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8/3/2019 Behavior Study
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Parental Assessment of Behavior in Chinese Adoptees During Early Childhood
Jay W. Rojewski, Ph.D.
Department of Occupational Studies
University of Georgia
Michael S. Shapiro, Ph.D.
Michael S. Shapiro and Associates, PC
Piedmont College
Athens, Georgia
Mary Shapiro, Ph.D.
Michael S. Shapiro and Associates, PC
Piedmont College
Athens, Georgia
All correspondence concerning this manuscript should be addressed to Dr. Jay W. Rojewski, Department
of Occupational Studies, University of Georgia, 210 Rivers Crossing, Athens, GA 30602 (706.542.4461;
e-mail: [email protected]).
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Abstract
The Parent Rating Scale of the Behavior Assessment Scale for Children (PRS-BASC) was used to
examine the behavior of 45 Chinese adoptees. In all but one case, results from the 9 BASC-PRS scales
ranged in the average, or normal, range. Thus, as a group, no deviations from normal behavior were
revealed. However, the variability of ratings for several scalesHyperactivity, Aggression, Conduct
Problems, and Attention Problemsindicated a greater potential for at-risk behavior. Age of adoption
from China was not a significant influence on parents perceptions of adoptees behavior. However, older
adoptees were more likely to be rated hyperactive or aggressive than younger children, while younger
adoptees were more likely to exhibit withdrawal.
KEY WORDS: Intercountry Adoption, Chinese Adoptees, Child Behavior.
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Parental Assessment of Behavior in Chinese Adoptees During Early Childhood
Today, adoption is viewed as a viable alternative for building a family. However, it has only been since
the end of World War II that the negative stigma associated with adoption has diminished.1
Ironically, as
the interest in adoption increased, the availability of healthy adoptable babies and young children in the
United States (and other industrialized Western countries) decreased due to falling birth rates and growing
social acceptance of single parenthood. As a result, many adoptive couples began to look to other
countries and cultures for adoptive children.2, 3
International adoption, also referred to as intercountry adoption (ICA), was popularized after the
Korean War when extensive efforts were initiated to bring orphaned and abandoned South Korean
children to the United States.4
Around this time, international adoption was largely motivated by the
adoptive parents desire to rescue abandoned children (p. 84).2
While many couples still cite religious and
humanitarian reasons for adopting internationally, more recent interest has increased among couples
primarily motivated by infertility. Regardless of adoptive couples motives, international adoption has
steadily increased over the past decade to where now the practice is a permanent part of American
culture.3, 5, 6
For example, in 1989, a total of 7,948 intercountry adoptions were recorded by the U.S.
Immigration and Naturalization Service.7
This figure almost doubled to 15,774 in the 1998 calendar year.
While many countries are represented in U.S. intercountry adoptions, a majority of adoptees come from
Asia, Central America, and South America.8
One country where international adoption has received increased attention over the past several years
is China. Given Chinas one childpolicy to control population growth and an historical preference for sons
to support and care for parents in old age, many female children are abandoned in hopes of giving birth to
a male child.9,10
As a result, the number of girls in state-run orphanages has swelled dramatically during
the past decade. In an effort to relieve some of the pressures associated with this extremely complex and
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difficult situation, the Chinese government allows the international adoption of abandoned girls.6
Adoption
of Chinese children by U.S. families has grown from 201 in 1992 to 4,206 in 1998.7
According to INS
immigration visa records, a total of 14,749 Chinese children have been adopted by U.S. parents from 1985
through 1998.11
Research on international adoption by U.S. families is limited, although a fair number of studies have
been carried out in Europe [Unfortunately,] most are not available in English and many are not
published (p. 747).3
Available research has tended to focus on the initial and long-term adjustment of
adopted children and their familiesKorean adoptees in the 1970s and a more diverse population including
Vietnamese and Colombian adoptees in the 1980s. Although much of the early research reports generally
positive outcomes, empirical findings on the adjustment of international adoptees is still inconclusive and, at
times, contradictory.4
Some studies have shown that functioning levels of intercountry adoptees do not significantly differ
from nonadopted or domestically adopted children. A nationwide study by Kim12
examined the long-term
adjustment of Korean adoptees in the U.S. focusing on identity and socialization patterns. Korean
adoptees were found to progress well in all areas of life, report a positive self-concept, and did not
experience any serious mental health problems. Bagley8
reported that Korean adoptees exhibit very good
patterns of adjustment and high academic achievement. Recently, Levy-Shiff, Zoran, and Shulman13
found
no significant differences in the school adjustment, psychological adjustment at home (e.g., anxiety,
depression, hyperactivity, and self-concept), or ability to cope with adoption issues between international
and domestic adoptees in a sample of 100 Israeli families. Tizard3
provided an extensive summary of
additional studies that have reported positive findings about the behavioral-emotional characteristics of
international adopteeschildren adopted from South Korea, Latin America, Thailand, Vietnam, India, and
other Asian countries (e.g., Hoksbergen,14
Kuhl15
).
