Third-World Adoption: Are there risk factors for Madonna's and Angelina's kids?

Angelina & KidsCelebrity adoption of children from third-world countries has become common enough for comedians to joke about it; in Sacha Baron Cohen's new movie, Brüno, a toddler is adopted from Africa in exchange for an iPod! That's not to say that most celebrities are adopting kids, but there have certainly been enough headlines in recent months that it's hard not to think of it as a "trend." But if it's true that, as a Public Service Announcement a few years back said, "The years before five last the rest of their lives," what could be expected for kids who are adopted from third-world orphanages? It's impossible to predict how children adopted by celebrities might develop, as there is a small number of them and these adoptions only recently received media attention. Celebrities also have access to medical care and other treatment that may be unavailable to other parents! I don't know anything about the backgrounds of the children adopted by these celebrities, but my guess is that it's unlikely that they would have been raised in the horrible conditions experienced by the children in post-Ceaucescu Romania. A few years ago, researchers began to examine the impact of adoption on kids from Romanian and other Eastern European orphanages. Keep in mind that these adoptees were removed from extremely difficult conditions of abuse and neglect. A new study published in the July issue of the International Journal of Behavioral Development looked at the functioning of some of these children.

Laurie Miller and her colleagues from Tufts Medical Center in Boston recruited families who had adopted children from Eastern European countries or the former Soviet Union; recruitment occurred through the International Adoption Clinic at Tufts. The children had been with their families for at least 5 years and ranged in age from 8 to 10 years. Most of the families were dual-parent homes, with an average parental age of about 41 years. In about a third of the families, the adopted child was the only child in the home, and half of the families had other, unrelated adopted children at home as well. Most of the children were adopted between the ages of 1 and 3.

Most of the kids in the study obtained average scores on measures of IQ and academic achievement. Nonetheless, behavioural problems, some of which could have an impact on school performance, were relatively common, although kids with higher IQ scores were less likely to have behavioural difficulties. Forty-six percent of the children had been diagnosed with Attention-Deficit/Hyperactivity Disorder, and 28% had received a diagnosis of a mental health problem. Parents and teachers reported significant externalizing behaviours (for example, aggression, rule-breaking, or defiance) for 44% of the kids. Despite their average achievement results on tests administered by the researchers, 40% of the adopted children in the study had been previously diagnosed with a learning disability. Although it wasn't discussed in the article, I'm curious about the extent to which second-language and cultural factors were taken into account in those learning disability assessments.

Perhaps the most distressing finding of the study was that 24% of the children who participated displayed what the researchers called "severe behavioural disturbances." This term referred to a range of difficult behaviour patterns that interfered with family life and academic functioning; all of the children who were given these labels had multiple psychiatric diagnoses of severe problems, including Post-Traumatic Stress Disorder (from prior abuse), Reactive Attachment Disorder, Asperger's Disorder, Pervasive Developmental Disorder, Fetal Alcohol Spectrum Disorder, and Obsessive-Compulsive Disorder. High rates of these kinds of problems have been found in previous research on kids who have experienced similar levels of adversity early in life. The researchers noted that adoptees from Eastern Europe have been found in some studies to have more difficulties than kids adopted from other countries. And let's be clear again, it's impossible to generalize these outcomes to the children adopted by Brad Pitt, Angelina Jolie, and Madonna.

Another factor that can't be generalized to the celebrities is parental stress. Miller and her colleagues found that slightly over half of the parents in the study reported significant levels of stress related to their role as parents. Many of them felt isolated and reported symptoms of depression as well. Unsurprisingly, parenting stress was linked to the children's behavioural problems - the more severe the behaviour, the higher the stress level was.

The abuse and neglect suffered by children in Eastern European orphanages appears to have a lasting impact on their behavioural functioning. Despite their challenges, we shouldn't underestimate the positive result that many of the children were able to achieve average IQ and school achievement scores. These stronger skills may indicate that they are capable of benefiting from psychological treatment - they may be able to use some of the strategies that psychologists teach to regulate emotion and manage behaviour. Hopefully, such resources will be available for these children and their parents!

You can read Miller's study here.

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