Support for adoptive parents

Most adopted children have been subject to child protection procedures culminating in a court application and orders. The backgrounds of such children are often traumatic and most, other than those removed from their birth parents at birth, will have been ‘significantly harmed’ for orders to have been made. Significant harm is a term used in the Children Act 1989 and has to be proved by the local authority seeking the Care order. It’s therefore no surprise that many adoptive parents face enormous difficulties and that some end up with placement breakdowns. A report prepared for the Department for Education (below) gives a detailed account of the nature and extent of problems.

What can adoptive parents do to try to secure additional help for the child and avoid a placement breakdown?

Arguing for help and support is often an uphill struggle but evidence of the child’s behaviour over time and the impact of the behaviour on you and other members of your family will be helpful in illustrating the frequency, extent and severity of the problem. Use OnRecord to keep a clear record of what goes on over time and you will have a detailed chronology to argue your case and seek additional help and support.

‘Beyond the Adoption Order: challenges, interventions and adoption disruption’

A report written for the DfE in 2014 by University of Bristol School for Policy Studies Hadley Centre for Adoption and Foster Care Studies.

This national study of adoption breakdowns found that over a 12-year period the national disruption rate was 3.2%, indicating that 3 in 100 adoptions would disrupt over a 12-year period. But a shorter survey also carried out by the team, put the figure at around nine percent. The researchers wrote: “The disruption rate was lower than we expected. The reasons for that became obvious when we met the families. The commitment and tenacity of adoptive parents was remarkable.”

The study found that teenagers (11-16 years old) were ten times more likely to have a disruption compared with children younger than four years old.

Children who were aged four or older at placement were about 13 times more likely to have a disruption compared with those who were infants at placement.

The majority of parents (66 percent) reported that the adoptions were going well and the study focused on adoptions that were in great difficulty. Researchers interviewed parents whose children had left home prematurely i.e. before the age of 18 and parents whose children still lived at home but who considered caring for them to be very difficult.

Risk factors

Previous research has shown that children who have multiple placements in care are more likely to experience disruptions compared with those who had experienced few moves.

The report found that the children who were adopted were likely to have had two or more moves before being placed with their adoptive family.

Although adopted children were on average the youngest at placement, they waited longer from entry to care to placement with their adoptive parents than in special guardianship cases or those with residence orders.

The data supported previous research, which showed that delayed entry to care and the consequent longer exposure to maltreatment are associated with increased risk of disruption, unstable care careers and poor outcomes.

A short survey completed by 210 adoptive parents from the 13 local authorities taking part in the study and by 180 Adoption UK members, which asked how their adoptions were going, revealed just over one-third reported few difficulties; around 30% said life was good but they were facing challenges.

About a quarter of parents described major challenges with children who had multiple and overlapping difficulties. Many were struggling to get the right support in place. Parents reported that they were physically and mentally exhausted and that there had been a negative impact on marital and family relationship.

About 9% of the young people had left their adoptive home under the age of 18 years (average age 14-15 years old).

Biggest challenges facing parents

The interview set out to discover the type of behaviours parents found most challenging.

The most striking feature was the extraordinarily high level of social, emotional, and behavioural difficulties in the ‘At home’ and ‘Left home’ groups.

Parents from the left home group were questioned using a screening tool for post-traumatic stress disorder. Thirteen parents had scores suggesting that they had PTSD and 11 other parents had some symptoms. Only nine parents were symptom-free.

Most often parents had problems with ‘intrusion’ – this includes being preoccupied with events, thoughts, and pictures popping up in the mind, waves of strong feelings, difficulty sleeping, and dreaming about the events.

Some of the children’s behaviours, such as self-harm, night terrors, soiling, manipulation and control, alarmed parents and they began to worry that information had been withheld and/or that the children were more traumatised than they had understood to be the case.

A quarter of adoptive parents whose adopted child was of school age thought that their child had started school too quickly after moving in.

Anger and aggression during adolescence was a major challenge for adoptive families.

  • Child to parent violence was shown by 41 young people (57%) and was statistically associated with children having left home.
  • Knives were used by 19 children to threaten, intimidate or control others.
  • Boys were statistically more likely than girls to show child to parent violence.

The researchers said:

“We had not expected child aggression and violence to feature so strongly in parental accounts of challenging behaviour. We had expected ADHD and attachment difficulties to feature as causes of disruption and although parents described great difficulty in managing these behaviours, on their own, they were not difficulties that broke families. Violence to parents and to siblings was the main reason (80%) young people had had to leave home.”

Parents also described difficulties in coping with teenage children who were oppositional and who showed inappropriate sexualised and attention seeking behaviour. Eleven children (16%) had engaged in serious criminal activity – all but one had left home.

Forty children (57%) had run away or gone missing from home. The police had often been involved in locating the children. Some went to stay with adults whose motivation for befriending the child was questionable and parents feared that children were at risk of exploitation.

Disruption risk factors

The survey findings also revealed that although disruption was not common, there were a significant minority of families struggling with very challenging children.

