Gross motor development in children adopted from orphanage settings.

AIM This study sought to examine the effect of environmental enrichment on the motor skills of children adopted from orphanage settings. We investigated balance and bilateral coordination skills in 33 internationally adopted postinstitutionalized children (16 males, 17 females; age range 8 y 5 mo-15 y 10 mo; mean age 10 y 9 mo; SD 2 y 2 mo) and compared them with 34 non-institutionalized children (21 males, 13 females; age range 8 y 3 mo-14 y 10 mo; mean age 11 y 2 mo; SD 2 y 1 mo) being raised in their birth families. METHOD The children were individually administered the balance and bilateral coordination subtests of the Bruininks-Oseretsky Test of Motor Proficiency in a research laboratory. Parents completed questionnaires about developmental history, family environment, and orphanage care. RESULTS Postinstitutionalized children showed motor system delays compared with the non-institutionalized comparison children (postinstitutionalized balance mean 9.44, SD 5.92, comparison children balance mean 14.12, SD 4.39; postinstitutionalized bilateral coordination mean 11.97, SD 5.43, comparison children mean 19.97, SD 3.97). The length of time that children remained institutionalized before adoption predicted balance delays (b=-1.57, t=-2.33, p=0.027) and the severity of caregiving deprivation the children experienced correlated with bilateral coordination (r=-0.44, p=0.013). INTERPRETATION These findings suggest that institutionalized settings do not provide the early life experiences needed for the development of age-level motor skills later in childhood and that simple environmental enrichment following adoption is not enough to remediate skills. Children who have experienced early institutional care may benefit from early identification and targeted intervention.