Language and cognitive outcomes in internationally adopted children

Gender differences in the associations between childhood adversity and psychopathology in the general population

PURPOSE

To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population.

METHODS

Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall psychopathology with nine symptom domains scores and total CA with exposure to five CA subtypes, respectively. The associations between CA and psychopathology were analyzed in men and women separately and were subsequently compared.

RESULTS

Total CA was associated with total SCL-90 and all symptom domains without significant gender differences. However, the analyses of CA subtypes showed that the association between emotional abuse and total SCL-90 was stronger in women compared to men [χ2(1) = 4.10, P = 0.043]. Sexual abuse was significantly associated with total SCL-90 in women, but emotional neglect and physical neglect were associated with total SCL-90 in men. Exploratory analyses of CA subtypes and SCL-90 subdomains confirmed the pattern of gender-specific associations. In women, emotional abuse was associated with all symptom domains, and sexual abuse was associated with all except phobic anxiety and interpersonal sensitivity. In men, emotional neglect was associated with depression, and physical neglect was associated with phobic anxiety, anxiety, interpersonal sensitivity, obsessive-compulsive, paranoid ideation, and hostility subdomains.

CONCLUSION

CA is a trans-syndromal risk factor regardless of gender. However, differential associations between CA subtypes and symptom manifestation might exist. Abuse might be particularly associated with psychopathology in women, whereas neglect might be associated with psychopathology in men.

Material Hardship Predicts Response Bias in Loss-Averse Decisions: The Roles of Anxiety and Cognitive Control

Income poverty is associated with an enhanced tendency to avoid losses in economic decisions, which can be driven by a response bias (risk avoidance) and a valuation bias (loss aversion). However, the impact of non-income dimensions of poverty on these biases remains unclear. The current study tested the impact of material hardship on these biases, and the mediating effects of anxiety, depression, and cognitive control in these associations. Healthy adults (N = 188) completed questionnaire and behavioral measures of the variables. Results of regression-based analyses showed that participants who reported higher material hardship exhibited greater response bias, but not valuation bias. This effect was mediated by anxiety. Although material hardship predicted lower cognitive control, cognitive control did not mediate the association between material hardship and either type of bias. These findings suggest that material hardship may lead to economic decision-making biases because it impacts emotional states rather than cognitive control.

Comprehension of irony in autistic children: The role of theory of mind and executive function

Although previous studies have examined irony comprehension in autistic children and potential impact factors, the relationship between theory of mind (ToM), executive function (EF), symptoms of autism, and comprehension of irony in this population remains largely unknown. This study explored irony comprehension in autistic children and examined the roles of ToM and EF in linking autism symptoms to deficits in irony comprehension. Twenty autistic children were compared with 25 typically developing (TD) children in an irony story picture task, ToM task, and EF task. The results showed that autistic children had impaired comprehension of irony compared with TD children, and performance on ironic stories showed a significant moderate discriminatory effect in predicting autistic children. A ToM deficit has also been proposed for autistic children. Comprehension of irony was significantly correlated with second-order ToM (2nd ToM) but was not significantly correlated with any components of EF. Moreover, 2nd ToM can predict the level of irony comprehension and mediate the relationship between symptoms of autism and irony comprehension. Taken together, these findings suggest that irony comprehension may offer a potential cognitive marker for quantifying syndrome manifestations in autistic children, and 2nd ToM may provide insight into the theoretical mechanism underlying the deficit in irony comprehension in this population.

The effects of early life adversity on children's mental health and cognitive functioning

Emerging evidence suggests that partially distinct mechanisms may underlie the association between different dimensions of early life adversity (ELA) and psychopathology in children and adolescents. While there is minimal evidence that different types of ELA are associated with specific psychopathology outcomes, there are partially unique cognitive and socioemotional consequences of specific dimensions of ELA that increase transdiagnostic risk of mental health problems across the internalizing and externalizing spectra. The current review provides an overview of recent findings examining the cognitive (e.g., language, executive function), socioemotional (e.g., attention bias, emotion regulation), and mental health correlates of ELA along the dimensions of threat/harshness, deprivation, and unpredictability. We underscore similarities and differences in the mechanisms connecting different dimensions of ELA to particular mental health outcomes, and identify gaps and future directions that may help to clarify inconsistencies in the literature. This review focuses on childhood and adolescence, periods of exquisite neurobiological change and sensitivity to the environment. The utility of dimensional models of ELA in better understanding the mechanistic pathways towards the expression of psychopathology is discussed, with the review supporting the value of such models in better understanding the developmental sequelae associated with ELA. Integration of dimensional models of ELA with existing models focused on psychiatric classification and biobehavioral mechanisms may advance our understanding of the etiology, phenomenology, and treatment of mental health difficulties in children and youth.