The researchers wanted to know whether they were disruptions waiting to happen or whether those families were likely to stay intact. Seventy parents were interviewed for this purpose: 35 parents who were experiencing great difficulty in caring for an adopted child who still lived at home and 35 parents where the difficulties had led to a young person leaving home prematurely (under the age of 18 years). Parents were selected for interview because adoptive family life was, or had been extremely difficult. The families are not typical of adoptive families generally but may be typical of families experiencing great difficulty:

  • The adopted young people in the ‘Left home’ group had left on average at 14 years old (range 10-17 years old).
  • The young people who had left home were significantly older on entry to care, at the time of their adoptive placement and when the Adoption Order had been made.
  • There was no statistical difference in the likelihood of a young person having left home by gender, by being placed as part of a sibling group, or by placement with a single adoptive parent.
  • The vast majority of the children had been maltreated by their birth parents.
  • Children who had been exposed to domestic violence were more likely to have left home than those who had not been exposed.
  • More (65%) of the parents whose child had left home described the preparation for adoption as inadequate compared with those parents (20%) whose child still lived at home.
  • 38% of parents were matched with children who did not meet their original preferences.
  • More of the parents whose child had left home had seen their preferences changed.
  • Most (70%) introductions seemed to have gone well.
  • Poorly managed introductions were associated with children having left home.
  • Most parents received good support from social workers during the introductions and transition.
  • About 20% described support as inadequate, with transitions planned when social work support was unavailable, or arranged to meet the foster carer’s needs rather than the needs of the child.
  • The role of the foster carer during the introductions and transition was crucial.
  • The majority of foster carers (61%) were welcoming. About 30% of foster carers were less helpful and obstructed the move. Those adoptive families who had not been supported by the foster carer in the transition were more likely to be families where the child had left home.
  • Two-fifths (41%) of adoptive parents had concerns about the quality of care their child had experienced whilst in foster care.
  • 69% of adopters thought that they had not received all the information that was available.
  • Most, though, had been able to talk to important people in the child’s life and 37% had met with one or both birth parents. These latter meetings were generally appreciated. They enabled some adopters to see birth mothers in particular, in a more positive light.
  • Families where the early difficulties were in the mother and child relationship were more likely to have disrupted than those families where both parents had early difficulties.
Family relationships

Most (93%) of the children were or had been living in families with other children.

Sibling relationships were considered typical for the majority of children but just under half (48%) of the children who had left home and 18% of the ‘At home’ group were in constant conflict with siblings.

Eleven marriages had ended.

Most (80%) of the families whose children were still at home had thought about asking for the child to be removed. Some families were waiting for the child to reach 16 or 18 years old when they would be leaving the family.

Seeking help and support

The majority of the parents were dissatisfied with the overall response from support agencies, citing difficulty in accessing services, arguments over funding and eligibility criteria that excluded adopted children.

The majority (83%) of parents had received some support from Local Authority post adoption services. A quarter of those rated social workers as the most helpful of all the interventions they had received.

Lack of appropriate intervention was also apparent in the delivery of child and adolescent mental health services (CAMHS).

Respite care was often used as a last ditch attempt to keep the family together and was rarely used proactively. Adoptive parents were using the police as a support agency.

For most children, their difficulties were apparent in school. About half of the parents had paid for private therapy and nearly a third had been in touch with their MP.

Many read widely on the subject of attachment disorder, foetal alcohol spectrum disorder and developmental trauma. Although they understood the theory behind the difficulties, they struggled to find effective interventions.

The disruption

Of 28 out of the 35 families with a child who had left home, child to parent or child to sibling violence had either triggered or contributed significantly to the disruption.

In the months leading up to the disruption, most of the young people were out of parental control. Typically:

  • the children were defiant and oppositional,
  • they refused to be parented, and
  • had withdrawn from family life.

Many parents described how they had fought for help when the difficulties at home escalated. Typically, however, appropriate support was not forthcoming or was simply insufficient.

Parents reported that professionals refused to acknowledge the gravity of the situation or parents thought that the professionals were simply out of their depth.

Some parents were sure that support had been denied due to budgetary constraints rather than a decision based on an assessment of the family’s needs.

Looking back

Thinking back over the course of the adoption, all but two adoptive parents could identify something that they would have changed. Seventeen percent wished they had turned down the match.

  • Some parents questioned their own personal qualities and their parenting style.
  • Many parents wished that they had sought help earlier but said it was very difficult to find out what support services were available.
  • The majority were critical of the support provided, of unhelpful advice and of the failure to provide appropriate services when needed.
  • The worst part of parents’ adoptive experience was often the physical and verbal aggression shown by their child.
  • Others described feeling socially isolated and shamed by their child’s behaviour. For a few parents, the rejection by their child had been hard to bear.
  • Most adopters considered themselves their child’s parent and thought that children, too, saw them as their parents.
  • The children’s challenging behaviours had had an impact on many aspects of parents’ lives.
  • There had also been losses, including loss of friendships, intimate relationships, social lives, self-esteem and employment opportunities. Parents also described a loss of the family they had once imagined.
  • Most of the parents would not recommend adoption to others, unless adoption support services were significantly improved.
Recommendations

A host of recommendations for changes were made which included:

  • The development of an on-line national database of adoption support services and evidence-based practices to support adoptive families.
  • Develop best practice guidelines in relation to life storybooks and later life letters.
  • Support the evaluation of the effectiveness of the youth justice system’s interventions to address child to parent violence (CPV) for adoptive families in which there is CPV.
  • Such interventions include Non Violent Resistance (NVR) and Break4Change.
  • Examine legislation and guidance to ensure that respite care can be provided without making the child ‘looked after’.
  • Require CAMHS to provide a comprehensive mental health service for children and adolescents.
  • Children should not be turned away because they have symptoms that the particular local service cannot manage. If services are unable to be provided in a local CAMHS (Tier 1-3), there should be a duty to refer in a timely way to a more specialist service or to commission the service.
  • Provide needs-led rather than service-led interventions.
  • Too often, parents and children got what was available in-house and not what was needed.
  • Provide comprehensive and explicit information to adoptive parents with truthful information about the child.
  • Adoptive parents need to be helped to understand the information they are given, and the current and potential implications for them and their child in the future.
  • Consider residential care when children are out of control and are a danger to themselves and to others.
  • There is sometimes a need to stabilise young people before therapeutic work can begin.
  • Continue to work on improving child and parent relationships after a disruption.
  • Reunification with the adoptive family should not be discounted