A few new children: postinstitutionalized children of intercountry adoption.

Research regarding children of intercountry adoption is limited, and most children of intercountry adoption have complex histories that may place them at risk for difficulty or failure in the classroom. Although the performances of some children from orphanage environments approximate those of chronological-age peers 2 to 4 years postadoption, duration of deprivation is consistently related, both historically and currently, to the cognitive delays and behavioral difficulties displayed by many postinstitutionalized children. Research regarding children of intercountry adoption is reviewed, and recommendations for future research are offered.

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Intercountry adoption, also called international adoption, refers to the adoption of foreign-born children by citizens of the United States. In the decade from 1993 to 2002, 137,272 children of intercountry adoption entered the United States with their new parents (U.S. Department of State, 2003). Approximately 90% of these youngsters were adopted from China, Russia, South Korea, Guatemala, Romania, and Vietnam or former Soviet states such as the Ukraine, Kazakhstan, and Belarus, with Russia and China alone accounting for more than 60% of all international adoptions by U.S. citizens from 1998 to 2002.

With the exception of South Korea, Guatemala, and parts of Romania, most of these countries use an orphanage system to provide care for their abandoned children. Thus, more than 80% of children currently adopted internationally, particularly those from China, Russia, and other eastern European countries, have spent one or more years in institutionalized care (Groze & Ileana, 1996; Meese, 2002). The quality of institutionalized care varies, of course, among different countries and even among orphanages within a particular country. Nevertheless, characteristics associated with orphanage life, including poor health care, inadequate nutrition, exposure to environmental toxins and infectious diseases, limited opportunities for language and cognitive stimulation, rotating shifts of caregivers who have little or no training, and regimented requirements for daily living, may delay or preclude normal development (Johnson & Dole, 1999). In addition, children are most often placed in such institutions abroad as a result of their birth history or because they come from single-parent, impoverished, or politically chaotic environments. According to Johnson (2000), "over 50% of institutionalized children in Eastern Europe are low birth weight infants, many were born prematurely, and some have been exposed to alcohol in utero [and] children with major medical problems or physical handicaps may be placed in orphanages by their [biological] parents due to limited access to corrective treatment and rehabilitation services" (p. 6).

Postinstitutionalized children of intercountry adoption, therefore, constitute a high-risk group; such adoptions are considered "special needs" adoptions (Johnson & Dole, 1999). These children may demonstrate complex behavioral, medical, and language difficulties (Gindis, 1997; Groze & Ileana, 1996; Johnson et al., 1992); yet their needs are not well understood and their backgrounds are often unknown. Furthermore, the research that exists regarding these children is primarily limited to a select few within the medical community who practice at international adoption clinics, to parent support groups (e.g., Families of Russian and Ukrainian Adoption, Families with Children from China, Parent Network for the Post-Institutionalized Child), and to research teams in Canada (Chisholm, 1998; Morison, Ames, & Chisholm, 1995; Morison & Ellwood, 2000) and Great Britain (Groothues, Beckett, & O'Connor, 2001; O'Connor, & Rutter, 2000; O'Connor et al., 2000; Rutter & the English and Romanian Adoptees [ERA] Study Team, 1998; Rutter, Kreppner,& O'Connor, 2001). Much like parents of children with disabilities in the years before federal legislation mandated special education services, parents of postinstitutionalized children of intercountry adoption are often more "tuned in" to the special needs of their children than are professionals in the schools. Consequently, when they approach their school for help, they are frustrated that school professionals do not know how to test or teach their children. Parents often receive conflicting opinions and encounter systems barriers to special services for their children.