Abstract
Internationally adopted children often arrive from institutional settings where they have experienced medical, nutritional and psychosocial deprivation. This study uses a validated research assessment tool to prospectively assess the impact of baseline (immediately post adoption) nutritional status on fifty-eight children as measured by weight-for-age, height-for-age, weight-for-height and head circumference-for-age z scores, as a determinant of cognitive (MDI) and psychomotor development (PDI) scores longitudinally. A statistical model was developed to allow for different ages at time of initial assessment as well as variable intervals between follow up visits. The study results show that both acute and chronic measures of malnutrition significantly affect baseline developmental status as well as the rate of improvement in both MDI and PDI scores. This study contributes to the body of literature with its prospective nature, unique statistical model for longitudinal evaluation, and use of a validated assessment tool to assess outcomes.
Highlights
Children immigrating via international adoption have frequently lived in large institutions where their physical and emotional needs are not consistently met
The results of our study indicate that children who are adopted from institutional environments have high rates of both malnutrition and developmental delay in the immediate post adoptive period
MDI and PDI scores both improved with time, reaching well into the mean range for the general population, with rate of improvement significantly related to markers of both acute and chronic malnutrition
Summary
Children immigrating via international adoption have frequently lived in large institutions where their physical and emotional needs are not consistently met. Many of these children arrive from orphanages in China, Eastern Europe and the former Soviet Union which often have high child to caretaker ratios, limited access to health care, poorly maintained buildings, low paid staff and frequent relocation of children. While internationally adopted children (IAC) have several risk factors for poor growth and development, under-nutrition, including macro and micronutrient deficiencies, is a large factor. Some studies compare growth and child development in foster care vs orphanage settings. These results support the idea that being raised in a family-like setting such as foster care is better for nutrition, growth, attachment, and development [6,7]
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