Post-adoption Contact and Relationships with Birth Family Members

The chapter draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort), completed on average 18 years after placement, and interviews focusing on 24 adult adoptees. Face-to-face post-adoption contact was a legal requirement. After placement with adoptive families, 93% of adoptees had contact with birth family members; at follow-up, 56% still saw at least one member of their birth family; 69% of both adoptees and adoptive parents thought contact was ultimately beneficial. There was minimal evidence of contact with birth parents destabilising placements. However, it introduced a ‘painful transparency’ for all parties and could be problematic. Over time, contact supported children’s identity needs by incorporating knowledge of their antecedents and could mitigate their difficulties with attachment, separation and loss. It forced all parties to engage with one another and helped adoptees achieve closure.

Introduction: International Issues and Debates Concerning Adoption

A history of systemic injustices and a lack of transparency have influenced public perceptions of domestic adoption. This book aims to introduce more empirical evidence into the debate by exploring the value of open adoption, as practised in Australia, as a route to permanence for abused and neglected children in out-of-home care who cannot safely return to their birth families. International evidence about the outcomes of adoption and foster care is discussed. The chapter introduces the Barnardos Australia Find-a-Family programme which has been finding adoptive homes since 1986 for non-Aboriginal children in care who are identified as ‘hard to place’. Regular post-adoption face-to-face contact with birth family members is an integral part of the adoption plan. The methodology for evaluating the outcomes for 210 children placed through the programme included case and court file analysis, a follow-up survey and interviews with adoptive parents and adult adoptees.

A Mosaic Mutation in the LAMA2 Gene in a Case of Merosin-deficient Congenital Muscular Dystrophy

Merosine deficient congenital muscular dystrophy is one of the most common forms of congenital muscular dystrophy. This disease is caused by a primary deficiency or a functionally inactive form of the protein merosin in muscle tissue. The type of inheritance of this disease is autosomal recessive. De novo variants with this type of inheritance are rare, and it is quite possible that the de novo variant may hide a mosaic form in the parent of an affected child. We present a birth family with two affected children who inherited a previously undescribed pathogenic variant c.1755del from their mother and a previously described pathogenic variant c.9253C > T in the LAMA2 gene from their mosaic father. LAMA2 gene mutation analysis was performed by mass parallel sequencing and direct sequencing of genomic DNAs.

Intentional Kinship through Caring Relationships, Heritage, and Identity: Adoptive Parents’ Inclusion of Non-Biological and Non-Affinal Relationships on Family Maps

Structural open adoption has been beneficial to adoptees in integrating their birth heritage and identity. Adoptive parents also may sometimes seek out others who are neither related biologically nor through partnership to support their child in developing an integrated sense of identity. To what extent do these intentional kinship relationships become incorporated within the adoptive family network and how do adoptive parents view their role in their child’s life? Qualitative data on family inclusion of non-biological and non-affinal kin are reported from interviews with lesbian, gay, bisexual, and heterosexual adoptive parents (n = 25 families). Analyses of verbal and visual data from family map drawing interviews indicated that adoptive parents from the different types of families similarly included intentional kin in their conceptualization of their child’s family. Adopted children’s foster carers, family friends, other adoptive families, and other children and adults were specifically included on family maps to facilitate children’s knowledge of different aspects of their birth heritage and adoption story. The implications of open adoption policy therefore move beyond considerations of only birth family contact. In practice, open adoption procedures convey a broad message to families that appear to widen adoptive parents’ conceptualization of kinship.

Hand and Upper Limb Malformations in Italy: A Multicentric Study

Background: Although hand and upper limb malformations are quite frequent, up to now very few reports have been published on epidemiology. The aim of this study is to evaluate the number of infants who presented with hand and upper limb malformations from 2010 to 2015 in Italy. Methods: A retrospective analysis of a pediatric population presenting with hand and upper extremity malformations was carried out, gathering reports achieved from eight Italian Centers of pediatric hand surgery. Other factors such as gender, date and region of birth, family distribution of malformations and associated syndromes, were analysed. Results: Out of 3,100,421 live births, 765 children presented with hand and upper limb malformations. The incidence was 2,5/10,000 live births with a predominance of males and the right side. Radial polydactyly was the anomaly with the highest percentage, closely followed by simple syndactyly, simbrachidactyly and complex syndactyly. Less common conditions were the triphalangic thumb, thumb in palm, proximal radioulnar synostosis and Sprengel deformity. Inheritance of and familial predisposition to those malformations was recorded in 25 cases, while 84 children presented with syndromes related to hand anomalies. Conclusions: In conclusion the incidence of hand and upper extremity malformations in Italy is lower than that registered in other countries. The retrospective nature of the study combined with the fact that some defects frequently evade pediatric hand surgeon consultations are some possible limitations of the study. However, our data confirmed that, in spite of the decrease in the birth rate in Italy, the trend of congenital hand disorders maintained a stable trend. We aim to integrate this study with a prospective analysis and to involve the institutional health authorities in other countries so as to register the correct incidence of hand and upper extremity defects.

