Article i s w

International Social Work

53(4) 510–527
School performance © The Author(s) 2010
Reprints and permission: http://www.
at age 16 among sagepub.co.uk/journalsPermissions.nav
DOI: 10.1177/0020872809360037

international http://isw.sagepub.com

adoptees: A Swedish
national cohort study

Bo Vinnerljung
National Board of Health and Welfare, Sweden

Frank Lindblad
Uppsala University, Sweden

Anders Hjern
Nordic School of Public Health, Sweden

Finn Rasmussen
Karolinska Institutet, Sweden

Monica Dalen
University of Oslo, Norway

Abstract
School performance at age 16 for 6448 intercountry adoptees to Sweden
was compared with that of siblings and majority population peers. The
school performance of Korean-born adoptees was on a par with non-
adopted peers, but non-Korean adoptees’ school performance was lower,
as was that of adoptees who were older at the time of adoption.

Corresponding author: Bo Vinnerljung, National Board of Health and Welfare, S 106 30

Stockholm, Sweden.
Email: bo.vinnerljung@socialstyrelsen.se
Vinnerljung et al. 511

Keywords
adoption, cohort study, education, international adoption, school perfor-
mance

Introduction
The adoption of foreign-born children (intercountry adoption, ICA) became
a common practice in Sweden and many other countries in northern Europe
and North America in the late 1960s. To date, approximately 50,000 foreign-
born children have been adopted in Sweden, initially primarily from Korea,
India and Colombia, but in recent years also from China and eastern Europe
(Stockholm, Swedish Inter-country Adoption Authority, available at: http://
www.mia.eu/). Today, there is a large body of follow-up studies on the
long-term development of intercountry adoptees. A primary target of those
research efforts has been educational outcomes. But studies in this area
display considerable methodological variations in the delimitation of the
study group, age at follow-up and choice of outcome measures. This has
resulted in partly contradictory messages from research on school perfor-
mance of intercountry adoptees. Our study attempts to address those prob-
lems. It is based on a national cohort sample, including all intercountry
adoptees (N = 6448) in Sweden born in 1973–7. We examine their school
performance at the last semester of primary school, at age 16, as measured
by school grades.

Samples in earlier research

Large population samples are unusual in studies on intercountry adoptees’
school performance, the main exceptions being one Dutch and one Swedish
study (Lindblad et al., 2003; Verhulst et al., 1990a, 1990b). Many samples
have been drawn from the records of a single adoption organization (Bagley
and Young, 1980; Dalen, 1995, 2001; Dalen and Rygvold, 2006; Stams
et al., 2000; Wickes and Slate, 1996). Samples from a single sending country,
usually Korea or China, are also common (Bagley and Young, 1980; My
Lien et al., 1977; Wickes and Slate, 1996).

Age at follow-up
Furthermore, there are large variations of age at follow-up. Most studies
contain a wide age range (Dalen, 1995; Levy-Schiff et al., 1997). We have
found only two studies that measured outcomes at the same age for all
512 International Social Work 53(4)

sample members, both during early school years (Bunjes, 1991; Stams et al.,
2000). There are at least two good reasons for examining school performance
at the end of the primary school phase. National adoption studies have found
that adoptees tend to have school difficulties in younger years, but perform
more on par with non-adopted peers in mid-adolescence (Bohman and
Sigvardsson, 1990). Also, since admittance to different secondary school
programs in Sweden (and several other European countries) depends to a
large degree on the grades from the final year in primary school, school
performance at that time in life can have a decisive influence on the future
life course.

