Adoptive Placement Research Articles

Risk factors for mental health diagnoses among children adopted from the public child welfare system

Abstract Children awaiting adoption through the child welfare system often have “special needs,” or characteristics that make securing an adoptive home for them challenging. A subset of these youth experiences significant psychiatric symptomatology, which may pose a problem for the stability of the adoptive placement. Clinicians and policymakers require information about precursors to mental health difficulties in order to plan effectively for the placement of these children. This study examines potential child and biological family risk factors for the presence of a DSM-IV mental health diagnosis among 368 children placed for adoption by a special needs adoption program between February 1997 and April 2005 using logistic regression within the Generalized Estimating Equations (GEE) framework. A significant proportion of the children and biological parents in our study experienced serious adversity prior to adoptive placement. Older age at adoptive placement, white race, male gender, having more than one placement, and a history of sexual abuse are significant predictors of the presence of a mental health diagnosis in the logistic regression model. Biological parent incarceration is significantly associated with the absence of a mental health diagnosis. Adoptive placement is a key transition for youth who have often experienced significant loss and trauma prior to placement. Support of the adoptive family and youth can be critical to ensuring placement stability and may be especially salient for youth with documented mental health diagnoses and corresponding behavioral problems, which put children at increased risk for placement disruption. More work is needed to understand the interplay of risk and protective factors for mental health difficulties among youth adopted from the child welfare system, including how these are affected by child welfare policies, informal procedures, and resources to produce varying outcomes for children in peril.

Social Factors Predicting Women’s Consideration of Adoption

Although there is a great deal of discourse about adoption in the popular press (Margolis, Elkin, Nemtsova, Polier, & Lee, 2008; Katz, 2008), few empirical research studies have examined the specific predictors of adopting. It is important to note that existing research indicates a significant disconnect between people's favorable attitudes toward adoption and actually adopting a child. Studies indicate that about 90% of people have a very or somewhat favorable attitude toward adoption (Evan B. Donaldson Adoption Institute, 1997; Evan B. Donaldson Adoption Institute, 2002). Additionally, over 80% of respondents also expressed agreement that parenting adoptive children can be as satisfying or more satisfying than parenting biological children (Evan B. Donaldson Adoption Institute, 2002), and anywhere from 25 to 40% of people say they have considered adoption themselves (Chandra, Abma, Maza, & Bachrach, 1999). However, this is in contrast to recent data showing that, among American women aged 18-44, only 1.1% had ever adopted a child and only 1.6% were currently seeking to adopt (Jones, 2008). Further, only about 2.5% of children under the age of 18 in the United States are adopted (Kreider, 2003). Consequently, while adoption is viewed as favorable by nearly all Americans, adopting a child continues to be a rather rare occurrence, experienced by relatively few individuals.A better understanding of the influences on adoption-seeking attitudes and behaviors is especially important considering the large number of children in need of adoptive families and the importance of permanent familial relationships on healthy child development. In the United States, children may be adopted through the foster care system, privately from within the United States or internationally, or through kinship adoptions, making the actual number of children in need of adoption difficult to quantify. Nonetheless, merely taking into account the number of children in foster care who are waiting to be adopted provides ample evidence for the significant continued need for adoptive placements for children. According to recent data, an estimated 408,425 children are in foster care in the United States, and more than 107,000 of them are waiting to be adopted ( U.S. Department of Health and Human Services, 2011).In light of the apparent disconnect between attitudes and behavior regarding adoption, and in response to the number of children waiting to be adopted in the United States and elsewhere, it is important to understand the factors that affect potential adoptive parents' consideration of adoption as well as those that influence them to move from merely considering adoption to actively pursuing the adoption of a child. A more thorough understanding of these processes is necessary to reduce barriers to adoption, and to increase the availability of adoptive families for children.In this study, we examine factors that predict consideration of adoption by comparing three groups of women: those who have never considered adoption, those who have considered adoption but have not taken any steps beyond considering it, and those who have considered adoption and have taken steps in the adoption process ranging from talking with an adoption agency to adopting a child. Data are from a representative probability sample of women between the ages of 25 and 50 who reside in the Midwest. Previous research suggests women are more likely to consider adoption than are men (e.g. Evan B. Donaldson Adoption Institute, 2002). Factors examined as predictors of women's considering and taking steps toward adopting include demographic, social, and attitudinal variables. The variables examined include age, race, marital status, income, religiosity, having given birth to a child, having experienced fertility problems, attitudes toward assisted reproductive technologies, the importance placed on parenting, whether the respondent intends to have another child, whether they have formally or informally cared for another person's child, and whether they believe adoptive parenting is as potentially satisfying as biological parenting. …