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Other studies have reported less positive findings. Kim et al.1
reported that common behavioral
problems of young Korean adoptees included temper tantrums and excessive or frequent crying, especially
in children adopted before the age of 3 years. In children adopted after the age of 3, learning difficulties
and shyness-withdrawing behavior were the most common problems. Jenista and Chapman16
compared
adopted and nonadopted children referred for mental health counseling and found that behavioral and
emotional problems increased for adoptees as the childs age of placement increased. Even then, however,
reported problems usually fell within the normal ranges of all children clinically referred.
Verhulst, Althaus, and Versluis-Den Bieman17
compared the prevalence of behavioral-emotional
problems and competencies of internationally adopted children living in the Netherlands with nonadopted
Dutch children and found that adopted boys, ages 12-15 years, exhibited higher rates of externalized
behavior problemshyperactivity and delinquency. In a follow-up study, Verhulst and Versluis-Den
Bieman18
continued to see a significant increase in maladaptive behaviorsparticularly withdrawn and
delinquent behaviorand a decrease in competencies of ICA adolescents. The authors were not able to
attribute these problem behaviors to the age or medical condition of the child at placement, early abuse or
neglect, or racial antagonism. Hoksbergen19 also reported increased behavior problems in his study of
international adopteeshigher rates of internalized behavior problems for girls and externalized behavior
problems for boys. In general, problem behaviors were most likely to be found in adolescents rather than
younger children.3
It is important to remember that for a majority of international adoptees outcomes are positive; they
have close and mutually satisfying relationships with their parents and are as successful as other adoptive
families.5
When difficulties do occur they are often attributable to children who were adopted at a
relatively late age or as a consequence of early traumatic experiences.3
Despite the increasing numbers of ICA adoptions, including those of Chinese children, by U.S.
families, relatively little is known about the scientific, psychological, or social issues surrounding these
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children and the adoption process. Therefore, our purpose in this study was to profile select behavioral
characteristics of young Chinese adoptees. The information provided may contribute to an emerging
understanding of the demographic, psychological, and social characteristics of Chinese adoptees. In
addition, knowledge can be used to address the general lack of awareness and understanding about (1) the
theoretical relevance, (2) potential applied and policy issues, and (3) developmental trajectories of social
relations and attachment patterns currently associated with intercountry adoption.2
Given the contradictory
nature of the literature, it was difficult to establish a priori hypotheses, although the trend toward finding
increased behavioral-emotional problems during adolescence influenced our belief that relatively fewer
behavioral problems would be encountered with young Chinese adoptees.
Method
Participants
A total of 61 research packets were mailed to adoptive families who had adopted children from China
within the past 5 years and completed their adoptions through a state-licensed, church-sponsored agency
located in the Southeast. Only parents with adopted children 2 years of age or older were included in the
original data pool. A total of 44 families returned completed research materials representing a 71.1%
return rate. Responding families resided throughout the United States. All parents were Caucasian and
between the ages of 35-50 years. Most families were in middle or upper socioeconomic levels.
