Adopted Children & Klanguage Aquisition

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LSHSS
Communication Development and Differences in Children Adopted From China and Eastern Europe
Deborah A. Hwa-Froelich Hisako Matsuo
Saint Louis University, MO
he number of children adopted from foreign countries has increased significantly. Between 1971 and 2001, 265,677 children from different countries were adopted in the United States. Since 2001, almost half (126,921) of this number were adopted over a 5-year time span (adoption.com, 2004; Adoption Institute, 2004; U.S. Department of State, 2007). In 2007 alone, 19,613 children entered the United States, most of whom were from China and Taiwan (5,637) or from Eastern European countries (3,601) (U.S. Department of State, 2007). Because most of the children who are adopted from abroad are from these two regions, it is important to investigate whether children adopted from China and Eastern Europe develop English similarly. Children who are adopted internationally are at high risk for developmental delays because of their exposure to institutional environments. In addition, because minimal information about typical postadoption development and recovery exists, internationally adopted children are often referred for and receive early intervention services that may or may not be appropriate. It has been reported that 54% to 60% of children adopted from Eastern Europe are receiving special education services (Glennen & Bright, 2005;
ABSTRACT: Purpose: The communication development of children adopted from China and Eastern Europe was compared by region of origin at 6 and 12 months after adoption. Method: Twenty children, recruited before or immediately following their adoption, participated in the study. Measures were collected between 2 and 6 months after adoption (Time 1) and between 12 and 14 months after adoption (Time 2). The childrens ages ranged between 1122 months and 2234 months, respectively. Parent-reported vocabulary comprehension and expression and behavioral communication assessments were administered. Results: No significant differences between region of origin were found at Time 1. At Time 2, significant group differences
Glennen & Masters, 2002; Mason & Narad, 2005). Glennen and Bright (2005) reported that 35% to 50% of children from a sample of 130 infants and toddlers adopted from Eastern Europe received speech and language intervention services before 36 months of age. In a subset (46) of this sample at ages 6;6 (years;months) and 9;1, the diagnosis of speech-language delay or disorder decreased from 47.3% to 11.4%. It is unclear whether children receiving these services reflect actual prevalence of speech-language disorders or overreferral. More information documenting English language development is needed to guide speech and language assessments of children adopted from abroad and to compare the developmental progression of English language development in children adopted from China and children adopted from Eastern Europe.
Preadoption Risk Factors

It has been well documented that children adopted from abroad are at risk of developmental delays (Johnson, 2000; Miller, 2005). Quality of care may vary across regions and countries, but most orphanages lack funding and have high childstaff ratios that
in expressive language performance were found, with children adopted from China and Eastern Europe demonstrating different patterns of English language development. Conclusion: Early prelinguistic measures may provide prognostic indicators for later English language development. Children adopted from different countries where they are initially exposed to different birth languages may acquire English differently.
KEY WORDS: internationally adopted children, English language development, regional differences
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negatively impact childrens (a) health care and nutrition, (b) social stimulation, and (c) availability of stimulating materials (Groza, Ryan, & Cash, 2005; Johnson, 2000; Johnson & Dole, 1999; Miller, 2005; Miller & Hendrie, 2000; Morison, Ames, & Chisholm, 1995; Sullivan et al., 2004). Early research on internationally adopted children indicates that these children are at increased risk of decreased physical growth, infectious diseases, and developmental delays (Albers, Johnson, Hostetter, Iverson, & Miller, 1997; Hostetter et al., 1991; Miller, 2005). The quality of institutionalized care and the length of institutionalization seem to be related to childrens postadoption adaptation and development. Children adopted from countries with increased health care and better economic conditions such as Korea tend to have better cognitive, academic achievement, and social adjustment outcomes than children adopted from countries with less developed infrastructures (Clark & Hanisee, 1982; Frydman & Lynn, 1989; Goodman & Kim, 2000; Kvifte Andresen, 1992; Wickes & Slate, 1996). In addition, some studies have found that children adopted at younger ages (<6 months of age) from Eastern Europe such as Romania, or Asian countries such as Korea, have better outcomes than children adopted at older ages (>2 years) (Dalen, 2001; Johnson, 2000; Morison et al., 1995; Morison & Ellwood, 2000; OConnor, Bredenkamp, Rutter, & the English and Romanian Adoptees Study Team, 1999; Pomerleau et al., 2005; Rutter et al., 2007a, 2007b). More information on Eastern European orphanage care than Chinese orphanage care is available, and different cultural issues may affect the children available for adoption from China (Miller, 2005; Tan & Yang, 2005). Because of the population and family planning policy instituted in China in 1978 (Hesketh, Lu, & Xing, 2005), Chinese parents face prosecution, fines, or sterilization if they are caught abandoning a child, and with the cultural preference for boys, female infants are abandoned, aborted, missing, or reported as cases of infanticide. Parents travel some distance from their homes to leave their infants in public places, with little information other than the infants birth date pinned to their clothing (Miller, 2005). In spite of these preadoption cultural differences, early postadoption health and development of children adopted from China was similar to that of children adopted from Eastern Europe (Miller & Hendrie, 2000; Pomerleau et al., 2005). Thus, soon after adoption, before internationally adopted children may benefit from improved environmental conditions, they may appear to be significantly delayed in comparison to biologically born children. Additionally, the process of international adoption involves an abrupt move from exposure to the childrens birth language and culture to a new adopted language and culture. Consequently, the language developmental milestones of internationally adopted children may differ from those of native children and domestically adopted children (Glennen, 2002, 2005; Glennen & Masters, 2002; Snedeker, Geren, & Shafto, 2007; Wadsworth, DeFries, & Fulker, 1993), and English language development may differ for children adopted from different countries who have been exposed to different languages. In addition, internationally adopted childrens language development is different from that of children learning two or more languages, as in the case of bilingual language development. (Glennen, 2007a, 2007b; Hwa-Froelich, 2007; Hwa-Froelich & Matsuo, 2008; Roberts et al., 2005). Bilingual children are exposed to two languages and can use one language to assist them in learning a second language. In contrast, internationally adopted children are often adopted by families who do not speak the adopted childs birth
language or who do not have the resources available to expose their adopted child to his or her birth language and culture on a consistent basis. Thus, the adopted children cannot use their birth language to assist them in learning their adopted language (Gindis, 1999, 2003; Nicoladis & Grabois, 2002). Unlike in bilingual language development, there is evidence of little to no interference between the childrens birth and adopted language for children adopted before 2 years of age in both speech and syntactic development (Glennen, Rosinsky-Grunhut, & Tracy, 2005; Pollock, 2007). Although there may be little birth language interference demonstrated in adopted language development, there may be differences in the acquisition rate of an adopted language when the adopted language is significantly different than the birth language. To date, English language development of children who were initially exposed to Chinese or Eastern European languages has not been compared. Given the preadoption experience of institutional care and exposure to different birth languages, and the abrupt change to exposure and development of English, it is difficult to determine whether adopted children acquiring English have a communication disorder or need more or less time to adjust to a language that is more or less different than their birth language. In other words, is the developmental progression for postadoption English language development similar for children adopted from China in comparison to children adopted from Eastern Europe?
Crosslinguistic Effects on Adopted Language Development