Maternal self concept as a provider and cessation of substance use during pregnancy

ObjectiveMaternal substance use during pregnancy is a common modifiable risk factor for poor birth outcomes, and is associated with long term psychological risks to offspring. As self concept is known to affect substance use behaviors in non-pregnant women, we hypothesized that self concept as a provider may be particularly salient to cessation of use during pregnancy. To isolate psychological processes specific to pregnancy from those associated with the transition to parenthood, we examined birth mothers who made adoption placements participating in the Early Growth and Development Study. MethodsWe obtained lifetime and pregnancy substance use history and psychological measures at 3 to 4months postpartum from 693 women recruited from the Northwest, Southwest, and Mid-Atlantic regions of the United States. Life history calendar and computer-assisted personal interviewing methods were used to minimize reporting bias. Using logistic regression, we assessed the association of self concept as an adequate provider with cessation of substance use during pregnancy, controlling for sociodemographic variables, depressive symptoms experienced during pregnancy, past year antisocial behaviors, family history of substance abuse, timing of pregnancy recognition, timing of initiation of prenatal care, and emotional adjustment to the adoption decision. ResultsMore positive self-concept as an adequate provider was independently associated with cessation of substance use and earlier initiation of prenatal care during pregnancy [OR=1.223; 95% C.I. (1.005–1.489); B(SE)=.201(.100)]. Familial substance abuse, depressive symptoms, and antisocial behaviors during pregnancy, were also independent predictors, and more strongly associated with cessation [OR=.531; 95% C.I. (.375–.751); B(SE)=−.634 (.178)], [OR. 940; 95% C.I. (.906–.975); B(SE)=−.062 (.019)], [OR=.961; 95% C.I. (.927–.996); B(SE)=−.040 (.018)]. ConclusionsEnhancing maternal identity as a provider for the fetus during pregnancy, along with treatment of depression, may improve motivation to stop substance use.

Infants' responsiveness, attachment, and indiscriminate friendliness after international adoption from institutions or foster care in China: Application of Emotional Availability Scales to adoptive families

In a short-term longitudinal design we investigated maternal sensitivity, child responsiveness, attachment, and indiscriminate friendliness in families with children internationally adopted from institutions or foster care in China. Ninety-two families with 50 postinstitutionalized and 42 formerly fostered girls, aged 11-16 months on arrival, were studied 2 and 6 months after adoption. Maternal sensitivity and child responsiveness were observed with the Emotional Availability Scales, attachment was assessed with the Strange Situation procedure, and mothers reported on children's indiscriminate friendliness. The postinstitutionalized children showed less secure attachment, whereas the former foster children did not differ from the normative distribution of attachment security. However, at both assessments the two groups of adopted children showed more disorganized attachments compared to normative data. Adoptive mothers of postinstitutionalized and former foster children were equally sensitive and their sensitivity did not change over time. Postinstitutionalized and former foster children did not differ on indiscriminate friendliness, but children with more sensitive adoptive mothers showed less indiscriminate friendliness. The former foster children showed a larger increase in responsiveness over time than the postinstitutionalized children, suggesting that children's responsiveness is more sensitive to change than attachment, and that preadoption foster care is more beneficial for the development of children's responsiveness after adoptive placement than preadoption institutional care.