Responses for 45 children (1 family had two children adopted from China) were included in the final
data pool including 39 females and 6 males. Thirty-eight children were under the age of 6 years (female, n
= 33; male, n = 5), while 7 children (female, n = 6; male, n = 1) were 6 years of age or older. The mean
current age of adoptees was slightly under 4 years of age (M= 46.9 months, SD = 19.1,Mdn = 43.0) with
ages ranging from 22 months to 116 months (9 years, 8 months) of age. The mean age at adoption was
found to be 21.7 months (SD = 17.9), although the median of 15.0 months may provide a more accurate
description of the sample as 86.7% of children were adopted on or before their 3rd birthday. Ages at
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adoption ranged from 1 month to 84 months (7 years). The average length of time adoptees had spent in
their adoptive homes was 25.5 months (SD = 15.6) ranging from a low of 3 months to a high of 62 months
(4 years, 2 months.). Interestingly, the mode of 38 months (3 years, 2 months) was reported by 20% of the
sample (n = 9).
Instrumentation
The Parent Rating Scale (PRS) of the Behavior Assessment System for Children (BASC)20
was used
to collect data regarding parental perceptions of adoptees behavior. The BASC provides a multimethod,
multidimensional assessment of emotional disorders, personality constructs, and behavioral problems of
children. The BASC contains five separate components that can be used individually or in any combination
including a childs self-report scale (for older children), parent rating scale, teacher rating scale, structured
developmental history, and a system for recording directly observed behavior.21
The PRS contains 131
items that measure parents perceptions of their childs adaptive and problem (clinical) behaviors in
community and home settings. Three forms are available for different age groupspreschool, child and
adolescent. The PRS uses a four-choice response format ranging from neverto almost always and takes
approximately 15-20 minutes to complete.
The following 9 clinical scales were used: Aggression, Anxiety, Attention Problems, Atypicality
(psychoticism), Conduct Problems, Depression, Hyperactivity, Somatization, and Withdrawl. The
Hyperactivity, Aggression, and Conduct Problems scales can be combined to reflect an Externalizing
Problems composite score. Hyperactivity refers to the tendency to be overly active, rush through activities,
and act impulsively. Aggression is defined as verbal or physical behavior that is hostile or threatening to
others. Conduct Problems consist of antisocial or rule -breaking behaviors including the destruction of
property (scores are available only for children 6 years of age or older). Internalizing Problems are
reflected in results of Anxiety, Depression, and Somatization scales. Anxiety is a tendency to be nervous,
fearful, or worried about real or imagined problems. Depression includes feelings of unhappiness, sadness,
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or stress that bring about an inability to carry out daily activities or bring on thoughts of suicide.
Somatization describes being overly sensitive to relatively minor physical problems or discomforts. Three
additional scalesAttention Problems, Atypicality, and Withdrawlwere also included for analysis.
Attention Problems denote a tendency to be easily distracted and unable to concentrate for extended
periods. Atypicality refers to immature behavior considered odd or associated with psychosis. Withdrawl is
the tendency to avoid social contact.21
The BASC has generally received high marks as a reliable instrument. Past studies on the reliability of
the PRS, in particular, have found internal consistency coefficients ranging from the low .60s to the high
.80s with median correlations near .80. Merenda22
indicated that in general, the coefficients of internal
consistency [for the BASC] are quite impressive . . . at least half of them are in the range .80-.89 (p.
231). Test-retest estimates are less impressive, although most studies have reported correlations ranging
from around .70 to .90. Sandoval and Echandia23
urged users to exercise caution when using the BASC
with preschool children as instrument reliability scores tended to be lower. Reasonable evidence of
instrument validity has been established in several studies showing moderate correlations with similar types
of scales, e.g., Conners Rating Scales, and the Revised Behavior Problem Checklist.24
Reynolds and
Kamphaus20
reported the results of both exploratory and confirmatory factor analyses for the PRS that
provide additional evidence of the underlying structure (i.e., validity) of BASC results.
