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September 7, 2021
by Patricia Tomasi

Looking At Developmental Effects That Manifest In Institutionalized Children

September 7, 2021 08:00 by Patricia Tomasi  [About the Author]


A new study published in the Journal of Pediatric Research looked at family environment and development in children adopted from institutionalized care.

“This prospective study followed children recently adopted from institutionalized care over two years to investigate the relationship between family environment, executive function, and behavioral outcomes,” study author Constantine A. Stratakis told us. “My research interest is how early life stress effects development.”

According to the Adoption Center, about 7 million US citizens are adopted, 1.5 million of which are children. Approximately 140,000 children are adopted by US families annually. The average age of adoption is one month and over 60 per cent of infants were placed with their adoptive homes by this age. Of the 135,000 children adopted in the US annually, about 26 per cent of adopted children are from other countries, 15 per cent are voluntarily relinquished US babies, and 59% are from the child welfare system.

About two per cent of US adults have participated in the adoption process and more than one third have considered it. Out of every 25 US families with biological and adopted children has participated in the adoption process. Nearly 20,000 international adoptions were completed by US citizens in 2007 and that number declined by over 10,000 in 2011. Many say this is because the international adoption process became more restrictive over time.

Prior studies provide evidence that a favorable environment may lead to improved outcomes but it is not clear what aspects of the family environment impact behavior and development.
For the study, children that were adopted from institutionalized care in Eastern Europe were recruited within two months of adoption by a US family. Consent was obtained from the adoptive parents or legal guardians. Children participating in the study did not have a history of significant developmental, behavioural or medical issues. Children in the study were screened to ensure they had spent at least 32 weeks in an institution or orphanage. Researchers also ensured that the children were placed in the institution or orphanage at 24 weeks old or less.

Local adoption referral centers helped with recruitment. Researchers separated the children into a control group and a group with adopted children. The control group consisted of children without a history of significant psychological, behavioural, or medical issues. Children with a history of chronic illness or growth hormone deficiency were excluded from the study.

The adopted children participating in the study were seen within two months of arriving in the US and again after one year and after two years. In total, 27 children for the control group were recruited and 11 adopted children were recruited. Included in the analysis for the study were 19 children in the control group and ten adopted children who completed a minimum of two follow-up visits.

“Family cohesiveness and expressiveness were a protective influence, associated with less behavioral problems, while family conflict and greater emphasis on rules were associated with greater risk for executive dysfunction at the two-year follow-up,” Stratakis told us. “We were not surprised with the results.”

Going forward, Stratakis believes the results show that early assessment of child temperament child and parenting context may provide useful information to optimize the fit between parenting style, family environment structure, and the child’s development.

“These findings provide preliminary data for larger studies that will further investigate the developmental effects that manifest in institutionalized children.”


About the Author

Patricia Tomasi

Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group - Facebook Postpartum Depression & Anxiety Support Group - with over 1500 members worldwide. Blog:

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