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.
“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.
Labels: after adoption: difficult child behaviors, after adoption: transitioning successfully, international adoption: worries