ADOPTION, FOSTER CARE, & INSTITUTIONALIZATION

kinship

When children are cared for by someone other than their biological parent(s)

• Adoption: the permanent, legal placement of an abandoned, relinquished, or orphaned child within a family of relatives (kinship adoption) or within an unrelated family (non-kinship adoption).

Adoption

• Not uniquely human.

• Not a modern invention.

• No “standard” adoption!

Adoption

• Why are children adopted? Ie, what are the reasons children are placed for adoption, vs cared for by their biological parent(s)?

• Inability to provide care for child child (economically, psychologically, physically).

• Lack of support (family, society).

• Lack of desire to be a parent.

Adoption: A Protective Intervention

• Historically, adoption often seen as a way to “help” children out of adverse environments.

  - Institutional care/orphanages, neglect, poverty, unstable foster care placement.

• With adoption, children typically experience…

  - An increase in family SES.

  - A move to an environment with more stability, security, stimulation, etc.

Adoption: A Protective Intervention

• Adoption as growth in physical development, attachment, cognitive development, school achievement, self-esteem.

• Compared to children raised in an adverse environment of origin.

Adoption: A Risk Factor

• Disproportionate numbers of adopted children in mental health settings.

• Adopted children at greater risk for problems in school, learning disabilities, behavior problems (externalizing), substance abuse, insecure attachment.

• Why?

  - Adverse pre- and post-natal environments?

  - Challenges in identity development?

  - Conceptualizing adoption loss?

  - Genetic predispositions?

Adoption: A Risk Factor

• Factors to consider:

  - Adverse pre-placement environments.

  - Quality of adoptive parenting.

  - Age of child.

  - Gender of child.

  - Openness in adoption → openness in communication about adoption, satisfaction with openness.

  - Cross-racial/international adoption. Complex! Benefits conferred to adoptive families based on their racial/ethnic status. Negative impacts of prejudice/stigma to being racial minority/immigrant, to being adopted.

Impact of Adoption

• Can be both a protective intervention and a risk factor, depending on the comparison group.

• Also important to consider individuals’ lived experience with adoption.

When children are cared for by someone other than their biological parent(s)

• Adoption: the permanent, legal placement of an abandoned, relinquished, or orphaned child within a family of relatives (kinship adoption) or within an unrelated family (non-kinship adoption).

• Foster Care: temporary long- or short-term out-of home placement for children whose parents are unable to care for them.

Why Foster Care?

• No clear-cut rules, lots of variability.

• Maltreatment: neglect, abuse.

• Parents unable to provide caregiving: substance abuse, psychological/physical illness.

• Homelessness.

• Incarceration.

• Failure to manage child’s behavior: juvenile offenses, truancy, running away.

• Parental abandonment.

Foster Care

• Intended to be a temporary arrangement.

  - Goal typically is reuniting child with birth parents.

• Child is legally the responsibility of the government.

  - Foster arrangements open to supervision.

  - Expectations, responsibilities of all involved may be unclear.

Foster Care

• In Canada, ~28,000 children <14 in care (2016 Census).

• In BC, ~6,000 children in care.

Impact of Foster Care

• Compared to general population, being/having been in foster care is associated with greater risk.

Impact of Foster Care

Impact of Foster Care

Impact of Foster Care

• No difference in outcomes between children placed in foster care vs stay in home with history of maltreatment.

Impact of Foster Care

Impact of Foster Care

Foster Care Policy

• How should policies approach foster care, particularly for children “at the margins” of placement?

• Concerns over bias in who gets placed into foster care.

  - Some studies suggest that Black and Indigenous youth are more likely to be removed from their homes, even with the same level/type of concern (ie, Macguire-Jack et al., 2020)

• Policies that help and support first families without separation?

When children are cared for by someone other than their biological parent(s)

• Adoption: the permanent, legal placement of an abandoned, relinquished, or orphaned child within a family of relatives (kinship adoption) or within an unrelated family (non-kinship adoption).

• Foster Care: temporary long- or short-term out-of home placement for children whose parents are unable to care for them.

• Institutionalization: in which an abandoned, relinquished, or orphaned child’s placement is in a residential facility (orphanage, children’s home, etc.)

Institutionalization

• Historically common method of care for orphaned or abandoned children, children experiencing abuse, and/or disabled children.

  - In mid-1900s fell out of use in N.America and Western Europe → foster care as alternative.

  - But has remained standard in many countries.

Institutionalization

• Many problems documented in institutionalized children.

• Physical growth.

• Cognitive problems; lower IQ.

• Social-emotional development.

• But, there was debate: Was this due to features of institutional care, or due to features of children who are placed into and remain in institutional care?

Bucharest Early Intervention Project

• Goal to investigate the impacts of institutional care, and whether the impacts of institutional care could be ameliorated.

• Begun in Romania in 2000-2001.

  - Nicolae Ceausescu: 1965-1989.

  - Institutional standard of care very poor: overcrowding, few caregivers, little stimulation, dirty.

  - 1990: media reports of institution conditions emerged.

BEIP: Desgiign

• Randomized, controlled study of institutionalization vs foster care.

• Subjects.

  - 136 institutionalized children: 6-31 months (all relatively healthy).

  - 72 matched never-institutionalized children.

• Half of children randomly assigned to foster care, half remained in institution with care-as-usual.

  - Average age of placement = 22 months.

• Assessed children prior to random assignment and then continued.

BEIP: Findings

• At the start of the study, institutionalized children were worse off than never-institutionalized children in almost every domain.

BEIP: Findings

• Children placed into foster care showed marked improvements compared to children who remained in institutional care.

BEIP: Findings

• But: duration of institutional care/timing of placement into foster care matters!

BEIP: Findings

BEIP: Findings

BEIP: Findings

BEIP: Findings

BEIP: Ethics

BEIP: Implications

• In response to this project, the Romanian government instituted foster care system, laws forbidding institutionalization <2 years of age.

• World-wide…

  - Led to questioning over the use of institutions.

  - Sparked new interventions for institutionalized children

BEIP: Implications

• For non-institutionalized children…

• The human brain expects experiences and environmental input → without these experiences/input, typical development does not occur.

  - Particularly important in first years of life