There is a general consensus that the evolution of the physical and psychological development of adopted children is significantly better than that observed in children who have grown up in institutionalization, transitional foster care or in their biological families when they are not engaged during their upbringing.
Evolution of diseases detected on arrival
With respect to physical health problems, delays in physical and psychological development (psychomotor and cognitive), in addition to the disorders of adaptation, attachment and behavior, which are most frequently detected on arrival in children adopted abroad, usually are solved after the first year of coexistence with the adoptive family .
In cases with significant delays in physical or psychological development, recovery may take more than three years and may not be complete. In particular, regarding the psychological improvement of the cognitive area, it is dependent on the level of delay that occurs upon arrival and that in 15% of children does not recover completely after three years of follow-up .
Evolution of mental health
Short- and medium-term follow-up shows that most are adequately adapted and linked and do not have mental health disorders. No significant differences have been observed in the prevalence of self-esteem problems with the general infant-juvenile population.
Those over the age of two years who have suffered from pre-adversative situations (prenatal exposure to alcohol, prematurity, abuse, neglect or chronic malnutrition) and who have lived in institutions for a long time (more than six months) are at greater risk of presenting mental health disorders. The more adversities that accumulate, the greater the risk of mental health disorders.
Visits to mental health services or pediatricians are mainly due to behavioral disorders, attention deficit hyperactivity disorder (ADHD), and cognitive and language disorders. Disorders of social adaptation and attachment are rare. Behavioral disorders predominate those that manifest externally, such as behavioral disturbance, aggression or impulsivity; versus the internalizers, such as shyness or information processing problems, and are more frequent and serious in adolescence. The prevalence of ADHD is five to eight times higher than that observed in the general infant-juvenile population. Cognitive and language disorders and social adjustment and attachment disorders are most commonly seen among those who were adopted above the age of six.
Successful adoption versus broken adoption
In general, the process of international adoption is successful and most families and children live with satisfaction after an initial adjustment period. But this does not mean that this process is free of challenges, risks and difficulties. About 10% of adoptive families do not adapt to the new situation and 1% of international adoptions are broken , a percentage that triples when the child was over six years old at the time of adoption. In many of these cases there have been failures in suitability and pre-adoptive training or mismatches between the application profile and the allocation profile. To avoid or reduce these painful situations it is necessary to know when to refer these families to specialized psychosocial intervention services.