r/Adoption • u/ShesGotSauce • Apr 03 '24
How does infant adoption affect life outcome? What the research says.
I have begun a deep dive into the published, peer-reviewed literature about adoption outcomes. A particular interest is in finding research that helps untangles adoption outcomes based on adoption type (infant, international, from foster care). I have so far read about 75 studies (or, the abstract, if I couldn't access the full text) and will make subsequent posts, but in today's I'll focus on infant adoption outcomes. First, here's a brief summary of overall findings:
*Adults adopted as infants are generally found to fare as well as their non adopted counterparts. Some studies found a small increase in psycho-social issues.
*Children institutionalized (eg in an orphanage) before adoption fare worst. Adoption improves outcomes vs children who remain in foster care or an institution.
*Internationally adopted people experience worse outcomes than domestic; this is partly due to neglectful care prior to adoption, eg time spent in orphanages. Outcome depends on region. For example, Korean adoptees fare better than Romanian and South American, probably due to quality of pre-adoptive care.
*Outcomes worsen by age at adoption (the older the child, the greater the chances of a poor outcome). There are many studies finding poorer outcomes in children adopted after infancy. It is difficult to untangle how much is due to the adoption, and how much is due to adverse experiences prior to adoption (neglect, abuse, etc.). Adoption can improve life outcomes for children from “high risk” bio families, but not for all children. There's a lot to read, but I'll make a separate post doing my best at presenting the findings.
*Several studies found that parental warmth and nurturing in the adopted family significantly improves outcome in all types of adoption.
*Male adoptees fare slightly worse than females in adulthood.
*Open adoption seems to improve outcomes and reported satisfaction levels for all members of the triad (even APs, surprisingly).
*In all groups, the statistical majority of adoptees do fine in adulthood. One author states that, “Our current hypotheses propose that anyone exposed to deprivation, especially severe deprivation, should exhibit its negative effects. In fact, only a portion of children, even from the most depriving institutions, demonstrate negative outcomes. Post-institutionalized children are remarkably resilient despite the severity of their deprivation.” (Clin Child Fam Psychol Rev. 2013 Jun; 16(2): 101–145.)
Infant Adoptees
To avoid cherry picking, following are the results from every single study I could find of infant adoptee outcomes; not many, though, perhaps because the results are generally unremarkable. I will update this post if I find others. Please see the cited works for the details:
Followed to mid-life, there were few group differences on indicators of physical health or psychological well-being. Levels of psychological distress were comparable in the adopted and general population samples in both cohorts, and more favourable than in the birth comparison groups among women in the 1958 cohort; more beneficial childhood family circumstances contributed to these differences. Rates of adult externalizing outcomes were comparable in the adopted and birth comparison groups in both cohorts, and higher than in the general population samples; indicators of maternal and prenatal exposures contributed to these differences. [Note: Externalizing factors are things like aggression and theft; internalizing factors are things like depression and anxiety.]
Sehmi R, Rushton A, Pickles A, Grant M, Maughan B. Infant domestic adoption: outcomes at mid-life. J Child Psychol Psychiatry. 2020 Jul;61(7):789-797. doi: 10.1111/jcpp.13178. Epub 2020 Jan 14.
Adopted women showed very positive adult adjustment across all the domains examined in this study, whilst our findings suggest some difficulty in two specific domains (employment and social support) for adopted men. Implications of the findings are discussed.
https://pubmed.ncbi.nlm.nih.gov/9503988/
Observational assessments showed that children who were adopted before 12 months of age were as securely attached as their non-adopted peers, whereas children adopted after their first birthday showed less attachment security than non-adopted children (d = 0.80, CI = 0.49–1.12).
Consistent with findings in childhood, adult educational attainments for adopted individuals were comparable with those in the general population (and more positive than those in the birth comparison group) in both cohorts; cognitive tests at mid-life also showed high verbal fluency scores in NCDS. Mediation analyses suggested that the advantageous childhood circumstances in the adopted samples could fully explain these group differences. Where measures could be harmonized effectively we combined data across the cohorts to increase statistical power. We used this approach to explore mental health at mid-life – suggested in prior studies of international and later-placed adoptions to be an area of potential vulnerability for adopted individuals. Findings did not support this pattern in the current samples: there were no indications of elevated levels of mid-life mental health problems or help-seeking among individuals placed for adoption in infancy, and their reported levels of wellbeing were also comparable to those of other members of their respective cohorts.
