Between 1990 and 2006, more than 76,000 children born in Eastern Europe were adopted into American families. Almost two-thirds of these children came from Russia. And in contrast to children adopted from Korea, China, Central America, and South America, most of the Russian children were not infants, but between one and four years old. This volume addresses adoption policies and practices as they pertain to adopted children from Eastern Europe, children who have histories of "pre-adoption adversity." Drawing on her decade-long experience as an adoptive parent of siblings born in Russia and her expertise as an applied sociologist, Josephine Ruggiero examines the central issues involved in international adoptions, focusing on older children as well as siblings, and suggesting needed changes in policy and practice.