Emotional and Behavioral Issues in International Adoptees

Introduction and Rationale

With the increase in international adoptions over the past decade, it is important to examine the emotional and behavioral issues that are often manifested in adoptees. Adoptive parents and educators must be aware of the risk factors that may be associated with this population. Understanding the causes of these problems — including genetics, pre- and post-natal care, and the length and nature of pre-adoptive care — can help in the planning of education and behavior management programs. The articles selected below examine recent literature on this topic.

Balbernie, R. (2010). Reactive attachment disorder as an evolutionary adaptation. Attachment & Human Development, 12(3), pp. 265–281.

Reactive Attachment Disorder as Evolutionary Adaptation

Behaviors associated with reactive attachment disorder (RAD) may be a function of adaptation rather than a mental health issue. RAD is most often observed in institutionalized children, but some fostered and adopted children may also exhibit characteristics of the disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) describes RAD as a form of "markedly disturbed and developmentally inappropriate social relatedness in most contexts." Understanding how and why RAD occurs may help adoptive parents better cope with a child when they realize that the child is not deliberately selfish, scheming, or distant. The child's survival instinct has taught him or her, from a very early age, what to expect from the adults they look to for care. The positive conclusion reached by the authors, following a review of the literature, is that even young children who were grossly deprived of affection and mothering in their infant and toddler years can benefit from normal family relationships after adoption.

Hawk, B., and McCall, R. (2010). CBCL behavior problems of post-institutionalized international adoptees. Clinical Child & Family Psychology Review, 13(2), pp. 199–217.

As the number of international adoptions increases, researchers are interested in the developmental outcomes of adoptees. Results to date have been inconsistent because of the variety of backgrounds from which adoptees have come. Hawk and McCall reviewed eighteen studies that used the Child Behavior Checklist. According to their findings, post-institutional children have more behavior problems and are more likely to have problems that manifest in adolescence. The researchers discussed their findings in terms of early deficient experiences, including caregiver interactions.

Behavior Problems in Post-Institutionalized Adoptees

Juffer, F., Palacio, J., Le Mare, L., Sonuga-Barke, E.J.S., Tieman, W., Bakermans-Kranenburg, M.J., Vorria, P., van Ijzendoorn, M.H., and Verhulst, F.C. (2011). II. Development of adopted children with histories of early adversity. Monographs of the Society for Research in Child Development, 76(4), pp. 31–61.

The authors report on seven longitudinal studies focusing on the development of adopted children. Children with and without experiences of early adversity were considered, as were biological effects and the supportiveness of the adoptive family. The authors concede that pre-adoption adversities play a significant role in the emotional and behavioral issues experienced by adoptees, but post-adoptive influences are equally important. Key factors include interactions both within and outside the family and the child's growing understanding of having been abandoned and then adopted. Race may also be a consideration, particularly when a child is biracial or has been adopted by a family of a different racial background.

Minnis, H., Green, J., O'Connor, T.G., Liew, A., Glaser, D., Taylor, E., Follan, M., Young, D., Barnes, J., Gillberg, C., Pelosi, A., Arthur, J., Burston, A., Connolly, B., and Sadiq, F.A. (2009). An exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children. Journal of Child Psychology & Psychiatry, 50(8), pp. 931–942.

Although Reactive Attachment Disorder (RAD) is documented in psychiatric classification systems, there has still not been significant research into the disorder, especially in relation to school-age children. The authors draw a distinction between RAD and the attachment insecurity described by Ainsworth and Bowlby. Children who display the characteristics of RAD have broad problems with social development, rather than a problem with a specific caregiver. Another important distinction is that children with attachment insecurity have had opportunities to form discriminating relationships, whereas children with RAD often have not. The authors call for future research to explore RAD in preschool and school-age children, with particular attention to the neurobiological mechanisms that underlie the disorder.

Nelson, C.S., Bos, K., Gunnar, M.R., and Sonuga-Barke, E.J.S. (2011). V. The neurobiological toll of early human deprivation. Monographs of the Society for Research in Child Development, 76(4), pp. 127–146.