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Unlabelled: Empirical evidence has shown that international adoptees present physical growth delays, precocious puberty, behavioral problems, and mental health referrals more often than non-adoptees. We hypothesized that the higher prevalence of (mental) health problems in adoptees is accompanied by elevated consumption of prescription drugs, including antidepressants, attention deficit hyperactivity disorder (ADHD) medication, and medication for growth inhibition/stimulation. In an archival, population-based Dutch cohort study, data on medication use were available from the Health Care Insurance Board by Statistics Netherlands from 2006 to 2011. The Dutch population born between 1994 and 2005 and alive during the period of measurement was included (2,360,450 including 10,602 international adoptees, of which 4447 from China). Their mean age was 6.5 years at start (range 1-12 years) and 11.5 years at the end of the measurement period (range 6-17 years). Chinese female adoptees used less medication for precocious puberty (as treatment for precocious puberty; odds ratio (OR) = 0.57, effect size Cohen's d = -0.31) and contraception (OR = 0.65, d = -0.24) than non-adoptees. For both males and females, non-Chinese adoptees used more medication for ADHD than non-adoptees (males: OR = 1.22, females: OR = 1.32), but the effect was small (males: d = 0.11, females: d = 0.15)., Conclusions: Adoptees in the Netherlands generally do not use more medication than their non-adopted peers., What Is Known: • Meta-analytical evidence shows that international adoptees present physical growth delays and mental health referrals more often than non-adopted controls. • With the exception of one Swedish study on ADHD medication, there is no other systematic research on medication use of international adoptees. What is New: • All differences in medication use between international adoptees in the Netherlands and non-adopted controls were below the threshold of a small effect with the exception of medication for precocious puberty, but this effect was in the opposite direction with female adoptees using less medication for precocious puberty than non-adoptees. • International adoptees in the Netherlands do not use more medication despite experiences of preadoption adversity and higher rates of mental health referrals during childhood and adolescence.

The associations between attachment representations of adopted young adults and their experiential and physiological arousal to infant crying were examined. Attachment representations were assessed with the Attachment Script Assessment (ASA), and the young adults listened to infant cries, during which ratings of cry perception were collected and physiological reactivity was measured. Secure adoptees showed a well-integrated response to infant distress: heart-rate increases and respiratory sinus arrhythmia (RSA) withdrawal were coupled with heightened perception of urgency in these individuals. In insecure adoptees RSA withdrawal was absent, and a combination of lowered perceived urgency and heightened sympathetic arousal was found, reflecting a deactivating style of emotional reactivity. Overall, our findings support the idea that internal working models of attachment explain individual differences in the way attachment-related information is processed., (Copyright © 2014 Elsevier Inc. All rights reserved.)

We examined whether differences in adult attachment representations could be predicted from early and later maternal sensitivity, controlling for early and later assessments of attachment. In this longitudinal study on 190 adoptees, attachment at 23 years was measured with the Attachment Script Assessment. Maternal sensitivity was observed in infancy and at seven and 14 years. Attachment was also measured in infancy and at 14 years. Higher maternal sensitivity in infancy predicted more secure attachment in infancy and more secure attachment representations in young adulthood. Higher maternal sensitivity in middle childhood also predicted more secure attachment representations in young adulthood. There was no continuity of attachment from infancy to young adulthood, but attachment in adolescence and young adulthood were significantly related. Even in genetically unrelated families, maternal sensitivity in early and middle childhood predicts attachment representations in young adults, confirming the importance of sensitive parenting for human development.

In a longitudinal study with 125 early adopted adolescents, we examined continuity of attachment from infancy to adolescence and the role of parental sensitive support in explaining continuity or discontinuity of attachment. Assessments of maternal sensitive support and infant attachment (Strange Situation Procedure) were completed when infants were 12 months old. When the children were 14 years old, we observed mothers' sensitive support during a conflict discussion. The adolescents' attachment representations were assessed with the Adult Attachment Interview. Mothers of secure adolescents showed significantly more sensitive support during conflicts than did mothers of insecure adolescents. Overall, no continuity of attachment from infancy to adolescence was found. However, maternal sensitive support in early childhood and adolescence predicted continuity of secure attachment from 1 to 14 years, whereas less maternal sensitive support in early childhood but more maternal sensitive support in adolescence predicted children's change from insecurity in infancy to security in adolescence. We conclude that both early and later parental sensitive support are important for continuity of attachment across the first 14 years of life., (PsycINFO Database Record (c) 2012 APA, all rights reserved.)

