Thursday, April 29, 2010

Troubled Adoptions: Why? What to do?

In recent weeks there has been a fair amount of attention given to troubled adoptions. This has, in turn, been unsettling to individuals with infertility who ultimately are considering adoption as an option for future parenthood. The media's attention to the mid-April return to Russia of 7 year old Artem Saveliev by his Tennessee adoptive mother has ballooned beyond this one situation to a host of articles and TV coverage on "adoptions gone sour." The formal term for the ending of a legal adoption is "disruption," but the stories behind these unanticipated family sorrows are causing many readers to think more carefully about the possible risks associated with adoption. So why might an adoption become problematic? And when it does, what resources do adoptive parents have?

Let's look first at the "why?" factors that can contribute to troubles after the adoption. Whether an adoption is domestic or international, the prenatal care of the developing fetus often is unknown. Alcohol or substance use, poor nutrition, low maternal age and other risk factors may be present in the mothers whose babies are placed for adoption. Life after birth of the baby may include institutional care that is substandard or routinized, with little opportunity for the interpersonal warmth and cuddling that can be so important to building future trusting relationships. For older children or sibling groups, there may be a history of foster home placements or institutional care where those children have, at best, needed to fend for themselves and, at worst, have experienced abuse and emotional rejection. A child's records that are available to prospective adoptive parents may not include this kind of information, and the reports from the examining physician may focus exclusively on obvious health problems. This sets up the possibility that an adoptive parent, eager to provide welcoming arms and a loving heart, may be unaware of the extent of physical and mental health difficulties experienced by a child. Given that the agency adoption process itself can take several years, the conditions in which the child has lived are important for adoptive parents to understand, as there will be more empathy for whatever adjustment difficulties occur post-adoption.

So now, let's consider the "what to do?" question. This is not only for adoptive parents who are experiencing troubles, it also is for prospective adoptive parents who want to know what their options are if their child's adjustment to their home is painful or filled with trauma. This is where the services of the adoption agency need to be evaluated. Is the agency one that offers workshops for prospective parents in which they cover both the joys of adoption and the potential problems? Do such workshops include information about predictable problems (sleep disruption, night terrors, food hoarding, testing behaviors, etc.) that children of different ages might demonstrate as part of the normal adjustment to a new home? Are prospective parents given an opportunity to meet with adoptive parents who have experienced adjustment difficulties, learning from them various ways they coped? And, most importantly, does the agency make itself available for adoptive parents to return for counseling around difficulties that arise after the adoption?

Clearly an agency that addresses possible troubles up front is helping prospective parents to anticipate the special needs that their children may have and to ask themselves if they are "up" for this possible challenge. This is a time when prospective parents need to assess whether they see adoption as "second best" or as a "second choice." Second best is worrisome, in that it presents a sense of disappointment and the belief that having a birthchild is preferred as a route to parenthood. Second choice identifies that the adults had hoped for, and tried for, a birthchild, but when that option was not promising, were sufficiently committed to becoming parents that they turned to adoption as their next (and second) choice.

Since all children at one time or another present unanticipated challenges for their parents, those adults with a second best perspective may be most likely to point to the adoption as the root of the child's difficulties, whereas second choice parents may direct their commitment to parenthood into problem solving strategies. Clearly a problem solving approach is most likely to enable parents to reach out for counseling, for support services, and for mental health treatment. And here is where prospective adoptive parents can do some important homework. Does the agency with which you are working offer that counseling? If not, does it provide referrals to agencies and services that are familiar with childhood adjustment problems and dynamics that families may use in response to these problems?

Clearly prospective adoptive parents are aching to hold a child in their arms and to provide the love and comfort that will nurture this new family member. At the same time, they are hopeful that this child will enable them to feel more fulfilled as adults, opening new experiences to them as they finally join the ranks of their siblings, friends and co-workers who are parents. Yet it is important for adoptive parents to realize that they will need to have a special sensitivity to an adopted child around everyday issues such as "tell me how I was born," assuaging grand-parental misgivings and apprehensions, appreciating how differences in skin color or facial features between the child and parents may present issues (both within the family and in community/school relationships), and deciding how to help their child feel a connection to the country of his/her birth.

So, much as troubled adoptions have been in the news lately, this actually presents an important opportunity to help prospective adoptive parents weigh quite carefully the circumstances under which adoption feels possible, the kinds of questions to ask as you consider what agency to work with, the importance of talking with adoptive parents about how they have weathered hard times in child rearing, and the availability of support services in your community for children and families experiencing adjustment problems. Entering into parenthood requires that each of us ask ourselves how ready we are for this new chapter in our lives; and contemplating adoption requires even more introspection and self awareness about the unique opportunities and possible challenges that adoption can bring into the lives of families. Feel free to share your experiences, both in anticipation and in reminiscing about your own adoptions!

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