As the number of international adoptions has increased over the past 2 decades, so has awareness and understanding of the risks associated with the conditions to which these children have been exposed. Prenatal alcohol and/or drug exposure, infectious diseases, malnutrition, and psychosocial deprivation all contribute to the profound growth and developmental delays seen in many adoptees at the time of placement and thereafter. This article provides an overview of preplacement conditions of children adopted internationally that predispose them to language delays and disorders so that the adoptees at greatest risk may be identified early and referred for appropriate evaluation and supportive services.