It has been well documented that infants attend and begin to learn their native language early in life. Researchers have found that 6- to 9-month-old infants use phonotactic patterns to discern words in running speech (Friederici & Wessels, 1993; Mattys, Jusczyk, Luce, & Morgan, 1999). In addition, early speech perception performance at 6 months of age has been found to predict language development at 2 years of age (Tsao, Liu, & Kuhl, 2004). Tsao and colleagues (2004) argued that having more advanced phonetic perception assists infants in detecting phonetic word differences and accelerates their language learning. These studies focused on infants who had been exposed to one language. In studies of children who have been exposed to different language stimuli, children demonstrated preferences for their native language at early ages. Moon, Cooper, and Fifer (1993) documented that as early as 2 days of age, infants showed preferences for native language sounds and melodies over foreign ones if the languages of choice were from significantly different origins. For example, infants discriminated between the rhythmically different languages of Japanese and English but not German and English (Nazzi, Bertoncini, & Mehler, 1998; Nazzi, Jusczyk, & Johnson, 2000). By 4 to 5 months of age, children can discriminate between languages from the same linguistic families (Bosch & Sebastian-Galles, 1997). Between 6 and 12 months of age, infants demonstrate an inverse relationship showing a decreased perception of foreign languages and an increased perception of native language stimuli (Kuhl, Tsao, & Liu, 2003). By 1 year of age, children do not discriminate different phonemes of other languages that are no longer meaningful to them (Werker & Polka, 1993; Werker & Tees, 1984). In other words, by 1 year of age, speech perception of the languages children hear affects their linguistic representations, and they no longer attend to speech stimuli outside of this representation. In the case of internationally adopted children who are exposed to one language and then
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removed from exposure to the birth language, dependent on the adopted language, the children may be exposed to similar or different phonologies, syllable structures, and morphological structures than their birth language. It is unknown whether crosslinguistic differences between the birth and adopted language impact development of the adopted language. Eastern European languages, in comparison to the Chinese language, are more similar to English. For the purposes of this report, linguistic differences between the two regions will be limited to general linguistic differences. Eastern Europe is loosely defined as the countries between the Ural mountains and Central Europe, encompassing the countries of Belarus, Bulgaria, Czech Republic, Hungary, Moldova, Poland, Romania, Russia, Slovakia, and Ukraine, where many languages including non-Slavic ones are spoken. Many children are adopted from Russia, where the commonly spoken Slavic language is Russian, with Indo-European linguistic roots (Cubberley, 2002). Although Russian phonology and morphology is notably different than English phonology and morphology, it has some similarities. Russian has 34 consonants and 5 vowels. Consonant sequences and syllable length can vary with up to four consonant sequences, and word length can consist of up to eight syllables (Wright, 2005). In a study of 11 monolingual English and 5 bilingual RussianEnglish preschool-age children, Wright (2005) found that most of the bilingual children expressed the majority of English consonants in the initial, medial, and final positions except for the /z, v/ and voiced and voiceless productions of th. The bilingual children also produced all of the English monophthongs and diphthongs except for two rhotic or r-colored vowels. A variety of two-element consonant sequences and at least one three-element sequence were produced by most of the children. Morphologically, Russian includes prefixes and suffixes to denote plurals, possession, and verb tense and aspect (Borras & Christian, 1971; Thelin, 1975; Townsend, 1968). Borras and Christian (1971) found the Russian language similar to English in plural, possession, and present progressive word formation. In addition, languages with elaborate inflectional morphology, such as Italian, have been found to influence childrens early syntactic development (Devescovi et al., 2005). Chinese, on the other hand, is a tonal language consisting of monosyllabic and disyllabic words with no consonant clusters or affixes (Cheng, 1991; Shi, 2002; So, 2007; Zhu, 2007). Although many regional dialects are spoken in China, all dialects are similar in that they are tonal languages with predominantly open syllables consisting of consonantvowel (CV, CV, CVV, VC, or CVC) syllable structures in which the only consonants that can be terminal consonants are the /n, h /. Some dialects use consonant clusters, such as colloquial Cantonese, which uses /kl/ in some words (So, 2007). Chinese dialects vary in their number of consonants, vowels, diphthongs, and tones. For example, Cantonese has 19 consonants, 11 vowels, 11 diphthongs, and 6 tones, whereas Putonghua (Mandarin) has 22 consonants, 22 vowels, 9 diphthongs, 4 triphthongs, 4 tones, and no consonant clusters (Zhu, 2007). Speech development data for Cantonese-speaking and Mandarin-speaking children indicate that syllable structure is acquired by the age of 2 years in both languages (So, 2007; Zhu, 2007). Historically, Chinese consisted of single syllables representing single words. In Modern Chinese, many words are disyllabic (Shi, 2002). Disyllabic words have two syllables spoken consecutively, but the second syllable tends to be phonologically reduced (e.g., its tone is neutralized) (Shi, 2002, p. 1). Tones are added to
morphemes to create different semantic meaning. Lexical information is conveyed by both tones and phoneme sequence (Zhu, 2002). Monolingual Cantonese-speaking children acquire tones between 14 and 25 months of age (So, 2007). Mandarin-speaking children acquire tones between 14 and 22 months of age (Zhu, 2002, 2007). Consonant sequences, syllabic stress in multisyllabic words, and inflectional morphemes are common in the English language and Eastern European languages but not in the Chinese language. Thus, consonant sequences, multisyllabic words, syllabic stress, and inflectional morphemes are difficult for Chinese speakers learning English (Cheng, 1991). The more similar a childs second language is to their first language, the easier it will be acquired. Dulay and Burt (1974) found that Chinese-speaking children were less accurate in expressing English morphemes than Spanish-speaking children whose second language was more similar to their first language. Given that Russian shares certain key characteristics with English that Chinese lacks, it is possible that these characteristics might facilitate ease of acquisition in those shared domains.
Postadoption Communication Development

