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The purpose of this study was to describe reflections of nine American parents on the strengths, challenges, and strategies in parenting young children newly adopted from another country. Eight mothers and one father with an adopted child aged less than 3 years and home for less than 3 months completed standardized assessments measuring the child's social emotional development, sensory processing, and parental stress. Each parent participated in qualitative interview to discuss challenges and strategies helpful in addressing their children's needs. All parents reported challenges addressing their child's needs in the areas of sleep, feeding, attachment and self-regulation, and soothing. Parents reported similar strategies to address their child's behavioral concerns. Parents also reported on family factors and community resources that supported the success of the adoption. Although many families described their adoptive child as having challenges with multiple daily life activities, parents reported being able to create effective strategies to address many of these challenging behaviors. (Contains 4 tables.)

More than 230,000 children have been adopted from other countries by American parents since 1989, including more than 72,000 from Eastern Europe. Many arrive with growth and development delays, and medical problems. Yet, little is known about the long-term outcomes for these children. Therefore, we assessed long-term developmental, neurobehavioral, and educational performance outcomes in a group of adopted 8- to 12-year-old children from Eastern Europe. A parent questionnaire was mailed to families of school-age Eastern European adopted children who had been in the United States for two years or more. Of the 81 children (33M: 48F) described in the returned surveys, 84 percent were 3 years old or older at adoption. Sixty-one percent of the children received special education services, and 32 percent received occupational therapy. Fifty-two percent had language disorders, 38 percent had attentional problems, and 36 percent had learning disabilities. Thirty-five percent had multiple neurodevelopmental diagnosis. Thirty-two percent of the children had post-traumatic stress disorder; these children were older at adoption than those without this problem (p = 0.04). Anxiety and depression each occurred in 19 percent of children; 66 percent of those with depression also had anxiety (p = 0.0001). Most children attended school willingly (70 percent), had a best friend (63 percent), and got along their parents (75 percent). Although nearly two-thirds of the internationally adopted children received special education services and 35 percent had multiple neurodevelopmental disorders, most children displayed remarkable social, peer, and family integration skills. (Contains 5 figures.)

Many of the >339,000 international adoptees arriving in the USA during the last 25 years are now teenagers and young adults (YA). Information about their long-term social integration, school performance, and self-esteem is incomplete. Moreover, the relation of these outcomes to facets of family function is incompletely understood. We hypothesised that growth, development, and health at arrival would predict the social and academic success of YA adoptees, and that family flexibility would correlate with more favourable outcomes for family and teen. Arrival records of 88 international adoptees aged 15–25 years were reviewed. Adoptees and their parents completed a series of standardised questionnaires. Results showed that self-esteem was good, although 15% were anxious or unhappy. Family stress varied widely and was higher for families with adopted sons. Adoption satisfaction varied, and correlated to family coping skills, inversely to family stress, but not to age, development, behaviour, growth at arrival, gender, or to parental experience. Generally, family flexibility corresponded to more favourable outcomes. [ABSTRACT FROM AUTHOR]

The article reports on the results of a 2006 research study which looked at the long term developmental, neurobehavioral, and educational performance outcomes of a group of 8 to 12 year old children from Eastern Europe who had been adopted by families in the United States. Researchers used a parent questionnaire which was mailed to families of school-age Eastern European adopted children who had been in the United States for two years or more. Research found that while two-thirds of the children received special education services and 35% had multiple neurodevelopmental disorders, most displayed excellent social, peer and family integration skills.

Assesses the relationship between developmental status of international adoptees at the time of entry into the United States and their nutritional status and concurrent medical problems. Nutritional status; Developmental abilities; Nutritional status and medical conditions; Developmental abilities and medical conditions.

The author reflects on the risks concerning the transmission of communicable diseases from international adoptees to their families in the U.S. She asserts that internationally adopted children may be the cause on the spread of various diseases acquired from their home countries, including tuberculosis, hepatitis B and rubella. The author contends that public awareness concerning the health risks offered by international adoptees should be considered.

The article focuses on support for adoptive parents. It explains that children adopted from countries outside the U.S. may need more support from child psychologists, schools, and pediatricians. It also comments on the fatalities among internationally adopted children as previously discussed in the journal. The U.S. policies on adoption are discussed, and it clarifies the fact that adoption is not necessarily a risk factor in child abuse. The article also encourages further research about and services for international adoption.

Editorial. Focuses on the issue of caring for internationally adopted children. Statistics on the number of children adopted in the United States from other countries; Possible diseases carried by these children; Reference to a boy in North Dakota who came from the Marshall Islands with infectious tuberculosis; Need for specialized medical attention to international adoptees; Screening tests conducted in the countries from which the children are adopted; Suggestions from the American Academy of Pediatrics.

