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Little is known about adoptive parents' experiences of and satisfaction with statutory child and adolescent mental services (CAMHS) in the UK, nor of parental concerns about their adopted children's mental health and well-being. Ninety-eight adoptive parents completed an online survey about their satisfaction with services as well as their mental health concerns for their child currently and retrospectively at the point of adoption. Parental concerns were diverse, and many overlapped with issues that CAMHS could normally help with. Attachment was the primary concern initially, but this decreased over time in placement; while challenging behaviour was the highest rated current concern, along with aspects of general functioning such as peer relations, social skills and education. Unexpectedly, trauma was a relatively low concern at both timepoints. There were very high levels of dissatisfaction with CAMHS, evident across questions of access, engagement and quality of services, all at levels much higher than typically reported by general samples. Adoptive parents' substantial dissatisfaction with CAMHS occurred despite an apparent fit between many parental concerns and the kinds of services typically offered in CAMHS. There remains a significant challenge to develop a shared understanding between parents and services of adopted children's needs, especially given the absence of data about adopted children's mental health and wellbeing problems. [ABSTRACT FROM AUTHOR]

Previous research suggests that adopted children are at a greater risk of experiencing psychological and behavioural difficulties or accessing mental health services than non-adopted peers and that post-adoption variables are significant risk and protective factors producing this situation. This review seeks to summarise the post-adoption variables associated with adopted children's mental health or behavioural difficulties to inform future research and shape interventions. A search for publications that assess associated risk and protective factors using Web of Science, Psychinfo, Medline and Sociological Abstracts identified 52 studies that met rigorous methodological criteria. Children's and adolescents' mental health and behavioural outcomes were associated with parent, parent–child and wider family factors and by contextual variables. The findings highlight the importance of focusing on the multitude of systemic factors surrounding a child following adoption. Clinical implications and direction for future research are discussed. [ABSTRACT FROM AUTHOR]

An introduction is presented in which editor discusses articles in issue on topics including impact of neurobiological science on family placement policy; domestic violence as a risk factor for children and adults; and the planning and decision-making for children whose parents faces challenges.

Early life experiences leave a mark on a child’s emotional, social and cognitive development. It is well established that children adopted from psychosocially depriving institutions have difficulties in executive functioning and social communication ability, but this type of research has not been replicated in children adopted from foster care. In this study, 30 primary school aged UK adoptees without a history of institutionalisation completed an assessment of their intellectual, executive functioning and social communication abilities. Compared to children of a similar age in the general population, the adopted group showed elevated emotional and behavioural difficulties on a parental report measure (Strengths and Difficulties Questionnaire, SDQ). They performed statistically poorer on two of three computerised executive functioning tests (CANTAB Intra-Extra Dimensional Shift and Spatial Working Memory) and elevated scores were observed on a parental report measure of executive functioning (Behavior Rating Inventory of Executive Functioning, BRIEF). A strong negative correlation was found between age of adoption and BRIEF scores controlling for ADHD symptoms; no other pre- or post-adoption variables strongly correlated with executive functioning. Although all participants scored below cut-off on an autism screening measure (Social Communication Questionnaire, SCQ), a moderate positive correlation was observed with age of adoption. The identified elevation in emotional, behavioural and executive functioning difficulties is in line with previous research examining children adopted from institutions; however, the observed negative correlation between BRIEF scores and age of adoption is contrary to previous evidence. Limitations and implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Background Attachment disorders in adopted and fostered children may be overdiagnosed and could obscure more common disorders. Methods A case note review of 100 referrals to a specialist adoption and fostering service compared community referrals with the specialist assessments of attachment disorders. Results Attachment disorders were identified four times more often in community referrals versus the specialist service, but this only partly explained the significant under-identification of more common disorders in the community, especially for neurodevelopmental factors and conduct disorder by up to 10-fold. Conclusions The relevant practice parameters are discussed and implications for service models for adopted and fostered children reviewed. [ABSTRACT FROM AUTHOR]

In many child services across health, education and social care, ‘attachment disorder’ is a popular description and explanation for complex presentations of children who have been neglected or maltreated and is frequently used to describe fostered and adopted children. Very often the use of this term bears little resemblance to the established diagnostic systems, nor indeed to attachment theory as conceptualised by Bowlby. Its misuse can lead professionals to overlook commoner and more treatable conditions, to the detriment of the children. In fact both reactive and disinhibited attachment disorders are rare, but are becoming better characterised by high quality research. Poor understanding about the attachment disorder construct can pose particular problems for clinicians working with adopted children. The current paper briefly reviews the practical difficulties with the attachment disorder diagnosis as applied to adopted children and uses four case studies taken from a specialist Adoption and Fostering Service to highlight some of the problems for services working with adopted children. Finally, we propose some provisional recommendations for the assessment and treatment of adopted children and their families, which aim to be consistent with attachment theory as well as with the existing evidence base on wider child mental health problems. [ABSTRACT FROM PUBLISHER]

The cutting-edge scientific research that is emerging regarding the neurobiological consequences of early maltreatment and neglect is highly relevant for thinking about the diverse needs of adopted and fostered children. Knowledge about the science has an important role to play in many areas, from child care proceedings to the mental health and educational needs of adopted children and young people. However, the science is complex and it is difficult to provide a succinct but valid summary of the rapidly expanding literature to guide practice. Indeed, there has been some concern from the scientists themselves that the research can be too easily misunderstood. The purpose of this article is to review some of the more recent research on the neurobiological consequences of maltreatment. A narrative is developed that pays due respect to the complexity of the findings, while drawing out practical implications for professionals working with adopted and fostered children. In particular, the notion of differential susceptibility and its consequences for individual differences in response to early negative environments is described. The science also stresses the inter-relatedness of the biological systems affected and, in turn, their dynamic relationships with environments over time. The article reviews the research relating to neuroscience, physiology and genetics in particular, before describing some animal research to integrate the various neurobiological consequences of maltreatment over the course of development, and which reveal implications for interventions. [ABSTRACT FROM PUBLISHER]