| Study | Lit review | Participants | Methods | Findings |
| | Disruption is differently defined: between placement and finalisation, between pre and post order, or longer term leaving adoptive home. Disruption factors include child age at placement and behaviour, birth family factors, system factors. No link with child disability. Issue re siblings. Need to understand child’s loss, sense of life coherence. | Survey of 390 parents, interview with 70 parents, | Data set of adoption records in England and Wales. Survey of adoptive families and interviews of disrupted adoptions and challenging adoptions: wellbeing measures, interviews with social workers, adoption managers and adoptees | 2/3 of disruptions happen in teenage years. Gender and ethnicity not relevant, age of adoption was. 3/4 of disrupted adoptees had been abused/neglected. Foster carer adoptions were no more stable than stranger adoptions. 1/3 had no problems, 1/4 had major challenges, 9% had teenagers leaving home after challenging behaviour. High levels of social, emotional and behavioural difficulties, even when “going well”. 1/4 of “left home” parents were depressed/PTSD but identified growth in their lives. Significance of introduction and foster carer support. Problems emerged at puberty—anger, aggression, sexualised behaviour, crime, running away, allegations of abuse. Common to have conflict with siblings. Some contact with birth families. Some bullying re being adopted. Most families had thought about removing child. Lost touch with adoption agency when needed support. Dissatisfied with service, but appreciated good social workers. Needed more mental health services and respite care. School difficulties. 80% of disruption occurred after violence, 43% regularly ran away. 2/3 of moves from home were instigated by parents. Post-disruption life unstable, friends or Care. Adoptees relieved by move, parents relieved/distressed. Looking back, parents criticised self and services—wouldn’t recommend but had positives. After disruption adoptees mostly kept in touch with adopting family. |
| | Disruption is differently defined: between placement and finalisation, between pre and post order, or longer term leaving adoptive home. Disruption factors include child age at placement and behaviour, birth family factors, system factors. No link with child disability. Issue re siblings. Need to understand child’s loss, sense of life coherence. | Survey of 390 parents, interview with 70 parents, | Data set of adoption records in England and Wales. Survey of adoptive families and interviews of disrupted adoptions and challenging adoptions: wellbeing measures, interviews with social workers, adoption managers and adoptees | 1/3 were NEET, vulnerable, depressed, lack of belonging. Most had not wanted to be adopted but unrealistic image of birth family. Conclusion: lower disruption rate than expected as adoptive parents were tenacious and committed. Social work has “all or nothing” approach which is unrealistic, victim/abuser not appropriate. History of abuse left legacy of relationship difficulties. Recommendations of appropriate support eg life story work. Recommendations for further research. |
| | Little is known about adoption disruption in England and Wales because of lack of data and changes in names and records and location. | Data set of adoption records in England and Wales: 565/36749 (Eng) and 35/2317 (Wales) disrupted | DfE information provided longitudinal database, survey of LA adoption managers on looked after children then adopted, and date of disruption | Disruptions are rare but more likely for placement age of 4+, delay in finalisation of adoption, teenage adoptees and previous multiple care placements |
| | Attachment theory, plus pre-adoption trauma indicate adoptees should lead to adjustment problems. Factors include age, institutionalisation, multiple placements, abuse/neglect, pre-natal drugs | 169 adolescents in Israel adopted between birth and 9 yrs old | Self reports of self-esteem, problem behaviours, peer and parental relations and communication, substance use, and school enrolment. Data on pre-adoption life events and age | Moderately close relations with parents, age appropriate peer orientation, few teenage problems |
| | Controversy over whether adopted children show significantly worse outcomes of later adjustment and behavioural problems. Pre-adoption adversity includes low birth weight, illness and disability, as well as abuse and neglect, institutions and foster care (conflicting findings re Romanian and Chinese adoptees). | 37 adolescents and 22 emerging adults who had been adopted through Italian system of open adoption (contact with birth family maintained) | Data on pre-adoption stressors from files, questionnaire re birth family contact, interview re adult attachment, inventory re family environment, self-report re distress and wellbeing, test for self-esteem | Attachment moderated the impact of age of adoption, foster care and biological children in the adopting family; quality of adoptive family relationships moderated impact of birth-family contact. Importance of parenting support programs for adopting family. |
