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DOI: 10.1055/s-2005-864211
International Adoption: A Health and Developmental Prospective
Publikationsverlauf
Publikationsdatum:
24. Februar 2005 (online)
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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.
KEYWORDS
Growth - stress - developmental delay - international adoption - children - orphanage
REFERENCES
- 1 Jenista J, Chapman D. Medical problems of foreign-born adopted children. Am J Dis Child. 1987; 141 298-302
- 2 Johnson D E, Miller L C, Iverson S et al.. The health of children adopted from Romania. JAMA. 1992; 268 3446-3451
- 3 Miller L C, Hendrie N W. Health of children adopted from China. Pediatrics. 2000; 105 1-6
- 4 Saiman L, Aronson J, Zhou J et al.. Prevalence of infectious diseases among internationally adopted children. Pediatrics. 2001; 108 608-612
- 5 Miller L C, Kiernan M T, Mathers M I, Klein-Gitelman M. Developmental and nutritional status of internationally adopted children. Arch Pediatr Adolesc Med. 1995; 149 40-44
- 6 Hostetter M K, Iverson S, Dole K, Johnson D. Unsuspected infectious diseases and other medical diagnoses in the evaluation of internationally adopted children. Pediatrics. 1989; 4 559-564
- 7 Hostetter M K. Infectious diseases in internationally adopted children: findings in children from China, Russia, and Eastern Europe. Adv Pediatr Infect Dis. 1999; 14 147-161
- 8 Miller L C. Internationally adopted children-immunization status. Pediatrics. 1999; 103 1078
- 9 Jenista J. Infectious disease and the internationally adopted child. Curr Opin Infect Dis. 1993; 6 576-584
- 10 Aronson J. Medical evaluation and infectious considerations on arrival. Pediatr Ann. 2000; 29 218-223
- 11 Ames E. Proceedings from the Thirteenth Meeting of the International Society for the Study of Behavioral Development. Burnaby, BC; Simon Fraser University 1994
- 12 American Academy of Pediatrics .Red Book Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL; American Academy of Pediatrics 2003: 172-180
- 13 Johnson D, Iverson S. Screening for infectious diseases in international adoptees: have Red Book guidelines made a difference? Paper presented at: Annual Meeting of the American Academy of Pediatrics. October 11, 2004 San Francisco, CA;
- 14 Albers L H, Johnson D E, Hostetter M K, Iverson S, Miller L C. Health of children adopted from the former Soviet Union and Eastern Europe. Comparison with preadoptive medical records. JAMA. 1997; 278 922-924
- 15 Mason P W, Narad C, Jester T et al.. A survey of growth and development in the internationally adopted child. Pediatr Res. 2000; 47 209A
- 16 Groze V, Ileana D. A follow-up study of adopted children from Romania. Child Adolesc Social Work J. 1996; 13 541-565
- 17 Benoit T C, Jocelyn L J, Moddemann D M, Embree J E. Romanian adoption. The Manitoba experience. Arch Pediatr Adolesc Med. 1996; 150 1278-1282
- 18 Mason P, Narad C. Growth and pubertal development in internationally adopted children. Current Opinions Endo Diabetes. 2002; 9 26-31
- 19 Rosenberg D R, Pajer K, Rancurello M. Neuropsychiatric assessment of orphans in one Romanian orphanage for “unsalvageables”. JAMA. 1992; 268 3489-3490
- 20 Kaler S R, Freeman B J. Analysis of environmental deprivation: cognitive and social development in Romanian orphans. J Child Psychol Psychiatry. 1994; 35 769-781
- 21 Chisholm K. A three-year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Dev. 1998; 69 1092-1106
- 22 Miller L C. Initial assessment of growth, development, and the effects of institutionalization in internationally adopted children. Pediatr Ann. 2000; 29 224-232
