Children adopted from
orphanages or in foster care have a high rate of foetal alcohol syndrome and
other physical, mental and behavioural problems related to alcohol exposure
before birth, according to a new review of past studies.
Among those children, researchers found that rates of
alcohol-related problems which can
include deformities, mental retardation and learning disabilities were anywhere
from nine to 60 times higher than in the general population.
increasingly well recognised that this is a very high-risk population and one
that we should really be paying attention to," Phil Fisher, a psychologist
who studies foster and adopted children at the University of Oregon in Eugene,
"We know that
one of the main reasons that kids end up in foster care or being made eligible
for adoption is because their parents have substance abuse problems,"
added Fisher, who wasn't involved in the new research.
The findings are based on a review of 33 studies of children
in the care of child welfare agencies or foster parents, as well as kids before
and after their adoption from orphanages.
Most of the studies were conducted in Russia or the United
States. Compiling the studies with the most accurate reporting techniques, Dr
Svetlana Popova from the Centre for Addiction and Mental Health in Toronto and her
colleagues found 6% of children in those settings had foetal alcohol syndrome.
The condition includes a distinctive set of facial features, including a small
head, jaw and eyes, and other physical developmental defects, especially of the
Slow growth and
delayed development after birth are also typical of foetal alcohol syndrome.
Close to 17% of the children had a more loosely-defined foetal alcohol spectrum
disorder, which covers any physical, mental or behavioural issues caused by
prenatal alcohol exposure.
The highest rates of foetal alcohol syndrome were seen among
children in a Russian orphanage for kids with special needs and among those
adopted from Eastern Europe by families in Sweden.
In those studies,
anywhere from 29% to 68% of children showed severe alcohol-related damage. In
other cases, such as a study of Chinese children adopted and brought to the
United States, there were no reported instances of foetal alcohol syndrome, the
study team reported Monday in Pediatrics.
Fisher said it's
important to know that although problems related to alcohol exposure are common
among adopted and foster children, not all kids have been exposed and some
with prenatal exposure are "quite resilient" and do fine.
"I don't think anyone wants to create the impression
that every child in the foster care system... and every child who's adopted
has very severe problems," he told Reuters Health.
Still, he said there is a need for more recognition of the
challenges faced by children who have been exposed to drugs and alcohol in the
womb. Rather than focusing only on their obvious current symptoms, he said
foetal alcohol disorders should be treated as chronic diseases, like
diabetes. "The supports need to be available in an ongoing way,"
He also pointed to the importance of identifying children
who have some of the effects of drug and alcohol exposure – but not ones as
obvious as the distinct facial features seen with foetal alcohol syndrome and
getting them support as soon as they enter the child welfare system or are
adopted. "If we don't do the early screening and detection... then I think
we're in a much more challenging position," he said.
"We hope that the results of this study will attract
attention to the needs of children in care affected by prenatal alcohol
exposure," Popova told Reuters Health in an email. She agreed that
spotting problems as soon as possible is important.
"Early screening may lead to early diagnosis, which can
lead to early participation in developmental interventions, which can in turn,
improve the quality of life for children with a (foetal alcohol spectrum
disorder)," she said. Early intervention, Popova added, may also help
prevent future mental health problems and trouble in school.