The Search for Origin of Young Adoptees—A Clinical Study

In the current area of social media propagation, the adoptees' search for the birth family is increasingly reversed: more and more adopted adolescents are contacted directly by their birth parents, even if they did not search for them. This study explores the impact of these new forms of contact between adoptive family members and birth family members, through the qualitative analysis of clinical protocols of five adoptive families that sought counseling in a clinical setting devoted to international adoption. The interpretative phenomenological analysis revealed three themes. Two of them shared by the parents and their children: the feelings of anxiety and intrusion, as well as the feelings of guilt and debt. The last theme concerns only the parents: feelings of endangered family relations and can be divided into two sub-themes: feelings of threat by the birth family, feelings of an undermined parental role. Nevertheless, these new kinds of confrontations with the children's origins bear a potential of renegotiating adoptive family relationships and positive effects on mutual feeling of filiation. Exploring the impact of the search of adoptees by the birth family enables professionals involved in adoption to improve preventive and supportive work in the adoption process.

“My Whole Family Is Not Really My Family”—Secure Care Shadows on Family and Family Practices Among Young Adults and Their Family Members

This study based in Sweden explores family practices and family displays among young adults with a history of secure care, which limits and restricts contacts and therefore causes fundamental changes in relationships. Almost 10 years after institutional placement, narrations of 11 young adults and 11 nominated family members reveal ongoing struggles between imagined and lived realities of family. These struggles are revealed by memories and emotions evoked by the context of secure care and show how deeply the secure care penetrated their family lives. By using the metaphor of shadows, shadows of recalled horror of secure care (reflecting family displacement) and the pressure to make family work (reflecting restricting practices in secure care where only (birth) family were considered as family and relations of (natural) importance) are discerned. We call for more attention to the perversity of secure care arrangements, at both policy and institutional levels.

Communication Privacy Management in Open Adoption Relationships: Negotiating Co-ownership across In-person and Mediated Communication

Open adoption relationships are rife with privacy dilemmas and fuzzy boundaries, which require ongoing coordination of private disclosures as a result. The present study employed communication privacy management (CPM) theory to examine adoptive parents’ ( N = 354) private disclosures with the birth family across in-person and mediated (i.e., texting and social media) contexts. SEM analysis revealed that adoptive families who were more private and were concerned about the birth family sharing private information with others viewed disclosures to the birth family as risky. These privacy concerns related to adoptive parents being more clear with the birth family about preferences for sharing that private information with others. More social media contact between birth and adoptive parents predicted increased perceptions of risk of disclosure to birth parents. Results advance CPM theorizing by underscoring the motivational bases of perceived risk, the importance of anticipated boundary turbulence, and the nuanced privacy management processes within communication modes.

Foster Care, Permanency, and Risk of Prison Entry

Objective: (1) Examine associations of foster care exit type (e.g., reunification with birth family, adoption, guardianship/permanent relative placement, or emancipation from care) with risk of entry into state prison; (2) Examine racial disparities in those associations. Method: With data on over 10,000 Wisconsin youth who entered foster care in mid- to late-childhood, we present imprisonment rates in young adulthood by race, sex, and foster care exit type. Proportional hazards models with a robust set of covariates compared prison entry rates among the most common exit types—reunification, aging out, and guardianship/permanent relative placement. Results: Nearly 13 percent of the sample experienced imprisonment in young adulthood. Compared with emancipated youth, hazard of imprisonment was 1.58–1.96 times higher among reunified youth. Differences were largely unexplained by observed individual, family, or foster care characteristics. Imprisonment rates were similar for emancipated youth and youth exiting to guardianship/permanent relative placement. Hazard of imprisonment for reunified Black youth was twice that of reunified white youth, but racial differences in prison entry were statistically non-significant among emancipated youth. Conclusion: Efforts to reduce incarceration risk for all youth in foster care are needed. Reunified youth may benefit from services and supports currently provided primarily to emancipated youth.