Developmental and nutritional status of internationally adopted children

L. C. Miller, M. T. Kiernan, M. I. Mathers and M. Klein-Gitelman
Department of Pediatrics, Floating Hospital for Children, New England Medical Center, Boston, Mass.

OBJECTIVES: To assess the relationship between developmental status of international adoptees at the time of entry into the United States and their nutritional status and concurrent medical problems. DESIGN: Prospective study. SETTING/PATIENTS: One hundred twenty-nine internationally adopted children attending the International Adoption Clinic at the Floating Hospital for Children, Boston, Mass, underwent detailed developmental assessments, anthropometric measurements, and medical examinations. RESULTS: The anthropometric measurements of the international adoptees were below the means for weight, height, and head circumference based on standards of the World Health Organization. Only 65 children (50%) were developmentally normal. Gross motor delays were identified in 43 children (33%), fine motor delays in 52 (40%), language delays in 23 (18%), cognitive delays in 21 (16%), and global delays in 18 (14%). The severity of delays were related to z scores for weight, height, and head circumference. The 36 children with medical problems had lower z scores compared with healthy children and were more likely to have delayed development. CONCLUSIONS: Careful developmental and growth screening of internationally adopted children at entry into the United States identifies adopted children at entry interventions and close follow-up. Longitudinal studies of internationally adopted children may provide evidence about the reversibility of growth and developmental delays, findings applicable to any environmentally deprived child.

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