Long-term developmental, behavioral, and attachment outcomes after international adoption

Children who are adopted internationally typically experience a wide range of life circumstances before joining their families that may have an impact their postadoptive health and development. All children, whether joining their families via adoption or via birth, have individual genetic and environmental strengths and challenges that may support or stress their capacity for healthy cognitive, behavioral, and emotional development over time [1]. Health and living conditions in children's home countries and child welfare systems experienced by internationally adopted children have changed greatly over the past several decades, partially because an increasing number of international adoptees have resided in institutions rather than foster care before their adoption into families. Reflecting the importance of this demographic change, this article highlights the potential impact of children's institutional living on their development, behavior, and attachment after international adoption. Because immediate developmental and behavioral concerns after adoption (see the article by Miller elsewhere in this issue) and an approach to assessment and accessing services for developmental and behavioral concerns (see the articles by Nalven and Dole elsewhere in this issue) are discussed elsewhere in this issue, our discussion focuses on the results of reported long-term follow-up studies examining developmental, behavioral, and attachment outcomes after intemational adoption.