In a short-term longitudinal design we investigated maternal sensitivity, child responsiveness, attachment, and indiscriminate friendliness in families with children internationally adopted from institutions or foster care in China. Ninety-two families with 50 postinstitutionalized and 42 formerly fostered girls, aged 11-16 months on arrival, were studied 2 and 6 months after adoption. Maternal sensitivity and child responsiveness were observed with the Emotional Availability Scales, attachment was assessed with the Strange Situation procedure, and mothers reported on children's indiscriminate friendliness. The postinstitutionalized children showed less secure attachment, whereas the former foster children did not differ from the normative distribution of attachment security. However, at both assessments the two groups of adopted children showed more disorganized attachments compared to normative data. Adoptive mothers of postinstitutionalized and former foster children were equally sensitive and their sensitivity did not change over time. Postinstitutionalized and former foster children did not differ on indiscriminate friendliness, but children with more sensitive adoptive mothers showed less indiscriminate friendliness. The former foster children showed a larger increase in responsiveness over time than the postinstitutionalized children, suggesting that children's responsiveness is more sensitive to change than attachment, and that preadoption foster care is more beneficial for the development of children's responsiveness after adoptive placement than preadoption institutional care.

Objective: To compare the physical, cognitive, and motor development of infants adopted from foster care with infants adopted from institutions., Method: Forty-two formerly fostered and 50 post-institutionalized girls adopted from China, aged between 11 and 16 months on arrival, were visited 2 and 6 months after adoption. Children's height, weight, and head circumference were measured. Stress regulation was assessed by diurnal salivary cortisol levels, and cognitive and motor development were assessed using the Bayley Scales of Infant Development-second edition., Results: At both assessments, the (modest) physical growth delays were similar for formerly fostered and post-institutionalized children. For weight and head circumference (but not for height) a catch-up over time was found, with a significant interaction between time and age at arrival, showing a more rapid catch-up for earlier adopted children. The daily cortisol curves of the formerly fostered and post-institutionalized children were similar and did not change over time. At both assessments, the former foster children outperformed the post-institutionalized children on mental and motor skills. Both groups showed a similar catch-up for mental development. For motor development, no catch-up was found., Conclusions: The influence of pre-adoption foster versus institutional rearing seems more pronounced for cognitive and motor development than for physical development and hormonal stress regulation. Our outcomes suggest that pre-adoption foster care is less detrimental to children's cognitive and motor development than institutional rearing.

Does child maltreatment occur more often in adoptive and stepfamilies than in biological families? Data were collected from all 17 Dutch child protective services (CPS) agencies on 13,538 cases of certified child maltreatment in 2005. Family composition of the maltreated children was compared to a large national representative sample of the Netherlands Kinship Panel Study (NKPS). Larger families, one-parent families, and families with a stepparent showed elevated risks for child maltreatment. Adoptive families, however, showed significantly less child maltreatment than expected. The findings are discussed in the context of parental investment theory that seems to be applicable to stepparents but not to adoptive parents.

Objective: To examine infant attachment and developmental functioning shortly after international adoption., Methods: At 14 months, infant-mother attachment and mental (MDI) and psychomotor (PDI) development were assessed in 70 internationally adopted children. Mean age at arrival was 5.5 months, mean stay in the adoptive family 8.7 months., Results: Adopted children's MDI and PDI did not deviate from normative scores. Also, their secure-insecure attachment distribution was comparable with that of normative groups. However, more adoptees were disorganized attached (36 vs. 15% in normative groups). Temporary residence in a foster home in the country of origin before adoption was related to higher MDI and PDI, whereas disorganized attachment in the adoptive family was related to lower MDI and PDI scores., Conclusions: The majority of internationally adopted children form secure attachment relationships and function at normative developmental levels shortly after adoption. Residence in a foster family before adoption may partly prevent developmental delays.