As stated previously, many internationally adopted children may not be exposed to their native language once they arrive in the United States because adoptive families may not be able to speak or have access to native language resources. In contrast to children who learn other languages simultaneously or sequentially, a newly adopted child gains a new language while development in his or her birth language suddenly stops (Gindis, 1999, 2003, 2005; Nicoladis & Grabois, 2002). In a case study of a 17-month-old adopted Chinese girl, Nicoladis and Grabois (2002) found that she stopped imitating, spontaneously expressing, and comprehending Chinese at 1, 2, and 4 months after adoption, respectively, and focused instead on the language of the adoptive family. Children who are adopted at older ages (48 years) demonstrate a similar progression of language loss, that is, they lose expression then comprehension of their birth language within 3 to 6 months after adoption (Gindis, 1999, 2003, 2005). Language development of internationally adopted children reflects disrupted, rather than bilingual, language development. Research documenting the communication development of children adopted from China and Eastern Europe has provided evidence that the majority of these children rapidly acquire the English language (Glennen, 2005, 2007b; Roberts et al., 2005). However, different measures were used at different postadoption ages, providing splintered developmental information. Some studies focused on postadoption development within one cultural and linguistic group acquiring different adopted languages such as Norwegian, British, Canadian, or American English (Cohen, Lojkasek, Zadeh, Pugliese, & Kiefer, 2008; Croft et al., 2007; Dalen & Rygvold, 2006; Glennen, 2005, 2007b; Roberts et al., 2005; Scott, Roberts & Krakow, 2008). A few studies grouped children adopted from different cultures and languages together to compare them with nonadopted peers (Berg-Kelly & Eriksson, 1997; Clark & Hanisee, 1982; Dalen, 1995, 2001; Hene, 1988; Kvifte-Andresen, 1992). Of these, only Clark and Hanisee (1982) collected behavioral receptive language measures comparing 25 children adopted before 3 years of age from Vietnam, Korea, Cambodia, and Thailand with U.S. receptive vocabulary test norms. Clark and Hanisee found that the adopted children between the ages of 31 and 71 months scored significantly higher than test norms in receptive vocabulary.
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Other studies have collected parent, teacher, or adoptee survey responses on either unpublished or published survey instruments with mixed outcomes (Berg-Kelly & Eriksson, 1997; Dalen, 2001; Hene, 1988; Kvifte-Andresen, 1992 ). Most of these studies focused on adult or adolescent adoptees perspectives of their own abilities. Kvifte-Andresen (1992) compared school-age children adopted from Korea and other countries with Norwegian age-matched nonadopted peers using parent/teacher surveys reporting on reading and writing performance. No significant differences were reported. Of these studies, only Dalen (2001) found language performance differences among school-age participants from different countries of origin. Using teacher surveys, Dalen compared children adopted from Colombia and children adopted from Korea between the ages of 2 and 81 months with nonadopted Norwegian peers. All children were matched by grade level and were between the fourth and ninth grades at the time of the study. Although no differences were found between the adoptees and their same-age Norwegian peers in their use of everyday language, children adopted from Korea were found to perform better than the Colombian children in their use of academic language. Dalen concluded that these differences may be related to quality of care in that Korean children may receive better preadoption care than children from Colombia. Dalen did not measure early Norwegian language development, and language performance was measured by teacher report. No studies have reported data comparing English language development in children adopted from China and Eastern European countries. Information comparing typical language development of an adopted language across different regional, cultural, and linguistic groups is needed to determine whether adopted language development differs depending on the country of origin. Children adopted from Eastern Europe. Studies on children who have been adopted from Eastern Europe have provided some information on postadoption English language development. Glennen (2002, 2005, 2007b; Glennen & Masters, 2002) provided both parent report and behaviorally measured linguistic developmental information. Glennen and Masters (2002) found that children who were adopted before 12 months of age caught up with their Englishspeaking peers on the Language Development Survey (LDS; Rescorla, 1989) within 12 months following adoption. Children adopted between 13 and 18 months met the 50-word cutoff for English-speaking peers by 3740 months of age, or 1927 months after adoption. Children adopted between 19 and 24 months met this same guideline by 28 months of age, or 49 months after adoption. In 2005 and 2007, Glennen recruited 28 children from Eastern Europe who were adopted between 11 and 23 months of age and were seen initially at 2 to 4 months after adoption and then again at approximately 12 months after adoption. Based on the data for this cohort, Glennen developed English vocabulary development, prelinguistic communication, and symbolic behavior developmental referral guidelines for adopted children from Eastern Europe between the ages of 11 and 23 months measured at 2 to 4 months after adoption (Glennen, 2005). She recommended that children adopted from Eastern Europe should be referred for intervention if they receive a developmental quotient < 47 for the parent-reported MacArthurBates Communicative Development InventoriesWords Comprehended subtest (MCDIWC; Fenson et al., 1993) and/or a total standard score < 80 on the Communication and Symbolic Behavior ScalesDevelopmental Profile (CSBSDP; Wetherby & Prizant, 2002). In a later study following this same cohort, Glennen (2007b) found that children performing above the referral guidelines had
average or higher language development a year later. Using the Preschool Language Scale, 3rd or 4th edition (PLS3 or 4, Zimmerman, Steiner, & Pond, 1992, 2002), Glennen reported receptive language scores that were average or above the mean for English-speaking peers (M = 103.85, SD = 16.02) and expressive scores that were average or within 2 SDs of the mean for English-speaking peers (M = 93.33, SD = 15.96). In contrast, those children who scored below the above-mentioned referral guidelines continued to have belowaverage scores on general language measures approximately 1 year later. Glennen et al. (2005) reported that expressive language scores and expressive morphological development of four inflectional morphemes (present progressive ing, plural s, possessive s, and past tense ed ) for children adopted from Eastern Europe seemed to lag behind receptive development at 12 months after adoption and recommended comparing performance to that of other children adopted from Eastern Europe to determine whether a true expressive language disorder existed. Glennen (in press) reported that after 2 years of exposure, Eastern European children appeared to have equivalent English language development according to test norms for Englishspeaking children of the same age. Children adopted from China. Little research exists that provides behavioral measures of English language development for children who have been adopted from China. Several studies have gathered parent- and/or teacher-reported data on the expressive English vocabulary and lexical syntax development of children who have been adopted from China (Dalen & Rygvold, 2006; Geren, Snedeker, & Ax, 2005; Krakow & Roberts, 2003; Pollock, 2005; Tan & Yang, 2005). Tan and Yang (2005) provided parent-reported vocabulary development from the Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2000), which includes the LDS, and found that Chinese children who had been adopted between 3 and 28 months of age were comparable in expressive vocabulary to their Englishspeaking peers by 16 months after adoption. They reported that the 18- to 23-month-old group had considerably higher delay than the normative sample (p. 63). In addition, Krakow and Roberts (2003) reported that by 30 months of age, or 21 months after adoption, 73% to 80% of 15 adopted Chinese children were comparable to English-speaking norms on the LDS. These LDS expressive vocabulary outcomes are developmentally later than those reported for Eastern European children adopted before 12 months of age and those adopted between 19 and 24 months of age (Glennen & Masters, 2002). Studies using the MCDI parent-report measures have found rapid expressive vocabulary development in internationally adopted children. Pollock (2005) reported that her sample of 150 children adopted from China between 7 and 24 months of age largely acquired English words at least as quickly as children adopted from Eastern Europe at similar ages and in fact reached the 50-word cutoff several months earlier (p. 27). Children adopted at older ages produced longer utterances more quickly than younger children. Snedeker et al. (2007) collected MCDI2 Words and Sentences parent reports and spontaneous language samples on 27 children adopted from China between 2;7 and 5;6. Measures were collected between 3 and 16 months after adoption every 3 months for 18 months. They found that older adopted children acquired English similarly but more rapidly than an infant control group matched for expressive vocabulary age. Because these older adoptees acquired more English in a similar sequence, the authors hypothesized that the adopted children were not mapping second language labels to previously acquired first language labels; instead, the children seemed to be mapping second language labels to
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prelinguistic representations of event components, making vocabulary acquisition similar to infants learning vocabulary (e.g., early noun and later verb learning). Thus, vocabulary learning was more a function of the learners linguistic knowledge and its effect on input representation. These studies focused primarily on parent-reported expressive vocabulary development of children from China. Few studies have involved behavioral measures of Chinese childrens development following adoption. To date, three studies with behavioral measures focused on children adopted from China. In a longitudinal study of 4 adopted Chinese girls between 11 and 13 months of age, Hwa-Froelich and Matsuo (2008) measured monthly prelinguistic social, speech, and symbolic play behaviors for the first year following adoption, with annual language measures collected at 2 and 3 years after adoption. They documented similar patterns of communication and play development as compared to data on Eastern European children during the first year following adoption (Glennen, 2005). Three girls were comparable to English-speaking standardized norms by 2 years after adoption. The youngest girl was comparable by 3 years after adoption. Roberts et al. (2005) and Roberts, Krakow, and Pollock (2003) reported on behavioral measures collected 2 to 3 years after adoption on 55 Chinese children who were adopted between the ages of 6 and 25 months. They found that 85.5% of their sample scored well within average range on at least two standardized tests of English language development 2 or 3 years following adoption. The authors also noted that the childrens adoption age and number of months following adoption predicted their performance on the language measures. Roberts and colleagues did not measure English language development in the early months following adoption. Cohen et al. (2008) compared children adopted from China with a nonadopted peer group. They followed 70 girls adopted from China and measured their physical, mental, psychomotor, and language development at initial, 6-month, 12-month, and 24-month follow-ups. Language was primarily assessed using the PLS3. They found that although the Chinese children were commensurate with their nonadopted peers in receptive language by 6 months following adoption, their expressive language was not comparable until 2 years after adoption. These studies did not compare English language development with children adopted from Eastern Europe. Because these data were not comparable to the data collected on Eastern European adopted children, it is unknown whether the rate of English language development is the same for children adopted from Eastern Europe and those adopted from China. Given the linguistic differences between Russian and Chinese languages and the early speech perception development in infants, it is important to study whether children adopted from different linguistic backgrounds develop English in the same way. This study focused on two research questions: & Do children adopted from China and Eastern Europe have similar English language development when measured soon after adoption? & Do children adopted from China and Eastern Europe have similar English language development when measured 1 year after adoption? The null hypothesis is that English language development is similar for children adopted from China and Eastern Europe before the age of 2 years. The research hypothesis is that English language development differs for children exposed to language typologies that differ from English.
METHOD Participants
