Placement Discontinuity for Older Children and Adolescents Who Exit Foster Care Through Adoption Or Guardianship: A Systematic Review

For over two decades, practitioners, advocates, and scholars involved with the U.S. child welfare system have engaged in coordinated efforts to increase the number of foster youth who find stable, permanent homes through adoption or guardianship, and these efforts have been shaped and guided by federal policies and directives. As a result, the number of children adopted or placed into guardianship out of foster care has increased significantly. This trend has significant implications for child welfare research, policy, and practice. However, the risk and protective factors for post-permanency discontinuity, or placement changes that occur after legal finalization of an adoption or guardianship, have received little attention in the literature. Also, many previous studies that investigated post-permanency adjustment for former foster youth have been limited by serious design and/or conceptual flaws. The purpose of this study is to investigate the peer-reviewed literature that examines risk or protective factors for discontinuity, or outcomes proximal to discontinuity, for older foster youth. A systematic search located 18 quantitative, quasi-experimental studies published in peer-reviewed journals that implemented multivariable methods. This review finds that the quality of the research evidence is generally weak, but previous studies do suggest several risk and protective factors for post-permanency discontinuity, including child, family, and service characteristics.     

From Foster Care to Adoption and Guardianship: A Twenty-First Century Challenge

For nearly four decades, child welfare policy and practice have focused on the achievement of legal permanence for children in foster care. Although federal child welfare policy has resulted in the movement of children from state custody to legally permanent adoptive or guardianship families, little is known about the quality and enduring nature of these placements. A significant challenge of the twenty-first century child welfare system is how to ensure the well-being of children currently living with adoptive parents or guardians. This paper discusses child welfare policy and trends related to post-permanency well-being, including the decrease in Title IV-E foster care caseloads nationwide and the simultaneous increase in Title IV-E adoptive and guardianship caseloads. We highlight the needs of a twenty-first century child welfare system, including increased federal efforts to ensure child permanence and well-being after legal adoption or guardianship has been achieved, as well as more rigorous longitudinal and interdisciplinary research focused on the post-permanency adjustment of children and their families.     

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

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.     

Supporting families throughout the international special needs adoption process

Due to changing trends in international adoption, a greater number of placements are now special needs. While most special needs adoptions are successful, they do present a higher risk for placement instability. Thus, adoptive parents and children are faced with an increasing need for support services. This article explores literature related to support throughout the international special needs adoption process including medical, information/education, social support and direct intervention both pre- and post-adoption. While many support strategies, both formal and informal, are utilized by families and adoption professionals, and some are promoted in policy related literature, few have been validated through empirical evidence. Findings reveal a need for further research around effective pre-adoption training programs for parents, preparation tools for children, and larger scale studies to evaluate post-placement services for each sub-group of international special needs adoptees.     

The postadoption experience: child, parent, and family predictors of family adjustment to adoption

Eighteen to 24 months after they adopted children in state custody, 159 parents were surveyed regarding their postadoption experiences. Most children remained with their new families, with parents reporting the adoption experience to be "about as hard as expected," and rating the past year of caring for the child as being more "smooth" than "stressful." Parents saw how the child contributed positively to their lives, were less positive about available social supports, and expressed dissatisfaction with the speed of the adoption, the availability of community supports, and the ability to link with supports. Children's special needs (e.g., older age at adoption) were predictive of postplacement adjustment.     

An Assortative Adoption Marketplace: Foster Care,Domestic, and Transnational Adoptions

Among sociologists of the family, there has been relatively little attention paid to child adoption. When it is mentioned, many characterize the process as a universal family form. The goal of this review is to complicate this subject by disaggregating adoption into three different market segments: foster care, domestic, and transnational. Specifically, the paper argues that adoption is an assortative process that stratifies parents and children. Of the members of the adoption triad (e.g. the birthmother, adoptive parent(s), and adopted child), prospective adoptive parents possess the greatest degree of choice when deciding which market segment to pursue. However, their options are often tempered by strict eligibility requirements and financial restraints. Drawing broadly on the extant sociological and child welfare literature, the bulk of the review is devoted to identifying and analyzing how these social forces funnel parents and children into forever families. I pay particular attention to the demographic profiles of children and adoptive parents, including how transracial adoption factors into foster care, domestic, and intercountry adoptions.     