Constitutional Colorblindness and the Family

Family law has escaped the colorblindness revolution. During the same time frame that the Supreme Court has adopted increasingly stringent constitutional standards for even “benign” uses of race (including most notably affirmative action), the lower courts have continued to take a loose and permissive approach to many government uses of race in the family. Thus, courts have continued to regularly affirm (and to apply minimal constitutional scrutiny to) the use of race to determine foster care and adoptive placements, as well as the use of race as a factor in custody disputes between interracial parents. This paper, drawing on heretofore unexplored historical sources, examines the Supreme Court’s role in the development of these divergent approaches to the use of race in the affirmative action and family law contexts. As those sources demonstrate, the Court has—over the last 40 years—had numerous opportunities to address the growing divide. Nevertheless the Court (and particularly its most ardent affirmative action detractors) has been reluctant to do so, at least in part because of a normative endorsement of the race-based practices at issue in the family law context. Thus, the Court has avoided taking up cases involving the use of race in family law—and taken other steps to limit the reach of its doctrine in the family law arena—based on a normative perception that remaining instantiations of race in family law are, at their core, benign. This history has profound implications for the Court’s broader race law jurisprudence. Supreme Court doctrine has—on its face—rejected the possibility of a role for normative judgments about the “benign” or “invidious” nature of particular race-based classifications in its Equal Protection doctrine. But the history of the Court’s approach to family law suggests strongly that the Court itself does in fact weigh such factors sub rosa in its approach to taking up and adjudicating race law claims. This Article suggests that there are serious process, legitimacy, and substantive concerns raised by such a divergence, and discusses alternatives for bringing the Court’s doctrine into greater alignment with its practice. 2 COLORBLINDNESS AND THE FAMILY [DRAFT] CONSTITUTIONAL COLORBLINDNESS AND THE FAMILY

Comprehensive Health Evaluation of the Newly Adopted Child

Children who join families through the process of adoption often have multiple health care needs. After placement in an adoptive home, it is essential that these children have a timely comprehensive health evaluation. This evaluation should include a review of all available medical records and a complete physical examination. Evaluation should also include diagnostic testing based on the findings from the history and physical examination as well as the risks presented by the child's previous living conditions. Age-appropriate screens should be performed, including, for example, newborn screening panels, hearing, vision, dental, and formal behavioral/developmental screens. The comprehensive assessment can occur at the time of the initial visit to the physician after adoptive placement or can take place over several visits. Adopted children should be referred to other medical specialists as deemed appropriate. The Section on Adoption and Foster Care is a resource within the American Academy of Pediatrics for physicians providing care for children who are being adopted.

Can gay and lesbian parents promote healthy development in high-risk children adopted from foster care?

Adoption is known to promote cognitive and emotional development in children from foster care, but policy debates remain regarding whether children adopted by gay and lesbian parents can achieve these positive outcomes. This study compared the cognitive development and behavior problems at 2, 12, and 24 months postplacement of 82 high-risk children adopted from foster care in heterosexual and gay or lesbian households. On average, children in both household types showed significant gains in cognitive development and maintained similar levels of behavior problems over time, despite gay and lesbian parents raising children with higher levels of biological and environmental risks prior to adoptive placement. Results demonstrated that high-risk children show similar patterns of development over time in heterosexual and gay and lesbian adoptive households.

England and Wales: Proceedings Delaying Placement for Adoption

England and Wales: Proceedings Delaying Placement for Adoption

Postplacement relationships between birth mothers and their romantic partners.

Using a mixed-methods approach, the understudied population of birth mothers who placed their infants for adoption 12-20 years ago was explored in the context of their romantic relationships. In a semistructured interview, 104 birth mothers answered detailed questions about their romantic relationships and adoption-related experiences. All birth mothers had disclosed the adoption placement to their romantic partners, and most had done so early because they wanted to be truthful about their past. On average, the birth mothers were satisfied with their romantic relationships and almost half did not believe that the adoption had affected it. Regarding contact in the adoption, a majority of the birth mothers' romantic partners (63.5%) were not directly involved in contact with the adoptive family or adopted youth. Implications about how adoption is perceived and processed within intimate relationships are discussed.

