Adoption outcomes for children with mental retardation in the custody of state child protective services systems: Implications for long-term well-being Elspeth Slayter, M.S.W., Ph.D. Narda Santos, B.S.W. School of Social Work Salem State College American Public Health Association November 5, 2007

Orientation to child welfare timelines Removal from family (imminent risk of abuse, neglect) Return to family within 22 months Work toward reunification (in most cases) Initiation of termination of parental rights proceedings after 15/22 months Parental rights terminated Adopted LT foster care or waiting for adoption Federal Adoption and Safe Families Act of 1996 (ASFA) *Focus on Permanency planning State-specific subsidies, programs, resources

Context Some indication children with MR at higher risk for abuse/neglect ( Johnson-Reid, Drake, Kim, Porterfield & Han, 2004; Hughes and Rycus, 1998; Vig & Kaminer, 2002; Westat, Inc., 1993) Long term impact of “foster care drift” especially for children with “special needs” (Renne and Mallon, 2005) –Notable racial and gender disparities Little known about foster care-to-adoption process for children with MR (Bonner, Crow, Hensley, 1997) –Implications of ASFA - permanency planning –Rates of terminations of parental rights (TPR) –Pre-adoptive placements

Research questions 1.What are the racial, gender and disability-related characteristics of adoptees with/without MR? 2.Are there differences in length of time between TPR and adoption for adoptees with/without MR? 3.Who are the people adopting children with MR? 4.Are adoptive parents of children with MR receiving post-adoption subsidies?

Methods Exploratory, Cross-sectional Data source: 2003 Adoption and Foster Care Analysis and Reporting System (AFCARS) Sample and comparison group –Sample: (N=1,323) Adoptees with MR –Comparison group: (N=46,078) Adoptees without MR Analyses: Univariate, bivariate statistics –Independent samples t-tests –Odds ratios derived from logistic regression analysis

Identification of MR among 2003 adoptees Definition: “Significantly subaverage general cognitive and motor functioning existing concurrently with deficits in adaptive behavior manifested during the developmental period that adversely affect socialization and learning” (AFCARS, 2007, 3) Using AFCARS term, not Intellectual Disability

Demographic differences between adoptees by MR status VariableAdoptees with MRAdoptees without MRTest Mean age at adoption M=7.7 (SD=4.4)M=7.2 (SD=4.3)t=4.2*** White72.0%58.9%OR=1.80*** Male53.5%50.2%OR=1.20** Physical disability 28.1%2.4%OR=16.1*** Vision/hearing impairment 19.8%1.4%OR=16.8*** Emotional disturbance 47.8%10.9%OR=7.5*** Other medical condition 58.2%17.1%OR=6.8*** ***p<.001 **p<.01

Time between TPR and adoption t=6.8, p<.001t=2.0, p<.001 Years

Time between TPR and adoption, gender analyses t=1.13, p<.05t=4.95, p<.001 Years

Time between TPR and adoption for children with MR, race ethnicity & gender analyses t=1.95, p<.004t=2.76, p<.001 Years

Who are the adoptive parents of children with MR? 2-parent families more likely to adopt (OR=1.74***) Bio families less likely to adopt (OR=0.7***) Children of color with MR more likely to be adopted by bio family than White children with MR (OR=2.8***)

Findings: Receipt of post- adoption subsidies 87% received subsidy BUT - adoptees with MR less likely to receive subsidy (age-adjusted OR=0.61, p<.001) State-specific analyses suggest children with MR receive higher subsidies t=1.95, p<.002

Key findings & implications Larger proportions of: –Male adoptees with MR –Adoptees with MR and co-occurring disabilities/conditions Is the foster care system able to support these children effectively? Existing research calls this into question re: education (Geenen & Powers, 2006) Longer time between TPR & adoption –All children with MR, girls with MR vs. boys with MR –Potential trauma of longer time without permanency –Children of MR of color - racial disparities regardless of disability

Key findings & implications Children of color with MR more likely to be adopted by bio family members Children with MR more likely to be adopted by 2- parent families Possible disparities in subsidy receipt –Need to assess role of SSI/SSDI, other state-specific programs Higher subsidies, for those who receive them

Future research How many children with MR remain in foster care after TPR without being adopted? Explore cultural differences in adoption and views of disability Assess possible subsidy disparities Adoption disruption likely for children with MR (Festinger, 2005) –How do post-adoption subsidies factor into adoption? –What can prevent disruption? $ incentives? Respite vouchers? Training/support on long-term planning, systems navigation?

Acknowledgement Data made available by the National Data Archive on Child Abuse and Neglect (NDACAN) Adoption and Foster Care Analysis and Reporting System (Children’s Bureau) NDACAN, Cornell University and their agents or employees bear no responsibility for these analyses or interpretations