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Elizabeth Bartholet - One of the best experts on this subject based on the ideXlab platform.
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the International Adoption cliff do child human rights matter
Social Science Research Network, 2013Co-Authors: Elizabeth BartholetAbstract:This revised speech characterizes the dramatic decline in International Adoption since 2004 as a major child human rights tragedy, deliberately created by governmental and NGO policy-makers. It contrasts U.S. human rights policy imposing sanctions for the violation of adult human rights, to U.S. failure to act in the face of child human rights violations. It calls for a change in U.S. policy that would: (1) Hold countries accountable for the human rights violations inherent in their shutdowns of International Adoption and their institutionalization of children; and (2) Stop enabling UNICEF, through our funding, to eliminate International Adoption as an option for children.
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permanency is not enough children need the nurturing parents found in International Adoption
2011Co-Authors: Elizabeth BartholetAbstract:Permanency in the form that truly serves children’s best interests will often be found only in International Adoption. Permanency in dysfunctional birth families, or in institutions or typical foster care, does not provide the nurturing parenting children require. This article focuses on the strategic thinking needed to advance International Adoption as a solution for more of the world’s unparented children. It urges that we who believe in such Adoption recognize the crisis today, but at the same time maintain belief in the future. International Adoption is consistent with many important globalization trends – International trade and commerce, emigration and immigration, intermarriage between people from different racial, ethnic, and national groups. The article urges further that the relatively small and fragile group of Adoption advocates work together, and reach out to new groups, including church organizations committed to the importance of providing true families for children. But at the same time it urges that they not compromise on principles key to child well-being, but fight for children’s right to International adoptive homes and their related right to early, permanent, and nurturing parenting, and reject the false romanticism surrounding birth and national heritage.
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International Adoption a way forward
New York Law School Law Review, 2011Co-Authors: Elizabeth BartholetAbstract:This is the introduction to a special issue of articles on International Adoption, summing up their relevance to the debate in the field. International Adoption is in turmoil, with a dramatic reduction in recent years in the number of children placed in adoptive homes. These articles provide important new support for International Adoption as an appropriate way to advance children’s rights and interests. And they provide information about ways to address any problems of corruption and abuse, without penalizing unparented children by denying them the homes they need.
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permanency is not enough children need the nurturing parents found in International Adoption
New York Law School Law Review, 2011Co-Authors: Elizabeth BartholetAbstract:but permanency is not enough. Permanency for children often exists in institutions and in dysfunctional families that commit abuse and neglect. Permanency in these contexts is harmful to children. Permanency for children can be achieved in foster care, although, generally, foster care is characterized by moves back and forth between the foster home and the home of origin, and between different foster homes. Even when children remain in the same foster home for the duration of their childhood, this form of permanency generally serves them badly as compared to Adoption. For children to flourish, they need true, nurturing parenting, and they need permanency in the form of stable parenting from early infancy through adulthood. So our goal should be to provide all children with early, permanent, and nurturing parenting.
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International Adoption the human rights position
Global Policy, 2010Co-Authors: Elizabeth BartholetAbstract:International Adoption is under siege, with the number of children placed dropping each of the last several years, and many countries imposing severe new restrictions. Key forces mounting the attack claim the child human rights mantle, arguing that such Adoption denies heritage rights, and often involves abusive practices. Many nations assert rights to hold onto the children born within their borders, and others support these demands citing subsidiarity principles. But children’s most basic human rights, at the heart of the true meaning of subsidiarity, are to grow up in the families that will often be found only in International Adoption. These rights should trump any conflicting state sovereignty claims.
Marinus H Van Ijzendoorn - One of the best experts on this subject based on the ideXlab platform.
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infants responsiveness attachment and indiscriminate friendliness after International Adoption from institutions or foster care in china application of emotional availability scales to adoptive families
Development and Psychopathology, 2012Co-Authors: Linda Van Den Dries, Marinus H Van Ijzendoorn, Marian J Bakermanskranenburg, Femmie Juffer, Lenneke R A AlinkAbstract: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.
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infants physical and cognitive development after International Adoption from foster care or institutions in china
Journal of Developmental and Behavioral Pediatrics, 2010Co-Authors: Linda Van Den Dries, Marinus H Van Ijzendoorn, Femmie Juffer, Marian J BakermanskranenburgAbstract: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.
