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Medication usage in adopted children is not elevated

Internationally adopted children do not use more medication than their non-adopted peers. This is what Joost van Ginkel, Femmie Juffer, Marian Bakermans-Kranenburg and Marinus van IJzendoorn – researchers of the Program for Emotion regulation and Attachment Research Leiden (PEARL) at Leiden University – conclude from a study published in the European Journal of Pediatrics, including more than 10.000 adoptees in the Netherlands.

Joost van Ginkel, Femmie Juffer, Marian Bakermans-Kranenburg, Marinus van IJzendoorn
11 March 2016
Do internationally adopted children in the Netherlands use more medication than their non-adopted peers?

Adoptees have often been exposed to malnutrition, abuse, and neglect in orphanages, prior to their arrival in the Netherlands. Earlier studies conducted by researchers from Leiden University showed that after adoption, international adoptees may suffer physical growth delays and behavioral problems, and that on average they have more mental health referrals and need more school support than their non-adopted peers1-3. However, it was unknown whether these problems would be accompanied by increased medication use by adoptees. The researchers investigated whether adoptees were prescribed more medication, specifically more antidepressants, medication for ADHD, and medication for growth stimulation or growth inhibition (the latter for preventing precocious puberty). Data from Statistics Netherlands (Centraal Bureau voor de Statistiek) were available for 2,360,450 Dutch children, 10,602 of whom were internationally adopted children, containing information about prescribed medication in the years 2006 to 2011. All children in the study were between 1 and 17 years during the measurement period. Because a substantial number of international adoptees in the Netherlands are from China (4,447 adoptees), this group was studied separately from the other adoptees (coming from, for example, Colombia and Ethiopia).

No indication for higher medication use

Generally, no increased medication use in adopted children was found. On average, adoptees from other countries than China were prescribed slightly more medication for ADHD than their non-adopted peers, but the difference was small. Adopted girls from China, however, used fewer growth inhibitors than non-adopted girls. Only a small group of adopted boys from China (approximately 10% of all adoptees from China were males) had a relatively high medication use. This is understandable because boys from China often have special needs of a severe kind, resulting in higher medication usage.

This large-scale study with population data shows that internationally adopted children in the Netherlands do not use more medication than their non-adopted peers. This finding is in accordance with previous research from Leiden showing that adopted children catch up remarkably fast and thoroughly after their arrival in the adoptive family. 4

As a powerful intervention adoption offers children many opportunities to recover from their negative experiences, and consequently extra medication is usually not necessary. 

  1. Van IJzendoorn, M.H., Bakermans-Kranenburg, M.J., & Juffer, F. (2007). Plasticity of growth in height, weight and head circumference: Meta-analytic evidence of massive catch-up after international adoption. Journal of Developmental and Behavioral Pediatrics, 28,334-343.
  2. Juffer, F., & Van IJzendoorn, M.H. (2005). Behavior problems and mental health referrals of international adoptees: A meta-analysis. JAMA - Journal of the American Medical Association, 293, 2501-2515.
  3. Van IJzendoorn, M.H., Juffer, F., & Klein Poelhuis, C.W. (2005). Adoption and cognitive development: A meta-analytic comparison of adopted and non-adopted children’s IQ and school performance. Psychological Bulletin, 131, 301 – 316.
  4. Van IJzendoorn, M.H., & Juffer, F. (2006). Adoption as intervention: Meta-analytic evidence for massive catch-up and plasticity in physical, socio-emotional and cognitive development. The Emanuel Miller Memorial Lecture 2006. Journal of Child Psychology and Psychiatry, 47, 1128 – 1245.
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