- 23 Morrison S, Ames E, Chisholm K. The development of children adopted from Romanian orphanages. Merrill Palmer Q. 1995; 41 411-430
- 24 Mason P, Stallings J, Worthman C et al.. The effect of institutionalization on growth and the stress response. Pediatr Res. 2000; 47 134A
- 25 Knauf L, Iverson S, Johnson D. International adoptees are at a high-risk for vision and hearing problems. Paper presented at: Annual Meeting of the American Academy of Pediatrics; October 11 2004 San Francisco, CA;
- 26 Brown M, Wheeler L. A study of health-related experiences among international adoptees and their families. Am J Nurse Pract. 1999; 3 17-41
- 27 Church M W, Klatenbach J A. Hearing, speech, language and vestibular disorders in the fetal alcohol syndrome: a literature review. Alcohol Clin Exp Res. 1997; 21 495-512
- 28 Church M W, Abel E L. Fetal alcohol syndrome. Hearing, speech, language, and vestibular disorders. Obstet Gynecol Clin North Am. 1998; 25 85-97
- 29 Ames E W. The Development of Romanian Orphanage Children Adopted to Canada. Burnaby, BC; Simon Fraser University 1997: 1-138
- 30 Glennen S, Masters M. Typical and atypical language development in infants and toddlers adopted from Eastern Europe. Am J Speech Lang Pathol. 2002; 11 417-433
- 31 Rutter M. Maternal deprivation, 1972-1978: new findings, new concepts, new approaches. Child Dev. 1979; 50 283-305
- 32 Levin S. Infantile experience and resistance to physiological stress. Science. 1957; 126 405-406
- 33 Meaney M, Aitken D, Bhatnagar et al.. Postnatal handling attenuates neuroendocrine, anatomical and cognitive impairments related to the aged hippocampus. Science. 1988; 238 766-768<
- 34 Clarke A, Wittwer D, Abbott D, Schneider M. Long-term effects of prenatal stress on HPA axis activity in juvenile rhesus monkeys. Dev Psychobiol. 1994; 27 257-269
- 35 Ogilvie K, Rivier C. Prenatal alcohol exposure results in hyperactivity of the hypothalamic-pituitary-adrenal axis of the offspring: modulation by fostering at birth and postnatal handling. Alcohol Clin Exp Res. 1997; 21 424-429
- 36 Lupien S J, McEwen B S. The acute effects of corticosteroids on cognition: integration of animal and human model studies. Brain Res Brain Res Rev. 1997; 24 1-27
- 37 deHaan M, Gunnar M R, Tout K, Hart J, Stansbury K. Familiar and novel contexts yield different associations between cortisol and behavior among 2-year-old children. Dev Psychobiol. 1998; 33 93-101
- 38 Schmidt L A, Fox N A, Rubin K H et al.. Behavioral and neuroendocrine responses in shy children. Dev Psychobiol. 1997; 30 127-140
- 39 Elzinga B M, Schmahl C G, Vermetten E, van Dyck R, Bremner J D. Higher cortisol levels following exposure to traumatic reminders in abuse related PTSD. Neuropsychopharmacology. 2003; 28 1656-1665
- 40 Gunnar M R, Brodersen L, Nachmias M, Buss K, Rigatuso J. Stress reactivity and attachment security. Dev Psychobiol. 1996; 29 191-204
- 41 Nachmias M, Gunnar M, Mangelsdorf S, Parritz R H, Buss K. Behavioral inhibition and stress reactivity: moderating role of attachment security. Child Dev. 1996; 67 508-522
- 42 Halligan S L, Herbert J, Goodyer I M, Murray L. Exposure to postnatal depression predicts elevated cortisol in adolescent offspring. Biol Psychiatry. 2004; 55 376-381
- 43 Brown E S, Varghese F P, McEwen B S. Association of depression with medical illness: does cortisol play a role?. Biol Psychiatry. 2004; 55 1-9
- 44 Carlson M, Earls F. Phychological and neuroendocrinological sequelae of early social deprivation in institutionalized children in Romania. Ann NY Acad Sci. 1997; 807 419-428
- 45 Worthman C M, Stallings J F. Hormone measures in finger-prick blood spot samples: new field methods for reproductive endocrinology. Am J Phys Anthropol. 1997; 104 1-21
