May 24, 2005 -- More than 40,000 children a year are adopted internationally, with about half coming to the U.S. So how are they doing?
Pretty well, according to a review of studies that compared behavioral and psychological issues among adopted and nonadopted children and adolescents.
International adoptees exhibited fewer behavioral problems than children who were adopted domestically. And they were also half as likely as domestic adoptees to have mental health issues that required treatment.
Study researchers concluded that most international adoptees adapt well to their new families and are well adjusted. The findings are published in the May 25 issue of The Journal of the American Medical Association.
"The positive message is that these children tend to do extremely well, especially when you consider the circumstances from which they came," researcher Femmie Juffer, PhD, tells WebMD. "Most of these children missed out on a lot of attention and a lot of love early on."
Not All Good News
Juffer and colleague Marinus H. van IJzendoorn, PhD, of Leiden University in the Netherlands did find that internationally adopted children were about twice as likely to seek treatment for depression and other mental health problems as children being raised by birth parents.
International adoptees also tended to have identity issues earlier than other adopted children, at ages 6, 7, or 8, rather than in adolescence.
Most of the adoptions included in the studies were interracial, and Juffer says it makes sense that children who don't look like their parents and many of their friends will have identity issues before kids who do.
"Parents need to be alert to signals that their child is questioning his or her identity or that they are feeling different," she says. "This may come much earlier than they think it will. The child could be more withdrawn or he may be exhibiting more aggressive behavior."
More than 300,000 children from other countries have been adopted by parents in the U.S. over the last three decades, and international adoptions have more than doubled in the last 15 years.
Roughly a quarter of the children brought to the U.S. from other countries come from China, with another quarter coming from Russia. The rest come from other countries in Asia, Eastern Europe, the Caribbean, and Central America.
Because of the Chinese government's one-child policy, most of the adoptions from that country are girls.
Adoption researcher Adam Pertman tells WebMD that the boom in international adoptions is largely responsible for a fundamental shift in the way Americans perceive families.
Pertman wrote the book Adoption Nation: How the Adoption Revolution is Transforming America, and he is executive director of the Evan B. Donaldson Adoption Institute.
"This is pretty monumental," he says. "Our ideas about what families are, of what they should look like, and how they form are literally changing every day. And the impact goes way beyond the family."
Education Is Key
Pertman says parents who adopt internationally these days tend to be more sensitive to the identity issues and other problems their children are likely to face than they were in the past.
"Gone are the days when white parents adopting a child from Korea were told to just raise the child as if he were born in the U.S.," he says.
He adds that it is critical that parents who adopt internationally educate themselves so that they will be prepared when the questions come.
Susan Soon-keum Cox was one of the first international adoptees to the U.S. She says the No. 1 mistake that parents make is trying to raise their adoptive children without acknowledging their background and cultural heritage.
Soon-keum, who was adopted from Korea in 1956, grew up in a small town in Oregon with almost no contact with other Asians. She now works with the adoption agency Holt International, which has placed more than 50,000 children from other countries with American families.
"These days, with the Internet and greater awareness, there are many more resources for children, even those who live in small towns," she says. "The barriers of distance have been greatly eliminated."
A Mom Weighs In
Suburban Atlanta mom Susan Williams has two adopted daughters from China -- Ella, who is 5, and Zelda, who is 2. She has already incorporated her daughters' native culture into their lives, going so far as to dress up in traditional Chinese dress to deliver a 30-minute talk at Ella's preschool on the Chinese New Year.
She says she feels fortunate that her young daughters have contact with other Chinese adoptees, knowing that this support system will become even more important as they grow older.
"I know that I won't be able to smooth over everything for my daughters, but no parent can do that for their child," she says. "All I can do is deal with it with a mix of humor, honesty, and love."
She says Ella has already been questioned by other kids about being different. Though they have talked about her adoption, it has been in general terms. Williams says she knows the tougher identity questions will come later.
"I have told her that every family becomes a family in a different way, which is true," she says. "I have seen parents who tell their children every little detail about their adoption the minute they can sit up. I think that is just crazy."