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attachment cognitive and motor development in adopted children short term outcomes after International Adoption
Journal of Pediatric Psychology, 2007Co-Authors: Monique W Van Londen, Femmie Juffer, Marinus H Van IjzendoornAbstract: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.
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plasticity of growth in height weight and head circumference meta analytic evidence of massive catch up after International Adoption
Journal of Developmental and Behavioral Pediatrics, 2007Co-Authors: Marinus H Van Ijzendoorn, Marian J Bakermanskranenburg, Femmie JufferAbstract:Are serious growth delays caused by malnutrition and neglect permanent or reversible? The effects of institutionalization and International Adoption on children's physical growth are estimated with meta-analysis. Studies with sufficient data to compute differences between adoptees and the reference population (33 papers with 122 study outcomes) were collected through Web of Science, ERIC (Education Resource Information Center), PsycINFO (Psychological Literature), and Medline (U.S. National Library of Medicine) (1956-2006). The influence of pre- and postAdoption care on height, weight, and head circumference was tested. Effect sizes (d) and confidence intervals (CIs) around the point estimate for the growth lag indices were computed. The more time spent in institutional care, the more the children lagged behind in physical growth (d = 1.71, 95% CI: 0.82-2.60, n = 893). At adoptive placement, the children showed large delays in height, weight, and head circumference (d = -2.39 to -2.60; n = 1331-3753). Although after Adoption, they showed almost complete catch-up of height (d = -0.57, 95% CI: -0.87 to -0.27, n = 3437 adoptees) and weight (d = -0.72, 95% CI: -1.04 to -0,39, n = 3259 adoptees), catch-up of head circumference seemed slower and remained incomplete (d = -1.56, 95% CI: -2.27 to -0.85, n = 527). Later age at arrival was related to less complete catch-up of height and weight. International Adoption leads to substantial catch-up of height and weight but not of head circumference, demonstrating differential plasticity of children's physical growth.
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the emanuel miller memorial lecture 2006 Adoption as intervention meta analytic evidence for massive catch up and plasticity in physical socio emotional and cognitive development
Journal of Child Psychology and Psychiatry, 2006Co-Authors: Marinus H Van Ijzendoorn, Femmie JufferAbstract: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. Keywords: Adoption, meta-analysis, catch-up, developmental plasticity, ethics, growth, attachment, behaviour problems, brain damage, malnutrition, residential care, resilience, self-esteem. Adoption may be defined as the permanent, legal placement of an abandoned, relinquished or orphaned child within a family of relatives (kinship Adoption) or within an unrelated family (non-kinship Adoption). Selman (2005) estimated the number of children adopted across the borders of countries (International, mostly non-kinship Adoption) to be at least 40,000 in 2003, which is an increase of 100% since the late eighties. The number of Adoptions within countries (domestic Adoptions) is harder to estimate. In the USA alone, 120,000 children are adopted annually, their total number amounting to
Sean V Tavtigian - One of the best experts on this subject based on the ideXlab platform.
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sequence variant classification and reporting recommendations for improving the interpretation of cancer susceptibility genetic test results
Human Mutation, 2008Co-Authors: Sharon E Plon, Diana Eccles, Douglas F Easton, William D Foulkes, Maurizio Genuardi, Marc S Greenblatt, Frans B L Hogervorst, Nicoline Hoogerbrugge, Amanda B Spurdle, Sean V TavtigianAbstract:Genetic testing of cancer susceptibility genes is now widely applied in clinical practice to predict risk of developing cancer. In general, sequence-based testing of germline DNA is used to determine whether an individual carries a change that is clearly likely to disrupt normal gene function. Genetic testing may detect changes that are clearly pathogenic, clearly neutral, or variants of unclear clinical significance. Such variants present a considerable challenge to the diagnostic laboratory and the receiving clinician in terms of interpretation and clear presentation of the implications of the result to the patient. There does not appear to be a consistent approach to interpreting and reporting the clinical significance of variants either among genes or among laboratories. The potential for confusion among clinicians and patients is considerable and misinterpretation may lead to inappropriate clinical consequences. In this article we review the current state of sequence-based genetic testing, describe other standardized reporting systems used in oncology, and propose a standardized classification system for application to sequence-based results for cancer predisposition genes. We suggest a system of five classes of variants based on the degree of likelihood of pathogenicity. Each class is associated with specific recommendations for clinical management of at-risk relatives that will depend on the syndrome. We propose that panels of experts on each cancer predisposition syndrome facilitate the classification scheme and designate appropriate surveillance and cancer management guidelines. The International Adoption of a standardized reporting system should improve the clinical utility of sequence-based genetic tests to predict cancer risk.
