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1.
Am J Orthopsychiatry ; 79(4): 522-31, 2009 Oct.
Article in English | MEDLINE | ID: mdl-20099943

ABSTRACT

Parents of 165 children adopted from Romania and 52 children adopted from within the United Kingdom rated the success of the adoptions when the children were 11 years old. As was the case at two earlier study waves, satisfaction was found to be extremely high. Both positive and negative assessments were generally stable between ages 6 and 11, although for the children who had more problems there was an increase in negative evaluation, albeit within an overall positive picture. Parents' evaluations were somewhat more negative for this group of children; however, parents reported that having the child as part of their family was very rewarding. Negative evaluation was not directly related to age at placement, but appeared to be a reflection of the later-placed children's higher rates of problem behavior. As found at earlier assessment waves, child factors, in particular conduct problems and inattention or overactivity, were key in predicting parental evaluations at age 11, as were four domains closely associated with institutional deprivation, namely cognitive impairment, quasi-autistic patterns, inattention or overactivity, and disinhibited attachment. The findings emphasize the need for early intervention for children in severely deprived conditions, and for access to postadoption services that target the particular problem behaviors the children may exhibit.


Subject(s)
Adoption/psychology , Parents/psychology , Achievement , Adoption/ethnology , Adult , Child , Child Behavior Disorders/psychology , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Parent-Child Relations , Personal Satisfaction , Romania/ethnology , United Kingdom/ethnology
2.
Dev Psychopathol ; 20(2): 547-67, 2008.
Article in English | MEDLINE | ID: mdl-18423094

ABSTRACT

The study assessed conduct and emotional difficulties in a group of Romanian adoptees at age 11, and serves as a follow-up to assessments made when the children were 6 years old. It was found that there was a significant increase in emotional difficulties, but not conduct problems, for the Romanian sample since age 6. It was also found that emotional difficulty was significantly more prevalent at age 11 in the Romanian group than in a within-UK adoptee group. Emotional difficulties in the Romanian adoptee group were found to be significantly and strongly related to previous deprivation-specific problems (disinhibited attachment, cognitive impairment, inattention/overactivity and quasi-autism); however, the presence of such early problems did not account fully for the onset of later emotional problems. Five contrasting hypotheses concerning possible mediators for later onset of emotional difficulties for the Romanian group were examined. No links were found to duration of deprivation or other deprivation-related indices, stresses/difficulties in the postadoption family environment, or educational attainment and self-esteem. There was some evidence that emotion recognition might play a role in the emergence of these problems, but other measures of social competence and theory of mind showed no associations with the onset of emotional problems.


Subject(s)
Adoption/psychology , Affective Symptoms/psychology , Conduct Disorder/psychology , Cross-Cultural Comparison , Psychosocial Deprivation , Achievement , Adolescent , Affective Symptoms/diagnosis , Affective Symptoms/epidemiology , Child , Conduct Disorder/diagnosis , Conduct Disorder/epidemiology , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Male , Peer Group , Personality Assessment , Risk Factors , Romania/ethnology , Self Concept , Social Adjustment , United Kingdom
3.
J Abnorm Child Psychol ; 36(7): 1057-68, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18427975

ABSTRACT

Theory of Mind (ToM) and Executive Function (EF) have been associated with autism and with attention-deficit hyperactivity disorder (ADHD), and hence might play a role in similar syndromes found following profound early institutional deprivation. In order to examine this possibility the current study included a group of 165 Romanian adoptees, of whom 144 were adopted into the UK from deprived institutional settings before 43months of age, and a group of 52 within-UK adoptees, all adopted before 6months of age. Both groups were assessed at 6 and 11years. The Strange Stories task was used to assess ToM and the Stroop task was used to assess EF, both at age 11. The Romanian adoptees displayed deficits in both ToM and EF compared with the within-UK adoptee group. The degree of deficit was greater for children who had experienced more than 6months of institutional deprivation. Deficits in both domains (ToM and EF) were associated with each of the three apparently deprivation-specific problems, namely quasi-autism, disinhibited attachment and inattention/overactivity. Statistical analyses indicated a mediating role for both ToM and EF with respect to quasi-autism; possibly a partial mediating role for EF with respect to inattention/overactivity; and probably no mediating role for either ToM or EF in the case of disinhibited attachment. In conclusion, there is evidence for a possible mediating role for ToM and EF in the development of some apparently deprivation-specific difficulties in institution-reared Romanian adoptees, but neither accounts for the overall pattern of deprivation-related difficulties.


