Development of children adopted from Poland (current research)

Development of children adopted from Poland (2015)

The development and behaviour of Polish adoptees after adoption was examined in relation to pre-adoptive risk factors, fetal alcohol spectrum disorders (FASD) and parenting. Participants were Dutch families of 133 children adopted from Poland in the period from January 1999 to December 2006 (73% response rate). These children were adopted by 79 families, at on average three years of age.

After adoption to the Netherlands, many children adopted from Poland were found to show behavioural problems, both internalizing and externalizing, as well as cognitive problems. Prior to adoption, the children were exposed to a multitude of early life risk factors. In particular, children who were known to have a history of abuse were at risk for behavioural problems after adoption. Two other important risk factors that were prevalent in children adopted from Poland were neglect and prenatal exposure to alcohol.

A specific concern among Polish adoptees is the high prevalence of FASD, because of associated developmental difficulties and expected related long-term adaptation problems. Another important finding was that the adoptive parents of Polish adoptees were at increased risk for parenting stress. In particular children’s externalizing behavioural problems were associated with more parenting stress. High satisfaction with the child-rearing situation, on the other hand, was present as well, possibly buffering parenting stress.

All in all, results indicate a need for more extensive support and follow-up after adoption. This would allow early diagnosis and referral to appropriate interventions, which might reduce later problems, both for the children themselves and for their families, as well as for the Dutch society as a whole.

For more information or the full dissertation in English you can contact Sandra Knuiman (

Knuiman, S. (2015). Development of children adopted from Poland: The role of early life risk factors, fetal alcohol spectrum disorders and parenting. (Doctoral dissertation). Ridderkerk, The Netherlands: Ridderprint BV.

Knuiman, S., Rijk, C. H. A. M., Hoksbergen, R. A. C., & Van Baar, A. L. (2014). Pre-adoptive risk factors and behavioural problems in children adopted from Poland. European Journal of Developmental Psychology, 11, 701-715. doi:10.1080/17405629.2014.930684
Knuiman, S., Rijk, C. H. A. M., Hoksbergen, R. A. C., & Van Baar, A. L. (2014).
Children adopted from Poland display a high risk of fetal alcohol spectrum disorders and some may go undiagnosed. Acta Paediatrica. Advance online publication. doi:10.1111/apa.12822
Knuiman, S., Rijk, C. H. A. M., Hoksbergen, R. A. C., & Van Baar, A. L. (2015). Children without parental care in Poland: Foster care, institutionalization and adoption. International Social Work, 58, 142-152. doi:10.1177/0020872812473138
Knuiman, S., Rijk, C. H. A. M., Hoksbergen, R. A. C., & Van Baar, A. L. (in preparation). Families raising adopted children with a high risk of FASD: Parenting stress, parenting satisfaction and parenting behaviour in relation to children’s behavioural problems.
Knuiman, S., Rijk, C. H. A. M., & Hoksbergen, R. A. C. (2013). Fetal alcohol spectrum disorders in children adopted from Poland: Diagnosis and early detection. In R. Feldman, G. Michalowski & K. Lepke (Eds.), Perspektiven für Menschen mit Fetalen Alkoholspektrumstörungen (FASD). Einblicke-Ausblicke 14. Fachtagung in Erfurt 28.-29.09.2012 (pp. 35–40). Idstein: Schulz-Kirchner Verlag GmbH.

Adoption and involuntary childlessness in India (current research)

This research involves four studies in the field of adoption. First article was published in “Journal of Psychosocial Research” on “Adoption in India – Past, current and future trends”. It is followed by “Quality of life of men with involuntary childlessness and fatherhood through adoption”. Next is a three group study on “Psychological wellbeing of couple in treatment, adopted and who have a biological child”. My fourth will be a qualitative research on “Psychosocial problems faced by adoptive parents”.

Bhaskar, S., Hoksbergen, R., Van Baar, A., Mothiram S., & Ter Laak, J. (2012). Adoption in India – the past, present and the future trends. Journal of Psychosocial Research, 7, 321-327.

Bhaskar, S., Hoksbergen, R., Van Baar, A., Tipandjan A., & Ter Laak, J. (2014). Life experiences and quality of life of involuntarily childless men in treatment and adoptive fathers. Journal of Reproductive and Infant Psychology, 32, 497–507. doi:10.1080/02646838.2014.956302

Children adopted from Romania (2008)

This longitudinal study among 80 children (in 72 families) adopted from Romania started in 1998 and finished in 2008. The aim of this study is to investigate the way children adopted from Romania function in their adoptive family, the psychosocial problems they experience and the (professional) care they receive. These children have all spent time in a children’s home in Romania, often in very bad circumstances. The children were severely neglected.

The goal of the first phase was to generally describe the functioning of the children. Using a semi-structured interview, information was gathered about the adoption process, medical and psychosocial problems, the development of the child and experiences of the family with adoption-organization, school and professional care.

During the second phase (1,5 years later), the interview was repeated and expanded. In addition to the interview, several standardized instruments were used, among which the Child Behavior Checklist (CBCL), The Nijmegen Child Rearing Questionnaire (NVOS), the Auti-R (a questionnaire investigating autistic symptoms), the ADHD-questionnaire (AVL) and a questionnaire measuring trauma. These instruments enabled us to give a more precise description of the problem behavior of the children. Over half of the children experienced psychosocial problems. The Nijmegen Child Rearing Questionnaire showed that this problem behavior places a heavy burden on the parents. Many parents decided to seek professional help, and most children had already visited several professional caretakers.

The third phase is aimed at the description of effective upbringing of adoptive children. The emphasis is on the way the direct environment of the child deals with  problem behavior of the child. The parents have been interviewed, and this time, the teacher and one or two of the professional caretakers also have been interviewed. The third phase of this study has a qualitative nature, as opposed to the first two phases. A selection of the group of 72 families will be approached. The selection of the study group is based on the results of the children on several instruments used in the second phase of the study.

Results have been published in several Dutch and international journals, and are described in two Dutch books. An English publication that can be ordered by email ( is: Effects of deprivation (2004). Hoksbergen, R.A.C., Rijk, K. e.a., 78 p. [€ 16,-].