The BASC provides two major types of norms for the PRS, general and clinical. The general norms
were used in this study and are considered representative of the general U.S. population. PRS norms are
based on maternal ratings only; relatively small differences exist between mothers and fathers scores.24
Norms are subdivided by age and gender to reflect actual differences reported between males and
females. Specifically, females tend to score higher on the Depression scale, while males tend to obtain
higher scores on Aggression, Conduct Problems, Hyperactivity, and Attention Problems. Reynolds and
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Kamphaus20, 21
recommended using the general (combined) norms for most situations to allow these
gender differences to be reflected in normative scores
Prior to the interpretation of an individuals results, the raw scores on the BASC-PRS are
standardized by calculating raw scores for each behavior scale into linear T-scores (M= 50, SD = 10).
This procedure is advisable because many of the constructs being measured are . . . not normally
distributed, and this metric preserves underlying dimensions (p. 422).23
The T-score range, 41-59 T, is
considered average. Conversely, T-scores of 60-69 Tare considered within the at-riskrange, while scores
greater than 70 Tare deemed clinically significant. Percentile equivalent scores are also provided for all
standardized scores.20,24
Procedure
A copy of the computer-scored BASC-PRS (1 page front and back) was included in a packet of
information sent by the adoption agency to all parents who had adopted children from China in the past 5
years and whose child was 2 years of age or older at the time of the investigation. The packet contained
information about a planned China families reunion weekend sponsored by the agency and scheduled for
later in the year. A cover letter informed participants about the behavior scale and that information
obtained from the BASC was being used in preparation for several workshops scheduled as a part of the
reunion weekend. Confidentiality of response was assured to all participants. A period of four-weeks was
established for receiving responses, at which time data collection ceased. Reminders to respond to the
instrument were included in several agency mailings that offered additional information about the summer
reunion.
Data Analysis
Several analyses were chosen to address our research questions. First, the entire sample was used to
calculate descriptive statistics for parent responses to the 9 BASC scales. In addition to an overall
description, we examined scores by gender as differences in behavior between male and female children
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have been reported.20,21,24
Next, we removed male adoptees scores from the remainder of our analysis as
males represented a small proportion of our sample (n = 6). The small number of male adoptees in our
sample reflects the current situation regarding adoption from China, i.e., the vast majority of children
adopted from China are female.9,10,6
While the removal of male adoptees scores did reduce our overall
sample size, the remaining pool of female scores can be interpreted without the potentially confounding
influence of gender and also reflects the fact that most Chines adoptees are female.
The final analysis included three sets of comparisons designed to examine parent ratings of adoptees
behavior on the 9 BASC scales (dependent variables) based on three independent variables: age of child at
adoption (2 groupschildren adopted before 18 months of age or after 18 months of age); current age of
adoptees (2 groupschildren 3 years of age or younger and those over 3 years of age); and, the length of
time since placement with adoptive family (2 groupschildren in adoptive homes less than 2 years or
those longer than 2 years). Only 2 groups were constructed for each set of statistical comparisons
primarily because of the small sample size. The alpha level for significance tests was set at .05, even
though this raised the possibility of Type I error because of probability pyramiding. The decision was made
because of the exploratory nature of this research and our desire to identify differences if they existed.
Effect size (ES) coefficients (Cohens d, standardized difference) were calculated for statistically
significant comparisons to examine the magnitude, or practical importance, of observed differences.
Knowledge of effect size can help clarify the implications that statistically significant results have for
theory and practice.25
Results
Description of Adoptees Behaviors
Descriptive data was generated for the entire sample, as well as by gender. However, since only a
small number of males were represented, these findings must be interpreted with caution. Even so, we felt
it was important to include data about male adoptees because of a lack of available literature describing
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adopted children from China. Using Reynolds and Kamphaus20
guidelines for interpretation, all but one of
the BASC-PRS scales ranged in the average, or normal, range. Thus, as a group, no deviations from
normal behavior were revealed (see Table 1). However, when looking at the variability of scores (using
1 SD to account for roughly 68% of the sample), ratings for several scalesHyperactivity, Aggression,
Conduct problems, and Attention problemsindicate greater potential for at-risk behavior (see Fig. 1).