Relational uncertainty: Does parental perception of adopted children's academic success change over time?

While initial findings suggested that children who are adopted (adoptees) perform less well academically, this result is not consistent across the literature. To explain these, often conflicting, results, researchers acquired a lagging view, in which adoptees need to "catch up" to their non-adopted peers. According to the lagging view, those adopted at a younger age have less catching up to do than those adopted when they are older. However, the lagging view does not account for the period in which adoptees and their new families adjust to one another. A period that we refer to as relational uncertainty. This is particularly relevant as data on adoptees' academic performance is largely based on parent reports. The overarching goal of this study was to determine if parental perception of adoptees' academic achievement changed over time, after accounting for the impact of age of adoption. Using a nationally representative dataset, we found that after accounting for age of adoption the length of time that children resided in their adoptive homes predicted parental perception of academic performance. Specifically, after accounting for age of adoption, parental perception of adoptees' academic performance demonstrated early consistency followed by a significant decline. We also investigated if the relation, of those factors previously associated with parental perception of adoptees' academic performance, remained after variance was accounted for by both age of adoption and children's length of stay in their adoptive homes. Several previous factors (where the child lived pre-adoption and the socioeconomic status of their adoptive household) and child characteristics (sex and the first language the child learned to speak) demonstrated a continued association. Results indicate the need for a paradigm shift in how we view parent reports of adoptees' academic achievement, as well as the frequently reported factors surrounding adoptees' academic performance. The implications for how to support adoptees' academic achievement are discussed.

Impact of dimensions of early adversity on adult health and functioning: A 2-decade, longitudinal study

Recent neurodevelopmental and evolutionary theories offer strong theoretical rationales and some empirical evidence to support the importance of specific dimensions of early adversity. However, studies have often been limited by omission of other adversity dimensions, singular outcomes, and short follow up durations. 1,420 participants in the community, Great Smoky Mountains Study, were assessed up to eight times between age 9 and 16 for four dimensions of early adversity: Threat, Material Deprivation, Unpredictability, and Loss (as well as a Cumulative Adversity measure). Participants were followed up to four times in adulthood (ages 19, 21, 25, and 30) to measure psychiatric disorders, substance disorder, and "real-world" functioning. Every childhood adversity dimension was associated with multiple adult psychiatric, substance, or functional outcomes when tested simultaneously in a multivariable analysis that accounted for other childhood adversities. There was evidence of differential impact of dimensions of adversity exposure on proximal outcomes (e.g., material deprivation and IQ) and even on distal outcomes (e.g., threat and emotional functioning). There were similar levels of prediction between the best set of individual adversity scales and a single cumulative adversity measure when considering distal outcomes. All dimensions of childhood adversity have lasting, pleiotropic effects, on adult health and functioning, but these dimensions may act via distinct proximal pathways.

Associations of Early-Life Threat and Deprivation With Executive Functioning in Childhood and Adolescence: A Systematic Review and Meta-analysis

IMPORTANCE

Many studies have demonstrated an association between early-life adversity (ELA) and executive functioning in children and adolescents. However, the aggregate magnitude of this association is unknown in the context of threat and deprivation types of adversity and various executive functioning domains.

OBJECTIVE

To test the hypothesis that experiences of deprivation are more strongly associated with reduced executive functioning compared with experiences of threat during childhood and adolescence.

DATA SOURCES

Embase, ERIC, MEDLINE, and PsycInfo databases were searched from inception to December 31, 2020. Both forward and reverse snowball citation searches were performed to identify additional articles.

STUDY SELECTION

Articles were selected for inclusion if they (1) had a child and/or adolescent sample, (2) included measures of ELA, (3) measured executive functioning, (4) evaluated the association between adversity and executive functioning, (5) were published in a peer-reviewed journal, and (6) were published in the English language. No temporal or geographic limits were set. A 2-reviewer, blinded screening process was conducted.

DATA EXTRACTION AND SYNTHESIS

PRISMA guidelines were used to guide data extraction and article diagnostics (for heterogeneity, small study bias, and p-hacking). Article quality was assessed, and data extraction was performed by multiple independent observers. A 3-level meta-analytic model with a restricted maximum likelihood method was used. Moderator analyses were conducted to explore heterogeneity.

MAIN OUTCOMES AND MEASURES

Primary outcomes included measures of the 3 domains of executive functioning: cognitive flexibility, inhibitory control, and working memory.