Adoptions by Single Parents

Adoptions by single parents are thought by the public and by adoption professionals to be a plan for children needing adoption which is less advantageous for the child than a two parent adoption. For this reason, children who are difficult to find homes for are often placed with single parents; these are usually older children whose experiences have led to emotional and behavioral problems. Single persons who wish to parent an infant often adopt a child from another country. A review of the literature concerning single parent adoptions, and examination of the findings of a longitu- dinal study, indicate that the single persons who adopt are well able to carry out the responsibilities of parenting. They handle the special issues of adoption competently. Because children placed with single parents are frequently children with complex needs, and because single parents do not have a partner to share the responsibilities of parenting, continuing support from family and friends, the commu- nity, and from the adoption agency are important. Children adopted by single parents are as well adjusted as children adopted into two parent homes. There is some evidence that single parent homes may have unique strengths and be the placement of choice for some children.     

Psychological Functioning Through the First Six Months in Mothers Adopting from China: Special Needs Versus Non–Special Needs

ABSTRACT

This paper describes research investigating maternal adjustment to parenthood via special needs and non–special needs adoption from China. China's adoption system has a program for adoption of children with special needs and those without and both have remained top sources for intercountry adoption. Participants were 46 women who were surveyed at six weeks before, six weeks after, and six months after adopting a child. The psychological functioning of mothers adopting from China was assessed using the Beck Depression Index, the Brief Symptom Inventory, and the Edinburgh Postnatal Depression Scales. Mothers adopting children without special needs reported higher levels of depression, anxiety, and adjustment problems at clinical levels six weeks following the adoption. Mothers adopting children with special needs reported positive adjustment and low psychological dysfunction at all three time points. These results suggest that mothers pursuing a non–special needs adoption route are at greater risk for adjustment and psychological difficulties post-adoption. Mothers adopting special needs children may be better prepared prior to the adoption and may receive more support after returning home.     

Social support needs of families adopting special needs children

A grounded theory begins to explain parental practices in seeking social support. Interviews with 20 parents who had adopted children with special needs and 5 health care providers indicated that parents lacked awareness of available resources; preferred informal support systems; sought help only when "failing" to solve problems; and perceived that health care providers lacked knowledge of adoption issues, family dynamics, and common health issues. Parents preferred informal to formal supports, and felt upset when formal supports were judged ineffective or non-existent.     

The influence of family environment on mental health need and service use among vulnerable children

Children in child welfare are especially likely to have unmet mental health needs. The role of family factors in children's use of mental health services was examined in a longitudinal sample of 1075 maltreated or at-risk children. Vulnerable family environment (poor family functioning, low social support, and caregiver psychological distress) is an important predictor of children's mental health needs. It also predicts them not having these needs met.     

ETHNIC IDENTITY DEVELOPMENT OF INTERNATIONALLY ADOPTED CHILDREN AND ADOLESCENTS: IMPLICATIONS FOR FAMILY THERAPISTS

The life story of the internationally adopted child tends to be an emotional one. How the story is tole and retold in the family can have lasting consequences for the child's adjustment and well-being. In telling the story, parents are faced with a qunique challenge: To what extent is it desirable to encourage their children, who adready struggle with identity issue related to adoption, to identify with their cultures of origin? Therapists working on these issues with multiethnic adoptive families can find little guidance in the family systems literature. To fill this gap, the present article reviews the literature on racial/ethnic identity development and the available research on ethnic identification, self-esteem, and the psychological adjustment of cross-ethnically adopted children and adolescents. Implications for practice include developmental considerations, identifying chldren and families at risk, and recommendations for those in need of intervention.     

“It's About Us”: Marital Adjustment and Marital Adaptation in Couples Who Adopt Children From the Child Welfare System

This article examines, using grounded theory methodology, the marital relationships of couples who adopted children from the child welfare system. Twenty-two spouses in four focus groups reported initial marital adjustment that featured husbands' support of their wives' initiation of adoption and management of child needs. About one half of these couples also developed time together and mutual influence to achieve a state of marital adaptation characterized by deeper intimate connection. Professionals are encouraged to understand the potential course of development of these marital relationships and to integrate attention to marital development into service throughout the entire adoption process.     

Are At-Risk Parents Getting What They Need? Perspectives of Parents Involved with Child Protective Services

This qualitative study explores the perspective of 24 parents who were at risk for having their children placed in foster care but ultimately retained custody of their children. We asked participants to reflect on their parenting needs prior to Child and Protective Services involvement and if and/or how they implemented parent education skills post-intervention. Parents most frequently cited stressors such as financial strain and single parenthood as contributing factors associated with their involvement with the child welfare system. Many parents stated that they wanted help with their parenting practices and provided their thoughts about time-out and physical punishment. Implications include assessing parental stress at the onset of services, seeking to understand the unique needs of families, evaluating the impact of length of time services are offered, and helping parents utilize age-appropriate discipline strategies.     