Do adopted children show lower self-esteem than nonadopted peers, and do transracial adoptees show lower self-esteem than same-race adoptees? Adopted children are hypothesized to be at risk of low self-esteem. They may suffer from the consequences of neglect, abuse, and malnutrition in institutions before adoption. They have to cope with their adoptive status, which often includes difficulties associated with the lack of resemblance to their adoptive parents. Additionally, transracial and international adoptees may feel less integrated into their family, resulting in low self-esteem. In a series of metaanalyses, the authors found, however, no difference in self-esteem between adoptees (N = 10,977) and nonadopted comparisons (N = 33,862) across 88 studies. This was equally true for international, domestic, and transracial adoptees. Across 18 studies including 2,198 adoptees, no differences in self-esteem were found between transracial and same-race adoptees. In contrast, in a small set of 3 studies (N = 300), adoptees showed higher levels of self-esteem than nonadopted, institutionalized children. The authors' findings may be explained by adoptees' resilience to overcome early adversity, supported by the large investment of adoptive families. Adoption can be seen as an effective intervention, leading to normative self-esteem.

Background: Research suggests that institutional care has long-lasting effects on children. However, no study has longitudinally studied infants in an institution and their subsequent development at age four., Methods: Sixty-one adopted children aged four years who had spent their first two years of life in an institution were compared to 39 children reared in their own two-parent families. Cognitive development, security of attachment, shyness, children's emotional understanding and behavioural problems were examined in both groups. Parental health and stress were also assessed., Results: At four years adopted children still had lower scores on cognitive development, were less secure, and less able to understand emotions than family-reared children. Children with a secure attachment type in infancy were found to be less secure at age four, compared with those who were classified in infancy as having an insecure attachment type. Their physical development had recovered, they were less shy, had no behavioural problems and no problems in the relationship with their teacher., Conclusions: Early residential group care has long-lasting effects on important socio-emotional and cognitive aspects of preschool children's development.

In the present longitudinal study, early adopted children (N = 160) were followed from infancy to adolescence to assess the influence of previous and concurrent factors on the children's social development. This study allowed for more conclusive evidence of the influence of early and concurrent rearing experiences and temperament on adolescents' social development, independent of shared genetic factors between children and parents. Results showed that social development and temperament were stable over time and that both previous and current parental sensitivity were important in predicting social development in adolescence. Quality of the early parent-child relationship was indirectly associated with social development in adolescence through the influence on social development in middle childhood. Maternal sensitivity in middle childhood and in adolescence partly buffered the negative effects of difficult temperament on social development in adolescence. Adaptation emerged as the product of both developmental history and current circumstances.

Context: International 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., Objective: To estimate the effects of international adoption on behavioral problems and mental health referrals., Data Sources: We 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 Selection: Studies 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 Extraction: Data 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 Synthesis: Among 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., Conclusions: Most 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.

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.

Background: As infant disorganized attachment is a serious risk factor for later child psychopathology, it is important to examine whether attachment disorganization can be prevented or reduced., Method: In a randomized intervention study involving 130 families with 6-month-old adopted infants, two attachment-based intervention programs were tested. In the first program, mothers were provided a personal book, and in the second program mothers received the same personal book and three home-based sessions of video feedback. The third group did not receive intervention (control group)., Results: The intervention with video feedback and the personal book resulted in enhanced maternal sensitive responsiveness (d=.65). Children of mothers who received this intervention were less likely to be classified as disorganized attached at the age of 12 months (d=.46), and received lower scores on the rating scale for disorganization than children in the control group (d=.62). In the book-only intervention group children showed lower disorganization ratings compared to the control group, but no effect on the number of infants with disorganized attachment classifications was found., Conclusion: Our short-term preventive intervention program with video feedback and a book lowered the rate of disorganized attachment. The effectiveness of our intervention documents the importance of parenting in the development of infant attachment disorganization.

In this paper we examine the prevalence of problem behaviors in samples of adolescents who were adopted from a foreign country as infants or young children. We reviewed ten studies and performed a meta-analysis, comparing 2317 internationally adopted adolescents with 14,345 nonadopted adolescents. Results indicate that internationally adopted adolescents exhibit more behavior problems than do nonadopted adolescents (d = 0.08; p = 0.02), with the difference seen in externalizing (d = 0.11; p = 0.00), but not in internalizing (d = 0.05; p = 0.12), behavior problems. Significantly more total behavior problems were seen in adopted than in nonadopted girls (d = 0.10; p = 0.03), but not in adopted boys compared to nonadopted ones (d = 0.07; p = 0.22). All differences, however, were small. The differences between adopted and nonadopted adolescents were somewhat larger when we considered behavior problems in the clinical range. The majority of the adopted adolescents are well adjusted and do not display significantly more problem behaviors than do their nonadopted peers.

