Helder Emily J, Mulder Elizabeth, Gunnoe Marjorie Linder
Child Neuropsychol. 2016;22(1):39-64.
Most existing research on children adopted internationally has focused on those adopted as infants and toddlers. The current study longitudinally tracked several outcomes, including cognitive, behavioral, emotional, attachment, and family functioning, in 25 children who had been internationally adopted at school age (M = 7.7 years old at adoption, SD = 3.4, range = 4–15 years). We examined the incidence of clinically significant impairments, significant change in outcomes over the three study points, and variables that predicted outcomes over time. Clinically significant impairments in sustained attention, full-scale intelligence, reading, language, executive functioning, externalizing problems, and parenting stress were common, with language and executive functioning impairments present at higher levels in the current study compared with past research focusing on children adopted as infants and toddlers. Over the three study points, significant improvements across most cognitive areas and attachment functioning were observed, though significant worsening in executive functioning and internalizing problems was present. Adoptive family-specific variables, such as greater maternal education, smaller family size, a parenting approach that encouraged age-expected behaviors, home schooling, and being the sole adopted child in the family were associated with greater improvement across several cognitive outcomes. In contrast, decreased parenting stress was predicted by having multiple adopted children and smaller family sizes were associated with greater difficulties with executive functioning. Child-specific variables were also linked to outcomes, with girls displaying worse attachment and poorer cognitive performance and with less time in orphanage care resulting in greater adoption success. Implications for future research and clinical applications are discussed.
大多数现有的关于国际收养儿童的研究都集中在那些婴幼儿时期被收养的儿童身上。本研究纵向追踪了25名学龄期被国际收养儿童的多项结果,包括认知、行为、情感、依恋和家庭功能(收养时平均年龄为7.7岁,标准差为3.4,范围为4至15岁)。我们研究了具有临床意义的损伤发生率、在三个研究时间点上结果的显著变化以及随时间推移预测结果的变量。在持续注意力、全量表智力、阅读、语言、执行功能、外化问题和养育压力方面具有临床意义的损伤很常见,与以往针对婴幼儿期被收养儿童的研究相比,本研究中语言和执行功能损伤的发生率更高。在三个研究时间点上,观察到大多数认知领域和依恋功能有显著改善,尽管执行功能和内化问题有显著恶化。收养家庭特有的变量,如母亲受教育程度较高、家庭规模较小、鼓励符合年龄预期行为的养育方式、在家上学以及是家庭中唯一被收养的孩子,与多个认知结果的更大改善相关。相比之下,有多个被收养孩子预测养育压力会降低,家庭规模较小与执行功能方面更大的困难相关。儿童特有的变量也与结果有关,女孩表现出更差的依恋和更差的认知表现,在孤儿院照料的时间较少导致收养成功率更高。讨论了对未来研究和临床应用的启示。