Key Factors in Promoting Successful Adoptions Susan Livingston Smith Evan B. Donaldson Adoption Institute

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)

Waiting vs. Wanted

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 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 InfantInt’l. CW Mean BPI Clinical range 8% 24% 23% 39% (Howard, Smith & Ryan, 2004)

Factors Predicting BPI Score Prenatal substance exposure Child able to give/receive affection 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 system Finding the right home early in child’s journey Better preparation of families for ongoing challenges: realistic expectations Identifying those who are high risk and building in additional intensive supports Ongoing post-adoption services that really address the needs