RESULTS

A total of 91 articles were included, representing 82 unique cohorts and 31 188 unique individuals. Deprivation, compared with threat, was associated with significantly lower inhibitory control (F1,90 = 5.69; P = .02) and working memory (F1,54 = 5.78; P = .02). No significant difference was observed for cognitive flexibility (F1,36 = 2.38; P = .12). The pooled effect size of the association of inhibitory control with deprivation was stronger (Hedges g = -0.43; 95% CI, -0.57 to -0.29) compared with threat (Hedges g = -0.27; 95% CI, -0.46 to -0.08). The pooled effect size of the association of working memory with deprivation was stronger (Hedges g = -0.54; 95% CI, -0.75 to -0.33) compared with threat (Hedges g = -0.28; 95% CI, -0.51 to -0.05).

CONCLUSIONS AND RELEVANCE

Experiences of both threat and deprivation in childhood and adolescence were associated with reduced executive functioning, but the association was stronger for exposure to deprivation. Efforts to address the consequences of ELA for development should consider the associations between specific dimensions of adversity and specific developmental outcomes.

Oral and Written Language Abilities of School-Age Internationally Adopted Children from Eastern Europe

PURPOSE

Children adopted from Eastern Europe were assessed at ages 6 to 7 years and results were compared to the same children when they were 8 years. Patterns of relative strengths and weaknesses in language, verbal memory and literacy were analyzed. Variables that predicted reading and writing were determined.

METHOD

Children adopted from Eastern Europe between 1;0 and 4;11 years of age were assessed at ages 6 to 7 years and age 8 years on a variety of tests that measured language, verbal memory and literacy. Results were compared across ages, and language, verbal memory and literacy domains.

RESULTS

Group means for all measures fell within the average range at both ages. The children's scores were not significantly different from test norms except for measures of rapid naming and number repetition. However, a larger than expected percentage of children scored -1SD below the mean on decontextualized measures of verbal working memory and reading fluency. At age 8 years 24% of children received speech language therapy services and 26% had repeated a grade level. Vocabulary, expressive syntax, verbal short-term memory and writing were areas of relative strength. Higher level vocabulary knowledge was strongly correlated with all literacy measures.

CONCLUSION

As a group, Eastern European adoptees scored average on measures of language and literacy at 6 or 7 years and again at age 8 years. However, 26% of the children had repeated a grade and 24% were still receiving speech and language services. Vocabulary was an area of strength reflecting the children's enriched adopted home environments. In-depth knowledge of vocabulary was the best predictor of reading and writing. Some aspects of working memory were a strength but others were not. Rapid naming was also a weakness.

The Relationship Between Childhood Stress and Distinct Stages of Dynamic Behavior Monitoring in Adults: Neural and Behavioral Correlates

Childhood adversity is a major risk factor for emotional and cognitive disorders later in adulthood. Behavior monitoring, one of the most important components of cognitive control, plays a crucial role in flexible interaction with the environment. Here, we test a novel conceptual model discriminating between two distinct dimensions of childhood adversity (i.e., deprivation and threat) and examine their relations to dynamic stages of behavior monitoring. Sixty young healthy adults participated in this study using event-related potentials (ERPs) and the dynamic stages of behavior monitoring including response inhibition, error detection, and post-error adjustments were investigated in a classical Go/NoGo task. Multiple regression analyses revealed that participants with higher severity of childhood adversity recruited more controlled attention, as indicated by larger (more negative) conflict detection-related NoGo-N2 amplitudes and larger (more negative) error detection-related ERN amplitudes. Higher severity of childhood abuse (an indicator of threat) was related to smaller (less positive) error appraisal-related Pe amplitudes on the neural level and subsequently lower post-error accuracy on the behavioral level. These results suggested that prefrontal-supported controlled attention is influenced by universal adversity in childhood while the error-related behavioral adjustment is mainly affected by childhood abuse, indicating the dimensions of deprivation and threat are at least partially distinct.

Working for the future: parentally deprived Nigerian Children have enhanced working memory ability

BACKGROUND

The dominant view based on the deficit model of developmental psychopathology is that early adverse rearing impairs cognition. In contrast, an emerging evolutionary-developmental model argues that individuals exposed to early-life stress may have improved cognitive abilities that are adapted to harsh environments. We set out to test this hypothesis by examining cognitive functions in parentally deprived children in Nigeria.

METHODS

Cognitive performance was compared between 53 deprived children who currently live in institutional homes and foster families and 51 nondeprived control participants. We used a multifaceted neurocognitive test battery for the assessment of inhibition, set-shifting and working memory.

RESULTS

Results showed that the deprived and nondeprived group did not significantly differ in their performance on set-shifting and inhibition tasks. Conversely, the deprived group performed significantly better than the nondeprived group in the working memory task.

DISCUSSION

We interpret the enhanced working memory ability of the deprived group as a correlate of its ecological relevance. In Nigeria, underprivileged children may need to rely to a larger extent on working memory abilities to attain success through academic work. This study provides further evidence that exposure to early adversity does not necessarily impair cognitive functions but can even enhance it under some conditions and in some domains.