Outcome measures
Surprisingly, school grades have rarely been used as an outcome measure in
research on intercountry adoptees’ school performance, in contrast to stud-
ies on national adoptions (Burrow et al., 2004; Miller et al., 2000). We are
aware of a single study only from scholars outside our own research group
(a small sample Israeli study; Levy-Schiff et al., 1997). The most common
indicators are teacher ratings (Dalen, 1995, 2001; Kvifte Andresen, 1992;
Stams et al., 2000), self-ratings (Bagley and Young, 1980; Westhues and
Cohen, 1997; Wickes and Slate, 1996), or parental reports (Bagley and
Young, 1980; Verhulst et al., 1990a, 1990b). As mentioned earlier, poor
school grades from primary school limit the choices of young people’s con-
tinued educational career. Thus, grades from the end of primary school are
an important hard measure of school performance. In two recent studies we
have analyzed the relation between male intercountry adoptees’ cognitive
capacity measured at national conscription at age 18 and their primary-
school grades (Lindblad et al., 2009), but also in relation to their educational
attainments in young adulthood (Dalen et al., 2008). We found that inter-
country adoptees had better school grades and reached higher levels of edu-
cation than non-adopted male peers with the same test scores at conscription.
This suggests that ICA has a noteworthy compensatory effect on school
performance.

Age at adoption and geographic origin

Results from earlier adoption studies have revealed that age of adoption and
geographic origin as probable indicators of pre-adoption adversity are likely
to be associated with school performance (Dalen et al., 2008). We examine
those factors. Research has also consistently reported that adoptees from
Vinnerljung et al. 513

Korea tend to have better long-term outcomes – almost regardless of

outcome measure – when compared with other intercountry adoptees;
differences among adoptees from other regions are less consistent (Elmund
et al., 2007; Hjern et al., 2002; Lindblad et al., 2003). Subsequently, compari-
sons on geographic origin are made here between Korean and non-Korean
intercountry adoptees. Finally, because few studies have examined the
influence of parental education or other socio-economic background factors
on the school performance of intercountry adoptees (Lindblad et al., 2003),
we also address that shortcoming.
Thus, our study focuses on the following, mainly descriptive, research
questions:

• How do intercountry adoptees perform in school at age 16, compared

with Swedish-born siblings of adoptees and non-adopted Swedish-
born peers?
• Does school performance vary by socio-demographic characteristics
of the adoptive home?
• Does school performance vary by age at adoption and geographic
origin?

Methods
This study was based on national registers held by Statistics Sweden and the
National Service Administration. All Swedish residents are assigned a
unique 10-digit ID number at birth or immigration. This ID was used to link
information from different register sources. The study was approved by the
regional ethics committee at Karolinska Institutet.

Study population
The study population was drawn from all Swedish residents born 1973–7
registered in the Population and Housing Census (PHCs) in November
1985. Five study groups were created, based on information about adoption
from the Multi-Generation Register, and information about birth country,
year of birth and date of immigration of the study subjects and their parents
from the Register of the Total Population.
The intercountry adoptee groups consisted of individuals born outside
Western countries (Europe, North America and Australia; very few adoptees
in our cohorts came from these regions) who had immigrated to Sweden
before 11 years of age and had Swedish-born adoptive parents without any
record of emigration or immigration. Adoptees were divided into two
514 International Social Work 53(4)

groups, Korean adoptees (n = 1434) and non-Korean international adoptees

(n = 5014). The major countries of origin for the non-Korean adoptees were,
in order of size, India, Thailand, Chile, Sri Lanka, Colombia, Ethiopia and
Ecuador. Siblings of international adoptees were defined as biological off-
spring of mothers who were recorded as also being an adoptive mother of a
foreign-born child (n = 533). The Swedish majority population consisted of
Swedish-born offspring of two Swedish-born individuals who were not
recorded to be adoptive parents (N = 404,116). A small group of domestic
adoptees were excluded from the study population for reasons of insuffi-
cient statistical power. In this cohort, domestic adoptions by others than step
parents or relatives were very rare.

