ADHD and Adopted Children

Is Attention Deficit Hyperactivity Disorder (ADHD) more commonly diagnosed in adopted children? One study published in the Journal of Abnormal Psychology found that of 808 adopted children, ages 4-18 years, 21 percent had enough behavioral symptoms to qualify for a diagnosis of ADHD. This is twice the rate in the general child population. (This study was based on extensive parent questionnaires.)

An analysis of risk factors showed that those with behavioral symptoms usually had pre-adoptive risk factors such as history of abuse or neglect, later age at adoption, prenatal drug exposure and/or multiple foster placements.

Still, experts advise being cautious about assumptions. Adoption and ADHD may be associated, but adopted children’s experiences vary so widely it is hard to separate out an explanation. Many studies fail to differentiate between children adopted at birth and those who spent time in institutions or experienced multiple moves.

If adoption is linked with a higher risk for ADHD, why? Some point to a genetic link and theorize that people with impulse control problems are more likely than others to experience or to cause an unplanned pregnancy, therefore children placed for adoption may be more likely to have a birthparent with ADHD. Other theories involve low birthweight, prenatal environment and drug or alcohol exposure.

Still others believe the idea of a relationship between ADHD and adoption becomes a self-perpetuating idea—that doctors, teachers and adoptive parents are more likely to perceive a problem because they believe these children are vulnerable. (The flip side, of course, is that adoptive parents may be more vigilant and willing to seek help when there truly is a problem, resulting in higher diagnosis rates.)

Many experts believe that a poor environment triggers problems of many kinds in people who are genetically susceptible. However, a couple of studies suggest that early environment may have a profound biological effect regardless of genes.

A study at the University of Minnesota is following children adopted from overseas orphanages. One finding of this study involves the body’s stress response. A system of glands called the Hypothalamic-Pituitary-Adrenal Axis (HPA) is forming during the first months of life and is set by the end of the first year. The study found that children who have formed secure attachments with caregivers by age one do not seem to produce increases in the hormone cortisol when they are upset, whereas children who do not have a secure attachment in the first year do produce extra cortisol when upset. It appears this effect of the first year of life may continue indefinitely.

A National Institute of Child Health and Human Development study found that monkeys who had been separated from their mothers at birth or soon after show more aggressive play, leap dangerously from branch to branch, are ostracized by their peers and drink more alcohol when given the chance. A study found low levels of a marker for the brain chemical serotonin in these monkeys.

The relationship between adoption and ADHD has not been definitively studied and more needs to be known. But it appears that some of our children could be contending with biological impacts of their prior environment, in addition to psychological impacts.

Please see these related blogs:

ADHD: Myths and Parental Guides

The Genetic Risks for Inheriting (or Passing Down) ADHD

This entry was posted in Special Needs and tagged , , , by Pam Connell. Bookmark the permalink.

About Pam Connell

Pam Connell is a mother of three by both birth and adoption. She has worked in education, child care, social services, ministry and journalism. She resides near Seattle with her husband Charles and their three children. Pam is currently primarily a Stay-at-Home-Mom to Patrick, age 8, who was born to her; Meg, age 6, and Regina, age 3, who are biological half-sisters adopted from Korea. She also teaches preschoolers twice a week and does some writing. Her activities include volunteer work at school, church, Cub Scouts and a local Birth to Three Early Intervention Program. Her hobbies include reading, writing, travel, camping, walking in the woods, swimming and scrapbooking. Pam is a graduate of Seattle University and Gonzaga University. Her fields of study included journalism, religious education/pastoral ministry, political science and management. She served as a writer and editor of the college weekly newspaper and has been Program Coordinator of a Family Resource Center and Family Literacy Program, Volunteer Coordinator at a church, Religion Teacher, Preschool Teacher, Youth Ministry Coordinator, Camp Counselor and Nanny. Pam is an avid reader and continuing student in the areas of education, child development, adoption and public policy. She is eager to share her experiences as a mother by birth and by international adoption, as a mother of three kids of different learning styles and personalities, as a mother of kids of different races, and most of all as a mom of three wonderful kids!