Romanian adoption. The Manitoba experience
T. C. Benoit, L. J. Jocelyn, D. M. Moddemann and J. E. Embree
Department of Pediatrics and Child Health, Children's Hospital, Health Sciences Centre, Winnipeg, Manitoba.
OBJECTIVE: To study the developmental, behavioral, and medical features in
a cohort of Romanian children adopted by Manitoba families. DESIGN: A
prospective longitudinal study. SETTING: The Child Development Clinic,
Children's Hospital, Winnipeg, Manitoba, from September 1990 to June 1992.
PATIENTS: Developmental, behavioral, and medical features were assessed in
22 Romanian children adopted by 18 Manitoba families. RESULTS: Mean (+/-
SD) age at adoption was 15.5 +/- 13 months. Mean (+/- SD) age at initial
assessment was 19 +/- 12 months and at follow-up, 35 +/- 13 months. Medical
complications included 6 children (27%) who were positive for the hepatitis
B surface antigen, 5 with intestinal parasites (23%), 1 positive for the
human immunodeficiency virus, 1 with rickets (5%), and 1 with monoplegia
and cleft palate (5%). Initial growth parameters were less than the fifth
percentile for age for head circumference in 10 children (45%), for weight
in 8 (36%), and for height in 7 (32%). At follow-up, statistically
significant improvement was seen in height and weight. Initial mean (+/-
SD) developmental quotients were 82 +/- 20 for gross motor, 83 +/- 23 for
fine motor, 83 +/- 19 for cognitive, and 79 +/- 18 for language domains.
Follow-up mean developmental quotients improved in all domains (P <
.05). Twelve children (55%) displayed abnormal behavior at the initial
assessment; behavioral findings persisted in 8 (36%). Initial appropriate
activity level and play behavior predicted normal cognitive outcome (P <
.05). CONCLUSIONS: This longitudinal study of Romanian adoptees delineates
improvements in growth and development once the children are placed in a
nurturing environment. The persistence of abnormal behavior in some
children underscores the importance of further follow-up.