Time 1. The participants for this study were 20 children who were drawn from a sample of 27 internationally adopted children between the ages of 11 and 23 months. Children were adopted from China and Eastern Europe. Five children were excluded because of scheduling problems, and 2 were excluded because they had unrepaired cleft palates. The children were recruited through adoption agencies in the Midwest, pediatric offices, and word-of-mouth. To avoid recruiting children whose parents suspected that their child had developmental delays, participants were recruited either before adoption or immediately following adoption. Families completed a case history form designed for adopted children. The childrens parents reported that their childrens general health at the time of adoption ranged between average to excellent, and none of the children had current diagnoses of any disabilities. Due to the inconsistency with orphanage records and the fact that most children adopted from China had no medical records before being found, most of the parents either did not know their childs health at birth or questioned the accuracy of the information they were given. Therefore, information regarding the childrens birth or birth parent was not included. In addition, the parents did not know the languages to which the children had been exposed, and none of the parents spoke their childs birth language. Twenty adopted children, 11 from China and 9 from Eastern Europe (5 males, 15 females), were included in this study. All children were between the ages of 11 and 23 months (M = 16.90, SD = 3.09) and were seen within 6 months following adoption (M = 4.10 SD = 1.55). No significant differences were found between the two groups in terms of number of months after adoption when the children were initially measured (z = 1.023, p = .331) or age at the initial time of testing (z = 1.839, p = .067). There are unequal gender distributions in this sample according to the regions; there were 11 girls and no boys from China, and there were 4 boys and 5 girls from Eastern European countries (c2 = 6.11, p = .016). Gender differences for children adopted from China are due to the Chinese cultural preference for male children (Miller, 2005). Thus, this is a typical sample for children adopted from China and Eastern Europe. See Table 1 for participant characteristics for the participant group at Time 1. Time 2. Due to sample attrition, 14 (70%) children were tested between 12 and 14 months after adoption (M = 12.50, SD = .760). The sample consisted of 7 Chinese females and 7 Eastern European children (2 males, 5 females). Their ages at the time of the 12-month follow-up ranged from 22 to 34 months (M = 26.857, SD = 2.742). See Table 2 for participant characteristics at Time 2. No significant differences were found between regional groups for time they were seen after adoption (z = .450, p = .710) or by chronological age (z = 1.556, p = .128). Refer to Table 3 for means and standard deviations of age at adoption at Time 1 and Time 2 assessments. To determine whether there were differences between the group of Chinese children who remained in the study at Time 2 and the children who discontinued participation in the study, the sample for Time 2 was compared with the children who discontinued
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Table 1. Participants scores at Time 1 on the MacArthur-Bates Communicative Development Inventories (MCDI; Fenson et al., 1993) and the Communication and Symbolic Behavior ScalesDevelopmental Profile (CSBSDP; Wetherby & Prizant, 2002).
MCDI Comprehension/Expression DQ Child TM SD 1 2 3 4 5 6 7 8 9 10 11 CM SD 12 13 14 15 16 17 18 19 20 EEM SD Age 16.90 3.09 11 12 13 14 15 16 17 18 18 19 19 15.64 2.84 14 16 17 18 18 19 19 22 23 18.44 2.79 AA 12.80 3.16 8 10 11 9 12 11 15 13 12 15 14 11.82 2.32 8 10 14 16 12 14 14 20 18 14 3.74 M M F M F F F F M Kazakhstan Russia Russia Russia Russia Russia Russia Ukraine Russia F F F F F F F F F F F China China China China China China China China China China China Gender Country PA 4.10 1.55 3 2 2 5 3 5 2 5 6 4 5 3.82 1.47 6 6 3 2 6 5 5 2 5 4.44 1.67 Words Comprehended 84.35 80.57 72.73 91.66 61.54 57.14 66.67 81.25 70.59 77.78 66.17 57.90 84.21 71.65 11.14 114.27 50.00 58.82 72.22 77.78 78.95 63.16 36.36 65.21 68.53 21.84 Phrase 15.27 11.22 72.73 66.66 123.08 57.14 66.67 100.00 82.35 77.78 77.78 47.38 84.20 77.80 20.57 92.86 62.50 58.82 55.56 66.67 84.21 84.21 36.36 69.56 67.86 17.39 Words Expressed 18.35 28.95 100.00 66.70 84.62 85.71 66.67 81.25 82.35 77.78 72.22 63.16 73.70 77.65 10.69 114.29 81.30 76.47 88.89 88.89 78.95 78.95 59.10 69.60 81.83 15.27 Social 11.50 3.30 10.00 10.00 9.00 9.00 11.00 11.00 16.00 15.00 17.00 8.00 8.00 11.27 3.23 7.00 9.00 16.00 17.00 11.00 11.00 8.00 15.00 12.00 11.78 3.56
CSBSDP Speech 8.50 1.82 11.00 10.00 8.00 8.00 8.00 7.00 11.00 11.00 9.00 7.00 4.00 8.55 2.16 8.00 9.00 11.00 10.00 9.00 7.00 7.00 8.00 7.00 8.44 1.42 Symbolic 8.40 2.37 9.00 8.00 12.00 7.00 7.00 8.00 12.00 8.00 11.00 9.00 5.00 8.73 2.20 5.00 6.00 11.00 9.00 6.00 10.00 8.00 5.00 12.00 8.00 2.65 Total 93.00 10.58 96.00 95.00 91.00 88.00 91.00 89.00 115.00 102.00 106.00 81.00 73.00 93.36 11.57 80.00 85.00 111.00 105.00 90.00 95.00 87.00 87.00 93.00 92.56 9.90
Note. AA = age at adoption, PA = number of months seen after adoption, DQ = Developmental quotient, TM = Total mean, CM = Chinese mean, and EEM = Eastern European mean.
participation across all measures at Time 1. No significant differences were found for adoption age (z = .761, p = .527), age at Time 1 (z = 1.519, p = .164), months after adoption (z = 1.860, p = .073), MCDIWords and Gestures (MCDIWG; Fenson et al., 1993) Words Comprehended (MCDIWC) subtest developmental quotient (DQ) (z = .568, p = .648), Words Expressed (MCDI WE) subtest DQ (z = 1.134, p = .315), and CSBSDP total score (z = .474, p = .648). Therefore, the sample for Time 2 was judged to be similar to the group of children who discontinued participation in the study. Family demographics differed for the children. Eighteen children had one sibling, and 2 (12 & 14) of the children had two siblings. Three (2, 8, & 16) of the families were single-parent families. Tan and Yang (2005) found that the adoptive family background (education level, income level, and marital status) was not predictive of communication outcomes. Thus, these differences were not expected to affect study findings.
Measures
Using the same measures described by Glennen (2005, 2007b), the CSBSDP and the MCDIWG were administered during the
first data collection session. The PLS4 was administered approximately 6 months later. The CSBSDP measures prelinguistic communication, social, and symbolic behaviors, such as eye contact, gestures, turn taking, and pretend play, as well as verbalizations, regardless of linguistic background. The Social Composite measures childrens emotion, eye gaze, and communicative functions. The Speech Composite measures childrens consonantvowel sound and word production. The Symbolic Composite measures childrens understanding of object labels, person names, and body parts as well as functional and symbolic use of common objects (e.g., books, blocks, doll, baby bottle, cups, spoons, and pots and pans with lids). The CSBSDP is used to identify infants and toddlers with language delays and is predictive of language development at age 2 (Wetherby, Allen, Cleary, Kublin, & Goldstein, 2002). The internal consistency reliability for the CSBSDP composite scores ranges from .86 to .93. Data on 4 children adopted from China have been collected using this instrument (Hwa-Froelich & Matsuo, 2008). The MCDIWG is a parent-report measure of infant English language development counting words, phrases, and symbolic gestures that the children comprehend and express. Research has found the MCDI to be a valid and reliable measure of early language abilities (Klee et al., 1998; Thal, OHanlon, Clemmons, & Frailin,
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Table 2. Participants scores at Time 2 on the CSBSDP and the Preschool Language Scale, 4th edition (PLS4; Zimmerman, Steiner, & Pond, 2002).
CSBSDP Child TM SD 1 5 6 8 9 10 11 CM SD 13 14 15 16 17 18 19 EEM SD Age 26.86 2.74 22 26 25 26 25 29 27 25.71 2.14 25 27 29 26 27 28 34 28 2.94 AA 12.80 3.16 8 12 11 13 12 15 14 11.82 2.32 10 14 16 12 14 14 20 14 3.74 M F M F F F F Russia Russia Russia Russia Russia Russia Ukraine F F F F F F F China China China China China China China Gender Country PA 12.50 .76 12 14 12 12 12 13 12 12.43 .79 14 12 12 13 12 12 13 12.57 .79 13.00 13.00 12.00 119.00 98.00 87.00 126.00 94.00 109.00 109.00 103.83 13.85 81.00 105.00 109.00 94.00 81.00 87.00 81.00 91.14 11.87 Social Speech Symbolic Total Comprehension 97.00 13.92
PLS4 Expression 94.77 10.87 91.00 89.00 87.00 83.00 91.00 91.00 88.67 3.20 95.00 100.00 126.00 97.00 87.00 103.00 92.00 100.00 12.60 Total 95.92 10.60 99.00 87.00 107.00 87.00 100.00 100.00 96.67 8.02 87.00 103.00 120.00 95.00 82.00 95.00 85.00 95.29 13.05
Note. AA = age at adoption, PA = number of months seen after adoption, DQ = Developmental quotient, TM = Total mean, CM = Chinese mean, and EEM = Eastern European mean.
1999). The internal consistency reliability for the MCDI composite score was reported to be .95. Data for 3, 6, 9, and 12 months after adoption have been collected on 78 children adopted from China at 12 months of age, 47 children adopted between 13 and 18 months of age, and 11 children adopted between 19 and 24 months of age (Pollack, 2005). Data on 28 children adopted from Eastern Europe
between the ages of 12 and 24 months measured at 1 to 5 months after adoption have been collected (Glennen, 2005). To create a DQ for MCDI scores, the 50th percentile age equivalency that matches the childs MCDI score is divided by the childs chronological age and multiplied by 100 (DQ = 50th percentile age equivalency/CA 100).
Table 3. Childrens ages (in months) at adoption and at Time 1 (N = 20; 5 boys, 15 girls) and Time 2 (N = 14; 2 boys, 12 girls) assessment times.
Childrens ages and time home Age of adoption Chinese Eastern European Age at Time 1 assessment Chinese Eastern European Months home at Time 1 assessment Chinese Eastern European Age at Time 2 assessment Chinese Eastern European Months home at Time 2 assessment Chinese Eastern European Note. MWU = Mann-Whitney U statistic.
M 12.800 11.820 14.000 16.900 18.640 18.440 4.100 3.820 4.440 26.857 25.714 28.000 12.500 12.430 12.570
SD 3.156 2.316 3.742 3.093 2.838 2.789 1.553 1.471 1.667 2.742 2.138 2.944 .760 .787 .787
Range 820 815 820 1123 1119 1423 26 26 26 2234 2229 2534 1214 1214 1214
MWU p value (1-tail) .175
.067
.331
.710
.128
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The PLS4 is a general measure of receptive and expressive language development. It was standardized on 15,000 children (39.1% were minorities) between birth and 6 years of age. Sensitivity scores for children with language disorders across age groups ranged from .74 to .83, and specificity scores ranged from .75 to .96. Glennen (2007b) reported 12-month postadoption PLS4 scores for 27 children adopted from Eastern Europe. No PLS4 scores have been reported for children adopted from China at 12 months after adoption. Refer to Table 2 for the scores of the children in the study.
Reliability
Three graduate students in a communication sciences and disorders department conducted intra- and pairwise interrater reliability measures on 6 (22%) randomly selected cases. Reliability measures for the CSBSDP were computed by dividing agreements on raw scores by the total raw score number. This measure of reliability was computed for each student examiner for both intrarater reliability and pairwise interrater reliability. Comparing the CSBSDP behavioral sample standard scores for the speech, social, symbolic behavior, and total scores, intrareliability ranged from .94 to .99. Pairwise interrater reliability on the same 6 cases ranged from .84 to .98. All PLS4 scores were checked and corrected by the first author.
Procedure
The methodology for this study was a replication of the Glennen (2005, 2007b) studies on 11- to 23-month-old children adopted from Eastern Europe, with the exception that a subsample of children adopted from China was included. Each child was seen at the Saint Louis University International Adoption Clinic for approximately 1-hr sessions. The children were evaluated during the first 6 months following adoption. This time period was selected based on an earlier study following the monthly communication development of 4 infants adopted from China (Hwa-Froelich & Matsuo, 2008). The authors found a pattern of depressed performance between 6 to 8 months following adoption, which may have been affected by the developmental process of attachment. Therefore, all participants for this study were measured within the first 6 months following adoption. All children received a hearing screening that included sound field testing, an otoscopic examination, and impedance tympanometry. Eighteen (90%) of the children passed both the sound field and tympanometry screenings. Two children passed the sound field screening but demonstrated flattened tympanograms; 1 of these children failed because of bilateral myringotomy tubes, the other because of fluid. All children were included in this study because they passed the sound field screening on initial or subsequent testing. The MCDIWG and CSBSDP were administered by speechlanguage pathology graduate students. The parents were given the MCDIWG approximately 2 weeks before the assessment and returned the MCDIWG at the assessment session. One of each childs parents participated in the CSBSDP sessions and was trained to follow the assessment procedures outlined in the manual. The second session (Time 2) was scheduled approximately at each childs 12-month postadoption time period. The PLS4 was administered to 13 of the 14 returning children. One child (1) was 22 months of age and was too young for the PLS4 so the CSBSDP was administered. Analyses were completed including and excluding Child 1 to determine if variations were due to use of a different measure. These analyses resulted in the same findings regardless of whether the CSBSDP scores for the child were included or excluded. Specific details for these comparisons are described in the Results section.
RESULTS
Children adopted from China and from Eastern Europe before the age of 2 years were measured between 2 and 6 months after adoption (Time 1) and between 12 and 14 months after adoption (Time 2). Three major findings from this study will be discussed in this section: (a) No significant differences were found by region of origin at Time 1, (b) both groups of children performed above a standard score of 80 on all portions of the PLS4 at Time 2 (the recommended cutoff score, Glennen, 2007b), and (c) significant differences in expressive English language development were found between children adopted from China and children adopted from Eastern Europe at Time 2. The results will be discussed in relation to the research questions.
Time 1 Regional Comparisons