In a longitudinal study, internationally adopted children (N = 146) placed before 6 months of age were followed from infancy to age 7. Results showed that girls were better adjusted than boys, except in cognitive development, and that easy temperament was associated with higher levels of social, cognitive, and personality development and fewer behavior problems. Higher quality of child-mother relationships, in terms of attachment security and maternal sensitivity, uniquely predicted better social and cognitive development. The combination of attachment disorganization and difficult temperament predicted less optimal ego-control and lower levels of cognitive development. It is concluded that even in adopted children, who are not biologically related to their adoptive parents, early mother-infant interactions and attachment relationships predict later socioemotional and cognitive development, beyond infant temperament and gender.

The present longitudinal study examined resting heart rate and heart rate variability and reactivity to a stressful gambling task in adopted adolescents with aggressive, delinquent, or internalizing behavior problems and adopted adolescents without behavior problems (total N=151). Early-onset delinquent adolescents showed heart rate "hypo"reactivity to the stress-eliciting gambling task compared to late-onset delinquent adolescents and adolescents without behavior problems. Heart rate, heart rate variability, and reactivity to stress were not related to environmental factors such as early-childhood parental sensitivity, parental socioeconomic status, or adoptee's health status at arrival. We conclude that the distinction between delinquency and aggression and between childhood-onset and adolescence-onset delinquency is important for the study of stress reactivity in adolescents.

Do adopted children show lower self-esteem than nonadopted peers, and do transracial adoptees show lower self-esteem than same-race adoptees? Adopted children are hypothesized to be at risk of low self-esteem. They may suffer from the consequences of neglect, abuse, and malnutrition in institutions before adoption. They have to cope with their adoptive status, which often includes difficulties associated with the lack of resemblance to their adoptive parents. Additionally, transracial and international adoptees may feel less integrated into their family, resulting in low self-esteem. In a series of metaanalyses, the authors found, however, no difference in self-esteem between adoptees (N = 10,977) and nonadopted comparisons (N = 33,862) across 88 studies. This was equally true for international, domestic, and transracial adoptees. Across 18 studies including 2,198 adoptees, no differences in self-esteem were found between transracial and same-race adoptees. In contrast, in a small set of 3 studies (N = 300), adoptees showed higher levels of self-esteem than nonadopted, institutionalized children. The authors' findings may be explained by adoptees' resilience to overcome early adversity, supported by the large investment of adoptive families. Adoption can be seen as an effective intervention, leading to normative self-esteem.

Background: Adopted children have been said to be difficult children, scarred by their past experiences in maltreating families or neglecting orphanages, or by genetic or pre- and perinatal problems. Is (domestic or international) adoption an effective intervention in the developmental domains of physical growth, attachment security, cognitive development and school achievement, self-esteem, and behaviour problems? Method: Through a series of meta-analyses on more than 270 studies that include more than 230,000 adopted and non-adopted children and their parents an adoption catch-up model was tested. Results: Although catch-up with current peers was incomplete in some developmental domains (in particular, physical growth and attachment), adopted children largely outperformed their peers left behind. Adoptions before 12 months of age were associated with more complete catch-up than later adoptions for height, attachment, and school achievement. International adoptions did not lead to lower rates of catch-up than domestic adoptions in most developmental domains. Conclusions: It is concluded that adoption is an effective intervention leading to massive catch-up. Domestic and international adoptions can be justified on ethical grounds if no other solutions are available. Humans are adapted to adopt, and adoption demonstrates the plasticity of child development.

In the present longitudinal study, early adopted children (N = 160) were followed from infancy to adolescence to assess the influence of previous and concurrent factors on the children's social development. This study allowed for more conclusive evidence of the influence of early and concurrent rearing experiences and temperament on adolescents' social development, independent of shared genetic factors between children and parents. Results showed that social development and temperament were stable over time and that both previous and current parental sensitivity were important in predicting social development in adolescence. Quality of the early parent-child relationship was indirectly associated with social development in adolescence through the influence on social development in middle childhood. Maternal sensitivity in middle childhood and in adolescence partly buffered the negative effects of difficult temperament on social development in adolescence. Adaptation emerged as the product of both developmental history and current circumstances.

