Children adopted internationally often have a history of multiple factors that can impact their academic performance. These can include; early environmental deprivation and malnutrition during critical periods of brain development, lack of educational opportunities, undiagnosed and unaddressed vision and hearing impairments, and underlying medical issues. There are also considerable differences in the educational settings the children have experienced. Children with significant physical impairments may have only minimal education within the orphanage. Other children have schooling within the orphanage, which can mean limited exposure to typically developing children. These differences lead to challenges in identifying appropriate school placements in the US. An additional factor for children who were found abandoned is that the actual age of the child is often unknown, which can raise further questions about appropriate school placement. Evaluation in our program can help identify these issues and guide appropriate school placement.

It is important to be aware that even children who have initially adjusted well after adoption at a young age may experience difficulties when they reach school age. Upon encountering the academic and social demands of school, new issues may emerge. This can manifest as learning difficulties, behavioral challenges, difficulties with peer relationships and school avoidance.

Children with a history of childhood trauma are also at increased risk for attention deficit disorder (ADHD), which can impact their academic progress. There are many other psycho-educationally relevant diagnoses which should be considered as well, including attachment problems, sensory integration problems, functional vision problems, and emotional issues. Each of these areas can contribute to what may look like "inattention" but which requires very different treatment.

At post adoption visits with the CHOP International Adoption Health team, the many issues impacting the education of these children are considered and guidance for educational planning is provided.