The development of phonological memory and language: A multiple groups approach

Pierce et al. (2017) have proposed that variations in the timing, quality and quantity of language input during the earliest stages of development are related to variations in the development of phonological working memory and, in turn, to later language learning outcomes. To examine this hypothesis, three groups of children who are at-risk for language learning were examined: children with cochlear implants (CI), children with developmental language disorder (DLD), and internationally-adopted (IA) children, Comparison groups of typically-developing monolingual (MON) children and second language (L2) learners were also included. All groups were acquiring French as a first or second language and were matched on age, gender, and socioeconomic status, as well as other group-specific factors; they were between 5;0-7;3 years of age at time of testing. The CI and DLD groups scored significantly more poorly on the memory measures than the other groups; while the IA and L2 groups did not differ from one another. While the IA group performed more poorly than the MON group, there was no difference between the L2 and MON groups. We also found differential developmental relationships between phonological memory and language among the groups of interest in comparison to the typically-developing MON and L2 groups supporting the hypothesis that language experiences early in life are consequential for language development because of their effects on the development of phonological memory.

Habilidades Sociais e Acadêmicas de Crianças e Adolescentes em Instituições de Acolhimento

Resumo Considerando que habilidades sociais (HS) podem ser preditoras de bom desempenho escolar e que crianças e adolescentes com longo tempo de permanência em instituições tendem a apresentar dificuldades escolares, buscou-se, no presente estudo, comparar HS, problemas de comportamento e desempenho escolar entre crianças/adolescentes com e sem histórico de acolhimento institucional. Participaram do estudo 36 crianças/adolescentes divididas em dois grupos: G1, composto por 18 crianças/adolescentes de três instituições de acolhimento do interior do estado do Mato Grosso do Sul, e G2, composto por 18 crianças/adolescentes sem histórico de acolhimento e do mesmo contexto escolar; além de seus respectivos docentes. Todos os estudantes responderam a inventários de HS, conforme a idade e ao Teste de Desempenho Escolar (TDE). Os professores responderam a duas escalas: uma de HS e uma de problemas comportamentais. Para o G1, maiores índices de habilidades sociais foram correlacionados a bom desempenho em leitura e problemas de comportamento foram correlacionados a índices mais baixos nos escores totais do TDE. Para o G2, maiores índices de habilidades sociais correlacionaram-se a melhor desempenho em matemática no TDE. Os participantes do G2 perceberam-se mais habilidosos que os do G1, apesar de os professores terem percebido as habilidades sociais de ambos os grupos como semelhantes. Em relação aos problemas de comportamento, os professores indicaram diferenças significativas, com maiores índices para o G1. Os dados sugerem intervenções junto aos professores para que possam reforçar comportamentos habilidosos de seus alunos, favorecer o autoconceito e o desempenho escolar.

Network structure reveals clusters of associations between childhood adversities and development outcomes

Exposure to childhood adversity is common and associated with a host of negative developmental outcomes. The most common approach used to examine the consequences of adversity exposure is a cumulative risk model. Recently, we have proposed a novel approach, the dimensional model of adversity and psychopathology (DMAP), where different dimensions of adversity are hypothesized to impact health and well-being through different pathways. We expect deprivation to primarily disrupt cognitive processing, whereas we expect threat to primarily alter emotional reactivity and automatic regulation. Recent hypothesis-driven approaches provide support for these differential associations of deprivation and threat on developmental outcomes. However, it is not clear whether these patterns would emerge using data-driven approaches. Here we use a network analytic approach to identify clusters of related adversity exposures and outcomes in an initial study (Study 1: N = 277 adolescents aged 16-17 years; 55.1% female) and a replication (Study 2: N = 262 children aged 8-16 years; 45.4% female). We statistically compare our observed clusters with our hypothesized DMAP model and a clustering we hypothesize would be the result of a cumulative stress model. In both samples we observed a network structure consistent with the DMAP model and statistically different than the hypothesized cumulative stress model. Future work seeking to identify in the pathways through which adversity impacts development should consider multiple dimensions of adversity.

Inhibitory control in trauma-exposed youth: A systematic review

The aim of this systematic review was to provide insight in inhibitory control (prepotent response inhibition and interference control) in trauma-exposed youth from a developmental perspective and exploring the effects of prolonged stress. A systematic search was conducted, resulting in 1722 abstracts. Of those, 33 studies met inclusion criteria. Twelve studies measured prepotent response inhibition (Go/no-go and Stop-signal task), 20 studies measured interference control (Flanker and Stroop task), and one measured both. Some studies indeed found evidence for prolonged trauma exposure impeding both subcomponents of inhibitory control, although others did not. At a later age, inhibitory control problems on task performance seem to disappear. However, distinct patterns of brain activity may suggest that those individuals employ compensation strategies. Together, the findings may suggest that non-specific inhibitory control problems occur after prolonged trauma exposure, with older youth possibly employing compensation strategies on the tasks. Future studies may provide a clearer picture of the compensation strategies and the circumstances in which they become visible.

