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PubMed1996

Protection of adult but not newborn mice against lethal intracerebral challenge with Japanese encephalitis virus by adoptively transferred virus-specific cytotoxic T lymphocytes: requirement for L3T4+ T cells.

The protective ability of cytotoxic T cells (CTL) raised in vitro against Japanese encephalitis virus (JEV) was examined by adoptive transfer experiments. Adoptive transfer of anti-JEV effectors by intracerebral (i.c.) but not by intraperitoneal (i.p.) or intravenous (i.v.) routes protected adult BALB/c mice against lethal i.c. JEV challenge. In contrast to adult mice, adoptive transfer of anti-JEV effectors into newborn (4-day-old)and suckling (8-14-day-old) mice did not confer protection. However, virus-induced death was delayed in suckling mice compared to newborn mice upon adoptive transfer. The specific reasons for lack of protection in newborn mice are not clear but virus load was found to be higher in newborn mice brains compared to those of adults and virus clearance was observed only in adult mice brains but not in newborn mice brains upon adoptive transfer. Specific depletion of Lyt 2.2+, L3T4+ or Thy-1+ T cell populations before adoptive transfer abrogated the protective ability of transferred effectors. However, when Lyt 2.2+ cell-depleted and L3T4+ cell-depleted effectors were mixed and transferred into adult mice the protective activity was retained, demonstrating that both Lyt 2.2+ and L3T4+ T cells are necessary to confer protection. Although the presence of L3T4+ T cells in adoptively transferred effector populations enhanced virus-specific serum neutralizing antibodies, the presence of neutralizing antibodies alone without Lyt 2.2+ cells are not sufficient to confer protection.

Aging↗
PubMedDate not supplied

Comparisons of adopted and nonadopted adolescents in a large, nationally representative sample.

There are conflicting findings about whether adopted children have more psychological and behavioral problems than nonadoptees. Research results are discrepant partly because many previous studies were based on small clinical samples or on samples biased by self-selection. A nationally representative school survey (Add Health) was used to compare adopted (n = 1,587) and nonadopted adolescents (total N = 87,165) across a wide variety of measures. Standardized mean differences show that adopted adolescents are at higher risk in all of the domains examined, including school achievement and problems, substance use, psychological well-being, physical health, fighting, and lying to parents. Demographic and background variable breakdowns show that the effect sizes for differences between adopted and nonadopted adolescents were larger for males, younger or older adolescents, Hispanics or Asians, and adolescents living in group homes or with parents of low education. Distributional analyses revealed approximately a 1:1 ratio of adopted to nonadopted adolescents in the middle ranges of the outcome variables but a ratio of 3:1 or greater near the tails of the distributions. These data clearly show that more adopted adolescents have problems of various kinds than their nonadopted peers; effect sizes were small to moderate based on mean differences, but comparisons of distributions suggest much larger proportions of adopted than nonadopted adolescents at the extremes of salient outcome variables.

Adolescent↗
PubMed1993

Adopted and biological children in the clinic: family, parental and child characteristics.

Adopted children are overrepresented in referrals to mental health facilities. Research has described child symptomatology but has rarely described family characteristics or how adoptive and biological families presenting a child for treatment differ. This study took a systemic approach carrying out a multilevel assessment of families of adopted and biological children presented for treatment with adopted and biological nonclinical comparison groups. The results from this study of 88 parents of 7-17-year-old children suggest that adoptive families have greater social and psychological resources that can be relied on in treatment. However, adopted children are perceived to have more problems and their families are more likely to consider removal of the child as a solution to problems. Therapists' failure to appreciate these unique strengths and vulnerabilities of adoptive families can lead to treatment failure.

Adolescent↗
PubMed2004

Adopted children's problem behavior is significantly related to their ego resiliency, ego control, and sociometric status.

BACKGROUND: Many studies have documented that adopted children are at higher risk for behavior problems, but less is known about the correlates of their problem behavior. METHOD: The correlates of parent-reported and teacher-reported problem behavior in 7-year-old internationally adopted children (N = 176) were investigated by examining these children's ego resiliency, ego control, and sociometric status, and exploring possible risks factors in the home and racial influences. RESULTS: Using the 25th percentiles lowest and highest scores on ego resiliency and ego control as cut-off criteria, we found that: (1) resilient children were almost free of behavior problems; (2) overcontrolling children showed predominantly internalizing behavior problems (33% at school, and 28% at home); (3) undercontrolling children showed high rates of externalizing behavior problems (50% at school, and 34% at home), and an elevated rate of comorbidity (21% at school, and 21% at home). Adopted children identified by peer report as controversial or rejected had significantly higher externalizing problem scores than popular, average or neglected adopted children. The adopted children did not experience much (racial) discrimination. Nevertheless, children who wished to be white (46%) presented more mother-reported behavior problems. CONCLUSIONS: Our findings replicate R.W. Robins et al.'s (1996) work on three types of personality functioning: resilients, overcontrollers and undercontrollers (identified by J. Block, 1971), extending the model from adolescent boys to school-aged boys and girls, adopted from Asia and South America. The wish to identify with white parents and white peers may constitute a potential risk factor for internationally adopted children in middle childhood.