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sequence variant classification and reporting recommendations for improving the interpretation of cancer susceptibility genetic test results
Human Mutation, 2008Co-Authors: Sharon E Plon, Diana Eccles, Douglas F Easton, William D Foulkes, Maurizio Genuardi, Marc S Greenblatt, Frans B L Hogervorst, Nicoline Hoogerbrugge, Amanda B Spurdle, Sean V TavtigianAbstract:Genetic testing of cancer susceptibility genes is now widely applied in clinical practice to predict risk of developing cancer. In general, sequence-based testing of germline DNA is used to determine whether an individual carries a change that is clearly likely to disrupt normal gene function. Genetic testing may detect changes that are clearly pathogenic, clearly neutral, or variants of unclear clinical significance. Such variants present a considerable challenge to the diagnostic laboratory and the receiving clinician in terms of interpretation and clear presentation of the implications of the result to the patient. There does not appear to be a consistent approach to interpreting and reporting the clinical significance of variants either among genes or among laboratories. The potential for confusion among clinicians and patients is considerable and misinterpretation may lead to inappropriate clinical consequences. In this article we review the current state of sequence-based genetic testing, describe other standardized reporting systems used in oncology, and propose a standardized classification system for application to sequence-based results for cancer predisposition genes. We suggest a system of five classes of variants based on the degree of likelihood of pathogenicity. Each class is associated with specific recommendations for clinical management of at-risk relatives that will depend on the syndrome. We propose that panels of experts on each cancer predisposition syndrome facilitate the classification scheme and designate appropriate surveillance and cancer management guidelines. The International Adoption of a standardized reporting system should improve the clinical utility of sequence-based genetic tests to predict cancer risk.
Femmie Juffer - One of the best experts on this subject based on the ideXlab platform.
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infants responsiveness attachment and indiscriminate friendliness after International Adoption from institutions or foster care in china application of emotional availability scales to adoptive families
Development and Psychopathology, 2012Co-Authors: Linda Van Den Dries, Marinus H Van Ijzendoorn, Marian J Bakermanskranenburg, Femmie Juffer, Lenneke R A AlinkAbstract: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.
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infants physical and cognitive development after International Adoption from foster care or institutions in china
Journal of Developmental and Behavioral Pediatrics, 2010Co-Authors: Linda Van Den Dries, Marinus H Van Ijzendoorn, Femmie Juffer, Marian J BakermanskranenburgAbstract: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.
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attachment cognitive and motor development in adopted children short term outcomes after International Adoption
Journal of Pediatric Psychology, 2007Co-Authors: Monique W Van Londen, Femmie Juffer, Marinus H Van IjzendoornAbstract: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.
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plasticity of growth in height weight and head circumference meta analytic evidence of massive catch up after International Adoption
Journal of Developmental and Behavioral Pediatrics, 2007Co-Authors: Marinus H Van Ijzendoorn, Marian J Bakermanskranenburg, Femmie JufferAbstract:Are serious growth delays caused by malnutrition and neglect permanent or reversible? The effects of institutionalization and International Adoption on children's physical growth are estimated with meta-analysis. Studies with sufficient data to compute differences between adoptees and the reference population (33 papers with 122 study outcomes) were collected through Web of Science, ERIC (Education Resource Information Center), PsycINFO (Psychological Literature), and Medline (U.S. National Library of Medicine) (1956-2006). The influence of pre- and postAdoption care on height, weight, and head circumference was tested. Effect sizes (d) and confidence intervals (CIs) around the point estimate for the growth lag indices were computed. The more time spent in institutional care, the more the children lagged behind in physical growth (d = 1.71, 95% CI: 0.82-2.60, n = 893). At adoptive placement, the children showed large delays in height, weight, and head circumference (d = -2.39 to -2.60; n = 1331-3753). Although after Adoption, they showed almost complete catch-up of height (d = -0.57, 95% CI: -0.87 to -0.27, n = 3437 adoptees) and weight (d = -0.72, 95% CI: -1.04 to -0,39, n = 3259 adoptees), catch-up of head circumference seemed slower and remained incomplete (d = -1.56, 95% CI: -2.27 to -0.85, n = 527). Later age at arrival was related to less complete catch-up of height and weight. International Adoption leads to substantial catch-up of height and weight but not of head circumference, demonstrating differential plasticity of children's physical growth.