- 46 Powell G F, Brasel J A, Blizzard R M. Emotional deprivation and growth retardation simulating idiopathic hypopituitarism. I. Clinical evaluation of the syndrome. N Engl J Med. 1967; 276 1271-1278
- 47 Powell G F, Brasel J A, Raiti S, Blizzard R M. Emotional deprivation and growth retardation simulating idiopathic hypopituitarism. II. Endocrinologic evaluation of the syndrome. N Engl J Med. 1967; 276 1279-1283
- 48 Miller J D, Tannenbaum G S, Colle E, Guyda H J. Daytime pulsatile growth hormone secretion during childhood and adolescence. J Clin Endocrinol Metab. 1982; 55 989-994
- 49 Schalch S D, Reichlin S. Plasma growth hormone concentration in the rat determined by radioimmunoassay: influence of sex, pregnancy, lactation, anesthesia, hypophysectomy and extracellular. pituitary transplants. Endocrinology. 1966; 79 275-280
- 50 Kokka N, Garcia J F, George R, Elliott H W. Growth hormone and ACTH secretion: evidence for an inverse relationship in rats. Endocrinology. 1972; 90 735-743
- 51 Brown G M, Martin J B. Corticosterone, prolactin, and growth hormone responses to handling and new environment in the rat. Psychosom Med. 1974; 36 241-247
- 52 Armario A, Castellanos J M, Balasch J. Adaptation of anterior pituitary hormones to chronic noise stress in male rats. Behav Neural Biol. 1984; 41 71-76
- 53 Armario A, Lopez-Calderon A, Jolin T, Castellanos J M. Sensitivity of anterior pituitary hormones to graded levels of psychological stress. Life Sci. 1986; 39 471-475
- 54 Smith E L, Coplan J D, Trost R C, Scharf B A, Rosenblum L A. Neurobiological alterations in adult nonhuman primates exposed to unpredictable early rearing. Relevance to posttraumatic stress disorder. Ann N Y Acad Sci. 1997; 821 545-548
- 55 Rivier C, Vale W. Involvement of corticotropin-releasing factor and somatostatin in stress-induced inhibition of growth hormone secretion in the rat. Endocrinology. 1985; 117 2478-2482
- 56 Barbarino A, Corsello S M, Della Casa S et al.. Corticotropin-releasing hormone inhibition of growth hormone-releasing hormone induced growth hormone release in man. J Clin Endocrin Metab. 1990; 71 1368-1374
- 57 Barinaga M, Bilezikjian L M, Vale W W, Rosenfeld M G, Evans R M. Independent effects of growth hormone releasing factor on growth hormone release and gene transcription. Nature. 1985; 314 279-281
- 58 Kuhn C M, Pauk J, Schanberg S M. Endocrine responses to mother-infant separation in developing rats. Dev Psychobiol. 1990; 23 395-410
- 59 Rutter M. Developmental catch-up, and deficit, following adoption after severe global early privation. English and Romanian Adoptees (ERA) Study Team. J Child Psychol Psychiatry. 1998; 39 465-476
- 60 Ellis B H, Fisher P A, Zaharie S. Predictors of disruptive behavior, developmental delays, anxiety, and affective symptomatology among institutionally reared Romanian children. J Am Acad Child Adolesc Psychiatry. 2004; 43 1283-1292
- 61 Gunnar M R, Morison S K, Chisholm K, Schuder M. Salivary cortisol levels in children adopted from Romanian orphanages. Dev Psychopathol. 2001; 13 611-628
- 62 Verhulst F C, Althaus M, Versluis-den Bieman H J. Problem behavior in international adoptees: II. Age at placement. J Am Acad Child Adolesc Psyschiatry. 1990; 29 104-111
- 63 Verhulst F C, Althaus M, Versluis-den Bieman H J. Damaging backgrounds: later adjustment of international adoptees. J Am Acad Child Adolesc Psychiatry. 1992; 31 518-524
Patrick MasonM.D. Ph.D. FAAP
Director, International Adoption Center, Inova Fairfax Hospital for Children
8505 Arlington Blvd., Suite 100
Fairfax, VA 22031
eMail: Patrick.Mason@inova.com