Auditory Mismatch Negativity Response in Institutionalized Children

The attunement of speech perception/discrimination to the properties of one’s native language is a crucial step in speech and language development at early ages. Studying these processes in young children with a history of institutionalization is of great interest, as being raised in institutional care (IC) may lead to lags in language development. The sample consisted of 82 children, split into two age groups. The younger age group (<12 months) included 17 children from the IC and 17 children from the biological-family-care (BFC) group. The older group (>12 months) consisted of 23 children from the IC group, and 25 children from the BFC group. A double-oddball paradigm with three consonant-vowel syllables was used, utilizing native (Russian) and foreign (Hindi) languages. A Mismatch Negativity (MMN) component was elicited within a 125–225 ms time window in the frontal-central electrode. Findings demonstrate the absence of MMN effect in the younger age group, regardless of the living environment. Children in the older group are sensitive to native deviants and do not differentiate foreign language contrasts. No significant differences were observed between the IC and BFC groups for children older than 12 months, indicating that children in the IC have typical phonological processing. The results show that the MMN effect is not registered in Russian speaking children before the age of 12 months, regardless of their living environment. At 20 months of age, institutionally reared children show no evidence of delays in phonetic development despite a limited experience of language.

Pragmatic Language Performance of Children Adopted Internationally

Purpose Pragmatic language is important for social communication across all settings. Children adopted internationally (CAI) may be at risk of poorer pragmatic language because of adverse early care, delayed adopted language development, and less ability to inhibit. The purpose of this study was to compare pragmatic language performance of CAI from Asian and Eastern European countries with a nonadopted group of children who were of the same age and from similar socioeconomic backgrounds as well as explore the relationship among emotion identification, false belief understanding, and inhibition variables with pragmatic language performance. Method Using a quasi-experimental design, 35 four-year-old CAI (20 Asian, 15 Eastern European) and 33 children who were not adopted were included in this study. The children's pragmatic language, general language, and social communication (emotion identification of facial expressions, false belief understanding, inhibition) were measured. Comparisons by region of origin and adoption experience were completed. We conducted split-half correlation analyses and entered significant correlation variables into simple and backward regression models. Results Pragmatic language performance differed by adoption experience. The adopted and nonadopted groups demonstrated different correlation patterns. Language performance explained most of the pragmatic language variance. Discussion Because CAI perform less well than their nonadopted peers on pragmatic communication measures and different variables are related to their pragmatic performance, speech-language pathologists may need to adapt assessment and intervention practices for this population.

Language Outcomes in Adults with a History of Institutionalization: Behavioral and Neurophysiological Characterization

Impoverished early care environments are associated with developmental deficits in children raised in institutional settings. Despite the accumulation of evidence regarding deficits in general cognitive functioning in this population, less is known about the impact of institutionalization on language development at the level of brain and behavior. We examined language outcomes in young adults and adolescents raised in institutions (n = 23) as compared to their socioeconomic status and age peers raised in biological families (n = 24) using a behavioral language assessment and linguistic event-related potentials (ERPs). Controlling for intelligence, adults with a history of institutionalization demonstrated deficits in lexical and grammatical development and spelling. Analyses of ERP data revealed significant group differences in the dynamic processing of linguistic stimuli. Adults with a history of institutionalization displayed reduced neural sensitivity to violations of word expectancy, leading to reduced condition effects for temporo-spatial factors that tentatively corresponded to the N200, P300/N400, and phonological mismatch negativity. The results suggest that language is a vulnerable domain in adults with a history of institutionalization, the deficits in which are not explained by general developmental delays, and point to the pivotal role of early linguistic environment in the development of the neural networks involved in language processing.

Early deprivation disruption of associative learning is a developmental pathway to depression and social problems

Exposure to psychosocial deprivation is associated with elevations in numerous forms of impairment throughout the life-course. Disruptions in associative learning may be a key mechanism through which adversity, particularly psychosocial deprivation, increases risk for impairment. Existing data consistent with this claim come entirely from correlational studies. Here, we present the first experimental evidence relating psychosocial deprivation and disruptions in multiple forms of associative learning. Using data from the Bucharest Early Intervention Project, we demonstrate that randomized placement into a family caregiving environment during the infant/toddler period as compared to prolonged institutional care normalizes two forms of associative learning in early adolescence: reward responsivity and implicit motor learning. These forms of associative learning significantly mediate the effect of institutional rearing on depressive symptoms and peer relationships. In sum, we provide evidence for a novel pathway linking early experience to psychopathology and peer relationships through basic associative learning mechanisms.