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the emanuel miller memorial lecture 2006 Adoption as intervention meta analytic evidence for massive catch up and plasticity in physical socio emotional and cognitive development
Journal of Child Psychology and Psychiatry, 2006Co-Authors: Marinus H Van Ijzendoorn, Femmie JufferAbstract: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. Keywords: Adoption, meta-analysis, catch-up, developmental plasticity, ethics, growth, attachment, behaviour problems, brain damage, malnutrition, residential care, resilience, self-esteem. Adoption may be defined as the permanent, legal placement of an abandoned, relinquished or orphaned child within a family of relatives (kinship Adoption) or within an unrelated family (non-kinship Adoption). Selman (2005) estimated the number of children adopted across the borders of countries (International, mostly non-kinship Adoption) to be at least 40,000 in 2003, which is an increase of 100% since the late eighties. The number of Adoptions within countries (domestic Adoptions) is harder to estimate. In the USA alone, 120,000 children are adopted annually, their total number amounting to
Dana E Johnson - One of the best experts on this subject based on the ideXlab platform.
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International Adoption a review and update
Pediatrics in Review, 2021Co-Authors: Judith K Eckerle, Dana E Johnson, Megan Marie Bresnahan, Maria G Kroupina, Cynthia R HowardAbstract:1. Judith Kim Eckerle, MD*,† 2. Megan Marie Bresnahan, OTR/L† 3. Maria Kroupina, PhD, LP*,† 4. Dana Ernest Johnson, MD, PhD*,† 5. Cynthia Ruth Howard, MD, MPHTM*,† 1. *Department of Pediatrics, University of Minnesota, Minneapolis, MN 2. †MHealth Fairview University of Minnesota Masonic Children’s Hospital, Minneapolis, MN * Abbreviations: Ab : : antibody ACE : : adverse childhood experience CDC : : Centers for Disease Control and Prevention CXR : : chest radiography IA : : International adoptee TB : : tuberculosis 1. Key information for accurate assessment of the preAdoption referral. 2. Determining immunization status and planning catch-up strategy. 3. Updated screening protocol for and treatment of latent tuberculosis infection. 4. Evaluation of developmental delays in the context of International Adoption. 5. Screening for risk factors indicating the need for referral to child mental health and developmental specialists. After completing this article, readers should be able to: 1. Review the basic components of an Adoption referral file and know when to consult an International Adoption medicine expert. 2. Perform the initial medical assessment of a newly arrived International adoptee, including evaluation of the efficacy of previous immunizations and planning of catch-up immunization based on new recommendations. 3. Screen for tuberculosis and treat latent tuberculosis infection based on recent Centers for Disease Control and Prevention (CDC) guidelines. 4. Understand the multiple areas of a developmental baseline of adopted children and assess for catch-up needs. 5. Identify the child with multiple risk factors and/or parental or family stressors who needs a referral to an Adoption-competent mental health specialist. Although interest in intercountry Adoption continues to be high, the numbers of International Adoptions have changed dramatically since the peak in 2004 when 45,483 International adoptees (IAs) were placed in families worldwide. By 2017, the number dropped 79% to 9,387. In the United …
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the International Adoption project population based surveillance of minnesota parents who adopted children Internationally
Maternal and Child Health Journal, 2008Co-Authors: Wendy L Hellerstedt, Richard M Lee, Harold D Grotevant, Megan R Gunnar, Nikki J Madsen, Dana E JohnsonAbstract:Objectives To conduct the first population-based surveillance in the United States of parents who adopted children from countries outside of the United States.
