Article

Early adolescent outcomes of institutionally deprived and non-deprived adoptees. III. Quasi-autism.

MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
Journal of Child Psychology and Psychiatry (impact factor: 4.28). 01/2008; 48(12):1200-7. DOI:10.1111/j.1469-7610.2007.01792.x pp.1200-7
Source: PubMed

ABSTRACT Some young children reared in profoundly depriving institutions have been found to show autistic-like patterns, but the developmental significance of these features is unknown.
A randomly selected, age-stratified, sample of 144 children who had experienced an institutional upbringing in Romania and who were adopted by UK families was studied at 4, 6, and 11 years, and compared with a non-institutionalised sample of 52 domestic adoptees. Twenty-eight children, all from Romanian institutions, for whom the possibility of quasi-autism had been raised, were assessed using the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) at the age of 12 years.
Sixteen children were found to have a quasi-autistic pattern; a rate of 9.2% in the Romanian institution-reared adoptees with an IQ of at least 50 as compared with 0% in the domestic adoptees. There were a further 12 children with some autistic-like features, but for whom the quasi-autism designation was not confirmed. The follow-up of the children showed that a quarter of the children lost their autistic-like features by 11. Disinhibited attachment and poor peer relationships were also present in over half of the children with quasi-autism.
The findings at age 11/12 years confirmed the reality and clinical significance of the quasi-autistic patterns seen in over 1 in 10 of the children who experienced profound institutional deprivation. Although there were important similarities with 'ordinary' autism, the dissimilarities suggest a different meaning.

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    Article: Health care support issues for internationally adopted children: a qualitative approach to the needs and expectations of families.
    Olivier Lesens, Anna Schmidt, Florence De Rancourt, Véronique Poirier, André Labbe, Henri Laurichesse, Laurent Marty, Jean Beytout, Philippe Vorilhon
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    ABSTRACT: Families of internationally adopted children may face specific problems with which general practitioners (GPs) may not be familiar. The aim of the study was to explore problems faced by families before, during and after the arrival of their internationally adopted child and to assess the usefulness of a specific medical structure for internationally adopted children, which could be a resource for the GP. We conducted a qualitative study using individual semistructured guided conversations and interviewed 21 families that had adopted a total of 26 children internationally in the Puy de Dome department, France, in 2003. Quantitative data were used to describe the pathologies diagnosed and the investigations performed.Our study showed that the history of these families, from the start of the adoption project to its achievement, is complex and warrants careful analysis. Health-care providers should not only consider the medical aspects of adoption, but should also be interested in the histories of these families, which may play a role in the forming of attachments between the adoptee and their adoptive parents and prevent further trouble during the development of the child. We also showed that adoptive parents have similar fears or transient difficulties that may be resolved quickly by listening and reassurance. Most such families would support the existence of a specific medical structure for internationally adopted children, which could be a resource for the general practitioner. However, the health-care providers interviewed were divided on the subject and expressed their fear that a special consultation could be stigmatizing to children and families. A specific consultation with well-trained and experienced practitioners acting in close collaboration with GPs and paediatricians may be of help in better understanding and supporting adopted children and their families.
    PLoS ONE 01/2012; 7(2):e31313. · 4.09 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

'ordinary' autism
 
12 children
 
52 domestic adoptees
 
Autism Diagnostic Interview-Revised
 
Autism Diagnostic Observation Schedule
 
autistic-like features
 
autistic-like patterns
 
clinical significance
 
developmental significance
 
domestic adoptees
 
institutional upbringing
 
profound institutional deprivation
 
profoundly depriving institutions
 
quasi-autism designation
 
quasi-autistic pattern
 
quasi-autistic patterns
 
Romanian institution-reared adoptees
 
Romanian institutions
 
UK families
 
young children reared
 

Michael Rutter