Performances among the children from China and from Eastern Europe were similar. The Chinese childrens MCDIWC DQs ranged from 57.14 to 91.66 (M = 71.65, SD = 11.14), and the Eastern European childrens DQs ranged from 36.36 to 114.29 (M = 68.53, SD = 21.84). Phrases comprehended DQs for the Chinese children ranged between 47.38 and 123.08 (M = 77.80, SD = 20.57), whereas the DQs for Eastern European children ranged from 36.36 to 92.86 (M = 67.86, SD = 17.39). MCDIWE DQs ranged between 63.16 and 100.00 (M = 77.65, SD = 10.69) for the Chinese children and between 59.10 and 114.29 (M = 81.83, SD = 15.27) for the Eastern European children. All MCDIWC DQs except for those of 1 Eastern European girl (#19) were above the recommended cutoff DQ of 47. Refer to Table 1 for the childrens individual scores. The majority of the Chinese childrens performances (10/11) on the CSBSDP were also at or above the recommended cutoff total standard score of 80. The total standard scores for the Chinese children ranged between 73.00 and 115.00 (M = 93.36, SD = 11.57), as compared to the Eastern European children, whose scores ranged between 80.00 and 111.00 (M = 92.56, SD = 9.90). The Chinese childrens Social Composite standard scores ranged from 8.00 to 17.00 (M = 11.27, SD = 3.23), and the Eastern European childrens scores ranged from 7.00 to 17.00 (M = 11.78, SD = 3.56). The Speech Composite standard scores for the Chinese children ranged between 4.00 and 11.00 (M = 8.55, SD = 2.16); the Speech Composite standard scores for the Eastern European children ranged
Analysis
Nonparametric statistical analyses were used because nonparametric analyses are recommended for small sample size analyses (McSweeney & Katz, 1978). The Mann-Whitney U nonparametric statistic was used to determine group differences between children adopted from China and those adopted from Eastern Europe at Time 1 and Time 2. Comparing differences in mean or median rank scores has been reported as a way of estimating effect size for nonparametric statistics (Green & Salkind, 2008).
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between 7.00 and 11.00 (M = 8.44, SD = 1.42). The Chinese childrens Symbolic Composite standard scores ranged from 5.00 to 12.00 (M = 8.73, SD = 2.20), and the Eastern European childrens Symbolic Composite standard scores also ranged from 5.00 to 12.00 (M = 8.00, SD = 2.65). One Chinese child (#11) scored below the recommended total, speech, and symbolic cutoff standard scores, but her MCDIWG DQs were above the recommended cutoff DQ of 47 (Glennen, 2005, 2007b). One Eastern European boy (#12) scored below the recommended standard score cutoff of 6 on the Symbolic Composite, but his total CSBSDP standard score was 80. The Eastern European girl (#19) who scored below a DQ of 47 for the MCDIWC scored an 87 for the CSBSDP total. Thus, 91% of the Chinese children and 78% of the Eastern European children in this sample performed at or above Glennens (2005, 2007b) recommended MCDIWC and CSBSDP total cutoff standard scores. These scores are listed in Table 1. At Time 1, no statistically significant differences were found between the two groups. No differences by country of origin were found for the MCDIWG DQs (WC z = .684, p = .503; phrases comprehended z = .761, p = .456, and WE z = .646, p = .552) or individual subtests or total standard scores on the CSBSDP (Social z = .383, p = .702; Speech z = .349, p = .727; Symbolic Behavior z = .652, p = .514; total z = .532, p = .594, respectively). Refer to Table 4 for regional group means, standard deviations, Mann-Whitney U statistics, and p values.
Time 2 Regional Comparisons

