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British-Chinese adoption study

Research by Professor Alan Rushton, King’s College London and the British Association for Adoption & Fostering (BAAF) gives new insight into the long-term effects and outcomes for children adopted from abroad.

During the 1960s, just over a hundred girls were sent to the UK via the International Social Services UK Hong Kong Adoption Project and placed for adoption. Funded by the Nuffield Foundation, the study reports how 72 women have fared in life.

The key findings of the study were:

  • When orphanage care is not severely depriving, mid-life outcomes may not lead their mental health outcomes, well-being and life satisfaction to be significantly different from comparison women. Neither was there evidence of severe difficulties in adult social relationships or poor self-esteem.
  • The quality of the adoptive home is an important contributor to well-being as adults
  • For some women, working out how separation from their birth family and being Chinese in the UK has proved to be difficult.
  • Virtually all the women reported some experience of racism or prejudice in both child and adulthood. This ranged from playground name-calling during childhood to serious racist attacks.
  • When asked how they usually describe their ethnic identity, half identified themselves as Chinese, 19% British, 15% British-Chinese and the remainder used personal definitions. There did not seem to be any evidence that they chose to live in areas with significant Chinese populations.
  • As the orphanages in Hong Kong seem to have provided a much better level of care than for example those in Romania, this might help to explain why this group of women seem to have fared much better than might be predicted based on what we know from child / adolescent / early adult studies of internationally adopted people.

Professor Alan Rushton, King’s College London’s Institute of Psychiatry and co-author of the study says: "We have increasing amounts of information about the childhood and adolescent outcomes of orphanage care but are still in the dark about the longer-term consequences. This study is perhaps a unique example of testing the links between early deprivation, international adoption and outcomes in midlife. Contrary to expectations, the psychological outcomes were found to be commensurate with matched groups of adopted and non-adopted women born in the UK. Such findings need to be taken into account in theories of lifespan development."

Julia Feast, from BAAF and co-author of the project says: “This study clearly identifies the adaptability, resilience and strength of human beings when faced with significant early adversity. It attests to the importance of family life in providing nurture, care, stimulation and opportunity even when children have had a poor start in life.

"Whilst the findings are in the main very positive.... the challenges and complexities of inter-country adoption should not be underestimated.”

The women were mostly abandoned as infants (and left to be found) and spent between 8 and 72 months in one of 4 orphanages in Hong Kong. Whilst they appear to have experienced a reasonable quality of physical and medical care and nutrition in comparison to the globally depriving environments reported in other adoption studies, they lacked the consistent one-to-one care and stimulation that infants typically need for their proper development.

There have been longstanding questions about how the extent to which early adversity in childhood, especially lack of individualised psycho-social care, creates problems developmentally and also how it effects the life choices people take in later life. This unique study gives a rare opportunity to explore the impact of adverse early experience, modified by adoption in creating both opportunities and risks through both child and adulthood over 50 years.

The report presents the main findings of the study, combining an in-depth analysis of some of the key outcome findings with a qualitative analysis of face-to-face interviews with the women. These interviews provide evocative and compelling stories of different aspects of their lives. The use of standardised measures has also enabled important comparisons to be made with other studies, particularly the National Childhood Study of 1958. These comparisons are particularly important in the understanding of how these women’s experiences are similar to or different from those of other adopted and non-adopted women raised in the UK.

A summary of the findings is available here

More information on the British-Chinese Adoption Study is available here.

For further information, please contact Seil Collins, Press Officer, Institute of Psychiatry, King's College London, email: or tel: 0044 207 848 5377