Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms in Children Adopted from Poland and their Atypical Association Patterns: a Bayesian Approach.

Although high rates of attention-deficit hyperactivity disorder (ADHD) symptoms have been observed among internationally adopted children, research on these symptoms in Polish adoptees is lacking. Therefore, we examined ADHD symptoms in Polish adoptees and their relationship to pre-adoptive risk factors, that is, time in institutional care, early deprivation, and prenatal alcohol exposure. We further compared the association patterns and gender distribution of ADHD symptoms in children adopted from Poland to those reported in the literature for ADHD symptoms in non-adopted children. Dutch adoptive parents of 121 Polish adoptees (52% boys; M age = 10.9 years, range 6.2-15.6; M ageadoption = 3.0 years, range 0.8-6.9) completed questionnaires regarding ADHD symptoms, pre-adoptive risk factors, attachment problems, conduct problems, and executive functioning deficits. Bayesian evaluation of informative hypotheses showed that Polish adoptees had increased levels of ADHD symptoms, compared to Dutch children in the general population. Time in institutional care, early deprivation, and prenatal alcohol exposure were not associated with ADHD symptoms. ADHD symptoms in Polish adoptees were more strongly associated with attachment problems and executive functioning deficits, but less strongly with conduct problems, compared to ADHD symptoms in non-adoptees. Furthermore, ADHD symptoms were more equally distributed among boys and girls than they are in non-adopted children. The findings indicate that Polish adoptees and their adoptive parents need special attention and support. The dissimilarities between ADHD symptoms in Polish adoptees and non-adoptees might indicate a different underlying causal mechanism, which may have important implications for clinical practice.

Children adopted from Poland display a high risk of foetal alcohol spectrum disorders and some may go undiagnosed.

AIM: Children adopted from Central and Eastern Europe have often had negative early experiences, including prenatal exposure to alcohol. We examined a group of Polish children, adopted by Dutch parents, to see how many were diagnosed with foetal alcohol spectrum disorders (FASD) and to what extent features of FASD were present. METHODS: The 121 children, aged between 6 and 17 years, were adopted from Poland at a mean age of 3 years (standard deviation 1.6 years). Their parents answered a questionnaire regarding FASD diagnosis, growth, educational attainment and the Behaviour Rating Inventory of Executive Function. RESULTS: Three groups were identified: children with an FASD diagnosis (31%), children whose adoptive parents suspected FASD (21%) and children whose adoptive parents did not suspect FASD (49%). Growth deficiency, enrolment in special education and difficulties with executive functioning were most frequently observed in children diagnosed with FASD. However, features of FASD were also observed in the other two groups. CONCLUSION: Children adopted from Poland showed a high risk of FASD and some children may go undiagnosed. Adoptive parents and professionals need to be aware of the potential consequences of prenatal exposure to alcohol.

Post-Institutional Autistic Syndrome in Romanian adoptees.

Romanian adoptees have a background of severe neglect. International research has shown that this can give rise to symptoms of autistic behavior. Rutter et al. (1999, Journal of Child Psychology Psychiatry, 40(4), 537-549.) refers to "quasi-autistic patterns", and Federici (1998, Help for the hopelss child: A guide for families. Alexandria: Federici & Assocoates.) to Post-Institutional Autistic Syndrome (PIAS). Eighty Romanian adoptees, averaging 8 years of age, who had resided in the Netherlands for 5 years were studied. Parent interviews and the Auti-R scale showed the extent to which the children exhibited PIAS. In one third of these children we observed (in addition to other behavioral problems) stereotypic behaviors and communication and language disorders. Our findings resembled the Rutter et al. (1999, Journal of Child Psychology Psychiatry, 40(4), 537-549). data. Six of the children were classified within the autistic spectrum pursuant to the Auti-R, and seven within the so-called intermediate group. No difference was found between the girls and the boys. Children who had been in their adoptive families for 5 years or more showed fewer behavior problems than children who had been in their adoptive families for four or less years.

Adoption of romanian children in The Netherlands: behavior problems and parenting burden of upbringing for adoptive parents.

Seventy-two Dutch adoptive parents of 80 Romanian children completed the Child Behavior Checklist (CBCL), the Nijmegen Questionnaire for the Upbringing Situation (NQUS), and participated in a semistructured interview (response 83%). Thirty-four percent of the adopted children scored in the clinical range on Externalizing and 36 % on Total Problems scales. Significantly more children who were at least two years at placement and had stayed less than five years in the adoptive family received scores in the clinical range on almost all CBCL clinical clusters. Nevertheless, the adoptive parents judge their upbringing situation positive (NQUS).

Experiences of Dutch families who parent an adopted Romanian child.

The pilot phase of a longitudinal study of 83 children (response 86%) adopted from Romania is reported; the present status of the children is compared with the past status on the basis of parental recollection. At placement, the average age of the children was 2.9 years; at the time of the interview of the adoptive parents, the average age of the children was 6.8 years. At placement, 67% of the adoptive parents needed professional help, and 10% of the children were infected with Hepatitis B. Only 13% did not show any important psychosocial problems. The number of psychosocial problems reported by the parents at placement predicts 69% of the lag of development observed 4 years later; the age of arrival adds up to 72%. Most problems still exist 4 years after placement; however, no disruptions of the adoption have taken place yet.