ABSTRACT
The first months and years of life have a critical impact on children’s later functioning, and deprivation during this developmental period can have significant and lasting consequences. This chapter discusses the development of children who were adopted from institutional care at a relatively older age (e.g., older than six months of age from a globally depriving institution, or older than 18 months of age from a socially-emotionally depriving institution). Quality of care and duration of exposure to institutional conditions are identified as key factors in determining children’s later outcomes. Prolonged institutional care is frequently associated with deficits in executive function and attention, social problems and attachment difficulties, externalizing and internalizing behavior problems, quasi-autistic behaviors, abnormal hypothalamic-pituitary-adrenal (HPA) axis activity, and stunted growth, with more severe deprivation and/or longer duration of institutional care associated with more pronounced problems. Factors contributing to some children’s resilience in the face of prolonged institutional care, the developmental course of symptoms, and matters related to timing of deprivation are also explored. Finally, this literature is discussed with regard to its implications for adoption-related policy and interventions both prior to and after adoption.