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the International Adoption project population based surveillance of minnesota parents who adopted children Internationally
Maternal and Child Health Journal, 2008Co-Authors: Wendy L Hellerstedt, Richard M Lee, Harold D Grotevant, Megan R Gunnar, Nikki J Madsen, Dana E JohnsonAbstract:To conduct the first population-based surveillance in the United States of parents who adopted children from countries outside of the United States. A 556-item survey was mailed to 2,977 parents who finalized an International Adoption in Minnesota between January 1990 and December 1998; 1,834 (62%) parents returned a survey. Eighty-eight percent of the parents reported transracial Adoptions (97% of the parents were white); 57% of the adopted children were Asian; 60% were female; and on average, the children were 18 months-old at the time of placement. Only 15% of the parents reported household annual incomes less than $50,000 and 71% reported they had college educations. Sixty-one percent traveled to their child’s country of birth prior to the Adoption. Almost three-quarters involved their children in experiences related to their birth countries and 98% would recommend International Adoption. Three-quarters of the parents believe that parental leave was an issue for them as they adopted. This is the first population-based survey of U.S. parents who have adopted Internationally. The adoptive parents were socioeconomically different than birth parents in Minnesota and their families are most likely to be transracial. Because International Adoption has become more prevalent, it is important to understand the strengths and needs of families that are created through this unique form of migration.
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health of children adopted from the former soviet union and eastern europe comparison with preadoptive medical records
JAMA, 1997Co-Authors: Lisa H Albers, Dana E Johnson, Margaret K Hostetter, Sandra Iverson, Laurie C MillerAbstract:Context. —Children born in the countries of the former Soviet Union and Eastern Europe are now a main source of International Adoptions in the United States, but often little information is available about these children prior to Adoption. Objective. —To analyze the preadoptive medical reports of children adopted from Eastern Europe and the former Soviet Union and to compare these reports with their evaluations after arrival in the United States. Design. —Case series. Subjects and Setting. —A total of 56 children adopted from Eastern Europe and the former Soviet Union were evaluated in 2 International Adoption clinics. Preadoptive medical records were available for 47 of these children. Results. —There were 43 (91%) of 47 medical reports available from the children's birth countries that included multiple unfamiliar neurologic diagnoses. Evaluations in the International Adoption Clinics frequently revealed growth delays ( z score -le-1 for weight in 44% of children, height in 68%, and head circumference in 43%). Children had 1 month of linear growth lag for every 5 months in an orphanage ( r =-0.48, P Conclusions. —Preadoptive medical records from these International adoptees included multiple diagnoses suggesting severe neurologic impairment. Although these diagnoses were not confirmed when the children were evaluated in the United States, substantial growth and developmental delays were identified.
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the health of children adopted from romania
JAMA, 1992Co-Authors: Dana E Johnson, Laurie C Miller, Sandra Iverson, William Thomas, Barbara Franchino, Kathryn Dole, Marybeth T Kiernan, Michael K Georgieff, Margaret K HostetterAbstract:Objective. —To determine the medical condition of Romanian adoptees and the effects of the Romanian orphanage system on their health. Design. —Case series. Setting. —The International Adoption clinics at the University of Minnesota, Minneapolis, and the New England Medical Center, Tufts University, Boston, Mass. Participants. —Sixty-five Romanian adoptees who were brought to the United States during a 12-month period beginning in October 1990. Main Outcome Measures. —Incidence of hepatitis B, intestinal parasites, tuberculosis, syphilis, human immunodeficiency virus type 1, growth failure, and developmental delay. Results. —Although the adopted children were presumably chosen from the most vital and attractive adoptees, only 15% were judged to be physically healthy and developmentally normal. Fifty-three percent had serological evidence of past or present hepatitis B infection, and 20% of screened children tested positive for hepatitis B surface antigen. In children aged 7 months or older, the overall prevalence of chronic hepatitis B was 23%. Intestinal parasites were found in 33% of subjects, and 45% of infected children had two or more pathogens identified. All the children tested for human immunodeficiency virus type 1 were negative. Two patterns of growth failure were observed that resembled the two subtypes of psychosocial short stature that occur in association with prolonged psychological harassment or emotional deprivation. Infants' length, weight, head circumference, and weight-for-height were adversely affected by institutionalization. Older children's height was reduced. Only 10% of children older than 12 months were developmentally normal. Conclusion. —Romanian adoptees are an extraordinarily high-risk pediatric group as a consequence of decades of government-sanctioned child neglect and abuse. ( JAMA . 1992;268:3446-3451)