Most international adoptees (IA) have rapid catch-up of the delays common at arrival. However, it is not known whether development at arrival predicts later abilities or school readiness. Therefore, we comprehensively evaluated language, fine motor, visual reception (VR), executive function (EF), attention (ATT), and sensory skills (SS) in IA preschoolers. We hypothesized that pre-adoptive risk factors, development at arrival, and the post-adoptive environment (time in day care) would predict developmental and behavioral outcomes and school readiness. 37 IA (12M:25F), currently age 4-5 years and previously seen in our clinic (mean arrival age 12 months), were evaluated with standardized tests of development, language, EF, ATT, and SS, along with demographic information, parent interview, and review of arrival clinic records. Fine motor and VR skills at arrival ranged from average to very below average. At followup, most IA were average or above average in fine motor, VR, and language skills, but many had concerning scores for ATT (42%), EF (11%) and SS (48%). Arrival expressive language T scores (Mullen) predicted follow-up scores for expressive language (PLS-4, r = .44, p = .005). Arrival fine motor scores (Mullen) correlated with follow-up auditory comprehension scores (PLS-4, r = .47, p = .002) and inversely with inattention scores (Conners', r = -.48, p = .003). Arrival visual reception scores correlated inversely with global measures of attention (Conners' opposition r = -.45, p = .005, ADHD scores r = -.49, p = .002, and to a lesser extent hyperactivity r = -.35, p = .03). Age at arrival was a very strong predictor of many of the outcome measures tested, including language performance, attention regulation, executive function, and sensory processing. Children who spent more time in daycare had significantly more difficulty with emotional control (p = .005). Although IA have good catch-up in specific areas of development, difficulties with ATT regulation, EF, and sensory processing may increase the risk of later school problems.

Objectives: Since 2000, American families have adopted 1,700 children from Ethiopia. Little is known about the health and development of these children., Patients and Methods: Retrospective chart review of the arrival health status of all 50 (26F:24M) children from Ethiopia/Eritrea seen in the International Adoption Clinic., Results: Prior to adoption, most children resided with relatives; 36% were >18 months old prior to entry into care. More than 50% were true orphans, often due to HIV. Arrival age ranged from 3 months to 15 years (mean +/- SD 4 years +/- 43.8 months). At arrival, growth z scores were near-average (weight -.59, height -.64, head circumference -.09); significantly better than adopted children Guatemala, China, or Russia seen in our clinic. However, some Ethiopian children were significantly growth delayed (WAZ < or =-2, 8%, HAZ 12%, HCZ 18%). Age at adoption did not relate to growth delays. Medical issues on arrival included intestinal parasites (53%, [14% with > or =3 types]), skin infections (45%), dental caries (25%), elevated liver transaminases (20%), latent tuberculosis (18%), and hepatitis B (2%). Age-appropriate vaccines had been administered in 15-77% of children (depending on specific vaccine). Behavior problems were uncommon. Gross/fine motor and cognitive skills were approximately 86% of expected for age. Age correlated inversely with developmental scores for cognition (r = -.49, P = .003). Five children had age reassignments., Conclusions: Ethiopian/Eritean adoptees differ from other groups of internationally adopted children: they reside for relatively long periods of time with relatives prior to institutionalization, often have uncertain ages, exhibit few behavioral problems at arrival, have better growth, and may have less severe developmental delays. Whether these differences at arrival predict better outcomes for the Ethiopian/Eritrean children is unknown.

The arrival of a newly adopted child into the family is usually a joyous time. Behavioral concerns arise in many internationally adopted children, most of whom are infants or toddlers at the time of placement with their adoptive families. Problems with feeding, sleeping, and other daily activities are often prominent in the first few weeks after the adoption. Some children display emotional distress and developmental delays; however, most recover rapidly. Anticipatory guidance from the pediatrician can assist families and children with this major life transition.

Background: Helicobacter pylori (H. pylori) infection has been linked to gastritis, diarrhea, peptic ulcers, failure-to-thrive, anemia, as well as predisposition to gastric malignancies. Because many internationally adopted children have diarrhea, failure-to-thrive, and anemia on arrival to the US, we determined the prevalence of HP antibodies among these children., Methods: Serum samples from 226 unselected children from 18 countries who were evaluated in the International Adoption Clinic at New England Medical Center were tested for antibodies to H. pylori. The results of serologic screening were analyzed in relation to age at adoption, site of residence prior to adoption, weight and height, and the presence or absence of anemia, diarrhea, or intestinal parasites., Results: 31% of internationally adopted children had antibodies to H. pylori. The presence of H. pylori-antibodies was associated with residence in an orphanage (vs. foster care) prior to adoption, older age at adoption, and coinfection with intestinal parasites. No direct effects on height or weight were identified; no associations with diarrhea or anemia were found., Conclusions: Internationally adopted children have a high incidence of exposure to H. pylori, as diagnosed serologically. Residence in an orphanage (compared with foster care), older age at adoption, and coinfection with intestinal parasites were more common among children seropositive for anti-H. pylori antibodies.