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Abstract Early caregiving adversity (ECA) is associated with elevated psychological symptomatology. While neurobehavioral ECA research has focused on socioemotional and cognitive development, ECA may also increase risk for “low-level” sensory processing challenges. However, no prior work has compared how diverse ECA exposures differentially relate to sensory processing, or, critically, how this might influence psychological outcomes. We examined sensory processing challenges in 183 8-17-year-old youth with and without histories of institutional (orphanage) or foster caregiving, with a particular focus on sensory over-responsivity (SOR), a pattern of intensified responses to sensory stimuli that may negatively impact mental health. We further tested whether sensory processing challenges are linked to elevated internalizing and externalizing symptoms common in ECA-exposed youth. Relative to nonadopted comparison youth, both groups of ECA-exposed youth had elevated sensory processing challenges, including SOR, and also had heightened internalizing and externalizing symptoms. Additionally, we found significant indirect effects of ECA on internalizing and externalizing symptoms through both general sensory processing challenges and SOR, covarying for age and sex assigned at birth. These findings suggest multiple forms of ECA confer risk for sensory processing challenges that may contribute to mental health outcomes, and motivate continuing examination of these symptoms, with possible long-term implications for screening and treatment following ECA. 

Early adversity, including institutional orphanage care, is associated with the development of internalizing disorders. Previous research suggests that institutionalization can disrupt emotion regulation processes, which contribute to internalizing symptoms. However, no prior work has investigated how early orphanage care shapes emotion regulation strategy usage (e.g., cognitive reappraisal, expressive suppression) and whether the said strategy usage contributes to internalizing symptoms. This study probed emotion regulation strategy usage and internalizing symptoms in a sample of 36 previously institutionalized and 58 comparison youth. As hypothesized, previously institutionalized youth exhibited higher rates of internalizing symptoms than comparison youth, and more frequent use of suppression partially accounted for the relationship between early institutional care and elevated internalizing symptoms. Contrary to our initial hypotheses, reappraisal use did not buffer previously institutionalized or comparison youth against internalizing symptoms. Our findings highlight the potential utility of targeting emotion regulation strategy usage in adversity‐exposed youth in future intervention work.