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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.


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Last update on May 8, 2018