Postinstitutionalized children's development: growth, cognitive, and language outcomes

J Dev Behav Pediatr. 2009 Oct;30(5):426-34. doi: 10.1097/DBP.0b013e3181b1fd08.


Objective: Children adopted internationally from institutions are a growing population presenting to professional care providers. Although postinstitutionalized (PI) children are adopted from multiple world regions, current knowledge is predominantly based on those adopted from Romania and Eastern European countries. This study examines and compares developmental outcomes of PI children adopted from multiple world regions.

Method: Five to 11 years after adoption, 8- through 11-year-old PI children (N = 91), children internationally adopted early from foster care (N = 109), and nonadopted children (N = 69) completed screening measures assessing vision, hearing, growth, and cognitive and language abilities. Parents completed questionnaires on service utilization, school performance, preadoptive history, and postadoption environment.

Results: Forty-four percent of PI children's growth was stunted (height <10th percentile) at adoption. At assessment, although physically smaller, nearly all PI children had average growth parameters. Relative to nonadopted children and children adopted early from foster care, PI children performed more poorly on cognitive and language screens with increased time in institution related to lower performance. Notably, group means on these measures were within the average range. PI children were more likely to be falling behind academically and to use intervention services. Family environment did not differ between PI and nonadopted children. There were few differences for PI children by world region of adoption once accounting for duration of institutionalization.

Conclusions: Despite currently living in similar environments, PI children have specific needs that differ from early-adopted and nonadopted children. Consideration of multiple factors, including length of institutionalization, is essential when providing care for these children.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adoption / psychology*
  • Child
  • Child Development*
  • Cognition*
  • Environment
  • Female
  • Foster Home Care / psychology
  • Humans
  • Institutionalization
  • Language*
  • Male
  • Neuropsychological Tests
  • Orphanages*
  • Schools
  • Surveys and Questionnaires
  • Time Factors