Subject(s)
Adoption/psychology , Attention Deficit Disorder with Hyperactivity/diagnosis , Autistic Disorder/diagnosis , Child, Institutionalized/psychology , Cognition Disorders/diagnosis , Personal Construct Theory , Psychosocial Deprivation , Reactive Attachment Disorder/diagnosis , Age Factors , Attention Deficit Disorder with Hyperactivity/psychology , Autistic Disorder/psychology , Child , Child, Preschool , Cognition Disorders/psychology , England , Female , Humans , Infant , Language Development Disorders/diagnosis , Language Development Disorders/psychology , Male , Personality Assessment , Reactive Attachment Disorder/psychology , Romania/ethnology , Wechsler Scales
4.
J Abnorm Child Psychol ; 36(3): 385-98, 2008 Apr.
Article in English | MEDLINE | ID: mdl-17965931

ABSTRACT

The current study examined the persistence and phenotypic presentation of inattention/overactivity (I/O) into early adolescence, in a sample of institution reared (IR) children adopted from Romania before the age of 43 months. Total sample comprised 144 IR and 21 non-IR Romanian adoptees, and a comparison group of 52 within-UK adoptees, assessed at ages 6 and 11 years. I/O was rated using Rutter Scales completed by parents and teachers. I/O continued to be strongly associated with institutional deprivation, with continuities between ages 6 and 11 outcomes. There were higher rates of deprivation-related I/O in boys than girls, and I/O was strongly associated with conduct problems, disinhibited attachment and executive function but not IQ more generally, independently of gender. Deprivation-related I/O shares many common features with ADHD, despite its different etiology and putative developmental mechanisms. I/O is a persistent domain of impairment following early institutional deprivation of 6 months or more, suggesting there may be a possible pathway to impairment through some form of neuro-developmental programming during critical periods of early development.


Subject(s)
Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/psychology , Institutionalization/statistics & numerical data , Maternal Deprivation , Adolescent , Age Factors , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Child, Preschool , Conduct Disorder/epidemiology , Conduct Disorder/psychology , Female , Humans , Inhibition, Psychological , Male , Object Attachment , Phenotype , Romania , Surveys and Questionnaires
5.
J Abnorm Child Psychol ; 35(6): 1063-73, 2007 Dec.
Article in English | MEDLINE | ID: mdl-17643189

ABSTRACT

The relationship between severe early institutional deprivation and scholastic attainment at age 11 in 127 children (68 girls and 59 boys) adopted from institutions in Romania was compared to the attainment of 49 children (17 girls and 32 boys) adopted within the UK from a non-institutional background. Overall, children adopted from Romania had significantly lower attainment scores than those adopted within the UK; the children within the Romanian sample who had spent 6 months or more in an institution had significantly lower attainment scores than those who had spent less than 6 months in an institution, but there was no additional risk of low attainment associated with longer institutional care after 6 months. The lower scholastic attainment in the children adopted from Romanian institutions, as compared with domestic adoptees, was mediated by IQ, and to a lesser degree, inattention/overactivity. When these factors were taken into account, only small between-group differences in attainment remained.


Subject(s)
Adoption/psychology , Child, Institutionalized/psychology , Cognition Disorders/epidemiology , Mathematics , Psychosocial Deprivation , Reading , Attention , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/psychology , Child , Child Development , Cognition , Cognition Disorders/psychology , Educational Status , Female , Follow-Up Studies , Humans , Intelligence , Intelligence Tests/statistics & numerical data , Male , Risk Factors , Romania/ethnology , United Kingdom/epidemiology
6.
Dev Psychol ; 43(4): 931-46, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17605526

ABSTRACT

Longitudinal analyses on normal versus impaired functioning across 7 domains were conducted in children who had experienced profound institutional deprivation up to the age of 42 months and were adopted from Romania into U.K. families. Comparisons were made with noninstitutionalized children adopted from Romania and with nondeprived within-U.K. adoptees placed before the age of 6 months. Specifically, the validity of the assessment, the degree of continuity and change in levels of functioning from 6 to 11 years, and the factors in the pre- and postadoption environment accounting for heterogeneity in outcome were examined. Pervasive impairment was significantly raised in children experiencing institutional deprivation for > or =6 months of life, with a minority within this group showing no impairment. There was no additional significant effect of duration of deprivation beyond the 6-month cutoff, and few other predictors explained outcome. The pattern of normality/impairment was mainly established by 6 years of age, with considerable continuity at the individual level between 6 and 11 years. The findings are discussed in terms of the possibility of a sensitive period for development.


Subject(s)
Adjustment Disorders/epidemiology , Adjustment Disorders/psychology , Institutionalization/statistics & numerical data , Social Behavior , Social Isolation , Adolescent , Adoption , Age Factors , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Romania/ethnology , Severity of Illness Index , United Kingdom
7.
J Child Psychol Psychiatry ; 48(1): 17-30, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17244267