An in-depth analysis of domestically adopted children with special needs and their biological mothers

• Summary: In 2001, federal research funding (#90-CO-0960) was awarded to conduct an in-depth study of one agency’s experience with domestic special needs adoption placements (US Department of Health and Human Services, 2001). This private Ohio agency has been involved in the placement of special needs children since the beginning of the US special needs adoption movement in 1976. A rigorous and comprehensive chart review was conducted profiling 362 consecutively referred special needs adoption cases from 1997 to 2005, providing one of the most accurate and in-depth profiles of both special needs adoption children and their biological mothers to date. • Findings: In summing the major child and biological mother risk factors reported in this study (i.e. child neglect + child physical abuse + child sexual abuse + child prenatal drug exposure + child positive toxicology screen at birth + maternal mental illness + maternal substance abuse + maternal homelessness + maternal history of domestic violence + parental incarceration + and death of a significant person), youth averaged 4.7 (SD = 1.61) cumulative risk factors, not including poverty, multiple placement disruptions, and other undocumented risk factors. • Applications: Accurate and comprehensive profiling of child and biological parent characteristics are required to inform the service needs of at-risk families, domestic special needs adopted children, and adoptive parents. Implications for adoptive parent recruitment, training, and support, as well child monitoring and treatment are discussed.

Adoption law: a district nurse's guide

The Government wants to see a large rise in the use of adoption as a means of giving children a secure, loving and permanent home. Guidance coming into effect from April calls for a more pragmatic approach to adoption placements, and calls for the active promotion of the adoption process by health and social care professionals. District nurses will encounter people interested in becoming prospective adopters, but who are unsure if their background or lifestyle makes them eligible. It is essential that district nurses have a working understanding of the guidance and provisions of the Adoption and Children Act 2002 to confidently advise others about adoption and clarify any issues raised.

Black Adoption Placement and Research Center at 25: Placing African-American Children in Permanent Homes (1983–2008)

The Black Adoption Research and Placement Center is a nonprofit organization delivering culturally specific adoption and foster care services. The organization developed as a response to concerns in the African-American community about the high numbers of African-American children entering and not exiting the public foster care system. The organization has undergone significant transformations over its 25-year history in relation to social, political, and economic changes that have altered the ways that the agency finances and delivers services. The history of Black Adoption Research and Placement Center presents an organization that has weathered many challenges because of its strong leadership, its committed governing body, its external relationships, and its internal operations.

Worker time and the cost of stability

This paper investigates the time caseworkers spend supporting long-term foster care and adoption placements. Undertaken in Australia through collaboration between university and non-government agency researchers, the ‘Cost of Support Study’ tracked the hours that caseworkers spent supporting twenty-seven children and their carers over a nine month period. 3 3 The research also tracked the time taken by carers for tasks related specifically to the placement — i.e. above and beyond ‘ordinary parenting’. See full report of the research at http://www.buseco.monash.edu.au/ebs/pubs/reports/cost-of-support-final-report.pdf; and Research Report Summary ( O'Neill, Tregeagle, Forbes, Cox, & Humpheys, 2010). Further papers on the carer findings and the methodology itself are in preparation. The placements were part of a ‘Find-A-Family’ program for ‘hard to place children’, many of whom had previously experienced multiple placement breakdowns. The program has a history of 78% stability on the first placement (over the young person's time in the program) and 93% by the second, with the type of support provided by this accredited agency's program detailed here. The weekly worker diaries reveal an average of 3 hours 32 minutes of worker time per week per placement; however wide variation is apparent in the time given to each placement, and depends on the characteristics of the child involved. Further, the resources required to support each placement are found by multiplying worker hours by the hourly cost per worker, using New South Wales government costings. The paper contributes to the important debate regarding the link between worker time and stability in care, by deepening our understanding of the costs involved in providing high quality support and supervision of casework.

The Well-Being of U.S. Children Adopted From Foster Care, Privately From the United States and Internationally

This article examines differences in the well-being of American children adopted from foster care, from other domestic sources, and from international sources using the National Survey of Adoptive Parents with data merged from the 2007 National Survey of Children's Health. The authors explore the independent associations of child, parent, and family factors such as age of adoptive placement, transracial placement, socioeconomic status, and family structure with 8 child well-being indicators on which children adopted from foster care fare tend to fare worse than other adopted children. Covariates explain the association of adoption type with well-being for 5 out of 8 indicators.