In reference to the second research question as to whether children from different regions performed similarly at Time 2, the answer is mixed. All of the children performed above the recommended cutoff score (80) on all sections of the PLS4. Although
no differences were found by country of origin for receptive language or total language scores, a significant difference in expressive language performance was found (z = 12.374, p = .014), with children adopted from Eastern Europe scoring higher than children adopted from China. One Eastern European child (#15) received a high expressive score of 126 (receptive 109, expressive 126, and total 120), and 1 Chinese child (#8) received a high Auditory Comprehension score of 126 (Auditory Comprehension 126, expressive 87, and total 107), which may have affected this finding. When the scores from #8 and #15 were excluded, expressive language differences between regional groups were meaningful in that the Eastern European mean rank was 7.83 and the Chinese mean rank was 3.80 (z = 2.027, p = .052). Receptive language scores were not significantly different (z = 1.855, p = .082), but mean rank differences with an Eastern European mean rank of 4.33 and a Chinese mean rank of 8.0 were indicative of a possible real difference in magnitude, despite the lack of significance of the p values found. Table 5 shows the PLS4 means, standard deviations, and p values at Time 2. Upon analyses of the total sample, including the two highscoring children (#8 and #15), no differences were found for the PLS4 Auditory Comprehension scores (z = 1.738, p = .101) or the total PLS4 total language scores (z = .72, p = .534). The Eastern European childrens Auditory Comprehension language scores ranged between 81.00 and 109.00 (M = 91.143, SD = 11.867), and the Chinese childrens Auditory Comprehension language scores ranged between 87.00 and 126.00 (M = 103.833, SD = 13.848). Mean rank differences for Auditory Comprehension scores were suggestive of possible differences, with an Eastern European mean rank of 5.29 and a Chinese mean rank of 9.0. The Eastern European children had expressive scores between 87.00 and 126.00 (M = 100.00, SD = 12.196), and the Chinese childrens expressive language scores ranged from 83.00 to 91.00 (M = 86.667,
Table 4. Mean, standard deviation, and Mann-Whitney U statistic by region at Time 1 assessment.
Measure MCDI DQ Words Comprehended Chinese Eastern European Phrases Comprehended Chinese Eastern European Words Expressed Chinese Eastern European CSBS-DP Social Chinese Eastern European Speech Chinese Eastern European Symbolic Chinese Eastern European Total Chinese Eastern European
Mean
SD
Mean rank
z score
p value
71.65 68.53 77.80 67.86 77.65 81.83
11.14 21.84 20.57 17.39 10.69 15.27
11.32 9.50 11.41 9.39 9.73 11.44
.684
.503
.761
.456
.646
.552
11.27 11.78 8.55 8.44 8.73 8.00 93.36 92.56
3.23 3.56 2.16 1.42 2.20 2.65 11.57 9.90
10.05 11.06 10.91 19.00 11.27 9.56 11.14 9.72
.383
.710
.349
.766
.652
.552
.532
.603
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Table 5. Mean, standard deviation, and Mann-Whitney U statistic by region at Time 2 assessment, without Outlier #15 and with #1 CSBSDP total standard scores.
Measure
Mean
SD
Mean rank
PLS4: Auditory Comprehension Chinese 103.833 Eastern European 91.143 PLS4: Expression Chinese Eastern European PLS4: Total Chinese Eastern European Without #8 and #15 PLS4: Auditory Comprehension Chinese 99.400 Eastern European 88.167 PLS4: Expression Chinese Eastern European PLS4: Total Chinese Eastern European With #1 included Combined CSBSDP & PLS4 total scores Chinese 99.857(11.172) Eastern European 95.286(13.048) *p < .05. 89.000 95.667 96.600 91.167 88.667 100.000 96.667 95.286
13.848 11.867 3.204 12.596 8.017 13.048
9.00 5.29 4.25 9.36 7.83 6.29
1.738
.101
2.374
.014*
.720
.534
9.607 9.725 3.464 5.716 6.950 7.859
8.00 4.33 3.80 7.83 7.00 5.17
1.855
.082
2.027
.052
.926
.429
8.57 6.43
.965
.383
SD = 3.204). The Eastern European childrens total language scores ranged between 82.00 and 120.00 (M = 95.286, SD = 13.048), as compared to the Chinese childrens total language scores, which ranged from 87.00 to 107.00 (M = 96.667, SD = 8.017). Mean rank scores between groups for the total PLS4 scores were relatively similar (Eastern European = 6.29, Chinese = 7.83). One Chinese child (#1) was not quite 2 years old and was administered the CSBSDP. Because the CSBSDP does not provide separate standard scores for comprehension and expression, these scores were excluded from the above-described analyses. This childs CSBSDP total score was included with the PLS4 total language scores and groups were compared. No differences by region were found (z = .965, p = .383). An item analysis of the childrens correct and incorrect responses revealed a general pattern of the Chinese children demonstrating comprehension of more different kinds of words and multiple step directions, expressing fewer multiword combinations and communicative functions, and asking fewer questions. In comparison to the Eastern European children, the Chinese children also rarely expressed inflectional morphemes (plural s or present progressive ing). Figures 1 and 2 show the patterns of PLS4 Auditory Comprehension and Expressive Communication responses between the total sample of children adopted from China and children adopted from Eastern Europe. When the 2 high-scoring children were excluded, the patterns of receptive language development between the two groups of children were more similar. The expressive patterns were different. Children adopted from Eastern Europe qualitatively expressed more functions and more multiword utterances and
demonstrated the use of the present progressive inflectional morpheme. Figures 3 and 4 show these patterns without the 2 highscoring children (#8 and #15). In general, at Time 2, most of the children scored within 1 SD of the mean for English-speaking peers. Six (45%) children scored at or above the mean, 3 (21%) scored within 1 SD, and 4 (29%) scored within 1.5 SDs of English-speaking norms. Thus, 13/14 (93%) scored within 1.5 SDs of the mean for English-speaking peers by 12 months after adoption. Only 1 child, an Eastern European girl (#17), scored < 1.5 SDs of the mean at 12 months after adoption but scored well above Glennens (2005, 2007b) recommended cutoff for Eastern European children at Time 1. Thus, all of the children performed within the average range as compared to reported data on the language development of internationally adopted children.
DISCUSSION
This studys research questions focused on comparing the (a) early postadoption (Time 1) vocabulary, prelinguistic communication, and symbolic behavior development of children adopted from China and Eastern Europe; and (b) English language comprehension, expression, and overall language development of children adopted from China and Eastern Europe after approximately 1 year of English language exposure (Time 2). To answer the first research question, children adopted before the age of 2 years from China and Eastern Europe show similar
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Figure 1. Item analysis of PLS4 Auditory Comprehension scorestotal sample.
English language and prelinguistic communication and symbolic behavior development. Parent-reported profiles of vocabulary comprehension and expression and prelinguistic communication and symbolic behavior development were not significantly different at
Time 1. These results confirm recent studies on parent-reported English vocabulary development for children adopted from China and Eastern Europe (Glennen, 2005; Glennen & Masters, 2002; Pollock, 2005; Tan & Yang, 2005). These results also confirm studies
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Figure 2. Item analysis of PLS4 Expressive Communication scorestotal sample.
reporting measures of prelinguistic and symbolic behavior development in children adopted from both regions (Glennen, 2005; Hwa-Froelich & Matsuo, 2008). These findings lend further support that parents adopting children from different countries seem to report similar developmental progression soon after adoption. In addition, infants adopted before age 2 may demonstrate similar prelinguistic and symbolic behavior development soon after adoption regardless of their country of origin. The second research question asked whether communication development was similar after 1 year of English language exposure
regardless of the childrens birth language. All of the children were developing English language similar to behavioral outcomes reported in the literature for children adopted from China (Pollock, 2005; Roberts et al., 2005) and children adopted from Eastern Europe (Glennen, 2005, 2007b). Chinese childrens receptive and overall language performances were not significantly different than those of their Eastern European peers. Despite these overall group similarities, preliminary findings showed different patterns in English language development, which may be indicative of linguistic differences along a typical language development continuum.
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Figure 3. Item analysis of PLS4 Auditory Comprehension scores without Child #8 and Child #15.
This is the first study to compare age-matched groups of children adopted from China and Eastern Europe and to provide evidence of different patterns of English language development between adopted Chinese and Eastern European children.
Receptive Language Patterns