| | Adopted children do better than children returned to parents’ care. Fostered children do less well, more on a par with those staying with parents. | 900 adoptees, 3100 fostered children and 900,000 majority population in Sweden. | Data analysis of adoption and fostering records, and tests at conscription, primary school, college degree, public welfare recipient | Fostered children did less well than adoptees on school performance, cognitive competence, educational achievement and self-support, and both did less well than majority population. |
| | Adoption is generally the most secure home, post-adoption services can help with disruption issues, particularly for unrelated adoptions and inter-cultural issues. Services include education (info/advice), clinical (medical and counselling) and material (subsidies/respite care). Differences re availability/access of services. | Survey of post-adoption service usage in British Columbia. 43 adoptive parents of 68 adoptees completed, 25 gave minimal details | Self-completion survey re family information, usage and usefulness of services, adoptee information | Parents said they would use services, but didn’t because they lack awareness of existence, are inconvenient, have sufficient alternatives, adoption agency’s reactive rather than proactive approach. Parents were concerned about openness, wellbeing and behaviour. Need services after stressful events and significant development points. Parents found a positive impact on their understanding but less on child’s behaviour. |
| | Most children placed in USA have SEN. Resilience theory shows the influence of risk/protective factors. Theories about the adoption life cycle: anticipation, accommodation, resistance, restabilisation. Risk factors: environmental/biobehavioural. Pre-adoption preparation: counselling, information, support. Post adoption services: general/clinical—helpful but inconsistent. | Longitudinal survey of 560 adoptive parents in California | Survey looking at pre-adoption risk (exposure to drugs/alcohol, disability, behave problems, history of abuse/neglect/multiple placements, receipt of pre-adoption services and use of post-adoption services | Pre-adoptive risk history and preparation influence use of post-adoption services— better informed parents use post services more. Use of post-adoption services increases over time, as later problems emerge e.g. interest in biological family, and identity. |
| | Association of access to support and service with successful adoption experiences. Services needed include self-help groups, respite care, advocacy, sibling support, emergency and crisis intervention, access to staff, financial support, special education services. | 249 special needs adoptive families in Nevada | Survey re need and satisfaction with services inventory, positive outcome incl: parental satisfaction, relationship with child, overall impact on family | Majority report good outcomes. Medical support and subsidies most needed and obtained. Unmet needs include counselling and in-home support. No difference between foster parent adoptions and strangers |
| | Family relationships are lowest in teen years (59% felt warmth) then return to 80% after 19. Most parents would adopt again, even after disruption. 10% - 16% of special needs adoption will disrupt—lower than guardianships or fostering. Reasons for (contested) adoptee problems: genetic defects, adoption process, families’ readiness, adoptees’ grief, attachment. Possible influence of greater reporting by adopting families (middle class). Child factors: age on adoption significant because longer period of neglect, stronger ties, resistant habits, more unstable placements; fetal alcohol. Family factors: more disruption from strangers, younger, educated mothers. Pre-adoption and post-adoption services | Four projects in USA | Review of 4 project findings | Parents want a) education/information about child and issues b) clinical services—counselling and respite, c) material services: subsidies, medical care, special education. Attachment theory over-used in education—focuses on history instead of divergence from adoptive family. Psychoanalytic theory unhelpful. Multisystemic family therapy and assertive community treatment are more promising |
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| 437 adoptive parents in USA | Online survey re ticklist of post-adoption services needed and accessed, and how valuable. Identification of whether adoption had dissolved or not | 17% dissolution. Substance abuse treatment, educational advocacy and parent support groups predicted (absence of) adoption dissolution. |