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Key Factors in Promoting Successful Adoptions. Susan Livingston Smith Evan 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
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Key Factors in Promoting Successful Adoptions Susan Livingston Smith Evan 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)
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 child87% 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 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