School data
The National School Register contains information on grades by subject
and summary scores for all students graduating from the ninth (final) year
in public schools since 1988. Non-public schools, which comprise fewer
than 5 percent of all Swedish schools, have been included since 1993. The
grading system during 1988–96 consisted of five-point scales in key sub-
jects, based on national tests administered by the Swedish School Authority.
In this study, we describe and analyze summarized average grade points
from the last semester, plus grades in Physics, Swedish, History, Music and
Sports. In one analysis (Table 3) we have aggregated those subjects into two
groups: theoretical subjects, requiring skills in abstract thinking (Physics,
Swedish and History); and Practical Subjects (Music and Sports).
During the years in focus, the Swedish national school system practiced
ability grouping – low or high level – in Mathematics and English at ages
13–16 (Slavin, 1987). Thus, grades from those levels cannot be compared,
but ability grouping itself is of interest because most secondary education
paths that lead to university studies require the high-level grouping in
Mathematics and English.
The quality of the data in the National School Register is high, and
summary statistics are published regularly (Stockholm, Swedish National
Agency for Education, available at: www.skolverket.se).

Independent and confounding variables

Data on maternal education were obtained from the Swedish Population and
Housing Census 1985 and categorized as brief (missing, 0–11 years), medium
(12–13 years), long (14–15 years) and very long (16+). The socio-economic
status (SES) and single-parent status of the household were identified in the
Vinnerljung et al. 515

Swedish Population and Housing Census of 1985. Socio-economic groups

were defined according to a classification created by Statistics Sweden
(Statistics Sweden, 1982). Geographical location of the home (residency)
was categorized as city, town or rural.
Age at adoption was defined as date of immigration minus date of birth
and categorized as 0–12 months, 13–24 months, 2–3 years, 4–6 years and
7–10 years. Regardless of the date of the court’s decision (adoption), the
date of immigration confirms that the child had been left in the care of the
adoptive parents.

Statistical analysis
Linear regression was used to analyze the grade points from the last semes-
ter in the nine-year primary school. The study groups were added as dummy
variables with Swedish majority as reference category. Boys and girls were
analyzed together in two models. The first model included gender and year
of birth only, and socio-economic variables were added as dummy variables
in the second model. Logistic regression models were used to analyze com-
pleted low- or high-level of Mathematics and English. In the first model
results were adjusted for gender and year of birth, while in the second model
socio-economic confounders were added. The year of birth was entered as a
continuous variable in all analyses because of the slight but systematic
increase of grade point averages over the years (not shown in tables). All
analyses were made with the aid of SPSS 13.0 software.

Results
In Table 1 the socio-demographic characteristics of the study groups are pre-
sented. Adoptees, particularly the Koreans, had a strong female preponderance.
Non-Korean adoptees and birth children in adoptive families more often lived in
households with a high SES and more often had mothers with a post-secondary
education compared with the Swedish majority, with the households of the
Korean adoptees in an intermediate position. The socio-economic background
data for the sibling group indicate that parents with both birth and adop-
tive children tended to be more privileged than other families. Finally, fewer
adoptees lived in rural areas compared with non-adopted Swedish-born peers.

Grades
Girls had higher grades than boys, (mean 3.37 compared 3.10; not shown in
tables). High SES, high maternal education and urban residency were
516 International Social Work 53(4)

Table 1. Socio-demographic variables by group

Korean Non-Korean Siblings of Swedish

adoptees adoptees adoptees majority

N= 1434 5014 533 404,116

% % % %
Year of birth
   1973 27.2 12.9 16.5 21.2
   1974 31.0 16.5 18.8 21.4
   1975 11.4 21.1 15.9 20.1
   1976 13.7 27.1 22.3 18.9
   1977 16.7 22.4 26.5 18.5
Gender
   Male 31.7 41.4 53.3 51.2
   Female 68.3 58.6 46.7 48.8
Maternal education
   Brief 37.2 24.0 16.3 34.7
   Medium 26.5 21.0 20.3 31.5
   Long 20.4 26.9 28.3 21.5
   Very long 15.9 28.1 35.1 12.3
SES
   Unclassified 10.9 10.9 10.7 14.4
   Manual workers 8.7 4.5 2.1 13.5
   Skilled workers 10.8 6.5 6.2 15.8
  White collar 1 14.2 10.6 10.7 12.9
  White collar 2 28.6 28.4 26.3 23.4
  White collar 3 26.8 39.1 44.1 20.0
Single-parent household
  Yes 11.9 14.8 10.9 15.8
   No 88.1 85.2 89.1 84.2
Geographic residency
   City 25.1 29.2 30.4 23.9
  Town 55.8 54.1 52.2 52.9
   Rural 19.1 16.7 17.4 23.2