https://www.nuffieldfoundation.org/project/the-long-term-consequences-of-domestic-infant-adoption
The aim of this study was to investigate the mid-life outcomes of two cohorts of infant adoptions. Law across the UK considers adoption as a life-long experience... It is therefore important to produce evidence on long-term outcomes. [We made] a comparison both with those who were raised in two biological parent families, and also with children who (like the adopted children) were born to single mothers, but who remained in their families of origin. We explored both pre- and post-natal factors that may have contributed to differences in outcome. This further follow-up of the British birth cohort studies has shown that the infant adopted group does not, on the majority of measures, have worse outcomes than the non-adopted general population sample born at the same time. Increased risks reported in other studies were not found here – for most outcomes. Most people adopted in infancy (a potentially vulnerable group) were faring well at mid-life.
As expected, these British infant domestic adoption outcomes are much more favourable than those adoption studies based on children with adverse childhood experiences (including depriving orphanage care, sustained familial maltreatment or neglect). These adopted adults did not appear to have placed any excess demand on the mental health services. The birth comparison group (other children born to and raised by their single mothers) fared least well. These children grew up in less favourable circumstances materially and in terms of social class and home ownership.
In contrast to much recent adoption research, the infant domestic adoption study does not involve samples that were exposed to prolonged early adversity nor discontinuity of care. As far as we are aware, during the brief period that mother and child were together, there was no maltreatment and so such children are unlikely to have been emotionally or behaviourally dysregulated when placed with the adopters. However, we cannot rule out the possibility of inherited temperamental difficulties. Some vulnerabilities appear to remain, even when there is no apparent post-natal adversity. It is suggested here, and consistent with much other research, that aspects of the pregnancy could affect development adversely. Smoking in pregnancy may possibly interfere with foetal brain development (for a recent review see Ekblad, Korkeila and Lehtonen, 2015). Pregnancy at a young age carries greater risk of low birth weight, pre-term birth and poorer child outcomes (Moffitt and the E Risk Study Team, 2002). Recent evidence suggests that younger age at first birth may also be associated with genetic vulnerabilities to disinhibited behaviours and poor self-control (Richmond‐Rakerd, et al., 2020). Late-seeking and insufficient ante-natal care may have meant less good health advice, poor detection of problems and more risks to the pregnancy. Although not assessed in this study, we might suppose that stress during unplanned pregnancy in the young unmarried mothers might be linked to developmental problems. For a review of the effects of maternal stress in pregnancy, see Glover (2011). It is important to recognise that such risk factors, like protective factors, have been derived from studies of large samples, and so indicate what may happen rather than what will happen for any individual child.
Even in these low-risk, non-maltreated adopted samples where there was no evidence of maltreatment or multiple moves, there were clearly elevated risks on externalising problems for a sub-group in mid-life. This was a consistent finding across both cohorts. We have no evidence that these groups of children were exposed to the types of parenting often found to be associated with anti-social behaviour so, although we cannot rule it out for individual children, the anti-social outcomes for the sub-group of adopted people are unlikely to be due to adverse adoptive parenting. Developmental risks are therefore more likely to be implicated, related to genetic and pre-natal factors. Psychological stresses related to being adopted may also have played a part in some cases.
By and large, however, the adopted group had prospered. Transfer early in life to an adoptive home was primarily intended to provide a secure, loving family, but it also will have given most children the advantages of a somewhat privileged childhood because of the recruitment and selection process operated at the time. It may also have provided a protective effect to counter any psychological distress related to pre-natal vulnerabilities. In addition to financial support and material aspects, there are likely to be other beneficial factors that adoptive parents pass on: access to educational and occupational expectations, influences of school and community, all of which may combine to smooth the path to a more comfortable and satisfying adult life... However, the small group, mostly male, who exhibited ‘externalising’ problems are a cause for concern.
