Q:
Are there any studies on ADHD in internationally adopted
children?
From anecdotal information it appears that
toddlers, who were adopted from orphanages in Russia, have
a greater incidence of attention problems than an average
American child.
Also, are you aware of studies that have addressed if the
nature of this issue is different in adopted children than
in those who have not been adopted?
Lastly, are there any studies that examined if there is
any difference in the long term improvement between the
adopted children who had learning or behavioral problems
and children that had not been adopted or lived in an orphanage
the first year of two of their lives?
A:There is a longitudinal study from a research
group in London (Drs. M. Rutter, T. O'Connor, et al), which has
studied a sample of Romanian adoptees for approximately ten years.
They found a high rate of what they called "inattentive-hyperactive"
behavior. They pointedly avoided calling this ADHD, since they
found significant differences between this condition and ADHD,
as it is manifested in "typical" American kids. For
example, in "typical" ADHD, there is a very high correlation
between the inattentive/impulsive behavior and aggression (70%
co-morbidity), while in the adoption sample, the kids were not
aggressive. Similarly, in "typical" ADHD, the overwhelming
majority (again, over 70%) of affected kids are boys, while in
the adoption sample boys and girls were equally affected. The
researchers were very careful in their conclusions about this,
but expressed concern that IA kids were being lumped with, and
treated like, typical ADHD kids when the etiology and symptoms
are probably different in significant ways. They are currently
undertaking a study comparing their inattentive-hyperactive kids
to typical ADHD kids, but it will probably be a while before any
of us see these data. The older the children were at the time
of placement in their Romanian sample, the more pronounced the
deficits in cognitive, physical, and emotional development. All
children showed improvement over time, with some catching up completely
and others remaining below the domestically adopted kids despite
considerable gains. We do not know if we can extrapolate these
findings onto the IA children from other countries.