related to higher grades (not shown in tables). In Table 2 the mean scores of
summarized and selected grades for the study groups are presented. Siblings
of adoptees and Korean adoptees tended to have the highest grades, better
than Swedish majority peers. Non-Korean adoptees had the lowest grades.
When grades for both genders were analyzed in a linear regression with
majority peers as comparisons (Table 3), non-Korean adoptees had lower
summarized grade points and grades in theoretical subjects compared with
peers in the Swedish majority population, but the difference was considerably
smaller in Music and Sports (model 1). After adjustment for socio-economic
Table 2. Grade point averages in ninth grade by group

N Mean summary Physics Swedish History Sports Music

of all grades education
Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI)
Vinnerljung et al.

A. Boys
    Korean 455 3.24 (3.19–3.29) 3.26 (3.17–3.35) 3.11 (3.03–3.19) 3.37 (3.27–3.47) 3.66 (3.58–3.74) 3.26 (3.22–3.30)
adoptees
    Non- 2077 2.83 (2.81–2.86) 2.70 (2.66–2.74) 2.68 (2.65–2.71) 2.85 (2.81–2.89) 3.48 (3.44–3.52) 3.04 (3.00–3.08)
Korean
adoptees
    Siblings of 284 3.38 (3.32–3.42) 3.49 (3.38–3.60) 3.34 (3.24–3.55) 3.54 (3.43–3.66) 3.59 (3.49–3.69) 3.41 (3.31–3.51)
adoptees
    Swedish 206,998 3.10* 3.17* 2.94* 3.12* 3.42* 3.09*
majority
B. Girls
    Korean 979 3.51 (3.49–3.53) 3.31 (3.25–3.37) 3.66 (3.61–3.71) 3.51 (3.45–3.56) 3.38 (3.32–3.44) 3.65 (3.60–3.70)
adoptees
    Non- 2937 3.03 (3.02–3.04) 2.71 (2.68–2.75) 3.12 (3.09–3.15) 2.95 (2.92–2.99) 3.13 (3.10–3.16) 3.33 (3.30–3.36)
Korean
adoptees
    Siblings of 249 3.66 (3.63–3.70) 3.56 (3.44–3.68) 3.78 (3.68–3.88) 3.70 (3.59–3.82) 3.59 (3.49–3.69) 3.77 (3.67–3.87)
adoptees
    Swedish 197,048 3.38* 3.21* 3.49* 3.33 * 3.26* 3.49*
majority
Note: * CI of standard of the mean <0.01.
517
518 International Social Work 53(4)

Table 3. Linear regression of grade point averages, data from boys and girls
combined

N Mean summary of Theoretical Music and

all grades subjects1 sports
Model 1 Model 2 Model 1 Model 2 Model 1 Model 2
B B B B B B
Korean 1425 .14*** .09*** .12*** .06 .16*** .12***
adoptees
Non- 4917 –.32*** –.47*** –.34*** –.53*** –.09*** –.21***
Korean
adoptees
Siblings of 530 .28*** .07* .39*** .14*** .24*** .07
adoptees
Swedish 404,116 0 0 0 0 0 0
majority
Notes:
1
Physics, Swedish and History.
Model 1 is adjusted for gender and year of birth. Model 2 is adjusted for gender, year of
birth, SES, maternal education, single-parent household and residency.
*p < 0.05; **p < 0.01; ***p < 0.001.

confounders (model 2), differences were enlarged. In model 1, Korean adopt-

ees’ grades were better than non-adopted peers’. Even after adjustment for
socio-economic confounders (model 2), their grades tended to be higher than
among non-adopted peers from similar socio-economic backgrounds.