Background: As infant disorganized attachment is a serious risk factor for later child psychopathology, it is important to examine whether attachment disorganization can be prevented or reduced. Method: In a randomized intervention study involving 130 families with 6-month-old adopted infants, two attachment-based intervention programs were tested. In the first program, mothers were provided a personal book, and in the second program mothers received the same personal book and three home-based sessions of video feedback. The third group did not receive intervention (control group). Results: The intervention with video feedback "and" the personal book resulted in enhanced maternal sensitive responsiveness (d = 0.65). Children of mothers who received this intervention were less likely to be classified as disorganized attached at the age of 12 months (d = 0.46), and received lower scores on the rating scale for disorganization than children in the control group (d = 0.62). In the book-only intervention group children showed lower disorganization ratings compared to the control group, but no effect on the number of infants with disorganized attachment classifications was found. Conclusion: Our short-term preventive intervention program with video feedback and a book lowered the rate of disorganized attachment. The effectiveness of our intervention documents the importance of parenting in the development of infant attachment disorganization.

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.

Background: Many studies have documented that adopted children are at higher risk for behavior problems, but less is known about the correlates of their problem behavior. Method: The correlates of parent-reported and teacher-reported problem behavior in 7-year-old internationally adopted children (N = 176) were investigated by examining these children's ego resiliency, ego control, and sociometric status, and exploring possible risks factors in the home and racial influences. Results: Using the 25th percentiles lowest and highest scores on ego resiliency and ego control as cut-off criteria, we found that: (1) resilient children were almost free of behavior problems; (2) overcontrolling children showed predominantly internalizing behavior problems (33% at school, and 28% at home); (3) undercontrolling children showed high rates of externalizing behavior problems (50% at school, and 34% at home), and an elevated rate of comorbidity (21% at school, and 21% at home). Adopted children identified by peer report as controversial or rejected had significantly higher externalizing problem scores than popular, average or neglected adopted children. The adopted children did not experience much (racial) discrimination. Nevertheless, children who wished to be white (46%) presented more mother-reported behavior problems. Conclusions: Our findings replicate R.W. Robins et al.'s (1996) work on three types of personality functioning: resilients, overcontrollers and undercontrollers (identified by J. Block, 1971), extending the model from adolescent boys to school-aged boys and girls, adopted from Asia and South America. The wish to identify with white parents and white peers may constitute a potential risk factor for internationally adopted children in middle childhood.

The current study examined the attachment development of 92 internationally adopted Chinese girls, focusing on the influence of type of pre-adoption care (institutional versus foster care) and sensitive adoptive parenting. Although the children were more often insecurely attached than non-adopted children 2 and 6 months after adoption (Times 1 and 2, N = 92), they had similar levels of secure base script knowledge (SBS knowledge) as a non-adopted comparison group at age 10 (Time 3, N = 87). Furthermore, concurrently observed sensitive parenting was positively associated with SBS knowledge. Finally, a significant interaction between type of pre-adoption care and early-childhood sensitive parenting indicated that the post-institutionalized children showed a stronger increase in security than the post-foster children when parents were more sensitive. [ABSTRACT FROM AUTHOR]

Unlabelled: Empirical evidence has shown that international adoptees present physical growth delays, precocious puberty, behavioral problems, and mental health referrals more often than non-adoptees. We hypothesized that the higher prevalence of (mental) health problems in adoptees is accompanied by elevated consumption of prescription drugs, including antidepressants, attention deficit hyperactivity disorder (ADHD) medication, and medication for growth inhibition/stimulation. In an archival, population-based Dutch cohort study, data on medication use were available from the Health Care Insurance Board by Statistics Netherlands from 2006 to 2011. The Dutch population born between 1994 and 2005 and alive during the period of measurement was included (2,360,450 including 10,602 international adoptees, of which 4447 from China). Their mean age was 6.5 years at start (range 1-12 years) and 11.5 years at the end of the measurement period (range 6-17 years). Chinese female adoptees used less medication for precocious puberty (as treatment for precocious puberty; odds ratio (OR) = 0.57, effect size Cohen's d = -0.31) and contraception (OR = 0.65, d = -0.24) than non-adoptees. For both males and females, non-Chinese adoptees used more medication for ADHD than non-adoptees (males: OR = 1.22, females: OR = 1.32), but the effect was small (males: d = 0.11, females: d = 0.15).Conclusions: Adoptees in the Netherlands generally do not use more medication than their non-adopted peers.What Is Known: • Meta-analytical evidence shows that international adoptees present physical growth delays and mental health referrals more often than non-adopted controls. • With the exception of one Swedish study on ADHD medication, there is no other systematic research on medication use of international adoptees. What is New: • All differences in medication use between international adoptees in the Netherlands and non-adopted controls were below the threshold of a small effect with the exception of medication for precocious puberty, but this effect was in the opposite direction with female adoptees using less medication for precocious puberty than non-adoptees. • International adoptees in the Netherlands do not use more medication despite experiences of preadoption adversity and higher rates of mental health referrals during childhood and adolescence. [ABSTRACT FROM AUTHOR]