Early childhood deprivation such as institutionalization can greatly affect early development. Here, the authors study children who were raised in institutions but later randomly placed in foster care vs. not, to understand how early-life deprivation affects associative learning in adolescence.

Neglect as a Violation of Species-Expectant Experience: Neurodevelopmental Consequences

The human brain requires a wide variety of experiences and environmental inputs in order to develop normally. Children who are neglected by caregivers or raised in institutional environments are deprived of numerous types of species-expectant environmental experiences. In this review, we articulate a model of how the absence of cognitive stimulation and sensory, motor, linguistic, and social experiences common among children raised in deprived early environments constrains early forms of learning, producing long-term deficits in complex cognitive function and associative learning. Building on evidence from animal models, we propose that deprivation accelerates the neurodevelopmental process of synaptic pruning and limits myelination, resulting in age-specific reductions in cortical thickness and white matter integrity among children raised in deprived early environments. We review evidence linking early experiences of psychosocial deprivation to reductions in cognitive ability, associative and implicit learning, language skills, and executive functions as well as atypical patterns of cortical and white matter development-domains that should be profoundly influenced by deprivation through the learning and neural mechanisms we propose. These patterns of atypical development are difficult to explain with existing models that emphasize stress pathways and accelerated limbic system development. A learning account of how deprived early environments influence cognitive and neural development provides a complementary perspective to stress models and highlights novel pathways through which deprivation might confer risk for internalizing and externalizing psychopathology. We end by reviewing evidence for plasticity in cognitive and neural development among children raised in deprived environments following interventions that improve caregiving quality.

False Belief Performance of Children Adopted Internationally

PURPOSE

The purpose of this study was to explore relationships among adoption, individual, and family variables on false belief performance of children adopted internationally (CAI).

METHOD

Using a quasiexperimental design, thirty-five 4-year-old children adopted from Asian and Eastern European countries before age 2 years were compared with a U.S. group of 33 nonadopted 4-year-old children on a standardized English-language measure, 3 false belief tasks, and a go/no-go inhibition measure.

RESULTS

The adopted group differed significantly from the U.S. nonadopted group in expressive language and false belief performance. For the adopted group, inhibition measures were significantly correlated with core language scores. Core language scores and number of older siblings predicted false belief performance.

CONCLUSIONS

Similar to children who are not adopted, language competence and living with older siblings positively influenced social understanding in CAI. Because CAI experience interrupted language acquisition and live with fewer older siblings, they are at risk of having weaker language competence and social understanding in their adopted language. When working with CAI, practitioners should assess social communication, language competence, and inhibition skills. They should assist adoptive families in providing socially mentored opportunities for their children to observe and interact with older children.

Optimizing Surgical Treatment of Internationally Adopted Children with Cleft Lip and/or Palate: Understanding the Family Experience

Objective

To understand the experience of families with children undergoing cleft surgery following adoption from a country outside the United States. To identify factors, including the timing of surgery, that influence family function throughout the surgical experience.

Design

Semistructured qualitative interviews were conducted with parents of internationally adopted children postrepair of cleft lip and/or cleft palate and coded by a multidisciplinary study team. Mixed methods were used to contextualize themes derived from the parent interviews.

Results

Twenty parent interviews were conducted, and four core themes were identified: (1) parental anxieties prior to surgery, (2) considerations for the timing of surgery, (3) impact of the surgical experience on the child and family, and (4) modifiable sociocontextual factors. Parents considered a strong child bond with at least one parent and the ability of the child to communicate basic needs to be important before undergoing surgery. In retrospect, parents generally felt that the surgical experience did not have a negative impact on their child or their families and that the surgical experience may have even facilitated bonding and attachment with their child. Acceleration of family bonding was expressed more often by parents of children who were adopted at older than 2 years.

Conclusions

In our study, parents reported that cleft surgery soon after international adoption did not appear to impair child bonding or adjustment. Specific family and provider factors that could optimize the experience for families were identified.

Executive Function in Previously Institutionalized Children

In studies of children adopted from institutions, being raised in an institution has been associated consistently with an increased risk of persistent cognitive, academic, and social-emotional problems. These findings raise questions about the neurocognitive mechanisms that contribute to these negative outcomes. Theory and models based on studies of animals indicate that development of the prefrontal cortex (PFC) and executive function (EF) may be particularly susceptible to environmental influences during early childhood. In this article, we review recent studies of postinstitutionalized children that examined EF components such as inhibitory control, working memory, shifting, and planning. We then describe emerging research on the structure and function of the PFC. Converging evidence suggests both EF difficulties and alterations in development of the PFC following early institutionalization. We conclude by discussing possible explanations for these findings and implications for prevention and intervention, and by offering suggestions for ongoing research.