Outcomes of ability grouping: Low level of Mathematics and English

In Mathematics (Table 4), 60 percent of the non-Korean adoptees were
placed in the lower level, compared with 32 percent of the Korean adopt-
ees and 40 percent of their Swedish non-adopted peers. In English the
percentages were 38, 18 and 29 respectively. When the results were ana-
lyzed in logistic regression models (Table 4), Korean adoptees had consid-
erably lower odds for both these outcomes of ability grouping than other
adoptees and the majority population peers. In contrast, adoptees from
other countries had elevated odds in both models.

School performance in relation to maternal education

In linear regression models, adjusted for gender and year of birth, lower
maternal education was strongly associated with lower grades for the majority
Vinnerljung et al. 519

Table 4. Frequencies and odds ratios (OR) in logistic regression models of being
grouped in the lower level of Mathematics and English

Low-level Mathematics Low-level English

% Model 1 Model 2 % Model 1 Model 2
OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)

Korean 32.4 0.7 (0.6–0.8) 0.8 (0.7–0.9) 17.5 0.6 (0.5–0.7) 0.6 (0.6–0.7)
adoptees
Non- 59.7 2.2 (2.1–2.4) 4.0 (3.8–4.2) 37.9 1.6 (1.6–1.7) 2.9 (2.7–3.1)
Korean
adoptees
Siblings of 24.6 0.5 (0.4–0.6) 0.8 (0.7–1.0) 18.4 0.5 (0.4–0.7) 1.0 (0.8–1.3)
adoptees
Swedish 40.4 1 1 29.0 1 1
majority
Note: Model 1 is adjusted for gender and year of birth. Model 2 is adjusted for gender, year of
birth, SES, maternal education, single parent household and residency.

population group and also for the sibling group (Table 5). But in the two
adoptee groups, this gradient was quite weak.

Age at adoption
Average grades tended to be lower in a stepwise manner with increasing age
at adoption in both adoptee groups, after adjustment for gender, birth and
socio-economic confounders in linear regression models (Table 6).
After adjusting for gender, birth year and socio-economic confounders in
logistic regression models (Table 7), the odds for leaving school with grades
from low-level Mathematics and English tended to increase in a stepwise
trend toward higher odds, with older age at adoption for both adoptee groups.

Discussion
This population study examined intercountry adoptees’ school performance
at time of leaving primary school (age 16). Almost 6500 intercountry adopt-
ees were compared with Swedish non-adopted peers and Swedish-born
siblings with intercountry adoptees. The study utilized several outcome
measures of school performance: mean grades from the last semester
(all subjects), grades in selected subjects and results of ability grouping.
A striking result was that adoptees from Korea did well. Both boys and girls
tended to have better grades than non-adopted peers, even after adjustments
 520

Table 5. Linear regression of grade point average on maternal education

Maternal education Population size Mean grade point average

Korean Non-Korean Siblings of Swedish Korean Non-Korean Siblings of Swedish

adoptees adoptees adoptees majority adoptees adoptees adoptees majority
N N N N B B B B

Brief 533 1203 87 140,155 –.10* –.08*** –.41*** –.68***

Medium 380 1054 108 127,120 –.07 –.07** –.44*** –.56***
Long 293 1348 151 86,947 –.01 –.05* –.21*** –.27***
Very long 228 1409 187 49,896 0 0 0 0
R-value 0.219 0.173 0.383 0.393
Notes:
Model is adjusted for gender and year of birth.
*p < 0.05; **p < 0.01; ***p < 0.001.
International Social Work 53(4)
Vinnerljung et al. 521

Table 6. Linear regression of grade point average on age at adoption

Age at adoption Population size Mean grade point average

Korean Non-Korean Korean Non-Korean

adoptees adoptees adoptees adoptees
N N B B
0 527 1992 0 0
1 599 1735 –0.08* –0.08***
2–3 198 722 –0.06 –0.15***
4–10 110 565 –0.19** –0.23***
R-value 0.238 0.216

Notes: Model is adjusted for gender, year of birth, SES, maternal education,
single-parent household and residency.
*p < 0.05; **p < 0.01; ***p < 0.001.

