Exploring links between early adversities and later outcomes for children adopted from care: Implications for planning post adoption support

Abstract

This study explored how child maltreatment, alongside a range of other variables, predicted adverse outcomes for children adopted from the foster care system in England. The participants were 319 adoptive parents who completed an in-depth online survey about their most recently adopted child. The mean age of children at placement for adoption was 28 months (range 0–11 years) and their ages at the time of the survey ranged from 0 years to 17 years (mean = 7 years). Detailed information was collected about children’s backgrounds, including their experiences in the birth family and the care system before adoption. Adoptive parents also reported on how well children were getting on in a range of areas of functioning and how well they felt the adoption was going overall. Child maltreatment and child adverse outcomes were modeled as two factors in a latent factor structural equation model. The relationship between these two factors was explored alongside a range of covariates. Associated with worse outcomes for children were potentially heritable factors (parental learning disability), the pre-birth environment (exposure to drugs or alcohol in utero) and the period between birth and moving to the adoptive family (higher levels of maltreatment, spending more than a year in care, having two or more foster placements). The child’s distress on moving from the foster home to the adoptive family was also highly significant in linking to poorer outcomes, suggesting the detrimental effect of poorly managed transitions. Implications for child welfare practices before and after adoption are discussed.

Patterns of adversity and post-traumatic stress among children adopted from care

“…These findings are consistent with studies which asked adoptive parents about their child's maltreatment (e.g. Neil et al, 2020) and used case file approaches (Kim, Wildeman, Jonson-Reid & Drake, 2017). In addition to maltreatment, around a third of our sample was exposed to domestic violence and/or a parent who abused drugs.…”

“…A study of German children adopted from care (international and domestic) found that psychosocial adjustment was significantly predicted by pre-adoptive risk factors, including pre-natal risk factors and maltreatment/neglect (Hornfeck et al, 2019). A recent study of children adopted from the foster care system in England found that children with exposure to drugs or alcohol in utero, parental learning difficulties, and adverse experiences between birth and moving to the adoptive family was associated with poorer child behavior, wellbeing and relationship quality (Neil, Morciano, Young, & Hartley, 2020).…”

“…These included: childhood emotional, physical, and sexual abuse; neglect and indicators of household dysfunction (including growing up with domestic violence, parental separation, drug abuse, alcohol abuse, mental illness, and incarceration) whilst in the care of their birth parents. Parental learning difficulties was also included based on the identification of it as a risk factor for poor child wellbeing in a recent study of adopted children (Neil et al, 2020).…”

Adoptive parents’ satisfaction with child and adolescent mental services and their mental health concerns over time: A question of fit?

“…Indeed, the lack of epidemiological data for the mental health and well-being needs of adopted children makes service delivery and innovations difficult to implement and to evaluate. However, the sample demographics presented here are similar to the Adoption UK 'State of the Nation' (Adoption UK, 2019) as well recent large samples of UK adopters (e.g., Neil et al, 2020), which suggest this sample is not a profoundly different group from UK adopters in general. What we have shown is that for adoptive parents who had had contact with CAMHS, they had significant mental health concerns about their children, their concerns were wide-ranging, and certainly not restricted only to issues of attachment and trauma, and when these families had accessed CAMHS they had been deeply dissatisfied.…”

Adversity profiles of children receiving care and support from social services: A latent‐class analysis of school‐aged children in Wales

“…the child having a recorded disability, as a recent report suggested that the 'Adverse Childhood Experiences' framework ignores other sources of adversity, including disability (Welsh Government, 2021); and parental learning difficulties associated with lower child well-being (Neil et al, 2020). See Table 1 for adversity definitions.…”