ContextInternational adoption involves more than 40 000 children a year
moving among more than 100 countries. Before adoption, international adoptees
often experience insufficient medical care, malnutrition, maternal separation,
and neglect and abuse in orphanages.ObjectiveTo estimate the effects of international adoption on behavioral problems
and mental health referrals.Data SourcesWe searched MEDLINE, PsychLit, and ERIC from 1950 to January 2005 using
the terms adopt* combined with (behavior) problem, disorder, (mal)adjustment, (behavioral)
development, clinical or psychiatric (referral), or mental health;
conducted a manual search of the references of articles, books, book chapters,
and reports; and consulted experts for relevant studies. The search was not
limited to English-language publications.Study SelectionStudies that provided sufficient data to compute differences between
adoptees (in all age ranges) and nonadopted controls were selected, resulting
in 34 articles on mental health referrals and 64 articles on behavior problems.Data ExtractionData on international adoption, preadoption adversity, and other moderators
were extracted from each study and inserted in the program Comprehensive Meta-analysis
(CMA). Effect sizes (d) for the overall differences
between adoptees and controls regarding internalizing, externalizing, total
behavior problems, and use of mental health services were computed. Homogeneity
across studies was tested with the Q statistic.Data SynthesisAmong 25 281 cases and 80 260 controls, adoptees (both within
and between countries) presented more behavior problems, but effect sizes
were small (d, 0.16-0.24). Adoptees (5092 cases)
were overrepresented in mental health services and this effect size was large
(d, 0.72). Among 15 790 cases and 30  450
controls, international adoptees showed more behavior problems than nonadopted
controls, but effect sizes were small (d, 0.07-0.11).
International adoptees showed fewer total, externalizing and internalizing
behavior problems than domestic adoptees. Also, international adoptees were
less often referred to mental health services (d,
0.37) than domestic adoptees (d, 0.81). International
adoptees with preadoption adversity showed more total problems and externalizing
problems than international adoptees without evidence of extreme deprivation.ConclusionsMost international adoptees are well-adjusted although they are referred
to mental health services more often than nonadopted controls. However, international
adoptees present fewer behavior problems and are less often referred to mental
health services than domestic adoptees.

https://jamanetwork.com/journals/jama/articlepdf/200958/JRV50009.pdf

Behavior problems and mental health referrals of international adoptees: a meta-analysis.

INTERNATIONAL ADOPTION IS AN INcreasing phenomenon involving more than 40 000 children a year moving between more than 100 countries. By setting uniform norms and standards, the 1993 Hague Convention endorsed and facilitated international adoption. International adoption may offer the advantage of a permanent family to a child for whom a family cannot be found in the country of origin. In 2004, most international adoptions in the United States (22 884) were from China, Russia, Guatemala, South Korea, and Kazakhstan, whereas most international adoptions in Europe (15 847 in 2003) were from China, Russia, Colombia, Ukraine, and Bulgaria. Since the 1970s, domestic adoptions in North America and Europe drastically decreased, whereas at the same time the number of international adoptions increased. International adoptees often experience inadequate prenatal and perinatal medical care, maternal separation, psychologicaldeprivation, insufficienthealth services, neglect, abuse, and malnutrition in orphanages or poor families before adoptive placement. Animal models have shown that early maternal

/pdf/behavior-problems-and-mental-health-referrals-of-19rqiu5izf.pdf

Behavior Problems and Mental Health Referrals of International Adoptees

This meta-analysis of 62 studies (N=17,767 adopted children) examined whether the cognitive development of adopted children differed from that of (a) children who remained in institutional care or in the birth family and (b) their current (environmental) nonadopted siblings or peers. Adopted children scored higher on IQ tests than their nonadopted siblings or peers who stayed behind, and their school performance was better. Adopted children did not differ from their nonadopted environmental peers or siblings in IQ, but their school performance and language abilities lagged behind, and more adopted children developed learning problems. Taken together, the meta-analyses document the positive impact of adoption on the children's cognitive development and their remarkably normal cognitive competence but delayed school performance.

/pdf/adoption-and-cognitive-development-a-meta-analytic-1ye5agh4a0.pdf

Adoption and cognitive development: a meta-analytic comparison of adopted and nonadopted children's IQ and school performance.

Fostering security? A meta-analysis of attachment in adopted children.

The current article provides a review of adoption research since its inception as a field of study. Three historical trends in adoption research are identified: the first focusing on risk in adopti...

Review: Adoption research: Trends, topics, outcomes

Infertility and Inter-country Adoption

Monitoring of the DfES Standards Fund Teenage Pregnancy Grant

This chapter compares and contrasts trends in international adoption in the two countries over a period of 27 years from 1992 to 2018. The data presented are based on statistics provided by 20+ receiving States. The period reviewed saw a sharp rise in the global number of intercountry adoptions from 14,000 in 1992 to 45,000 in 2005, followed by a steady decline over the next 14 years. During this period, China became the major source for international adoption, accounting for 152,000 of the 700,000 adoptions recorded in these years. In this chapter, changes in the characteristics—e.g. age and gender—of the children chosen for adoption are also explored, focusing on the move towards special needs adoption and the growth in domestic adoption in the two countries.

Peter Selman

Papers

Infertility and Inter-country Adoption

Monitoring of the DfES Standards Fund Teenage Pregnancy Grant

International Adoption from China and India 1992–2018

Intercountry Adoption as Globalised Motherhood

Sibling relationships in families adopting a child with Downs Syndrome