Table 1
Parental Ratings (T-Scores) of Childrens Behavior on 9 BASC Scales
BASC scales Female Male Total
M SD %-tile M SD %-tile M SD %-tile
Hyperactivity 46.92 11.87 43rd
54.33 13.92 69th
47.91 12.26 46th
Aggression 47.97 10.28 47th
50.00 11.98 55th
48.24 10.40 47th
Conduct problemsa
52.00
15.40 67th
60.00
86th
53.14 14.38 70th
Anxiety 44.92 7.45 32nd
44.17 6.79 32nd
44.82 7.29 32nd
Depression 45.54 8.34 35th
45.00 9.47 35th
45.47 8.38 35th
Somatization 46.03 9.85 36th
39.50 4.46 17th
45.16 9.54 36th
Atypicality 47.97 8.75 50th
47.00 9.82 50th
47.84 8.79 50th
Withdrawl 49.85 10.31 52nd 39.33 9.18 12th 48.31 10.82 47th
Attention problems 45.79 10.57 33rd
54.83 11.57 54th
47.00 11.01 37th
Note. Some percentile scores have been rounded or estimated to accommodate use ofT-scores rather
than raw scores.aScores for Conduct Problems were available only for children 6 years of age or older (n
= 6 for females, n = 1 for males).
Scales indicating slightly elevated risk of behavior problems. While none of the mean ratings fell into
at-risk or clinically significant categories, four scales had enough score variability to indicate the presence
of an elevated risk of behavior problems. Hyperactivity T-scores ranged from 23 to 76 T. The mean score
for boys was approximately three-fourths a standard deviation higher than for girls. Additionally, when
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score variability was considered, boys were at a higher risk of being identified as hyperactive. Eight
adoptees scores were rated at or above the at-riskthreshold, T 60 (female, n = 6; male, n = 2).
BASC-PRS scales
Figure 1. Mean T-scores and standard deviations on BASC-PRS clinical scales for children from China.
As a group, parent ratings of aggressive behavior were within normal limits. Scores ranged from 33 to
73 Tand were similar for boys and girls. Five children (female, n = 4; male, n = 1) had scores above the
range reflecting normal behavior. It seems that when parents indicated aggressive behavior in their child,
they were likely to rate it as a serious concern. Four of these 5 children had Aggression scores that placed
them in the clinically significant range (T 70). As a group, boys were at slightly greater risk of being
identified as aggressive than girls.
Parents ratings on conduct-related behavior was obtained only for the 7 adoptees who were 6 years
of age or older; this may have been a contributing factor to the larger variability of scores observed for
girls. Only one boy was included in this group which did not allow for any meaningful comparison of mean
Conductproblems
(6+yearsofage)
Attentionproblems
10
20
30
40
50
60
70
80
90
100
Hyperactivity
Aggression
Anxiety
Depression
Somatizatio
Atypicality
Withdraw
At-risk range
Clinically significant
risk
T-scores
Female mean T-scores
and standard deviations
Male mean T-scores and
standard deviations
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scores based on gender. Two adoptees (female, n = 1; male, n = 1) had behavioral ratings that placed
them in the at-risk range for conduct problems.
Scores on the Attention problems scale ranged from 25 to 71 Twith the overall mean at the 37th
percentile. Boys had a considerably higher mean score on the Attention problems scale (+.82 SD) than
their female peers. Scores of 2 boys (out of 6) and 3 girls were situated in the at-risk range.
Scales within normal ranges of behavior. With only one exception, results on the remaining 5 BASC-
PRS scales are interesting for their similarities rather than differences. Mean scores on the Anxiety,
Depression, and Atypicality scales were almost identical for girls and boys, as was the variability of these
scores expressed in standard deviation units. Scores on the Anxiety scale ranged from 29 to 59 T. None
of the individual Anxiety ratings were at or above the at-risk threshold of 60 T. Depression scores ranged
from 30 to 71 T; although, the behavior of only one girl was rated high enough to be identified as at-risk.