Children adopted from China demonstrated a different pattern of receptive language development, that is, comprehension of more
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Figure 4. Item analysis of PLS4 Expressive Communication scores without Child #8 and Child #15.
different kinds of words and multistep directions. From an item analysis, a generalized pattern of increased receptive knowledge for the Chinese children emerged, which may be typical for children who are adopted from China. When a high-scoring Chinese childs scores were removed, however, these different patterns were minimized. Thus, individual differences among the children in this small sample make it difficult to generalize these findings. Supporting evidence for advanced receptive language development in Asian children can be found from two studies. Clark and Hanisee (1982) provided support of advanced receptive vocabulary development of children adopted from Vietnam, Korea, Cambodia, and Thailand.
Cohen et al. (2008) found that adopted Chinese children were comparable to their English-speaking peers in receptive language much earlier than in expressive language. Chinese children may initially focus their attention on comprehending their adopted language rather than expressing it. More research with a larger sample is needed to verify the patterns observed in this study.
Expressive Language Patterns

Children adopted from Eastern Europe demonstrated an expressive pattern of more communicative functions, multiword combinations,
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and inflectional morphemes. An item analysis of the PLS4 scores revealed a pattern of fewer productions of multiword utterances and inflectional morphemes for children adopted from China. When a high-scoring Eastern European childs scores were removed, these expressive patterns remained. Previous studies provide evidence of rapid English language development in children adopted from Eastern Europe. Glennen et al. (2005) provided evidence of little to no first language influence on the development of English morphology in children adopted from Eastern Europe. Children adopted from Russia were reported to learn English morphemes similar to monolingual English speakers, with a developmental lag of approximately 9 months. Previous studies on children adopted from China provide some evidence of different patterns of English language development in comparison to reported English language development in children adopted from Eastern Europe. Tan and Yang (2005) provided parentreported vocabulary development from the LDS and found that Chinese children adopted between 3 and 28 months of age were comparable to their English-speaking peers by 16 months following adoption, which is slightly later than reported findings for Eastern European children (Glennen & Masters, 2002). Pollock (2005), however, reported that from MCDI expressive vocabulary development of 150 children adopted from China, the children acquired English words at least as quickly as children adopted from Eastern Europe at similar ages and in fact reached the 50-word cutoff several months earlier (p. 27). In the study by Snedeker et al. (2007), older children adopted from China demonstrated rapid expressive vocabulary development that mirrored monolingual infant vocabulary development in that the children seemed to map labels to previous experiential knowledge instead of first language labels. None of these researchers compared children adopted from China with children adopted from Eastern Europe in English acquisition. In addition, because most of these studies used parent-reported expressive vocabulary measures, the data may reflect different outcomes than the current study in which behavioral measures were used. Behavioral studies on children adopted from China may also indicate different patterns of English language development. Roberts et al. (2005) and Roberts et al. (2003) provided evidence that Chinese children are comparable to their English-speaking peers by 2 or 3 years after adoption, but they did not measure language development at 1 year after adoption. Roberts and colleagues also found that a younger adoption age predicted English language development 2 to 3 years later, indicating that more exposure to English assisted with language development. Hwa-Froelich and Matsuo (2008) also provided early longitudinal data of English language development in 4 Chinese children who were comparable to English-speaking norms in receptive and expressive language by 2 or 3 years following adoption. In this study, the child with the youngest adoption age needed 3 years to develop commensurate language development. Thus, the authors stated that it was difficult to determine which adopted children needed 2 or 3 years to develop English language. A recent study by Cohen et al. (2008) found that adopted Chinese children were comparable to a nonadopted Canadian peer group in receptive language at 6 months after adoption but were not comparable in expressive language until at least 2 years after adoption. The authors suggested that children who did not demonstrate commensurate development at 2 years after adoption may be at risk of later learning problems. It remains unclear whether children adopted from China need 2 or 3 years of English language exposure to develop nonadopted peer-like English language skills.
In conclusion, children adopted from China and Eastern Europe demonstrate similar prelinguistic and English language development but different patterns of expressive language performance 12 months after adoption. Due to the preliminary nature of the study and other limitations, however, it is difficult to determine whether exposure to birth languages during the first 12 to 24 months of life influences adopted childrens expressive English language development. More research is needed to verify these findings.
Limitations
The sample size for this study was small, and more studies with larger samples are needed to validate the findings from this study. Due to the small sample size and later attrition, individual differences may have influenced the statistical analyses. Although using nonparametric statistics helps to safeguard against individual variation in the data, these findings need to be confirmed with studies using larger samples. It is possible that our sample may not be representative of the population of children adopted from China or Eastern Europe, but the Eastern European sample means were largely within 1 SD of Glennens (2007a) sample means, supporting the similarity between these Eastern European samples. In addition, there were no significant differences in adoption age, age at time of data collection, or postadoption time periods between the two regional groups, and no significant differences were found at Time 1, supporting the fact that both groups were similar in vocabulary, prelinguistic communication, and symbolic behavior development. These early prelinguistic measures were found to be predictive of later language development (Glennen, 2007b). It is also possible that language patterns observed at Time 2 were unique to the individual children who remained in the study. Not knowing the childrens birth language was a major weakness of this study. Thus, it is unknown whether the groups shared the same language backgrounds or were exposed to many different languages. Different patterns in English language development could be due to differences in the amount of language input before adoption (Windsor, Glaze, Koga, & The Bucharest Early Intervention Project Core Group, 2007); typology of the childrens birth languages; individual differences in a small sample; or other uncontrolled variables influencing language development such as the effects of siblings, child care, or number of adults in the home. However, no differences were found for chronological age or postadoption time periods between groups, and the groups did not differ in their total language scores. In addition, because fewer Chinese children continued in the study, the two groups of Chinese children (those who remained and those who discontinued the study) were compared across all variables for Time 1, and no significant differences were found. Therefore, attrition may not have been a factor for this study. However, too many other factors, including individual variability within a small sample, may have influenced these results. Thus, additional studies with larger samples are needed to verify these findings.
Clinical Implications
This study provides evidence that children who have been adopted from China before the age of 2 years seem to demonstrate similar profiles of early postadoption vocabulary and prelinguistic and symbolic behavior development as compared to children adopted from Eastern Europe. Parent-reported measures of vocabulary development
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and behavior measures of prelinguistic and symbolic behavior development may be appropriate assessment tools for children adopted from China or Eastern Europe within the first 6 months following adoption. The guidelines for referral of an MCDIWG Words Comprehended subtest DQ score > 47 and a CSBSDP total score 80 (Glennen, 2007b) seem to be appropriate referral guidelines for children adopted from China. Children adopted from China and Eastern Europe before the age of 2 years may demonstrate different patterns of English language development by 12 months after adoption. These differences may be related to cultural and linguistic differences in English language development. Both groups, however, appear to develop English language development comparable to English-speaking peers by 12 months after adoption. Thus, total language scores may be more clinically relevant than receptive or expressive subtest scores. At 12 months after adoption, caution should be exercised when assessing children adopted from abroad. Although the majority of children adopted from China and Eastern Europe (Cohen et al. 2008; Glennen, in press) who were adopted before 2 years of age were comparable to their English-speaking peers by 2 years after adoption, there is a subgroup of children who continued to improve language development after the 2-year after adoption time period. Children adopted from China and Eastern Europe should not be compared to each other nor should either group be compared to English-speaking peers in expressive language performance. It is advisable to gather community data on children adopted from similar linguistic backgrounds as a comparison sample for expressive English language development at 12 months after adoption.
Albers, L. H., Johnson, D. E., Hostetter, M. K., Iverson, S., & Miller, L. C. (1997). Health of children adopted from the former Soviet Union and Eastern Europe. Comparison with preadoptive medical records. Journal of American Medical Association, 278(11), 922924. Berg-Kelly, K., & Eriksson, J. (1997). Adaptation of adopted foreign children at mid-adolescence as indicated by aspects of health and risk takingA population study. European Child & Adolescent Psychiatry, 6, 199206. Borras, F. M., & Christian, R. F. (1971). Russian syntax. Glasgow, Scotland: Oxford University Press. Bosch, L., & Sebastian-Galles, N. (1997). Native-language recognition abilities in 4-month-old infants from monolingual and bilingual environments. Cognition, 65, 3369. Cheng, L. L. (1991). Assessing Asian language performance (2nd ed.). Oceanside, CA: Academic Communication Associates. Clark, E. A., & Hanisee, J. (1982). Intellectual and adaptive performance of Asian children in adoptive American settings. Developmental Psychology, 18(4), 595599. Cohen, N. J., Lojkasek, M., Zadeh, Z. Y., Pugliese, M., & Kiefer, H. (2008). Children adopted from China: A prospective study of their growth and development. The Journal of Child Psychology and Psychiatry, 49(4), 458468. Croft, C., Beckett, C., Rutter, M., Castle, J., Colvert, E., Groothues, C., . . . Sonuga-Barke, E. J. S. (2007). Early adolescent outcomes of institutionally-deprived and non-deprived adoptees. II: Language as a protective factor and a vulnerable outcome. Journal of Child Psychology and Psychiatry, 48, 3144. Cubberley, P. (2002). Russian: A linguistic introduction (1st ed.). Cambridge, UK: Cambridge University Press. Dalen, M. (1995). Learning difficulties among inter-country adopted children. Nordisk Pedagogik, 15(4), 195208.
ACKNOWLEDGMENTS
This project was funded by Regionwise from the metropolitan St. Louis region. We are grateful for the hard work and support of the many persons who collaborated on the project: Anne Ackerson, Katie Anderson, Keith Clemson, Sarah Mills, Amy Moleski, Elizabeth Mueller, Clayton Notgras, J. Douglas Pettinelli, Christin Pryor, Kim Smith, Elizabeth Voyles, Margaret Walkenhorst, Danileah Werner, and Janine Zahrli. We appreciate the help John Clements provided in creating the figures and editing provided by Sara Steele.This project would not have been possible without the help of the adoption agencies who helped us recruit families: Americans Adopting Orphans, Catholic Services, Childrens Hope International, Children of the World, Dillon International, Foreign Adoption Clinic and Educational Services, Families with Children from China, International Family Services, Love Basket, Small World Adoption Foundation, and Ultimate Places. We would also like to thank the families who participated in and supported this project.
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Received July 23, 2008 Revision received January 16, 2009 Accepted July 2, 2009 DOI: 10.1044/0161-1461(2009/08-0085)
Contact author: Deborah A. Hwa-Froelich, 3750 Lindell Boulevard, 12 McGannon Hall, St. Louis, MO 63108. E-mail: hwafroda@slu.edu.
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Communication Development and Differences in Children Adopted From China and Eastern Europe Deborah A. Hwa-Froelich, and Hisako Matsuo Lang Speech Hear Serv Sch 2010;41;349-366; originally published online Aug 24, 2009; DOI: 10.1044/0161-1461(2009/08-0085) The references for this article include 16 HighWire-hosted articles which you can access for free at: http://lshss.asha.org/cgi/content/full/41/3/349#BIBL
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Preadoption Risk Factors

