Why Adoptees Have Higher Rates of ADHD

"The ADHD brain is structurally different, and research shows that it's linked to lower dopamine levels, difficulty regulating dopamine, and increased activity in the brain's default mode network (DMN). The DMN, the brain region active during daydreaming and self-reflection, should quiet when a person engages in a task, but tends to remain active in people with ADHD. From a neurological perspective, an inability to regulate dopamine and deactivate the DMN contributes to hallmark ADHD symptoms: interest-based attention, cognitive and/or physical hyperactivity."

"ADHD risk reflects an interplay of genetic, prenatal, perinatal, and post-adoption environmental factors that can amplify vulnerability. Research consistently finds that adoptees are diagnosed with, or treated for, ADHD at higher rates than their non-adopted peers (Cawthorne et al., 2025). These elevated rates appear across adoption contexts: infants adopted at birth, international adoptees who experienced institutionalized care, and children adopted from foster care (Kennedy et al., 2016; Keyes et al., 2008; Abrines et al., 2015)."

ADHD is a neurodevelopmental condition influenced by genetic and environmental factors. ADHD brains show structural differences, lower dopamine levels, impaired dopamine regulation, and persistent default mode network activation that undermines task-focused attention. These neurobiological features drive interest-based attention, cognitive and physical hyperactivity, and emotional dysregulation. Genetic heritability in childhood is estimated at 70–80 percent, but prenatal, perinatal, and post-adoption environments modify risk. Maternal stress during pregnancy can alter fetal brain development and later self-regulation. Early deprivation, institutional care, trauma, and other adversities increase ADHD symptoms and emotional challenges, especially among adoptees. Trauma-informed care, interventions addressing systemic inequities, and supports for birth mothers and adoptive families can reduce harms and improve outcomes.

Read at Psychology Today