Parent ratings on the Atypicality scale ranged from 29 to 79 Twith 2 scores in the at-risk range.
Ratings obtained for Somatization and Withdrawl scales were higher for boys than girls; the only two
with this response pattern. Scores on the Somatization scale ranged from 16 to 71 T. And, while the mean
Somatization score for girls was .69 SD greater than for boys, both ratings were within acceptable
behavior ranges. Only 3 scores, all girls, were above the specified range for normal behavior.
Scores for adopted girls on the Withdrawl scale were almost a full standard deviation higher than for
boys. This large difference can probably be attributed to several issuesa very low mean score for boys
located at the 12th percentile, and although not reflective in the overall distribution of scores (see Figure 1),
Scores for five girls were in the at-risk range and one was in the clinically significant risk range. Parent
perceptions on this behavior scale ranged from 25-71 T.
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Influence of Age on the Perceived Behavior of Girls Adopted form China
A series oft-tests were used to examine the possible influences of three variablesage of child at
time of adoption, current age of adoptees, and the length of time children had lived with their adoptive
familyon the behavior ratings of adoptees using to the 9 BASC scales as dependent variables.
Age at adoption. Two age groups were constructedchildren adopted before 18 months (n = 25) and
children adopted after 18 months of age (n = 13). None of the t-tests comparing these two groups on the 9
BASC-PRS scales were statistically significant at the .05 level. This seems to indicate that age of adoption
from China was not a significant influence on parents perceptions of adoptees behavior. The behaviors
of children were similar regardless of their age at the time of adoption.
Current age of adoptees. A second series of analyses examined perceived behaviors of adoptees
according to current age: 3 years of age or younger (n = 17) and over 3 years of age (n = 22). Results of
the t-tests revealed statistically significant differences on Hyperactivity, Aggression, and Withdrawl scales.
Although differences were noted, mean scores for both groups were still well within normal ranges for
behavior. Even so, the behavior of older adoptees was rated more hyperactive (M= 51.68) than that of
their younger peers (M= 40.76), t(37) = -3.17,p = .003. The magnitude of this difference was
substantial. AnES coefficient of 1.02 indicated that approximately 84% of younger children scored at or
below the mean score established for the older adoptees group. Similarly, older adoptees were rated higher
on the Aggression scale (M= 51.91) than younger adoptees (M= 42.88), t(37) = -2.99,p = .005,ES =
1.00. Conversely, younger children were rated significantly higher in withdrawl behavior (M= 53.82) than
their older peers (M= 46.77), t(37) = 2.23,p = .03,ES = .71.
Length of time with adoptive family. A final series oft-tests examined the potential differences
between children placed with their adoptive family for less than 2 years (n = 22) and those placed for
more than 2 years (n = 16). Statistically significant differences were found on the Hyperactivity,
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Aggression, and Somatization scales. Consistent with earlier findings, the mean scores of both groups
were within normal behavior ranges. Children placed over 2 years ago were rated higher on the
Hyperactivity scale (M= 51.63) than adoptees in their homes less than 2 years (M= 43.32), t(36) = -2.21,
p = .03,ES = .73. Likewise, children with longer residence had higher aggression scores (M= 52.19) than
children in their adoptive homes for shorter lengths of time (M= 45.23), t(36) = -2.14,p = .04,ES = .66.
Children placed with their adoptive family more than 2 years ago were also rated higher (M= 49.75) on
the Somatization scaleoverly sensitive to minor physical problemsthan children in adoptive homes for
2 years or less (M= 43.09), t(36) = -2.13,p = .04,ES = .77.