Language development of internationally adopted children: Adverse early experiences outweigh the age of acquisition effect

We compared English language and cognitive skills between internationally adopted children (IA; mean age at adoption=2.24, SD=1.8) and their non-adopted peers from the US reared in biological families (BF) at two time points. We also examined the relationships between outcome measures and age at initial institutionalization, length of institutionalization, and age at adoption. On measures of general language, early literacy, and non-verbal IQ, the IA group performed significantly below their age-peers reared in biological families at both time points, but the group differences disappeared on receptive vocabulary and kindergarten concept knowledge at the second time point. Furthermore, the majority of children reached normative age expectations between 1 and 2 years post-adoption on all standardized measures. Although the age at adoption, age of institutionalization, length of institutionalization, and time in the adoptive family all demonstrated significant correlations with one or more outcome measures, the negative relationship between length of institutionalization and child outcomes remained most robust after controlling for the other variables. Results point to much flexibility and resilience in children's capacity for language acquisition as well as the potential primacy of length of institutionalization in explaining individual variation in IA children's outcomes.

LEARNING OUTCOMES

(1) Readers will be able to understand the importance of pre-adoption environment on language and early literacy development in internationally adopted children. (2) Readers will be able to compare the strength of the association between the length of institutionalization and language outcomes with the strength of the association between the latter and the age at adoption. (3) Readers will be able to understand that internationally adopted children are able to reach age expectations on expressive and receptive language measures despite adverse early experiences and a replacement of their first language with an adoptive language.

Internationally Adopted Children in the Early School Years: Relative Strengths and Weaknesses in Language Abilities

Purpose

This study aimed to determine the relative strengths and weaknesses in language and verbal short-term memory abilities of school-age children who were adopted from Eastern Europe.

Method

Children adopted between 1;0 and 4;11 (years;months) of age were assessed with the Clinical Evaluation of Language Fundamentals—Preschool, Second Edition (CELF–P2) and the Clinical Evaluation of Language Fundamentals, Fourth Edition (CELF–4) at age 5 and ages 6–7. Language composites and subtests were compared across time.

Results

All CELF–P2 and CELF–4 mean scores fell in the average range. Receptive composites were 102.74 and 103.86, and expressive composites were 100.58 and 98.42, at age 5 and ages 6–7, respectively. Age of adoption did not correlate to test scores. At ages 6–7, receptive language, sentence formulation, and vocabulary were areas of strength, with subtest scores significantly better than test norms. Verbal short-term memory and expressive grammar subtest scores were within the average range but significantly worse than test norms. A high percentage of children scored 1 standard deviation below the mean on these 2 subtests (27.3%–34.1%).

Conclusion

Eastern European adoptees had average scores on a variety of language tests. Vocabulary was a relative strength; enriching the environment substantially improved this language area. Verbal short-term memory and expressive grammar were relative weaknesses. Children learning a language later in life may have difficulty with verbal short-term memory, which leads to weaknesses in expressive syntax and grammar.

Language and memory abilities of internationally adopted children from China: evidence for early age effects

The goal of the present study was to examine if internationally adopted (IA) children from China (M = 10;8) adopted by French-speaking families exhibit lags in verbal memory in addition to lags in verbal abilities documented in previous studies (Gauthier & Genesee, 2011). Tests assessing verbal and non-verbal memory, language, non-verbal cognitive ability, and socio-emotional development were administered to thirty adoptees. Their results were compared to those of thirty non-adopted monolingual French-speaking children matched on age, gender, and socioeconomic status. The IA children scored significantly lower than the controls on language, verbal short-term memory, verbal working memory, and verbal long-term memory. No group differences were found on non-verbal memory, non-verbal cognitive ability, and socio-emotional development, suggesting language-specific difficulties. Despite extended exposure to French, adoptees may experience language difficulties due to limitations in verbal memory, possibly as a result of their delayed exposure to that language and/or attrition of the birth language.

A Longitudinal Study of Language and Speech in Children Who Were Internationally Adopted at Different Ages

Purpose

The author followed 56 internationally adopted children during the first 3 years after adoption to determine how and when they reached age-expected language proficiency in Standard American English. The influence of age of adoption was measured, along with the relationship between early and later language and speech outcomes.

Method

Children adopted from Eastern Europe at ages 12 months to 4 years, 11 months, were assessed 5 times across 3 years. Norm-referenced measures of receptive and expressive language and articulation were compared over time. In addition, mean length of utterance (MLU) was measured.

