Adopted children’s internalizing symptoms and externalizing problems 8 years post-placement: Developmental trajectories and transitions

Children adopted from public care are more likely to experience mental health problems associated with their histories of early life adversity and instability, but few studies have investigated children's mental health longitudinally across developmental turning points. We followed a sample of N = 92 UK domestically adopted children and their families at six time points over eight years post-placement (children's ages ranged from 2 to 15 years). We used multilevel growth curve analysis to model time-related changes in children's internalizing symptoms and externalizing problems and spline models to investigate patterns of change before and after school entry. Children's internalizing symptoms followed a linear increasing trajectory, and externalizing problems followed a quadradic pattern where problems accelerated in early childhood and decelerated in late childhood. Spline models indicated an elevation in internalizing symptoms and externalizing problems as children started school. Internalizing symptoms continued to increase over time after school started and externalizing problems plateaued after the first years in school. Children adopted close in time to school entry displayed more problems when they started school. The transition to school represents a time of vulnerability for adopted children, especially for those who are adopted close in time to this transition, underscoring the need for ongoing support for their mental health across childhood.