SCHOOLS Vol. 41 349366 July 2010 * American Speech-Language-Hearing Association

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Crosslinguistic Effects on Adopted Language Development

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Postadoption Communication Development

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MWU p value (1-tail) .175

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Time 1 Regional Comparisons

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Time 2 Regional Comparisons

71.65 68.53 77.80 67.86 77.65 81.83

11.14 21.84 20.57 17.39 10.69 15.27

11.32 9.50 11.41 9.39 9.73 11.44

11.27 11.78 8.55 8.44 8.73 8.00 93.36 92.56

3.23 3.56 2.16 1.42 2.20 2.65 11.57 9.90

10.05 11.06 10.91 19.00 11.27 9.56 11.14 9.72

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13.848 11.867 3.204 12.596 8.017 13.048

9.00 5.29 4.25 9.36 7.83 6.29

9.607 9.725 3.464 5.716 6.950 7.859

8.00 4.33 3.80 7.83 7.00 5.17

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Figure 1. Item analysis of PLS4 Auditory Comprehension scorestotal sample.

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Figure 2. Item analysis of PLS4 Expressive Communication scorestotal sample.

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Receptive Language Patterns

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Expressive Language Patterns

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SCHOOLS Vol. 41 349366 July 2010

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Adopted Children & Klanguage Aquisition

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