Postadoption Services for Families

by Child Welfare Information Gateway

It is common for adoptive families to need support and services after adoption. Postadoption services can help families with a wide range of issues. They are available for everything from learning how to explain adoption to a preschooler, to helping a child who experienced early childhood abuse, to helping with an adopted teen's search for identity. Experience with adoptive families has shown that all family members can benefit from some type of postadoption support. Families of children who have experienced trauma, neglect, or institutionalization may require more intensive services.

This factsheet provides the following information regarding postadoption services:

• Postadoption issues that most adoptive families encounter
• Milestones (and developmental stages) that may trigger a need for postadoption support
• Types of postadoption services
• Finding postadoption services
• Paying for postadoption services
• Resources for adoptive families

Postadoption Issues That Most Adoptive Families Encounter

Because of the lifelong impact of adoption, members of adoptive families may want or need additional support, education, and other services as their children grow. The following are some issues for which families typically seek postadoption support.

Loss and grief. All adopted children experience loss at one or more points in their lives, and they may grieve their loss as they come to understand the role that adoption has played in their lives. They may struggle with understanding why they were placed for adoption and how that affects who they are. These feelings may change and reappear at different stages of life. Some adopted children may be confused by conflicting emotions about their birth parents - anger at having been placed for adoption or having their birth parents' rights terminated or worry about their birth parents' circumstances. All of these feelings may be acted out as hostility toward their adoptive parents.

Adoptive parents also may experience loss and grief issues of their own, often stemming from infertility issues or the stresses of the adoption experience itself. For some adoptive parents, these issues may cause strains in their marriages.

Understanding adoption. Children's understanding of adoption changes as they mature and can begin to comprehend its complex social and emotional foundations. Parents need to know how to answer children's questions at each stage of development.

Trust and attachment. Children who have experienced abuse, neglect, or institutionalization prior to joining their adoptive families often have not known consistent love and affection and may have difficulty trusting and attaching to their new family. In fact, any child separated from birth parents has experienced a break in attachment. These children may need help to begin to make sense of their history and come to terms with what has happened in their lives.

School problems. Children adopted from foster care often have experienced multiple placements among homes, as well as multiple moves among schools. An educational consultant or a child psychologist may be able to test for educational status and work with teachers from the child's school to ensure an appropriate education. School problems and the need for the services of an educational consultant may also be helpful for older children adopted through intercountry adoptions who already have some school experience in their former country.

Other school issues can arise around classroom assignments that are insensitive or inappropriate for adopted children, such as traditional "family tree" assignments or basic genetics lessons (e.g., identifying inherited family traits). Additionally, school is where many adopted children are first challenged to explain adoption to their peers, often as they themselves are just beginning to understand what it means. Some materials have been developed for adoptive parents and educators to use in the classroom and to educate teachers and other school personnel about adoption. Support groups may be especially helpful in pointing adoptive parents to appropriate materials.

Post institutionalization issues and behaviors. Children who have spent more than a few months in an institutional setting may have missed out on important developmental activities due to a lack of stimulation and suboptimal nutrition. They may have difficulties with feeding, sleeping, and speech, as well as difficulties in forming healthy attachments.

Identity formation. Teenagers who were adopted at any age may experience identity confusion as they confront the primary questions of adolescence - "Who am I? How am I different from my parents? Which of their values will I take as my own?" Young people who joined their families through adoption also must try to determine how these questions relate to their birth parents, who may be unknown and even unknowable. These questions may be further complicated if the child's race or birth culture differs from that of the adoptive family.

Birth relative contact. During the past decade or two, the professional adoption community has learned that many adopted children and adults desire or even need information about their birth family or to reconnect with birth relatives. This desire in no way reflects upon adoptive family relationships or the quality of parenting that adopted children received. Agency staff and private specialists can assist in providing information about birth relatives or in initiating contact, if desired, and mediating the relationships that may form.

Medical concerns. Children who have been in multiple placements may not have received regular medical care. These children, as well as children adopted through intercountry adoptions, often have medical information that is inaccurate and/or incomplete. It is important for all children to have as complete and accurate a health history as possible. Assessment by an adoption-competent physician will provide a plan to update a child's health and immunization status.

Racial issues. Adults who parent children of different races or cultures need skills to prepare their children to function successfully in a race-conscious society. A survey of adults who had been adopted from Korea as infants or children found that racial discrimination was one of the most profound issues they faced.

Milestones That May Trigger a Need for Postadoption Support

Children understand, think, and feel differently about their adoption at different developmental stages. For most adopted children most of the time, thinking about adoption and its complexities does not occupy a large amount of time and focus. They are busy with schoolwork and sports activities, religious functions, social events, family gatherings, and squabbling with their siblings.

But there are times and events that predictably trigger adoption issues. Parents should watch for signs, such as changes in mood or eating and sleeping habits, indicating that their adopted child may need special support during these times. Children can be prepared by discussing the possibility that these triggers will cause a reaction, which a child likely cannot control. Parents should let their children know that they understand what is happening and will be there to help and find other resources as needed.

Common adoption issue triggers:

• Birthdays (of the adopted child, siblings, parents, birth parents)
• Anniversaries (of placement into foster care, an orphanage, or into the adoptive family, or the date of adoption finalization)
• Holidays (especially Mother's and Father's Days, but any holiday that involves family gatherings and sentiment, such as Christmas, Passover, or Thanksgiving)
• Entering kindergarten and first grade (which may be the first time an adopted child must explain adoption to peers; it can be the first time the child realizes that most children were not adopted into their families)
• Puberty (as children become sexually mature and able to conceive or father a baby themselves, thoughts of birth parents may arise)
• Adoptive mother's pregnancy and birth of child, or adoption of another child (may trigger doubts about the adopted child's place in the family)
• Adopted person's pregnancy and birth of child or fathering of a child (often a powerful trigger that may ignite interest in reconnecting with birth relatives, if only to obtain medical histories and updated information)

About the Author

www.childwelfare.gov
Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.