By Susan Smith and Adam Pertman
For over three decades, the U.S. government has focused considerable effort and funding on promoting adoptions from foster care, resulting in huge increases in their numbers -- from an estimated 211,000 in FY 1988-1997 to 524,496 in the most recent 10 years, FY2003-2012. We have made this effort as a nation because we have embraced the value of permanency for children who cannot safely live in their original families, a value based on the belief that all children need consistent, nurturing families to promote optimal development and emotional security throughout their lives.
While adoption from foster care has become a federal mandate and a national priority, less attention has been paid to serving children after adoption to ensure that they can remain in their new families and that their parents can successfully raise them to adulthood. Given the traumatic life experiences that most children in care have endured, a substantial proportion of them will continue to have ongoing adjustment issues, some of which may intensify as they age. Many children adopted from institutions in other countries have had comparable experiences that pose some risks for their healthy development.
Preparing and supporting adoptive and guardianship families both before and after adoption not only helps to preserve and stabilize at-risk placements, but also offers children and families the best opportunity for success. Furthermore, these adoptions not only benefit children, but also result in reduced financial and social costs to child welfare systems, governments and communities.
A continuum of Adoption Support and Preservation (ASAP) services is needed to address the informational, therapeutic and other needs of children and their families. The overall body of adoption research has associated receiving post-adoption services with more positive outcomes and has linked unmet service needs with poorer outcomes.
A new study by the Donaldson Adoption Institute (DAI), "Supporting and Preserving Adoptive Families," provides the most extensive examination to date of what services states are providing, who is eligible to receive them and how they are being funded. DAI is simultaneously publishing a companion report, "Keeping the Promise: The Case for Adoption Support and Preservation," which synthesizes past knowledge and provides new research on the extent of adopted children re-entering foster care, the circumstances involved in both foster care re-entry and adoption dissolutions, and the significant number of children adopted from foster care who require ongoing mental health services.
An analysis of the profiles of post-adoption services in 49 states indicates that as a nation, we have made some strides in developing ASAP services, particularly in those 17 states that were rated as having "substantial" programs. At least 13 states, however, have almost no specialized ASAP programs, and even the most developed service arrays often serve only a segment of those with significant needs. For example, many of the specialized therapeutic programs have limits in service duration or frequency or serve only those special needs children adopted from foster care in their own state. Some target only those children who are at imminent risk of placement outside of the home.
ASAP must be an integral, essential part of adoption. Just as the complex process of treating a significant and ongoing health issue requires ongoing care and specialists who understand the complications that can arise and how to best address them, the adoption of a child with complex special needs requires distinctive services to address the challenges that arise over time.
No one would conceive of sending a heart transplant patient home with no follow-up, aftercare or access to expert treatment if difficulties develop. In the same vein, ASAP services are just as vital to an adoptive family's success in integrating and effectively parenting a child who had early experiences of maltreatment and loss.
The Adoption Institute recommendations, resulting from its studies, include:
•Create an array of ASAP supportive and preventative services and make them accessible to all families who need them.
•Develop services for specific types of families, such as those with children with special needs or dealing with issues related to transracial or open adoptions, or adoptions by LGBT parents.
•Develop programs that provide support directly to children and youth.
•Enhance funding for ASAP services by creating a dedicated federal funding stream and by developing partnerships among federal, state and community organizations.
•Provide adoption-competency training to child welfare and mental health professionals.
•Educate pre-adoptive parents on the benefits of adoption support and preservation services, and reframe help-seeking as a strength.
•Facilitate additional research on post-adoption interventions in order to create an evidence base on services that are most effective.
When families struggle to address the developmental consequences of children's early adversity, they should be able to receive -- as a matter of course integral to the adoption process, and not as an "add-on" that can be subtracted -- the types of services that meet their needs and sustain them. Adoptive parents, professionals, state and federal governments, and we as a society share an obligation to provide the necessary supports to truly achieve permanency, safety and well-being for the girls and boys whom we remove from their original homes.
Given the profound changes that have taken place in the field today -- that is, most adoptions are of children from foster care with some level of special needs -- adoption should be reshaped into an institution that not only creates families, but also enables them to succeed.
Susan Smith is the Program and Project Director of the Donaldson Adoption Institute