Findings show that boys with preadoptive abuse are prone to significantly higher levels and clinically severe externalizing symptomology as compared to adopted boys without such histories. Research supports a strong association between CSA and emotional and behavioral disturbances, indicating a need for better understanding and support for the needs of families who adopt children with a history of CSA. This study investigated the impact of preadoptive CSA on the emotional and behavioral adjustment of adopted boys, whereas other studies on the risk factors associated with adoption generally grouped special needs children and their adoptive families into one single category. Data were drawn from 1,136 boys age 6-18 years, adopted under the Florida child welfare system. The study was based upon panel surveys of adoptive parents whose children experienced preadoptive CSA. Findings confirmed that preadoptive CSA is significantly related to clinically significant rule-breaking and aggressive behavior across the 3-year period of the study. Tables and references