Clinical Child and Family Psychology Review

, Volume 13, Issue 2, pp 199–211 | Cite as

CBCL Behavior Problems of Post-Institutionalized International Adoptees

  • Brandi Hawk
  • Robert B. McCallEmail author


With the increase in international adoptions during the last decade, many researchers have investigated the developmental outcomes of these adoptees, including their extreme behaviors. Collectively, these results have not always appeared consistent across studies, perhaps because studies have used children reared in institutions or not, the institutional environments vary in severity, children spend different lengths of time in the institution and are assessed at different ages, and studies use different outcome measures. In an attempt to discern more order in the literature, this review focuses on 18 studies, each of which used the Child Behavior Checklist, and their outcomes are viewed with respect to these parameters. Results suggest that the major factor contributing to extreme behaviors is age at adoption, with those adopted after 6/18 months having more behavior problems, especially Internalizing, Externalizing, and Attention problems. Generally, samples of post-institutional children have more problems than samples of mixed or non-institutional internationally adopted children, and some problems are more likely to be manifest in adolescence, suggesting the effects of deficient early experiences are not simply the persistence of learned behavior but more general dispositions that become more noticeable or severe during adolescence. Findings are discussed in terms of early deficient social–emotional caregiver–child interactions that characterize most institutional environments as a possible major cause of later difficulties in post-institutionalized children.


Internationally adopted children Post-institutional children CBCL behavior problems Effects of early experience Age at adoption Age at assessment 



This paper is supported in part by a NIMH grant R25MH5431813 awarded to Gretchen Haas and NICHD grants R01HD39017 and R01HD50212 awarded to McCall and Christina J. Groark. The authors thank Christina J. Groark, Megan Julian, Emily Merz, and Johana Rosas for their helpful comments on earlier drafts of this paper.


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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.University of Pittsburgh Office of Child DevelopmentPittsburghUSA

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