Adoption↗
PubMed2000

Health of children adopted from China.

OBJECTIVE: Since 1989, American parents have adopted 18 846 Chinese children. This study assesses the health and developmental status of these children after their arrival in the United States. PATIENTS AND METHODS: A total of 452 children (443 girls) in 2 groups were evaluated. The clinic group children (n = 192) included all Chinese adoptees seen in an international adoption clinic between 1991 and 1998. The travel group comprised 260 of 325 Chinese children placed by a single Massachusetts adoption agency between 1991 and 1996 whose adoptive parents and American physicians responded to mailed questionnaires. One hundred ninety-one of the travel group children were cared for by 1 of us (N.W.H.) during the adoption process in China. RESULTS: Growth and developmental delays were frequent in the clinic group. Z scores </=-2 were found in 39% of children for height, 18% for weight, and 24% for head circumference. The duration of orphanage confinement was inversely proportional to the linear height lag (r =.9), with a loss of 1 month of height age for every 2. 86 months in the orphanage. Of the children, 75% had significant developmental delay in at least 1 domain: gross motor in 55%, fine motor in 49%, cognitive in 32%, language in 43%, social-emotional in 28%, activities of daily living in 30%, and global delays in 44%. The incidence of medical problems was similar in both groups of children (travel group and clinic group). Overall, among the 452 children, elevated lead levels were found in 14%, anemia in 35%, abnormal thyroid function tests in 10%, hepatitis B surface antigen in 6%, hepatitis B surface antibody in 22%, intestinal parasites (usually Giardia) in 9%, and positive skin test results for tuberculosis in 3.5%. One child each had hepatitis C exposure and congenital syphilis. No child had human immunodeficiency virus infection. Unsuspected significant medical diagnoses, including hearing loss, orthopedic problems, and congenital anomalies, were found in 18% (81/452) of the children. CONCLUSIONS: Chinese adoptees display a similar pattern of growth and developmental delays and medical problems as seen in other groups of internationally adopted children. An exception is the increased incidence of elevated lead levels (overall 14%). Although serious medical and developmental issues were found among the children, overall their condition was better than expected based on recent publicity about conditions in the Chinese orphanages. The long-term outcome of these children remains unknown. China, adoption, orphanage, institutionalized child.

Adoption↗
PubMed2006

International adoption: issues in infectious diseases.

International adoptions have become increasingly common in the United States. Children awaiting international adoption and families traveling to adopt these children can be exposed to a variety of infectious diseases. Compared with the United States, foreign countries often have different immunization practices and methods of diagnosing, treating, and monitoring disease. Reporting of medical conditions can also differ from that of the United States. The prevalence of infectious diseases varies from country to country and may or may not be common among adopted children. The transmission of tuberculosis, hepatitis B, and measles from adopted children to family members has been documented. Furthermore, infectious organisms (e.g., intestinal parasites), bacterial pathogens (e.g., Bordetella pertussis and Treponema pallidum), and viruses (e.g., human immunodeficiency virus and hepatitis viruses) may cause clinically significant morbidity and mortality among infected children. Diseases such as severe acute respiratory syndrome or avian influenza have not been reported among international adoptees, but transmission is possible if infection is present. Family members may be infected by others during travel or by their adopted child after returning home. Families preparing to adopt a child from abroad should pay special attention to the infectious diseases they may encounter and to the precautions they should take on returning home.

Adoption↗
PubMed2004

Prevalence of house soiling and aggression in kittens during the first year after adoption from a humane society.

OBJECTIVE: To determine frequency of house soiling, aggression toward people, and aggression toward other cats among kittens adopted from an animal shelter and whether frequency of these behaviors was associated with age at the time of neutering. DESIGN: Survey. ANIMALS: 126 kittens adopted from a humane society at 6 to 13 weeks of age. PROCEDURE: Owners of the kittens were contacted by telephone approximately 4, 18, and 52 weeks after kittens were adopted, and a behavioral assessment questionnaire was administered. Owners were asked to indicate whether the kitten had displayed the specific behavior in the preceding 30 days. Sixty-three kittens were neutered prior to adoption; the remaining 63 were neutered at 5 to 7 months of age, after the second behavioral assessment. RESULTS: In the month following adoption, 64 (50.8%) kittens were reported to have at least 1 of the 3 behaviors. There was no evidence that the 3 behaviors were related. The percentage of kittens reported to urinate or defecate outside the litter box decreased from the first to second evaluation and remained low at the third evaluation. The percentage of kittens reported to show aggression toward people and the percentage reported to show aggression toward other cats decreased from the first to second evaluation, but increased again at the third evaluation. There was no significant association between age at the time of neutering and any of the 3 behaviors. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest behavior problems may be common in kittens adopted from a humane society, particularly during the first month after adoption.