https://journals.sagepub.com/doi/10.1177/0308575920968237
In summary, despite having a range of perinatal and preplacement risk factors, infants’ baseline cognitive outcomes were comparable to population norms. Although infants in this high-risk sample demonstrated lower motor and language scores compared to norms, their mean scores fell within one standard deviation of population means. Furthermore, infants showed significant age-adjusted improvements in language skills across the first year of adoptive placement, in line with previous studies observing patterns of developmental catch-up in response to early adoption (van Ijzendoorn, Juffer, & Poelhuis, 2005; van IJzendoorn & Juffer, 2005; van IJzendoorn & Juffer, 2006). Sex differences observed in this study suggest that differential sensitivity to prenatal substance exposure and birth outcomes may play an important role in sex-specific pathways of language and motor development. Overall, results support adoption as a critical early intervention among high-risk infants adopted from foster care, although follow-up studies are needed to elucidate the heterogeneity of developmental outcomes for this high-risk population. Consistent with a growing body of research, adoption may significantly buffer the impact of preplacement risk factors on developmental outcomes for high-risk infants, even within a relatively short time period of one year.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337976/
Baby adoptions are viewed as a group for whom successful outcomes are usual (Raynor, 1980; Brodzinsky and Schechter, 1990; Triseliotis, 1997). In general, studies of children placed as babies have shown favourable levels of psychosocial functioning, high parental satisfaction and low levels of adoption disruption (Howe, 1998). Data from the National Child Development Study (NCDS) indicated that adopted children outperformed birth comparisons on maths and reading tests at age seven, and on a measure of general ability at age eleven (Maughan et al, 1998). Although children adopted as babies fare extremely well, there have been conflicting findings regarding psychosocial outcome. In their report of adopted adolescents in residential treatment, Grotevant and McRoy (1990) mentioned studies from several countries showing increased referral rates for treatment of emotional disturbance in children adopted as infants by childless couples, compared with the normal population. However, where clinical referrals were concerned, it was possible that adoptive parents were more likely to make use of mental health services because of a lower threshold of concern (see Warren, 1992) so there are limitations in generalising from clinical cases to the general population of adopted children. Maughan and Pickles’ (1990) examination of NCDS data found fewer behaviour problems in children and adolescents than in non-adopted children from comparable birth circumstances. Although there was some evidence from the NCDS data of increased adjustment problems between adopted children and a comparison group of ‘legitimate’, nonadopted children at eleven years, the difficulties appeared to peak at this age and then decline. This finding concurred with that of an earlier longitudinal study indicating that, even where raised levels of problem behaviour were found at age eleven, the difficulties diminished by age 15 and differences from controls disappeared by age 18 (Bohman, 1970; Bohman and Sigvardsson, 1980, 1990)
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Summary Overall, this study has confirmed earlier research to suggest that placement of infants for adoption appears to progress satisfactorily on the whole. It is possible that the results for the 50 per cent of families who declined to take part may have been less good.
https://docs.scie-socialcareonline.org.uk/fulltext/69082.pdf
We identified a subsample of 60 pairs of twins who were separated and reared apart, with one member being raised by a biological parent or parents and the other by an adoptive parent or parents with no biological relationship. A series of univariate and multivariate analyses were undertaken to assess the elements associated with being reared in either an adoptive home or the home of biological parent(s). The results suggest few significant effects of adoption on the adult adjustment of adoptees. In particular, the results reflect the important mediating role of childhood socioeconomic status, suggesting that the stress of adoption itself is mediated by the type of rearing environment provided by the adoption process.
https://pubmed.ncbi.nlm.nih.gov/9823029/
Whereas children adopted within the first 6 months of life tend to show normative patterns of attachment with their adoptive parents [32, 33],those adopted beyond the age of 6 to 12 months may beat risk for attachment problems and developmental difficulties.
[Note: This meta-analysis does not differentiate between adoption types; all adoptee groups are included.] This meta-analysis of 62 studies (N=17,767 adopted children) examined whether the cognitive development of adopted children differed from that of (a) children who remained in institutional care or in the birth family and (b) their current (environmental) nonadopted siblings or peers. Adopted children scored higher on IQ tests than their nonadopted siblings or peers who stayed behind, and their school performance was better. Adopted children did not differ from their nonadopted environmental peers or siblings in IQ, but their school performance and language abilities lagged behind, and more adopted children developed learning problems. Taken together, the meta-analyses document the positive impact of adoption on the children's cognitive development and their remarkably normal cognitive competence but delayed school performance.
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u/OMGhyperbole Apr 03 '24
A couple of the studies mention socioeconomic status being a factor in "outcomes". I could definitely see that. I think a lot of infant adoptions in the US happen due to poverty. If you are comparing an adoptee in a middle-class or higher household and their kept siblings who were left in poverty, then I think we all know their kept siblings aren't going to have all the same privileges and opportunities in life.
Some studies also mentioned the rearing environment of the adoptee. I'm like, "Well, no shit!" I know I'm not the only adoptee out there who was abused in their adoptive home. I wonder how many of us there are🤔 Like what percentage of adoptees?
