Johnson Dana E. MD PhD; Dole,, Kathryn MS, OTRInfants & Young Children: April 1999 Original Article: PDF Only Abstract Over the past decade, the health and well-being of international adoptees have deteriorated significantly. Reasons for these changes include increased placements of children from economically troubled countries and a shift from foster to institutional care prior to adoption. Institutionalized children are at risk for a number of medical problems. However, developmental delays are far more common, particularly in children confined for more than 6 to 8 months within an orphanage. Early intervention programs play an important role in identifying these problems, rehabilitating the child, and supporting the family through this stressful period of parenting. ©1999Aspen Publishers, Inc.