Discussion
This study sought to describe the behavior of young children, primarily preschoolers, adopted by U.S.
parents from China and to examine the potential influence of age and placement on behavior. The
importance of analyses like this one is the improved understanding they can bring to the practice of
intercountry adoption in general and to children adopted from China in particular. Even so, several
delimitations should be kept in mind as these results are interpreted. First, we measured and examined
parent perceptions of their adopted childs behavior. While parents perceptions are critical in determining
the appropriateness of behavior, other sources of information were not used. Future studies may
incorporate additional information sources such as childcare providers or social workers. Regardless of
how data was collected, the positive results described in this study cannot be used as a predictor of future
behavior. In fact, some researchers3,5
have indicated that most behavior problems in adopted children
occur during adolescence. Third, our results were obtained with a relatively small sample and may not be
reflective of the population of U.S. adopted children from China. However, many past ICA studies have
also relied on small sample sizes given the difficulty in locating and following up with adoptive
families.1,12,26
Finally, many issues of particular interest and importance in determining long-term behavior
of intercountry adopteescultural identity formation, self-concept, attachment and bonding, or experiences
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of racism and discriminationwere not addressed. Additional study is needed to provide information on
these issues.
Despite these potential constraints, we feel our results do contribute to a better understanding of the
behavior patterns of Chinese adoptees in early childhood. Data can be added to the existing literature on
ICAs to form a preliminary baseline of behavior and behavioral expectations for children from China; not
only for current adoptees but for future adoptees, as well.
Past literature1, 3, 5, 6, 8, 12
describes the vulnerability of intercountry adoptees to a variety of problems
including developmental delays, social difficulty, and behavioral/emotional problems as a result of maternal
deprivation and abandonment, lack of an attachment figure in country of origin, visible differences between
adoptive family and adoptee, racism-discrimination-prejudice, and concern or confusion with cultural
identify formation. Although these are important concerns and could contribute to behavior-related
problems, our results show that, in general, adoptees, regardless of their gender, did not deviate from
normally expected behaviors to a significant degree. These findings support the past work of researchers
like Kim12
who reported no significant behavioral or mental health problems with a sample of South
Korean adoptees. Other studies8,13,14,15
have found concurring results for children adopted from a variety
of countries including Latin America, Thailand, India, and Vietnam. Our findingsthat some adoptees
were at slightly greater risk of hyperactivity, aggression, and conduct or attention problemsextends the
results of these previous studies.
The normalcy of BASC-PRS ratings might be the result of several factors, either alone or in
combination. Typically, families able to adopt internationally have the economic resources that allow
access to needed services, institutions, and support.2, 27
Conceivably, parents would have greater access to
medical care and psychological counseling should behavior problems be identified The nature of parenting
may also be reflected in these findings. Most parents adopting from China, or any other international
locale, tend to be older (at least 35 years of age for China) and have made conscious decisions about
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bringing an adopted child into their family. This situation probably results in highly motivated, interested,
and actively involved parenting that may reduce, distinguish, or overlook minor behavior problems. Third,
while speculative, it is possible that adoptive families share similar values and beliefs (e.g., middle/upper-
class values) that are reflected in daily interactions between adoptive parents and child, e.g., discipline and
nurturing.
Another possible explanation for these positive findings may be the preponderance of girls in our
sample. Kim28
claimed that the positive results from behavioral studies on intercountry adoptees,
particularly children from South Korea, was probably due to the overrepresentation of adopted girls. He
observed that, regardless of adoptive status, most epidemiological studies have shown a lower risk of
emotional and behavioral problems for girls than boys. Future study may focus on the characteristics of
boys adopted from China to determine if they are at greater risk of emotional or behavioral problems.
Several other possible explanations exist, such as the one advanced by Jenista,29
Bazzoli30
and others
who noted that a majority of infants being adopted from China have been in excellent physical and mental
condition. Kim28
attributes the good health of Chinese adoptees to a reflection of Confucian beliefs held by
orphanage workers that place high value on children. These views result in good pre-adoption care.
Further, since most children are young when adopted, the long-term, maladaptive effects of
institutionalization, if any, are less apparent. Even for children that many have suffered from
institutionalization, Tizard3
reported that most intercountry adoptees make rapid progress within the first
year of their arrival, especially younger children.
