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Infants' Physical and Cognitive Development After International Adoption From Foster Care or Institutions in China

van den Dries, Linda MA; Juffer, Femmie PhD; van IJzendoorn, Marinus H. PhD; Bakermans-Kranenburg, Marian J. PhD

Journal of Developmental & Behavioral Pediatrics: February-March 2010 - Volume 31 - Issue 2 - p 144-150
doi: 10.1097/DBP.0b013e3181cdaa3a
Original Articles

Objective: To compare the physical, cognitive, and motor development of infants adopted from foster care with infants adopted from institutions.

Method: Forty-two formerly fostered and 50 post-institutionalized girls adopted from China, aged between 11 and 16 months on arrival, were visited 2 and 6 months after adoption. Children's height, weight, and head circumference were measured. Stress regulation was assessed by diurnal salivary cortisol levels, and cognitive and motor development were assessed using the Bayley Scales of Infant Development—second edition.

Results: At both assessments, the (modest) physical growth delays were similar for formerly fostered and post-institutionalized children. For weight and head circumference (but not for height) a catch-up over time was found, with a significant interaction between time and age at arrival, showing a more rapid catch-up for earlier adopted children. The daily cortisol curves of the formerly fostered and post-institutionalized children were similar and did not change over time. At both assessments, the former foster children outperformed the post-institutionalized children on mental and motor skills. Both groups showed a similar catch-up for mental development. For motor development, no catch-up was found.

Conclusions: The influence of pre-adoption foster versus institutional rearing seems more pronounced for cognitive and motor development than for physical development and hormonal stress regulation. Our outcomes suggest that pre-adoption foster care is less detrimental to children's cognitive and motor development than institutional rearing.

From the Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands.

Received September 15, 2009; accepted December 1, 2009.

This study was supported by a grant from the Netherlands Organization for Scientific Research (NWO 400-03-208) (to F.J., M.H.v.IJ, and M.J.B-K). Femmie Juffer is supported by Wereldkinderen. Marinus van IJzendoorn and Marian Bakermans-Kranenburg are supported by the Netherlands Organization for Scientific Research (SPINOZA prize and VIDI grant, respectively).

Address for reprints: Femmie Juffer, PhD, Leiden University, Centre for Child and Family Studies, P.O. Box 9555, 2300 RB Leiden, The Netherlands; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.