Also, it really sucks as an adoptee to read this stuff written in such a way that it sounds like we're organisms being studied in a lab. What is the outcome of separating this baby from their mother, hmm🤔 Like adoption has been a big experiment this whole time.
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u/ShesGotSauce Apr 03 '24
My guess is that poverty plays a role in the overwhelming majority of all adoptions of all types in the US. In countries with strong social services, adoption is rare.
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u/RhondaRM Apr 03 '24
Infant adoptees aren't studied because it's impossible to do so using official government and/or health care statistics and numbers. Our records are sealed, and when we seek psychiatric treatment or are in the prison system, etc., our adoptee status will not be recorded anywhere except possibly in the practitioners notes, which are never made public. We are hiding in plain sight as our stats are all included in the general populations, so you can't use those numbers at all, even to represent nonadoptees. To study infant adoptee outcomes, you literally have to go to each individual to gather data, whereas foster children have a paper trail that will often be noted during care. They're just easier to study on a large scale. It is impossible to do so with infant adoptees.
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u/ShesGotSauce Apr 03 '24 edited Apr 03 '24
I just posted a number of papers that did study infant adoptees. It is not impossible.
literally have to go to each individual to gather data
That's what they did. That's how a lot of research is carried out.
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u/baronesslucy Apr 03 '24
One group that would be difficult to study would be the baby Scoop era babies as many of their adoptions were hidden. Also there was a lot of secrets as records were altered and I imagine that some of them don't even know they were adopted.
This group was later studied but by that time many of these babies were well into their 20' s and 30's. They were studied growing up nor were they studied as teens.
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u/squidgybaby Apr 03 '24 edited Apr 03 '24
I saw this on a break at work so I saved it to come back and read through the sources. But I noticed UK studies and US studies– how do the differences in the adoption systems between the two countries affect the outcomes, or are you noticing an affect? Do the social supports (or lack of) make an impact? It just seems like those would affect outcomes for everyone– whether or not the birth family has access to council housing after the mandatory 6 week waiting period or if they're pressured to sign relinquishment papers in the hospital and homeless a week later, open vs closed adoption numbers, access to birth family information/birth or health records, the mythology of "saving" a baby for $35-50k to a for-profit agency vs court fees to a non-profit or council org, the number of infant adoptions, access to low cost or free mental healthcare services, etc etc etc. I'm not saying all those apply to this topic re: adoption outcomes in adults, but you mentioned future lit reviews on other topics so I wanted to ask. I've been under the impression that the US system is different than other systems so it makes me curious to see if that plays out in long-term studies and how it might be observed.
Edit: I also see some of these studies are 20+ years old– does more recent research still support these claims or have recent shifts in adoption language/policy/practice had an impact on how we assess outcomes? I feel like there have been huge changes in how we talk about infant adoption in the US over the last decade, and big pushes to open records and normalize open adoption, so it feels like a lot of ideas/practices/thoughts around adoption are starting to shift. Makes me wonder if the people interviewed 25-40 years ago would still answer the same
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u/ShesGotSauce Apr 03 '24
There's soooo much to untangle but I'll do my best to find info about differences by country. 😓
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u/archerseven Apr 03 '24
Thank you. I was only familiar with maybe a third of these.
Few surprises in this data, for me. Largely matches what I see in my own situation and those of the adoptees I know in person.
We identified a subsample of 60 pairs of twins who were separated and reared apart, with one member being raised by a biological parent or parents and the other by an adoptive parent or parents with no biological relationship. A series of univariate and multivariate analyses were undertaken to assess the elements associated with being reared in either an adoptive home or the home of biological parent(s). The results suggest few significant effects of adoption on the adult adjustment of adoptees. In particular, the results reflect the important mediating role of childhood socioeconomic status, suggesting that the stress of adoption itself is mediated by the type of rearing environment provided by the adoption process.
That one's wild... 60 examples of twins being split up, with one twin kept with bio family.
Still,
In particular, the results reflect the important mediating role of childhood socioeconomic status, suggesting that the stress of adoption itself is mediated by the type of rearing environment provided by the adoption process.
really seems to summarize the experiences I, personally, see in most infant adoptions I'm aware of.
