Adopted children are more likely to have psychological problems and academic problems compared to their non-adopted peers. But let me put it into a context. About 2% of the population of children are adopted. About 5% of the children seen in outpatient mental health settings though are adopted. That’s about 2.5 times what we would expect. There are number of reasons why children who are adopted have these kinds of problems. It has more to do with the conditions or the experiences before adoption though than with adoption per se. It certainly has to do at times with genetics – we are a product of our genes. It has to do with prenatal experiences at times – exposure to drugs, to alcohol, to inner uterine malnutrition. And it certainly has to do with the experiences after the children are born, but before they enter their adoptive families. It could be neglect, abuse, orphanage life, malnutrition – all of these things lead to the kinds of problems we’re talking about. Adoption does color the sense of self for the adoptee, it does color the family dynamics and if it’s not handled well, adoption issues themselves can contribute but they usually don’t contribute the most important part of what underlies these problems. And one last point that I would make is that adoptive families we know are quicker to utilize mental health services. Some of their overrepresentation in these mental health settings probably has to do with what we call a ‘referral bias’, a willingness and a desire and perhaps the ability financially to utilize mental health services more than non-adoptive families.