title: Does age at adoption and geographic origin matter? A national cohort study of cognitive test performance in adult inter-country adoptees.
abstract: BACKGROUND
  Inter-country adoptees run risks of developmental and health-related problems. Cognitive ability is one important indicator of adoptees' development, both as an outcome measure itself and as a potential mediator between early adversities and ill-health. The aim of this study was to analyse relations between proxies for adoption-related circumstances and cognitive development.
  
  
  METHODS
  Results from global and verbal scores of cognitive tests at military conscription (mandatory for all Swedish men during these years) were compared between three groups (born 1968-1976): 746 adoptees born in South Korea, 1548 adoptees born in other non-Western countries and 330 986 non-adopted comparisons in the same birth cohort. Information about age at adoption and parental education was collected from Swedish national registers.
  
  
  RESULTS
  South Korean adoptees had higher global and verbal test scores compared to adoptees from other non-European donor countries. Adoptees adopted after age 4 years had lower test scores if they were not of Korean ethnicity, while age did not influence test scores in South Koreans or those adopted from other non-European countries before the age of 4 years. Parental education had minor effects on the test performance of the adoptees - statistically significant only for non-Korean adoptees' verbal test scores - but was prominently influential for non-adoptees.
  
  
  CONCLUSIONS
  Negative pre-adoption circumstances may have persistent influences on cognitive development. The prognosis from a cognitive perspective may still be good regardless of age at adoption if the quality of care before adoption has been 'good enough' and the adoption selection mechanisms do not reflect an overrepresentation of risk factors - both requirements probably fulfilled in South Korea.
authors.affiliation: Stress Research Institute, Stockholm University, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Odenstad
authors.forename: A
authors.initials: A
authors.lastname: Hjern
authors.forename: F
authors.initials: F
authors.lastname: Lindblad
authors.forename: F
authors.initials: F
authors.lastname: Rasmussen
authors.forename: B
authors.initials: B
authors.lastname: Vinnerljung
authors.forename: M
authors.initials: M
authors.lastname: Dalen
mesh_terms: D000300:Adoption; D000328:Adult; D000367:Age Factors; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015331:Cohort Studies; D005060:Europe / Q000208:ethnology; D005843:Geography; D006801:Humans; D007723:Korea / Q000208:ethnology; D008297:Male; D009483:Neuropsychological Tests; D012042:Registries; D014481:United States / Q000453:epidemiology