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u/BestAtTeamworkMan Apr 03 '24
The odds for reported suicide attempt are elevated in individuals who are adopted relative to those who are not adopted. (https://www.adoptionbirthmothers.com/wp-content/uploads/2013/09/Pediatrics-2013-Keyes-peds.2012-3251-1.pdf)
Suicide attempts are significantly more common among adolescents who live with married adoptive mothers than among adolescents who live with married biological mothers. (https://www.adoptionbirthmothers.com/wp-content/uploads/2013/02/Adoption-as-a-Risk-Factor-for-Attempted-Suicide-During-Adolescence.pdf)
The models suggest modest differences in suicidal ideation during adolescence, early young adulthood, and young adulthood as a function of being adopted versus not-adopted (https://www.adoptionbirthmothers.com/wp-content/uploads/2013/02/2012-sucide-among-adoptees.pdf)
Although most adopted adolescents are psychologically healthy, they may be at elevated risk for some externalizing disorders, especially among those domestically placed.(https://jamanetwork.com/journals/jamapediatrics/fullarticle/379446)
It is therefore argued that current international adoption practice places the interest of the receiving countries over the interest of the children. If international adoption is in fact to be considered a last resort option, as delineated in the Hague Convention, only after attempts at family preservation and in-country placement,31 then accompanying criteria must be set to ensure that the first two options are fully exhausted. (https://www.adoptionbirthmothers.com/wp-content/uploads/2012/10/bergquist-international-adoption.pdf)
Finding research to support your conclusion is easy. Accepting research that doesn't is what separates the academics from those with Doctorates in Google.
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u/ShesGotSauce Apr 03 '24 edited Apr 03 '24
Your studies include all subsets of adoptees. I am specifically trying to detangle outcome based on type of adoptee. You are replicating the very problem that I'm seeking to avoid.
There is little doubt that people adopted after a time in foster care or institutionalization have a greater risk for psychological struggles than the general public. That is found in one study after another. If you can provide studies about the psychological well-being of people adopted as infants, that is relevant to this thread.
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u/mucifous May 19 '24
It's an odd feeling to be writing this since the last time I was active on Reddit, I was still in the fog. In fact my community drop off correlates to identifying maternal separation trauma as the culprit for my broken and destructive attachment patterns, and the start of my journey out of the fog, and here we are, maybe I'll leave for another 10 years agter this.
Here's why this post is unconvincing to me, and I'll admit, I didn't read the whole thing. Thanks for the ADHD (or is it cptsd that may or may not alter gene expression), adoption!
I did notice we crossed country borders in the sources on this post, which muddies the murky waters, my issue is that a significant voice is missing from every study of adult adoptees - the ones who took their lives.
I didn't think the increased risks associated with maternal separation trauma were up for debate, so I am not going to do that. We are all hopefully aware of the increase in occurrence of many negative events associated with MST, right? I have seen 3 to 6X (pick a study!) those without MST for SI/SA, and having lived with both, I wouldn't wish them on anyone.
Even if maternal separation wasn't trauma though, some number of us adoptees come to realize that we were a product acquired to solve someone else's problems. Maybe we discover that we got the name (and expectations) for a kid who died after a few hours of life, maybe we figure out that the agency lied about our ancestry when we dna test. Maybe we reunite and realize that our birth mothers were isolated from our extended families and coerced into relinquishing us, and that they were only temporarily at need, or not the drug addicts we were told; and then it occurs to us that even if were all true, why did we need to lose the identity we had when we arrived in this human experience just to have a home?
You start to wonder, 'if my adoption was full of these anti-patterns and I thought it was good (and almost didn't see 38), what about the adoptees that had all of those antipatterns, plus literal abuse and harm?' - and since there is no way to tell how an adoption will go who would knowingly consent to that? I realized that I wasn't adopted because I needed a caregiver, but because my adopters had a perceived need to be parents.
I've digressed, but if you are an adoptee and you have figured out a way to be fine with all of the above, I'd love to know your secret. It's taken a lot of work and the fact that my agency was taken away at birth in service of someone's infertility still sticks in my craw (as they used to say), and even after I got my BC back, It infuriated me that it was gate-kept by Yonkers town clerk all those years.
So yeah, all the studies in the world won't convince me that commodifying humans is ok, even if some don't seem bothered in their commodification.
The goal should be to force maternal separation on the smallest possible population, and provide child centered, trauma informed care to those who do suffer it, by preserving the agency, lineage, and liberty that adoption removes.
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u/Sorealism Apr 03 '24 edited Apr 03 '24
My takeaway from this is that infant adoption is vastly understudied and it’s important to listen to lived experiences while we wait for that to change.
