The Adoption of Children from Public Care: A Prospective Study of Outcome in Adolescence

doi:10.1097/01.chi.0000220850.86768.e8

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 45, Issue 7, July 2006, Pages 877-883

https://doi.org/10.1097/01.chi.0000220850.86768.e8 Get rights and content

ABSTRACT

Objective:

To discover the outcomes for children placed late for adoption (between 5 and 11 years old) from public care and to establish which factors predict poorer outcome.

Method:

Data were collected prospectively (1993-2003) from a representative sample of domestic U.K. adoptive placements (N = 108) at the start of placement, at 1 year, and 6 years later. Most of the children entered care because of abuse and neglect. Outcome was assessed by the disruption rate, by a twofold classification of the character of continuing placements, and by an assessment of psychological well-being.

Results:

At the adolescent follow-up, 23% of placements had disrupted, 49% were continuing positively, and 28% were continuing but with substantial ongoing difficulties. Four factors contributed independently to a higher risk of disruption: older age at placement (odds ratio = 1.07), having been singled out from siblings and rejected (5.87), time in care (1.04), and a high level of behavioral problems (1.25). Two factors predicted differences in continuing placements.

Conclusions:

Late adoption can be successful in that half the children made good progress, but the extent of disruptions and difficulties in continuing placements gives rise to concern. Knowledge of predictors will help in devising planning pre- and postplacement support services.

Section snippets

Predictors of Outcome

Some degree of consensus has been achieved about the factors that raise the risk of poor outcome in late adoption (Rosenthal, 1993, Rushton, 2004). The most frequently replicated finding is the relationship between older age at placement and poorer outcome. Also influential is the level of behavioral, emotional, and social difficulty the child brings to the placement and the challenges this poses for the adopters. Other factors have been reported as predictors but have not found univ ersal

Sample and Follow-up

The sample was based on combined data from two prospective, longitudinal, late-placement, domestic-adoption studies. The sampling criteria were similar, and the studies were designed with a view to combining data sets. These planned adoptions were representative of publicly managed adoption agency placements in England in the early 1990s. Children were selected for the study if they were between 5 and 11 years old when placed for adoption with a new, unrelated family. Children with profound

RESULTS

Of the 99 index children, 56 were male and 43 were female. Fifteen were of minority ethnic origin (all mixed parentage), and five had been placed with other minority families. They were, on average, just under age 7 years at placement (mean age 6.9 years; range 5-11; SD = 1.59) and 13 years 8 months at this follow-up (13.7 years; range 10-17; SD =1.79). Seventy-six months had passed, on average, since they first joined their new families (range 57-97; SD = 9.5). One third of the index children

DISCUSSION

This 6-year prospective late-adoption study allows more secure conclusions to be drawn on the outcome of such placements. Late adoption can clearly be of benefit because, despite considerable adversity before placement, half of the original sample made good progress in their adoptive homes and an additional 28% experienced a stable period with their new families despite ongoing difficulties. However, some placements carried too high a level of problems for the placements to be sustained. The

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The U.K. Department of Health supported the earlier data collection phases and the Nuffield Foundation provided funding for the 6-year follow-up. The authors are grateful to adopters and adoption professionals who have assisted with the various phases of this follow-up study. David Quinton and Deborah Mayes contributed to the first follow-up of this sample. Claire Grace-Thorne, Claire Hopkins, and Adrienne Shaw undertook most of the data collection at follow-up.

Disclosure: The authors have no financial relationships to disclose.

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ARTICLESThe Adoption of Children from Public Care: A Prospective Study of Outcome in Adolescence

ABSTRACT

Objective:

Method:

Results:

Conclusions:

Section snippets

Predictors of Outcome

Sample and Follow-up

RESULTS

DISCUSSION

J Am Acad Child Adolesc Psychiatry

Adoption and Disruption: Rates Risks and Responses

Permanency Planning and Disruptions in the Lothian Region

Adoption

Emotional abuse in early childhood: relationships with progress in subsequent family placement

J Child Psychol Psychiatry

Children Looked After in England (Including Adoptions and Care Leavers (2003-04) Statistics for Education

Permanent Family Placement: A Decade of Experience

The Strengths and Difficulties Questionnaire: a research note