Thursday, March 30, 2006
JAMA speaks about International Adoption
JAMA is the premier medical research publication. So when JAMA speaks, people pay attention. JAMA’s recent article on adoption is very important news. Here is a summary of their findings.

JAMA. 2005;293:2501-2515

“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.”

1. Adoptees (both within and between countries) presented more behavior problems than non-adoptees, but effect sizes were very small.

2. Adoptees were over-represented in mental health services and this effect size was large. Although most international adoptees are well-adjusted, they are referred to mental health services more often than non-adopted controls.

3. International adoptees showed more behavior problems than nonadopted controls, but effect sizes were very small.

4. Contrary to their expectations, international adoptees showed fewer total, externalizing and internalizing behavior problems than domestic adoptees.

5. International adoptees were less often referred to mental health services than domestic adoptees.

6. International adoptees with pre-adoption adversity showed more total problems and externalizing problems than international adoptees without evidence of extreme deprivation.

7. Contrary to their expectations, age at adoption does not appear to be important for the development of behavioral problems.

8. They found no significant differences between male and female international adoptees for total behavior problems.

9. Contrary to their expectations, they found that international adoptees presented fewer total behavior problems in adolescence compared with international adoptees in early and middle childhood.

10. Children who had been with their adoptive family for more than 12 years showed fewer total behavior problems than children who had been with the family for less than 12 years.

11. Normative crises in adopted children, eg, coming to terms with the loss of their birth family, may be misperceived as behavior problems.

12. Children placed in adoptive families with relatively lower socioeconomic status have more favorable outcomes than those placed with more privileged families.

Femmie Juffer; Marinus H. van IJzendoorn
Behavior Problems and Mental Health Referrals of International Adoptees: A Meta-analysis
JAMA 2005 293: 2501-2515

I am going to put in my opinion here. I think perhaps the reason they found that international adoptees presented fewer total behavior problems compared with domestic adoptees is because they are including the older children that have been adopted domestically after they have gone through our horrible foster care system. Frankly, I think being kept in a Russian orphanage is preferable to being tossed around from home to home in the U.S. Some of the foster parents here are saints, but others are just in it for the money. Just the idea of being rejected time and time again and trying to adjust into a new family would lead almost anyone to behavior problems in my estimation.

What do you think about these findings? To me, the ones that are most intriguing are #7 and #12.

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Blogger 6blessings said...
I find all of the statistics very interesting. One fear I have, due to our recent circumstances, is Russia beginning to have the same problems the US has, now that they are trying to implement the foster care system there. If we understood right, they have raised the "salary" for foster parents hoping to decrease the number of children in orphanages. Like you said, there are some wonderful foster parents out there. However, there are a lot of people just in it for the money. I think this will be very true in Russia. One of the biggest fears we had when we didn't know where the boys were at was who they were with. Was it someone who truly cared or someone trying to make some money?

I also find #12 the most interesting. I believe it proves a point that materialism and indulgence isn't what makes a person happy, love and discipline is.

Anonymous Leggy said...
Those are interesting. One thing I've heard about the reason domestic adoptees have so many problems is that our system is so skewed toward reconciliation with birth parents that it takes something fairly horrific for parental rights to be terminated making the child eligible for adoption. In other countries, the birth parents aren't given as many chances to straighten out before parental rights are terminated, so the children who are eligible for adoption may be less traumatized.

#12 is interesting. Something to think about.

Blogger -Jenny said...
I find #12 very interesting and I think one of the reasons maybe expectations. If you are priveledged you tend to have more expectations of success that may or may not be realistic. Thus subconsciously imposing those expectations on the children. This is just my opinion and in no way judging anyone. Just my take.

I also think that what leggy said is true. Kids have to be run through the mill here to have their parent's rights terminated. This may or may not cause more trama.

Anyway, my 2 cents for the day....maybe right maybe completely wrong...

Blogger Margaret said...
That was interesting. #12 was the most surprising to me. Not that I would have respected the reverse, I just wouldn't think that socioeconomic standards would have much effect. To me, the type of family is so much more important than income. (As long as basic needs can be met, of course.)

Blogger Trina said...
#12 to me. I was surprised to read that more well to do families would have more of an adverse effect on the children. I think love is the most important for sure. "Children need your presence, not your presents."

Blogger Rhonda said...
Great post, Jen. Its always good to hear of some statistics and scientific findings, because this certainly isn't the image that's portrayed with international adoption. This is encouraging.

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