Table 7. Odds ratios (OR) in logistic regression models of being grouped in the
lower level of Mathematics and English on age at adoption

Age Korean adoptees Non-Korean adoptees

N Low-level Low-level N Low-level Low-level

Math English Math English
OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)

<1 527 1 1 1992 1 1

1 599 1.3 (1.0–1.7) 1.4 (1.0–2.0) 1735 1.2 (1.0–1.4) 1.3 (1.1–1.4)
2–3 198 1.1 (0.8–1.6) 1.9 (1.3–2.0) 722 1.6 (1.3–1.9) 2.1 (1.7–2.5)
4–10 110 1.6 (1.0–2.4) 4.2 (2.6–6.8) 565 1.8 (1.5–2.2) 3.5 (2.9–4.3)
Note: Model is adjusted for gender, year of birth, SES, maternal education, single-parent
household and residency.

for parental socio-economic confounders. But their grades were lower than
the sibling group’s. Other intercountry adoptees had lower grades than the
other study groups, especially in theoretical subjects. This pattern was
repeated when looking at the results from ability grouping in Mathematics
and English. When results were analyzed in regression models, Korean
adoptees were less likely to have been placed in low-level Mathematics and
English, notably also after controlling for socio-economic background fac-
tors, while non-Korean adoptees were more likely to be have been placed in
the lower tracks.
522 International Social Work 53(4)

Effects of parental education on grades of adoptees were minimal, in

contrast to the grades for majority population peers. Older age at time of
adoption was associated with lower school performance in both adoptee
groups (after controlling for socio-economic confounders).
The results concerning variations in outcomes between Korean and other
intercountry adoptees point in the same direction as earlier long-term out-
come research (Dalen et al., 2008; Hjern et al., 2002; Lindblad et al., 2003).
Non-Korean adoptees tended to have a more uneven grade profile compared
with Korean adoptees and Swedish majority peers, with particularly low
grades in physics, low grades also in other theoretical subjects, but more or
less comparable grades with the Swedish majority in Music and Sports. This
seems to indicate that non-Korean adoptees tend to have problems in sub-
jects where cognitive competence is needed the most, a fact which is further
underlined by the comparatively low proportion in this group that com-
pleted an advanced course in Mathematics. Earlier cohort studies from our
research group on intercountry male adoptees, using cognitive test results
from conscription, showed that Korean male adoptees had higher test scores
than male non-Korean adoptees, higher than or on par with non-adopted
male peers (before and after adjustments for socio-economic confounders)
(Dalen et al., 2008; Lindblad et al., 2009; Odenstad et al., 2008).
But given what we know of cognitive requisites for both non-Korean and
Korean adoptees, it is important to stress that the general picture of adopt-
ees’ school performance is bright. In two earlier studies from our research
group, men from both adoptee groups had better school performance (mea-
sured in grades from the last semester of primary school) and higher educa-
tional attainments in young adulthood than non-adopted peers with equal
scores on the cognitive tests at conscription (Dalen et al., 2008; Lindblad et al.,
2009). The explanation is probably the educationally stimulating environ-
ment that the adoptive families provide, regardless of the adoptive mother’s
own level of education.
The results showing substantial differences between the two adoptee
groups probably reflect differences of pre-adoption factors, since non-
Korean adoptees in Sweden tend to be adopted into even more favorable
socio-economic family environments than their Korean-born peers. In the
absence of reliable pre-adoption data in our and almost all other studies on
long-term outcomes of ICA, causal explanations become hypothetical. But
there are two reasonable explanations, both probably affecting long-term
outcomes. The first is likely to be the quality of care before adoption
(Chandra et al., 1999). For many decades, Korea has been known for its
high-level control of adoption agencies. Since the 1960s, agency staff
requirements include a psychologist, a physician and a nurse. At least 50
Vinnerljung et al. 523