ABSTRACT

BACKGROUND: Disinhibited attachment is an important sequel of an institutional rearing, but questions remain regarding its measurement, its persistence, the specificity of the association with institutional rearing and on whether or not it constitutes a meaningful disorder. METHOD: Children initially reared in profoundly depriving institutions in Romania and subsequently adopted into UK families were compared with respect to findings at 11 years with children who had not experienced institutional deprivation and who had been adopted within the UK before the age of 6 months. Measures included parental reports, a Strange Situation procedure modified for use in the home and systematic standardised investigator ratings of the children's behaviour. RESULTS: Disinhibited attachment, as reported by parents, showed a high degree of persistence from 6 to 11, but also a reduction over time in its frequency. Investigator ratings validated the parental reports but suggested that much of the fall in rate of disinhibited attachment was a function of the parental measure being less developmentally appropriate at 11 than it had been at 6. Disinhibited attachment was strongly associated with institutional rearing but there was not a significant increase in relation to duration of institutional deprivation beyond the age of 6 months. Mild, but not marked, disinhibited attachment was quite frequent in non-institutionalised adopted children but both the course and correlates indicated that its meaning was probably quite different. In the institution-reared children, disinhibited attachment was associated with a marked increase in service usage and associations with other forms of psychopathology. CONCLUSIONS: Disinhibited attachment constitutes a valid, and handicapping, clinical pattern that is strongly associated with an institutional rearing.


Subject(s)
Adoption , Child Behavior/psychology , Inhibition, Psychological , Institutionalization , Object Attachment , Psychosocial Deprivation , Adolescent , Age Factors , Child, Preschool , Female , Humans , Male , Romania/ethnology , Social Behavior , United Kingdom
8.
J Child Psychol Psychiatry ; 48(1): 31-44, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17244268

ABSTRACT

BACKGROUND: There is uncertainty about the extent to which language skills are part of general intelligence and even more uncertainty on whether deprivation has differential effects on language and non-language skills. METHODS: Language and cognitive outcomes at 6 and 11 years of age were compared between a sample of 132 institution-reared Romanian children adopted into UK families under the age of 42 months, and a sample of 49 children adopted within the UK under the age of 6 months who had not experienced either institutional rearing or profound deprivation. RESULTS: The effects of institutional deprivation were basically similar for language and cognitive outcomes at age 6; in both there were few negative effects of deprivation if it ended before the age of 6 months and there was no linear association with duration of deprivation within the 6 to 42 month range. For the children over 18 months on arrival (range 18-42 months), the presence of even very minimal language skills (imitation of speech sounds) at the time of arrival was a strong beneficial prognostic factor for language and cognitive outcomes, but not for social/emotional/behavioural outcomes. Individual variations in adoptive parent characteristics were unrelated to differences in language or cognitive outcomes, possibly as a consequence of the limited variability in the adoptive family group. CONCLUSIONS: Minimal language probably indexes some form of cognitive reserve that, in turn, indexes the degree of institutional deprivation.


Subject(s)
Adoption , Cognition Disorders/epidemiology , Institutionalization/statistics & numerical data , Language Development Disorders/epidemiology , Psychosocial Deprivation , Adolescent , Child , Child, Preschool , Cognition Disorders/diagnosis , Family/psychology , Female , Humans , Language Development Disorders/diagnosis , Linguistics/methods , Male , Neuropsychological Tests , Nonverbal Communication , Prevalence , Romania/ethnology , Severity of Illness Index , United Kingdom
9.
Child Dev ; 77(3): 696-711, 2006.
Article in English | MEDLINE | ID: mdl-16686796

ABSTRACT

Cognitive outcomes at age 11 of 131 Romanian adoptees from institutions were compared with 50 U.K. adopted children. Key findings were of both continuity and change: (1) marked adverse effects persisted at age 11 for many of the children who were over 6 months on arrival; (2) there was some catch-up between ages 6 and 11 for the bottom 15%; (3) there was a decrease of 15 points for those over 6 months on arrival, but no differentiation within the 6-42-month range; (4) there was marked heterogeneity of outcome but this was not associated with the educational background of the adoptive families. The findings draw attention to the psychological as well as physical risks of institutional deprivation.


Subject(s)
Adoption/psychology , Child Development , Child, Institutionalized/psychology , Intelligence , Psychosocial Deprivation , Adolescent , Age Factors , Child , Child Behavior , Child, Preschool , Female , Humans , Infant , Male , Risk Factors , Romania/ethnology , Socioeconomic Factors , United Kingdom
10.
J Dev Behav Pediatr ; 23(5): 297-303, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12394517

ABSTRACT

This study examined the prevalence and persistence of behaviors associated with institutional rearing in a sample of 144 children from Romania adopted by UK families. Patterns of rocking, self-injury, unusual sensory interests, and eating problems were assessed in children aged between a few weeks and 43 months who were adopted from institutional care. Forty-seven percent of the institutionally reared children rocked at the time of UK entry and 24% engaged in self-injurious behavior. By age 6 years, the percentages were 18% and 13%, respectively. Eleven percent of the children were displaying unusual sensory interests at the time of arrival, and at 6 years 13% of the children did so. Fifteen percent of the children were still experiencing difficulties with chewing and swallowing solid food at age 6 years. The primary factor affecting the prevalence and persistence of the behaviors was the length of time the children had spent in institutional deprivation.


Subject(s)
Adoption , Institutionalization , Psychosocial Deprivation , Self-Injurious Behavior/psychology , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Romania
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