The influence of adoptee age on parents behavior ratings was somewhat mixed. The childs age at
time of adoption did not make a difference in assessment of behavior. Girls adopted earlier or later in life
exhibited similar types of behavior patterns. When current age was examined, older adoptees were found
to have higher ratings for hyperactivity and aggression, while younger adoptees rated higher in withdrawl
behavior. When length of placement in adoptive home was examined, adoptees placed for longer periods
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of time had higher hyperactivity, aggression, and somatization scores than their more recently placed
peers. As these differences are considered, it is important to note that group mean scores were all within
normal behavior ranges.
Several possible explanations for these findings might be advanced. For example, the lack of at-risk
behavior in our sample of adoptees might reflect Tizards3
belief that the earlier adoptions occurred, the
smaller chance of educational or behavioral problems. It is also possible that our participants were simply
too young (most under 5 years of age) for us to be able to detect behavior problems or differences. Many
studies assert that behavior problems become more evident as adoptees grow older. Jenista and
Chapman16
found that while adoptees behavior problems increased with age, they were within normally
acceptable limits. For our group, it is possible that the short time span between younger and older adoptees
was not sufficient to reveal many differences. Deacon5
noted that significant increase in counseling of
intercountry adoptees for psychological and behavior problems between ages 11 to 15 years. Follow-up
study is important to determine the long-range implications of age and placement issues like those studied.
Differences we found generally support and extend the conclusions of past researchers. Adoptees
who were older or had been placed in their adoptive home longer generally had higher scores, although
behavior ratings were still within normal ranges. Kim12
found that age at placement and length of
placement did not significantly relate to formation of adoptees self-concept. Similarly, Verhulst and
Versluis-Den Bieman18
reported that the age or time of placement could not explain increases in
maladaptive behaviors of adopted adolescents. It is possible that the behavior differences we observed are
precursors to the increased chances of behavior problems many intercountry adoptees experience as
adolescents. However, as Serbin2
noted, the developmental trajectories of such patterns are currently
unknown (p. 89). This, again, points to the need for long-term research and follow-up of adoptees.
Another possible explanation is that behaviors (hyperactivity and aggression in particular) may be initiated
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by adoptees as preliminary efforts to differentiate self from family members but are misinterpreted by
parents as inappropriate behavior5.
International adoption from China, or any other country, is a complex and oftentimes controversial
practice.6,13
Difficulties are compounded by limited and inconclusive data about the effects of international
adoption on childrens adjustment and well being. While discrepancies exist, evidence from this study
suggests that Chinese adoptees exhibit generally normal behavior patterns similar to international adoptees
from other countries examined in prior studies. Although older children had higher hyperactive and
aggressive behavior patterns than their younger peers, these behaviors were still well within normal
behavioral expectation for preschoolers. The results are positive in that, at least at this relatively early
stage of life, adoptees did not experience significant behavioral problems as a result of their experience.
Continued study and follow-along will be important to document developmental obstacles, beneficial
supports, or behavior changes that occur as adoptive preschoolers enter elementary school, become
adolescents, and enter adulthood.
Summary
The purpose of our study was to profile select behavioral characteristics of children adopted from
China. The Parent Rating Scale of the Behavior Assessment Scale for Children (PRS-BASC) was
completed and returned by 44 of 61 families (71.1%) with children adopted from China. Results indicated
that, as a group, no deviations from normal behavior were found. When the variability of scores was
examined, several scalesHyperactivity, Aggression, Conduct problems, and Attention problems
revealed the presence of an elevated risk for behavior problems. The age at which children were adopted
was not a significant factor on parents perceptions of behavior. Older children were more likely to be
rated hyperactive or aggressive than younger children, while younger children were more likely to exhibit
withdrawl. Even so, the majority of respondents scores placed adoptees behavior well within normal,
acceptable ranges. While discepancies exist, our evidence is positive, suggesting that Chinese adoptees
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exhibit generally normal behavior patterns similar to international adoptees from other countries. Continued
study and follow-along will be important to document the changes that may occur in behavior, self-identity
and adjustment in future years.
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