Myth vs. Reality: Adoption, Development, and the Role of Neuropsychology

Adoption is a wonderful way to create family. I say this both as a psychologist who has extensive research and clinical experience working with this population, as well as a person who was adopted. However, my experience working with children and families in the “adoption triad” over the past 20 years has made me aware of the negative stereotypes that are perpetuated by well-meaning professionals that are simply not based in fact and can, in fact, have a deleterious impact on the health and development of those children whom they are trying to serve.

In simplest terms, there is nothing inherently pathological about the process of adoption or individuals who were adopted. Yes, there can be particular family dynamics and developmental issues unique to the adoptive experience (for an interesting perspective on child development through an adoptive lens, see Dr. Joyce Pavao’s “The Family of Adoption”). However, these can be thought of much like other demographic factors that contribute to our development but do not define who we are in totality, such as ethnicity, gender, sexual orientation, or socioeconomic status.

So, if adoptive status is not a causal factor for later psychopathology, why do some children who were adopted display emotional, behavioral, and learning challenges? This is where neuropsychology comes into play. Research suggests that children adopted at older ages, from foster care, or from institutional settings have a higher risk for certain psychological challenges compared to non-adopted peers. However, this increased risk is not due to adoption itself but rather to neurobiological factors that are known to result in developmental challenges regardless of adoptive status. These can include sensory, cognitive, and social deprivation; chronic early stress; attachment disruptions; and teratogenic exposure (e.g., factors that can cause developmental abnormalities in a fetus); all factors that are known to impact the developing brain.

For example, a child who has been separated from their primary caregiver during an early sensitive period of development may show delays in social cognition, understanding others’ emotions, and their ability to form peer relationships. While this child could have been adopted after living in an orphanage, they may also be a non-adoptive child who was separated from their birth parent secondary to an injury/illness and subsequent hospitalization or had a birth parent who was not consistently available due to their own medical or mental health issues. The adoptive status of the child is not the issue at hand, rather the specific experiences of the individual, and for a professional to simply label a child’s challenges as a result of their adoptive status is overly simplistic and possibly unethical.

Thus, as with all children, it is important to understand the “whys” (e.g., why are they having this particular problem) to figure out the “hows” (e.g., how do parents and professionals best address it) when working with children who were adopted. This often requires a comprehensive evaluation of neuropsychological functioning that goes beyond the label of “adopted child” and helps to identify both the risk and protective factors unique to that individual that will impact their health and development.

About the Author

Dr. Sean O’Brien has been providing comprehensive neuropsychological evaluations in the Greater Boston area since 2006. He specializes in the assessment of children and adolescents who present with a wide range of developmental conditions, such as  Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder (reading, writing, math), Intellectual Disability, and Autism Spectrum Disorder; as well as children whose cognitive functioning has been impacted by medical, psychiatric, and genetic conditions. He also has extensive experience working with children who were adopted both domestically and internationally.

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NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, NY (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.