percent of the children’s counsellors must have four-year college social

work training (Kim and Caroll, 1975). In addition to well-functioning
orphanages, Korea-based adoption agencies have for many years operated
pre-adoptive foster family homes as an alternative to infant residential care
(Ghera et al., 2009; Tahk, 1986). Another reason may be the selection of
children put up for ICA in Korea. The literature indicates that the majority
of Korean adoptive children born in the 1970s and the 1980s were born out
of wedlock and adopted because of socio-cultural prejudices against single
parenthood (Kim, 1995; Tahk, 1986). Selection criteria and quality of care
of the biological mother as well as of the child are reported to vary consider-
ably more in other donor countries, suggesting that Korean adoptees are
favored in both these aspects (Fonseca, 2002; Triseliotis, 2000).
Generally, age at adoption seems to be a proxy for the magnitude of
exposure to pre-adoption adversity (Marcovitch et al., 1997; Rutter, 2005;
Verhulst et al., 1991). This study demonstrates a consistent correlation
between higher age at adoption and lower grades for Korean as well as for
non-Korean adoptees (Van IJzendoorn et al., 2005). A previous study from
our research group (Odenstad et al., 2008) reported a similar relationship
for intellectual performance at military conscription and age at adoption for
non-Korean adopted men but not for male Korean adoptees. Cognitive
competence may be contributing to the relationship in non-Korean adopt-
ees; the lack of a correlation in the Korean group indicates that other factors
have to be taken into account. We speculate that such factors may include
higher rates of behavioral disturbances such as hyperactivity, ADHD and
antisocial behavior that have consistently been found to increase with age
at adoption (Elmund et al., 2007; Juffer and van IJzendoorn, 2005; Verhulst
et al., 1990a, 1990b).

Limitations
The major strength of this study is the register design which made it possi-
ble for us to study a large national cohort with negligible attrition. The lack
of data about pre-adoptive circumstances (such as institutional rearing,
early neglect and selection of children given up for adoption) limits the
conclusions that can be drawn about why school performance varies so
clearly between the two study groups of adoptees.

Conclusion and implications for practice

The school performance of adopted children from Korea at the end of
primary school is on par with, or even better than, non-adopted peers. But
524 International Social Work 53(4)

non-Korean adoptees tend to do worse in school when compared with peers

in the majority population. Age at adoption is negatively correlated with
school performance, while the influence of the adoptive mothers’ educa-
tional attainments on adoptees’ school performance seems to be weak.
Studies have shown that intercountry adoptees more often get help with
homework than non-adoptees, and their parents are also in general more
supportive during the children’s school years (Dalen and Rygvold, 2006).
Educational services should take advantage of the capacity of these families
to support their children’s school work. Hypotheses about psychological
problems related to being an adoptee (e.g., identity problems) should not be
used as indiscriminatory explanations for individual adoptees’ weak school
performance, without a preceding cognitive assessment.

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Author biographies

Bo Vinnerljung is researcher at the National Board of Health and Welfare, Stockholm.

He is also Professor of Social Work at the University of Stockholm, Sweden.

Frank Lindblad is researcher at the Department of Neuroscience, Uppsala University,

Sweden. He is also Professor at Stockholm University and Associate Professor at
Karolinska Institutet.

Anders Hjern is professor of Paediatric Epidemiology at the Nordic School of Public

Health and researcher at the National Board of Health and Welfare, Stockholm,
Sweden.

Finn Rasmussen is Professor in the Department of Public Health Sciences, Karolinska

Institutet, Stockholm, Sweden.

Monica Dalen is Professor at the Department of Special Needs Education, University

of Oslo, Norway.