1. Key Factors in Promoting Successful Adoptions Susan Livingston Smith Evan B. Donaldson Adoption Institute ssmith@adoptioninstitute.org

2. 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)

4. Waiting vs. Wanted

5. 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

6. 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

7. 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

8. Behavior Problem Index Birth InfantInt’l. CW Mean BPI 6.2 9.1 9.4 11.9 Clinical range 8% 24% 23% 39% (Howard, Smith & Ryan, 2004)

9. 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

10. 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)

11. 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

12. 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

13. 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

14. 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

15. 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