Progress After Placement

The chapter explores the progress made by the 93 adoptees in the core follow-up sample in terms of physical and mental health and education from the time they entered their adoptive homes until they were followed up, on average 18 years later. It draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort) completed at follow-up, and interviews focusing on 24 adult adoptees. On entering their placements, 40% of adoptees were developmentally delayed; 13% had poor physical health; 38% were in poor mental health. Emotional and behavioural problems affected their academic progress; 76% required specialist help. After placement, 74% improved in physical health, 66% in mental health and 68% in academic performance. The challenges faced by adoptive parents provide a powerful case for careful preparation and long-term post-adoption support.

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.

Permanence

This chapter considers how far the Barnardos adoptees achieved legal, residential and emotional permanence after adoption. It draws on minimal follow-up data, available for 124 adoptees (59% of the original cohort); extensive data collected through responses to an online survey concerning 93 adoptees (44% of the cohort) 5–37 years after placement; and interviews focusing on 24 adult adoptees. Ages at follow-up ranged from 5 to 44. All adoptees had achieved legal permanence. Many had achieved residential permanence after numerous placements in care: 34% of those aged 18 or over were still living with their adoptive parents. Twelve (13%) placements had disrupted, but all except eight (9%) adoptees had achieved psychological permanence. Relationships between adoptees and adoptive parents were twice as likely to persist as those between care leavers and foster parents.

The Children

The children’s early experiences provide a context for assessing subsequent outcomes. Data collected from case files and records presented to the courts show that before separation from birth parents, almost all 210 adoptees had experienced serious and often multiple forms of maltreatment; this was the primary reason for removal. Before entering their adoptive homes, 69% of the adoptees had had four or more adverse childhood experiences (ACEs), 32% had experienced failed reunifications and 48% had had three or more foster placements. Adverse childhood experiences before entry to care, harmful experiences in care and repeated exposure to grief and loss are likely to have contributed to the high prevalence of emotional and behavioural difficulties, displayed by 49% of the adoptees. According to our classification, 57% were at high risk of experiencing adverse outcomes in adulthood.

The Adoptive Parents

The chapter draws on case file data and papers presented to the court at the time of the adoption order. The 210 adoptees were placed in 138 adoptive homes. The adoptive parents were on average ten years older than birth parents and had more stable relationships. They were also better educated. Most lived in owner-occupied homes and the secondary carer was generally in full-time work. Attempts to match children with families of the same ethnicity and culture and to place siblings together were mostly successful: 77% of children with siblings were placed in intact groups; only 8% were placed alone. Almost half (44%) the parents adopted more than one child; 9% adopted three or more; many also had biological children still living with them. While adoptive parents had considerable resources, they also faced challenges including helping children overcome the sequelae of early adverse experiences and parenting several children with diverse needs.

Adult Outcomes

The chapter focuses exclusively on the 60 adoptees aged over 18 who completed the follow-up survey. It draws on data collected through survey responses and interviews focusing on 24 adult adoptees. It explores their outcomes across a range of dimensions that together contribute to a composite measure of adult functionality. It presents the outcomes the adoptees achieved on each of these key domains and explores how they compared both with those of the normative Australian population and a contemporaneous cohort of care leavers. The adoptees showed more evidence of poor mental health than care leavers, but often did better in terms of education and employment. The presence of a committed adoptive parent appears to have acted as a powerful protective factor, and only extreme indicators of vulnerability at entry to the adoptive home correlated with poor adult outcomes.

Conclusion: Implications for Policy and Practice

The book focuses on a study of 210 children in out-of-home care in Australia who were adopted over a 30-year period; 93 were traced for an average of 18 years after placement. The requirement for regular face-to-face contact with birth parents was considered beneficial by 69% of participants. Other findings show the adoptees’ extreme vulnerability, improved stability post adoption and the importance of adoptive parents’ commitment in facilitating positive outcomes. They also imply that child protection policy should focus on strengthening family support and more timely decision-making when parents cannot overcome their difficulties. Policy for children in long-term foster care should focus on reducing instability, increasing the quality of care and providing better care leaving support. Internationally, adoption policy needs to reflect the increased similarities between adoption and fostering engendered by open adoption from care, and acknowledge their implications for recruitment, training, contact arrangements and post-adoption support.

Issues Facing the Birth Parents and Their Implications for Open Adoption

The 210 children in the full cohort came from 142 families. Their birth parents’ circumstances provide a context for evaluating adoption outcomes. The chapter explores data collected from the children’s case files and records presented to the court at the time the order was made. Parents demonstrated a high incidence of factors known to be associated with recurrent child abuse: 31% of mothers had experienced abuse in their own childhoods; 45% were known to statutory child welfare services before their child’s birth, and 29% had already experienced the permanent removal of a child. Almost all parents struggled with complex factors including mental health problems, substance misuse, unstable relationships and domestic abuse that placed their children at risk of harm; for some parents, cognitive impairment was an exacerbating factor. About 10% of birth parents had died, and 23% of mothers and 60% of fathers had already lost contact with children before the adoption placement.