Is the cognitive development of adopted children different from that of (a) children who have remained in institutional care or in their birth families or (b) their current (environmental) nonadopted siblings or peers? We attempt to answer these questions on the basis of a meta-analysis of 62 studies including 17,767 adopted children. Compared to their nonadopted siblings or peers who stayed behind, adopted children scored substantially higher on IQ tests and they performed much better at school. Compared to their current nonadopted environmental peers or siblings, adopted children showed similar IQ scores but their school performance and language abilities lagged somewhat behind. Most importantly, we found a twofold increase in special-education referrals in adopted children compared to their nonadopted peers. Taken together, the findings document the positive impact of adoption on children's cognitive development and adopted children's remarkably normal cognitive competence but somewhat delayed school performance. [ABSTRACT FROM AUTHOR]

Abstract: Adopted children are hypothesized to be at risk of insecure attachment relationships because of their background of institutional care, maltreatment and neglect. We conducted two series of meta-analyses, one using only observational assessments of attachment and one using both observational and self-report assessments. Observational assessments showed that children who were adopted before 12 months of age were as securely attached as their non-adopted peers, whereas children adopted after their first birthday showed less attachment security than non-adopted children (d =0.80, CI =0.49–1.12). Regarding the overall effect for attachment security, adoptees were comparable to foster children. Adopted children showed more disorganized attachments compared to their non-adopted peers (trimmed d =0.36, CI =0.04–0.68), but again were comparable to foster children (trimmed d =0.35, CI =0.02–0.67). Compared to institutionalized children, adoptees were less often disorganized attached. When self-report measures of attachment were included no difference was found between adoptees and their non-adopted counterparts (trimmed d =0.12, CI =−0.02–0.26, 39 studies, N =2912 adopted children). Compared to institutionalized children, (early) adoption proves to be an effective intervention in the domain of attachment. [Copyright &y& Elsevier]

The focus of this study was on the longitudinal relation between infant attachment, early maternal sensitivity and the diurnal cortisol curve of adopted young adults. 86 adoptees (mean age at adoption 11 weeks) were followed from infancy to young adulthood. Attachment quality and maternal sensitivity were observed in infancy. When the adoptees were 23 years of age saliva samples were collected at six time points across the day, on two different days. To assess compliance to the instruction the Medication Event Monitoring System (MEMS) was used. The data were analyzed with growth models using multilevel analyses (Day 1) and structural equation modeling (as a more confirmatory approach, Day 2). Results revealed no associations between early attachment security, attachment disorganization, maternal sensitivity and the diurnal cortisol curve more than two decades later. Attachment experiences (in the normative range) may not induce changes in the later diurnal cortisol curve in the same way as severe chronic stressors do. Alternatively, adoption related experiences may dampen associations between attachment experiences and the diurnal cortisol curve in later life. [ABSTRACT FROM AUTHOR]

Abstract: Background: 160 early-adopted children were followed from infancy to adolescence. Central question was whether early and concurrent parenting and child temperament predicted adolescent delinquent and aggressive behaviors. Methods: Structural equation modeling was used to test the relations between early and concurrent observed maternal sensitivity, mother reported effortful control and teacher reported delinquent and aggressive behaviors. Results: This longitudinal adoption study showed that lower effortful control, concurrent as well as 7years earlier, predicted higher levels of delinquency in adolescence and aggression in middle childhood and in adolescence. Lower levels of effortful control in infancy predicted higher levels of maternal sensitivity in adolescence which in its turn predicted less adolescent delinquent behavior. Conclusions: The findings suggest that effortful control is an important predictor of both aggressive and delinquent behaviors. Maternal sensitivity also plays a role in the development of delinquent behavior, buffering a lack of effortful control, but is not related to aggression at age 14. It is important to note that these relations were found in a sample of parents and their genetically unrelated adopted children. [Copyright &y& Elsevier]