information is taken from the AAP Red Book. 18,56 For non-US-born children, serological testing may be a strategy to determine if antibody concentrations are present for some vaccine-preventable diseases.…”