The International Adoption Experience: Do They Live Happily Ever After?

This study presents the perspective of parents who adopted children internationally and their now adult adopted children regarding the impact of international adoption on their lives. Areas explored include adaptation of the child and family, challenges experienced along the way, influence on various aspects of their lives, parent-child relationship, rewards and regrets associated with the adoption experience, recommendations for those considering international adoptions, and an adjective that would describe their journey. The outcome illuminates the success of international adoptions and the life-changing bond that is formed when parents and children transcend all boundaries to form a family to call their own.     

Influence of Age on Transracial Foster Adoptions and Its Relation to Ethnic Identity Development

In the United States, ethnic minorities are disproportionately represented in the foster care system and underrepresented among potential adoptive parents. The need to find permanent homes for foster children has led to an increase in the controversial practice of transracial adoption (TRA), wherein ethnic minority children are placed in adoptive homes with Caucasian parents. While many child welfare scholars and dependency stakeholders support TRA as a positive alternative to foster care, others are concerned that such adoptions may inhibit the ethnic identity development of transracially adopted children. This article documents the large number of ethnic minority children who are adopted through TRA prior to the onset of ethnic identification and how age influences which children are adopted out of foster care. The findings indicate that young ethnic minorities are significantly more likely to be adopted through TRA compared to older children, an effect especially prominent among African Americans. Implications for the child welfare system are discussed.     

Families who adopt children with special needs

This study explores the type of family who adopts children with special needs. Fifty-six families who adopted special needs children were interviewed. Many of the interview questions were based upon a cognitive social learning framework. These questions assessed such areas as parent expectations, competencies, and sense of responsibility and attachment. This framework, along with demographic characteristics and an assessment of parents' discretionary and support resources, resulted in a profile of adoptive parents. Implications are discussed for recruitment of adoptive parents for children with special needs and suggestions are given for future research.     

Transracial Adoption of Children with Developmental Disabilities

ABSTRACT

This study investigated the transracial adoption of children with developmental disabilities. Thirty-four families who had adopted a child transracially were compared with 63 families who had adopted a child inracially; additionally, we compared adoptions in 13 families who had adopted both transracially and inracially. The adjustment of mothers and fathers was gauged separately at three time points using measures of depression, stress, family strengths, and subjective well-being. Results indicated few differences in functioning between transracial and inracial adoptive parents. Mothers in both conditions maintained low depression scores and comparable means on all other outcome variables. Fathers also revealed similar adjustment patterns despite adoption type. Thus, parents experience both short- and long-term positive outcomes from the transracial adoption of children with developmental disabilities.     

Blue-Ribbon Babies and Labors of Love: Race,Class, and Gender in U.S. Adoption Practice by Christine Ward Gailey

ABSTRACT

We investigated the adjustment of differing sized adoptive families rearing children with developmental disabilities. Families of 5 or more children (large: n = 54) were compared with families of 4 or fewer children (conventional: n = 69) on a variety of demographic and outcome variables measuring family strengths, family disharmony, marital adjustment, and adjustment to the adopted child. Analyses of covariance on the outcome variables demonstrated that parents of large families were functioning as well or better than parents of conventional-sized families. We concluded that adoption placement practice should not exhibit bias against the placement of multiple children with developmental disabilities in the same family.     

Supporting Post-Adoption Contact for Children Adopted From Care: A Study of Social Workers' Attitudes

New legislation in England and Wales requires adoption agencies to specify the contact adopted children will have with their birth families and obliges agencies to offer all parties support to maintain such contact. This study, based on responses from 112 adoption social workers in England and Wales, used a case vignette methodology to explore workers' attitudes towards supporting post-adoption contact. The findings suggest that social workers think primarily about the child's needs and about providing services to or on behalf of the child. In contrast, adults' needs, especially the relationship between birth parents and adoptive parents, were less often considered. Workers were least orientated toward supporting birth parents. Workers from different agencies had very different attitudes towards the case vignette. This study suggests that supporting post-adoption contact is a complex professional task likely to be influenced by workers' own attitudes. Implications for training, support and supervision are discussed.