Date of Award

1-10-2003

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Margaret Hostetter

Abstract

The major purpose of this study was to examine whether the assessment of pre-adoption video (pre-vid) by an experienced pediatrician accurately predicts the post-adoption developmental (post-dev) status of the adoptee on arrival and to examine any difference in the extent of developmental delay between those adoptees with and those without a pre-vid review. As a foundation for the study, an extensive database for all adoptees seen at the Yale International Adoption Clinic was created and their demographic characteristics were analyzed. The developmental status of 20 children from Russian and Eastern European orphanages was assessed by an experienced pediatrician using a pre-vid review while the post-dev status was evaluated by a developmental-behavioral pediatrician. Using the Denver Developmental II Scoring Test (pre-vid) and the Bayley Scale of Infant Development Second Edition (post-dev), children were scored (0, 1, 2 or 3) to indicate the degree of developmental delay in fine motor, gross motor and language domains. A control group of international adoptees was assembled on the basis of age, gender, length of time in orphanage, length of stay in US before developmental exam and country of origin. The degree of post-dev delay in the cohort with a pre-vid was then compared to that of the control group without a pre-vid using a chi-square test and Fishers exact test. The Pearson r coefficient between the pre-adoption video and post-adoption developmental ratings indicated a significant correlation, r=0.53 and two-tailed p = 0.01, between the two ratings. Chi-square and Fischer test analysis examining the extent of developmental delay between the cohort and control groups were not significant. Although there is no significant difference in the extent of developmental delay between the adoptees who did and did not receive a pre-vid assessment, results of this study show that a video review by an experienced pediatrician predicts with statistically significant accuracy the childs developmental status after arrival.

Comments

This is an Open Access Thesis.

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