Adoption↗
PubMed2003

Preventing infectious diseases during and after international adoption.

Families of internationally adopted children face risks associated with travel if they pick up their children overseas. Unlike other travelers, they also face risks because of close contact with a child with uncertain infection and vaccination status. Tuberculosis organisms, hepatitis A virus, hepatitis B virus, and measles virus have been transmitted from adopted children to family and community members. Intestinal parasites, Bordetella pertussis, and other infectious disease agents can also be transmitted. Some of these infections may be inapparent or may not manifest in adopted children until many years after the adoption. Increased attention to preventive measures for family members and early diagnosis of infectious diseases in adopted children can reduce transmission of the organisms causing these infections. Those providing health care to families planning international adoption should know about standard pretravel advice, as well as the spectrum of possible infections in adopted children, so that they can protect the health of the travelers and family members and close friends who will welcome the new child into the home.

Adoption↗
PubMed1986

Hospitals' key role in the adoption experience.

Although adoption offers a positive, moral solution to a problem pregnancy, it often is overlooked and misunderstood. Many birthmothers, for example, turn to independent placements so that their medical costs will be covered--without realizing the risks of such arrangements. In addition to failing to guarantee privacy, such placements tend to provide insufficient counseling and screening of the involved parties. Licensed agencies, on the other hand, not only must comply with the law but also must conform to professional standards of practice. Committed to honoring the confidentiality of all parties, they are in a better position to serve the needs of those in the adoption circle. In addition to developing an awareness of accepted adoption procedures, health care providers have a special role to play during the adoption experience. They must be sensitive to the new mother's situation, helping to affirm rather than undo her decision to relinquish her child. Health care administrators must ensure that hospital policy addresses the rights of all involved in the adoption process and that standards reflect high-quality adoption practice. Providers and administrators also have the opportunity to develop community partnerships that promote a positive image of professional adoption services to the public.

Adoption↗
PubMed2006

Internationally adopted children: a new challenge for pediatricians.

Children adopted from abroad by Italian families have increased during the last years. Since 2001 to 2004 they have been more than 10,000, mainly from Eastern Europe, and all indications suggest that they will continue to increase. Most of the internationally adopted children reside in orphanage before adoption where they may experience malnutrition, exposure to infectious diseases, environmental deprivation, neglect. Moreover, their pre-adoptive records are scarcely reliable and their immunization status is not always adequate. The most common long-term problems of internationally adopted children concern developmental and scholastic delay especially if they come from a long and severely deprived institutional setting, precocious puberty and, during adolescence, depressive disorders as well as antisocial behaviours. Inter-country adopted children are at increased risk for health and social problems and have to be recognized as a group of subjects requiring special medical attentions. Specialized centres for internationally adopted children where they could receive medical evaluations upon arrival and a prolonged health follow-up should be set up.

Adoption↗
PubMedDate not supplied

Caring for adoptive families: lessons in communication.

PURPOSE: To describe the experiences of families whose adopted children were hospitalized and to compare those experiences to the experiences of families of hospitalized biological children. METHOD: The parents of 10 adopted and 55 biological children participated in the study in which the source and intensity of stress for parents and the level of distress demonstrated by the children during their hospitalization were measured and compared. RESULTS: Adopted children hospitalized for the first time were significantly more distressed during hospitalization than biological children hospitalized for the first time. Adoptive parents experienced significantly more stress than biological parents related to how staff communicated with them about their child's illness. Concerns identified by several adoptive families included difficulties associated with having limited information about their child's family medical history and concerns about attachment issues. CONCLUSIONS: Health care providers need to be aware of adoptive parents' concerns about their child's response to hospitalization, attachment issues, and limited family medical history. The quality of communication with adoptive parents is especially important.

Adaptation, Psychological↗
PubMed1991

The fourth stage of labor: the health of birth mothers and adoptive mothers at six-weeks postpartum.

This study was conducted to determine the frequency of various health problems in new adoptive and biological mothers six weeks after they adopted or delivered their infants. Participants included 108 married first-time adoptive mothers, 72 married first-time biological mothers, and 133 controls (married women without children), each of whom completed a mailed questionnaire. Compared to controls, adoptive and biological mothers reported more fatigue, less readiness to work at a job, and less activity with household chores and recreational or social functions. In addition, biological mothers complained of more breast and genitourinary problems than did adoptive mothers or controls. Apart from their fatigue and hesitation to work at a job, adoptive mothers reported relatively good health, with the best mental health outcomes and the fewest acute physical problems of the three groups. These findings suggest that, for both adoptive and birth mothers, some aspects of postpartum recovery may continue up to and beyond the sixth postpartum week.