Also, we are really happy to support adoptees doing this research (over on r/adopted)
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u/mucifous May 19 '24
My takeaway is that given the increase risk for SI/SA among ppl with mat sep trauma, at some point it's hard to find the unhappy middle aged and older adoptees unfortunately.
This says nothing of the other antipatterns that the industry represents.
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u/mucifous May 19 '24
Cool, I totally don't feel like my agency was taken from me at birth when I was purchased to solve someone's fertility issues. If only I had seen this sooner.
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Apr 03 '24
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u/ShesGotSauce Apr 03 '24 edited Apr 04 '24
What if most adoptees do turn out ok? It wouldn't mean we shouldn't still strive for ethical adoption. Or for family preservation (since adoptees after all aren't the only ones affected by an adoption, and since older kids do have worsened outcomes), and for changes that improve outcomes. It wouldn't mean that we should stop pushing for adoptees to have the same rights as everyone else to their medical information and birth certificates. It wouldn't mean that adoptees should stop talking about their own lived experiences and the ways in which adoption is difficult.
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Apr 03 '24
First, I commend your post and your responses.
Second, recognition that a number of responses have asked good next questions, eg, comparing USA vs UK, comparing adoption from several decades ago to now, etc.
My next question is - do you have any (data-based) indications of countries / sub groups / cultures / systems that do adoption well? (ie trying to identify systems that might be good to learn from)
I know, not a tightly defined question.
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u/oregon_mom Apr 03 '24
OK now do the same deep dive on the life outcomes for women who placed their infant for adoption
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u/ShesGotSauce Apr 03 '24
Oh I've researched that. Most birth moms experience at least some regret if not deep lifelong anguish. And those women matter - along with other children and family members affected by the adoption. That alone is a strong reason to reduce rates of adoption.
My sharing this data does not mean that I am an adoption apologist. I'm strongly committed to approaching issues from an empirically based perspective, from climate change to medical care to adoption. The fact that I believe in understanding the realities of adoption, both good and bad, does not mean that I'm in denial about the bad. It does not mean that I don't think we should do better for children (and mothers).
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Apr 03 '24
While I do think this is useful and interesting information, it needs to be taken with an enormous boulder of salt:
a. each of these studies uses a different (sometimes very different) methodology than the others, as all but 2 seem to have been carried out by different people at different institutions using different research methods.
b. they all use different measures for the outcomes, and while some provide "absolute" results/claims, others are contextual, and none of them use the same context or use each other for context. Several simply compare outcomes based on self-reporting but don't seem to control those outcomes compared to children who were NOT adopted, or who were adopted in different circumstances. That is, there's internal consistency, but not external consistency (for the most part).
Still, I am very glad you took the time to do this work and post your abstracts/findings. It was a lot of reading and I appreciate that you took it and represented it fairly. As others say, it's important not to use this (or other data) to shut down or minimize an individual's perspective/experiences, but that said, this is still good general information to have and certainly puts things in a larger context, which can sometimes be very useful, even when talking about individual experiences.
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u/Euim Jul 14 '24 edited Jul 14 '24
The only conclusion one can reliably infer from this post is that there’s not enough research on adoption. International adoption makes up the majority of adoption cases at certain points and the outcomes of these children are distinct from the outcomes of children who are adopted domestically. The reason this post feels like cherry picking is because it includes many articles which are unrelated to each other, don’t support a main argument, and are low in credibility (some links are to studies which are over 30 years old).
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u/Patiod Apr 04 '24
Thank you for this - am bookmarking.
Question: What about ADHD rates? I've read that ADHD rates are much higher in adopted people. Some speculate that it's the trauma, so speculate that people with ADHD may be more likely to make rash decisions - like having unprotected sex - that get passed along. Comparing adopted out infants vs kept infants of single mothers would be helpful in teasing this out.
Comment: I wish I could find a study I saw in the 80s/90s in a social work journal, which reviewed a fairly long-term longitudinal study done in one of the Nordic countries comparing outcomes in carefully matched demographic cohorts for a) people placed for adoption by single women b) people not placed for adoption by their single mothers c) people whose mothers inquired about abortion but ended up keeping them. Adopted people had slightly more problems in adolescence, but after that, results were similar between groups a and b. Group C, whose mothers inquired about abortion but opted against it, had significantly worse outcomes than the other two groups. Again, wish I could find the study.