Developmental and nutritional status of internationally adopted children

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.

Prospective study.

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.

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.

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.