Adoption↗
PubMed1989

[The Family Counsel for Wards of the state. Its essential role in adoption matters].

Every regional branch of the Agency of Health and Social Affairs includes a Child Welfare Service (CWS) whose responsibilities include ensuring the best possible guardianship and future for children registered as Wards of the State. The CWS must immediately register as a Ward of the State every child fitting the criteria for one of the categories defined by the July 11 1966 Act, and take the earliest possible steps towards adoption of such Wards. To achieve these two objectives, a Family Council has been created within the CWS. This Council, that includes eight members with various types of experience or competence in matters of guardianship and adoption, is responsible for pronouncing the registration of Wards and achieving their adoption. Rather than a discussion of general considerations, we have elected to describe the methodical agenda and progress of the Paris CWS Family Council's regular meetings. Emphasis is put on the important aspects of wards eligible for adoption, on the investigation at the homes of candidates and on the "matching" which should be sought for between adoptive families and adoptees. Without doubt, the Family Council's systematic work, denoting a high level of awareness of its responsibilities, is the cause of the significant increase in the number of adoptions and, above all, of the recent availability of adoption to categories that were formerly neglected or permanently "abandoned".

Adoption↗
PubMed1987

A physician's guide to adoption.

The growing number of couples seeking to adopt may have outstripped the number of babies in the United States available for adoption. Although increased availability and use of abortion have resulted in fewer single women continuing their pregnancies, the increased tendency of unmarried mothers to raise rather than relinquish their children has, in particular, limited the number of babies available for adoption. Despite the unpopularity of adoption among women with unintended pregnancies, addressing this option remains an important part of pregnancy counseling. Appropriate obstetric care of women placing their babies for adoption includes acknowledgment of the loss these women experience. Knowledge of adoption resources and willingness to discuss adoption can help physicians provide better care of unintentionally pregnant as well as infertile patients.

Adoption↗
PubMed1984

Children's understanding of adoption.

200 adopted and nonadopted children, ranging in age from 4 to 13 years, were interviewed about their understanding of adoption. Both open-ended interview and structured Q sort procedures were used. Results indicated clear developmental trends in children's knowledge of the nature of the adoptive family relationship, as well as the motivational basis underlying adoption. Relatively few differences were found, however, between adopted and nonadopted children's knowledge of adoption. Results are discussed within the general context of children's acquisition of social knowledge. Implications of the findings for adoption policy and practice also are discussed.

Adolescent↗
PubMed1983

The Minnesota Adoption Studies: genetic differences and malleability.

In 1974 we launched 2 large adoption studies for 2 quite different purposes. The Transracial Adoption Study was designed to test the hypothesis that black and interracial children reared by white families perform on IQ and school achievement tests as well as other adoptees because they are reared in the culture of the tests and the schools. In addition, transracial families provided a sample with large numbers of adopted and natural children in the same families. Sources of individual differences among siblings could be studied without fear of possible differences between adoptive families and those with their own children. The Adolescent Adoption Study was designed to assess the cumulative impact of differences among family environments at the end of the child-rearing period. All of the children were adopted in the first year of life and averaged 18.5 years at the time of the study. A comparison sample of families with their own adolescents was also studied. Black and interracial children scored as well on IQ tests as adoptees in other studies. Individual differences among them, however, were more related to differences among their biological than adoptive parents, whether they lived together or not. Young siblings were found to be intellectually quite similar, whether genetically related or not. Adolescents' IQ test scores were similar to those of their parents and siblings only if they were biologically related. Our interpretation of these results is that younger children are more influenced by differences among their family environments than older adolescents, who are freer to seek their own niches.

Achievement↗
PubMed1981

Adoption: pediatric, legislative and social issues.

Physicians may find themselves involved in many phases of the adoption process, ranging from advising infertile couples who wish to adopt a child to caring for adopted children, adolescents or adults. Recent legislation has been aimed at making it possible for children to be adopted who have been receiving foster care and at providing financial assistance to implement the adoption of children with handicaps and with medical problems. The adoption process is becoming more open. Adoptees are searching for and finding their biological parents and all parties in the "adoption triangle" are developing relationships with one another.

Adoption↗
PubMed1993

[Risks of failure of uncontrolled adoption of foreign children].

Four cases of failed adoptions of children from abroad are reported. Risk factors included advanced age of the adopting parents or adoptee and insufficient commitment on the part of the adopting parents who organized the adoption on their own without undergoing counselling. Prevention of adoption failures would require counselling by competent professionals and support groups (e.g., adopting parent groups, competent physicians) and mandatory review of adoption requests by an appropriate commission.

Acculturation↗