Results

Across all children, receptive language reached age-expected levels more quickly than expressive language. Children adopted at ages 1 and 2 “caught up” more quickly than children adopted at ages 3 and 4. Three years after adoption, there was no difference in test scores across age of adoption groups, and the percentage of children with language or speech delays matched population estimates. MLU was within the average range 3 years after adoption but significantly lower than other language test scores.

Conclusions

Three years after adoption, age of adoption did not influence language or speech outcomes, and most children reached age-expected language levels. Expressive syntax as measured by MLU was an area of relative weakness.

Microstructural abnormalities in language and limbic pathways in orphanage-reared children: a diffusion tensor imaging study

This study utilized diffusion tensor imaging fiber tractography to examine the miscrostructural integrity of limbic and paralimbic white matter tracts in 36 children (age M = 124 months) with histories of early deprivation, raised from birth in orphanages and subsequently adopted into the United States, compared to 16 age-matched typically developing children. We found increased mean diffusivity bilaterally in the arcuate fasciculus and increased mean diffusivity and reduced fractional anisotropy bilaterally in the uncinate fasciculus and cingulum in children with early deprivation. Microstructural integrity of the left arcuate fasciculus and right cingulum was related to language and behavioral functioning, respectively. White matter abnormalities were also associated with length of deprivation and time in the adoptive home. Our findings suggest that white matter pathways, connecting limbic and paralimbic brain regions is abnormal in children with histories of early deprivation, with some pathways appearing more susceptible to early deprivation than others.

Phonological processing skills of children adopted internationally

PURPOSE

In recent years, large numbers of children have been adopted from abroad into the United States. This has prompted an interest in understanding and improving the developmental outcomes for these children. Although a growing number of studies have investigated the early language development of children who have been adopted internationally, few have focused specifically on the phonological processing development of this group of children, even though it is widely acknowledged that phonological processing skills are important in language and literacy acquisition. The purpose of this study was to examine the phonological processing skills of a group of children who had been adopted from China into the United States.

METHOD

The participants were 45 children who had been adopted from China ( M age at adoption = 13.09 months). The children were assessed between the ages of 6;10 (years;months) and 9;4. Their phonological processing skills, spoken language skills, and reading comprehension skills were assessed using norm-referenced measures.

RESULTS

Overall, the majority of children scored at or above the average ranges across measures of phonological awareness, phonological memory, and rapid naming. The children's reading comprehension scores were moderately to highly correlated with their phonological processing scores, but age at the time of adoption was not highly correlated with phonological processing or reading comprehension.

CONCLUSION

The findings of the current study provide a basis for an optimistic view regarding the later language and literacy development of school-age children who were internationally adopted by the age of 2 years.

Attention and language as mediators of academic outcomes following early psychosocial deprivation

Children adopted from institutions at older ages are at increased risk of persistent attention problems, lower cognition, and academic difficulties. This study examined cognitive and behavior problems as mediators of the association between early psychosocial deprivation and academic functioning. Participants were 8–17-year-old children adopted from psychosocially-depriving Russian institutions after 14 months of age ( n = 34) and before 9 months of age ( n = 39). Children completed a cognitive assessment, while their parents completed questionnaires on child behavior problems and use of learning support services in school. Children adopted after 14 months were found to have significantly lower vocabulary, higher levels of attention problems, and higher rates of using learning support services relative to children adopted before 9 months after controlling for age at assessment. The two groups did not differ significantly in nonverbal reasoning, anxiety, or oppositional behavior. Attention and vocabulary significantly mediated the association of early psychosocial deprivation with the use of learning support services. These findings suggest that interventions targeting attention regulatory and language skills may be beneficial in terms of improving school performance in this population.

Inhibitory control and working memory in post-institutionalized children

Inhibitory control and working memory were examined in post-institutionalized (PI) children adopted into United States families from Russian institutions. The PI sample originated from institutions that were less severely depriving than those represented in previous studies and approximated the level of psychosocial deprivation, which is characterized by adequate physical resources but a lack of consistent and responsive caregiving. PI children (N = 75; 29 male) ranged in age from 8-17 years (M = 12.97; SD = 3.03) and were grouped according to whether they were adopted after 14 months or before 9 months. A non-adopted comparison group (N = 133; 65 male) ranged in age from 8-17 years (M = 12.26; SD = 2.75). PI children adopted after 14 months of age displayed poorer performance on the stop-signal and spatial span tasks relative to PI children adopted before 9 months of age after controlling for age at assessment. The two PI groups did not differ in their performance on a spatial self-ordered search task. Older-adopted PI children also showed poorer spatial span task performance compared to non-adopted children, but younger-adopted PI children did not. Task performance was significantly associated with parent-rated hyperactive-impulsive behavior in everyday contexts. These findings suggest that exposure to prolonged early institutional deprivation may be linked with inhibitory control and working memory difficulties years after adoption.