Key Factors in Promoting Successful Adoptions

Susan Livingston SmithEvan B. Donaldson Adoption Institute

ssmith@adoptioninstitute.org

3 decades of changes

About 150,000 adoptions a year:

Approx. 40% are stepparent adoptions

51,000 child welfare adoptions

20,000 international adoptions

15,000-16,000 domestic infant adoptions

(decreased tenfold since 1970)

Numer 0f Adoptions with Public Agency Involvement 1988-2005

0

10,000

20,000

30,000

40,000

50,000

60,000

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Waiting vs. WantedFoster Children Adopted vs Waiting

0

20000

40000

60000

80000

100000

120000

140000

2002 2003 2004 2005 2006

Source: U.S. Children's Bureau

Waiting

Adopted

Characteristics of waiting children

Age: median = 8.4 years

68% are 5 or older

Time in care:

Mean months = 41.6 months

Median months = 30.7 months

21% waiting 5 or more years, continuously

What do we know about outcomes in child welfare adoptions?

93% would definitely or probably adopt again “knowing what they now know”

91% satisfied with adoption experience

Only 4%:adoption negative impact on family

Howard, J.A. & Smith, S.L. (2003) After Adoption

Comparing Children’s Adjustment

Birth Infant Int’l CW 175 481 89 1340

Feel very close to child 87% 90% 87% 83%

Good+ adjustment at home 95% 93% 92% 87%

Special education services 9% 24% 32% 40%

On meds for behaviors 3 % 28% 21% 31%

Howard, Smith, & Ryan (2004), Adoption Quarterly

Behavior Problem Index

Birth Infant Int’l. CW

Mean BPI 6.2 9.1 9.4 11.9

Clinical range 8% 24% 23% 39%

(Howard, Smith & Ryan, 2004)

Factors Predicting BPI Score

Prenatal substance exposure + 4.4

Child able to give/receive affection - 5.5

Child is white +2.4

Sexual abuse history +2.9

Child is female -1.6

Back/forth fr.birth home to foster care +2.0

Howard, J.A. & Smith, S.L. (2003). After Adoption

Child Outcomes

About 40% have behavioral problems at “clinical level”

These problems are chronic and often do not respond to traditional services

Underlying emotional issues drive behaviors (loss, identity, trauma)

Continuum of Needs

55%--good attachment, may have slightly more behavior problems than average child but functioning fairly well BPI=8.7

30%--Significant issues; high behavior problems; push-pull attachment BPI=15

Top 15%--Severe behavior problems; significant attachment issues BPI=19

Implications for Practice

Severity & chronicity of behavior problems

Preparation of parents-realistic expectations, normalize help-seeking, & linkage with resources

Teaching therapeutic parenting & attachment building

Need for early intervention if high risk

High Risk Indicators

Prenatal alcohol/drug exposure

Difficulty in giving and receiving affection High level of oppositional, defiant

behaviors (might use standardized instrument)

History of serious abuse Symptoms evidencing mental illness/

family history of this

Other implications for practice

Address child emotional issues over course of child’s development

Importance of comprehensive, adoption-competent therapeutic services which can address multi-systems issues

Ongoing supports for chronic, high need children & families

Key Factors>Successful Permanency

Minimizing damage to child in the systemFinding the right home early in child’s

journeyBetter preparation of families for ongoing

challenges: realistic expectations Identifying those who are high risk and

building in additional intensive supportsOngoing post-adoption services that

really address the needs