Vision and hearing deficits and associations with parent-reported behavioral and developmental problems in international adoptees

Judith K Eckerle, Lindsay Knauf Hill, Sandra Iverson, Wendy L Hellerstedt, Megan R Gunnar, Dana E Johnson

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


To determine the occurrence of vision and hearing deficits in international adoptees and their associations with emotional, behavioral and cognitive problems. The Minnesota International Adoption Project (MnIAP) was a 556-item survey that was mailed to 2,969 parents who finalized an international adoption in Minnesota (MN) between January 1990 and December 1998 and whose children were between 4 and 18 years-old at the time of the survey. Families returned surveys for 1,906 children (64 %); 1,005 had complete data for analyses. The survey included questions about the child's pre-adoption experiences and post-placement medical diagnoses, and the Child Behavior Checklist (CBCL). Multivariate logistic regression assessed associations between hearing and vision problems and problems identified by the CBCL. Information on hearing and vision screening and specific vision and hearing problems was also collected via a telephone survey (HVS) from 96/184 children (52 %) seen between June 1999 and December 2000 at the University of Minnesota International Adoption Clinic. In both cohorts, 61 % of children had been screened for vision problems and 59 % for hearing problems. Among those children screened, vision (MnIAP = 25 %, HVS = 31 %) and hearing (MnIAP = 12 %, HVS = 13 %) problems were common. For MnIAP children, such problems were significant independent predictors for T scores >67 for the CBCL social problems and attention subscales and parent-reported, practitioner-diagnosed developmental delay, learning and speech/language problems, and cognitive impairment. Hearing and vision problems are common in international adoptees and screening and correction are available in the immediate post-arrival period. The importance of identifying vision and hearing problems cannot be overstated as they are risk factors for development and behavior problems.

Original languageEnglish (US)
Pages (from-to)575-583
Number of pages9
JournalMaternal and child health journal
Issue number3
StatePublished - Apr 2014

Bibliographical note

Funding Information:
This research was supported by a National Institute of Mental Health Grants (MH59848, MH080905, P50MH078105, Gunnar PI). The authors thank the parents and children who helped with this research. We would also like to thank members of the Minnesota International Adoption Project Team including H. Grotevant, R. Lee, N. Madsen, and K. Dole as well as the parent advisory board, and personnel at the adoption unit at the Minnesota Department of Human Services for their contributions to this work.


  • Adoption
  • Behavior
  • Child
  • Developmental delay
  • Disabilities
  • Hearing
  • Orphanages
  • Psychosocial deprivation
  • Vision


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