Finnish Adoption Study (FinAdo)
The first phase of the study (FinAdo 1, survey data) was launched in the December 2007. The study consisted of questionnaires for the adoptees and their parents. The second phase of the study (FinAdo 2, pilot study) was launched in December 2009 and was a follow-up study with two different substudies, the language study and the early interaction study. Since last October, 2012 we have invited newly adopted children with their families to join a longitudinal study, FinAdo 2 (follow-up study), which aims to collect all adopted children who are arriving in Finland in 2013 and 2014. The follow-up is planned to continue until adulthood.
All FinAdo studies have been planned according to the highest ethical principles, they are all classified as medical studies, and therefore they have all been evaluated by the Ethics review committee of the Hospital District of the South-West Finland. (These principles include e.g. that the families participate voluntarily, they can give up from the study at any time without reporting their reasons. When the children are 12 years, they are asked to give their own consent to the FinAdo study and for the follow-up)
FinAdo 1. Survey data
Surveys have been conducted in the December 2007 (children under 18 years) and January 2008 (adult adoptees) and consist of questionnaires of about 3000 international adoptees and their current of previous adoptive families. The surveys were adjusted for the different age groups. Examples of the scales used: Child behavior checklist, CBCL (Achenbach ja Edelbrock 1981), Kinship Center Attachment Questionnaire, KCAQ (Kappenberg & Halpern, 2006 ), Five to Fifteen Questionnaire, FTF, (in Finnish VIIVI 5-15, Kadesjö ym. 2004), Child Depression Inventory (CDI), Youth Self Report (YSR), Self-esteem (Rosenberg), General Health Questionnaire (GHQ 12), Sense of coherence (Antonovsky), Family Functioning Style, FFS (Vauras 2000).
FinAdo 2 pilot study. This study serves as a pilot study for the larger follow-up study and consists of language substudy and substudy of the early interaction. It was launched in December 2009 and continues still.
a) Language substudy is a follow-up study of the development of internationally adopted young children under the age of 14 months. The scales used in this substudy: MacArthur Communicative Development Inventory, (CDI –menetelmä, Fenson et al., 1994), Communication and Symbolic Behavior Scales developmental profile, (CSBS, Wetherby & Prizant, 2002; in Finnish Laakso, Eklund ja Poikkeus 2011: ESIKKO - Lapsen esikielellisen kommunikaation ja kielen ensikartoitus), Reynell Developmental Language Scales (Reynellin kielellisen kehityksen testi, Edwards ym., 1997, in Finnish: Kortesmaa, Heimonen, Merikoski, Warma & Varpela, 2001), Bayley Scales of Infant Development (BSID III, Bayley, 2006)
b) Early interaction substudy is a follow-up study of a group of young adopted, children (under 14 months) who have just arrived in Finland. The parent-child interaction is assessed twice by the Emotional Availability Scale (EAS): first after arrival in Finland and later after a year. The parent’s mentalizing capacity is evaluated by using Parent Development Interview (PDI). In this study we evaluate possible association between these two and with children’s symptoms assessed by scales and questionnaires.
FinAdo 2 follow-up study.
Adoption offers a unique opportunity to study the effects of early
adversity, the potential protective factors and the factors contributing recovery of the brains and neurological systems after placement into normative environment. The aim of this study is to learn 1) the effects of the early adverse experiences on the child’s development, growth delay, health status, developmental delay, disturbances in social reciprocity, and on brain functions affecting emotion regulation (ERP), 2) the persistence of these disturbancies after placement into normative environment and 3) associations of the adverse experiences with the psychiatric outcome at school-age (CBCL). 4) We will also study the risk and protective factors for the psychiatric outcome in the child’s background (late adoption age, institutional rearing), as well as in the new adoptive environment (parental depression, parents’ reflective functioning). 5) Furthermore, we will test the potential mediating and modifying factors between adversity and psychiatric outcome or somatic illness (persistent developmental delay, genetic vulnerability for stress responses, temperament, diurnal cortisol, oxytocin secretion as a reaction of closeness with the parent, parents’ emotional availability, child’s responsivity and involvement).
The study includes all adopted children who arrive to Finland between October 2012 and December 2014 and their parents. In practice, the children are met by a peaditrician twice, soon after arrival and one year later. Parents are able to discuss of the children’s health issues with the doctor and the children will be evaluated by a standardized method suitable for their age. The growth and the stress level (cortisol) of the child are followed. Later we will contact the families with questionnaires (at chid’s ages 5, 10 and 15 years). At the age of 12 own consent of participation of each child will be asked. There are also several substudies for voluntary families.
Design Marko Elovainio