Patterns and Predictors of Adoption Openness and Contact: 14 Years Postadoption

Increased attention is being paid to open adoption arrangements between birth parents and adopted children and families. This study examines openness and contact among 469 adoptions at 14 years postadoption from the fourth wave of the California Long‐Range Adoption Study (CLAS) and 378 adoptions matched across all waves. The proportion of families reporting contact declined from Wave 3 (1997) to Wave 4 (2003) although contacts increased within open adoptions. Positive ratings of the contact's effect on the family increased the likelihood of contact between adoptive and birth families, although greater levels of overall satisfaction lowered the likelihood of openness over time. At any point in time, public agency adoptions were less likely to be open. Findings suggest that increased attention should be paid within agencies to how open arrangements are pursued for adoptive placements.

Mixed ethnicity, identity and adoption: research, policy and practice

ABSTRACTMixed ethnicity children are over‐represented in the care system and constitute a significant group of those seeking adoption placements. Social workers are presented with a specific set of concerns in seeking to find adoption placements for mixed ethnicity children as they come from two or more cultural backgrounds. Practitioners face uncertain principles concerning how to respond to these issues, especially in light of social and political pressures, and within the realm of existing debates around ‘transracial’ adoption. There is a danger that among these uncertainties the individuality of the child will be lost as his or her identity needs become viewed narrowly. Social workers may seek to simplify and classify the identities of mixed ethnicity children in the adoption process through pressures that they feel to find ‘matched’ placements. This paper explores how theories concerning identity can provide some insight into the difficulties practitioners face and may help to inform social work practice in this area.

Adoption as a solution to intractable parenting problems: Evidence from two English studies

This paper reports the results from two English studies of adoption to illustrate issues and beliefs in the use of adoption as a solution to intractable parenting problems. The data are taken 1) from a study of the placement and psychosocial outcomes for a representative sample of 130 three to eleven-year-old children from the point at which they were recommended for adoption and 2) samples of children from a study of the pathways to permanent placements for children of white and minority ethnic heritage. These representative samples are used to examine the extent to which the decision for adoption results in an adoptive placement, the factors influencing this, including delays in decision-making, and differences in Social Services treatment of children of minority ethnic status. Delay was a major factor in whether adoption took place, but there was no evidence of systematically adverse treatment or processing of ethnic minority children. The psychosocial outcomes for adopted children in study 1 compared with those in the same study who entered long-term foster care showed few differences, but there was significantly better attachment for the adopted children.

‘Adoption Success’: The Reality of Adoptive Placements Today

In order to make adoption a true success story for adoptive parents and their children the number of adoptive placements that disrupt needs to become a key target. At present approximately 20 per cent of all adoptive placements breakdown. This paper discusses the issues and difficulties facing adoptive families, using literature and personal experience, and suggests strategies and interventions that social workers need to be implementing if the disruption rate is to decrease.

Domestic and International Transracial Adoption: A Synopsis of the Literature

AbstractWhile adoptions are as ‘old as humanity itself’, transracial adoptions are a fairly recent phenomenon, particularly in the United States. This article reviews the state of transracial adoption research through an examination of the domestic and international transracial adoption literatures. Special attention is paid to the controversy that erupted in the 1970s over Black–White adoption placements and to the emergence of international adoption as the dominant form of transracial adoption.

Bridging the divide: openness in adoption and postadoption psychosocial adjustment among birth and adoptive parents.

Using 323 matched parties of birth mothers and adoptive parents, this study examined the association between the degree of adoption openness (e.g., contact and knowledge between parties) and birth and adoptive parents' postadoption adjustment shortly after the adoption placement (6 to 9 months). Data from birth fathers (N = 112), an understudied sample, were also explored. Openness was assessed by multiple informants. Results indicated that openness was significantly related to satisfaction with adoption process among adoptive parents and birth mothers. Increased openness was positively associated with birth mothers' postplacement adjustment, as indexed by birth mothers' self-reports and the interviewers' impression of birth mothers' adjustment. Birth fathers' report of openness was associated with their greater satisfaction with the adoption process and better postadoption adjustment.