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December 1996

Romanian Adoption: The Manitoba Experience

Author Affiliations

From the Department of Pediatrics and Child Health, Section of Child Development (Drs Benoit, Jocelyn, and Moddemann), and Section of Infectious Diseases (Dr Embree), Children's Hospital, Health Sciences Centre, Winnipeg, Manitoba.

Arch Pediatr Adolesc Med. 1996;150(12):1278-1282. doi:10.1001/archpedi.1996.02170370056008

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.Arch Pediatr Adolesc Med. 1996;150:1278-1282