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The pathway from adverse early experience to adulthood for internationally adopted children is complex in identifying key influences, impacts, and outcomes. This review arose from the authors' involvement in the British Chinese Adoption Study, a recent outcomes study that explored the links between early orphanage care, adoptive experiences, and midadulthood. It differs from previous reviews in focusing on a greater length of time since adoption. Both quantitative and qualitative studies were included to allow for examination of a fuller range of adult-related outcomes rather than mental health scores alone. The sampling, methods, and results of reviewed articles are summarised and a critical commentary is provided. Despite methodological differences and identified strengths and weaknesses, conclusions are drawn on the basis of the evidence available. Special attention is paid to the interpretation of negative outcomes. Findings identify areas that should be explored further in order to gain a fuller understanding of midlife outcomes of people who experienced a poor start in life followed by international adoption. Such studies help in refining lifespan developmental theories.

Background: While studies of ex-orphanage care show adverse effects on development, the longer-term impact on mid-life psychosocial functioning and physical health has not been established., Methods: Orphanage records provided baseline data on a sample of 100 Hong Kong Chinese girls who were subsequently adopted into the UK. A mid-life follow-up using standardised questionnaires and face-to-face interviews assessed current circumstances, life satisfaction and mental and physical health outcomes. Comparisons were made with age-matched UK-born adopted and nonadopted women., Results: Half the group spent between 1 and 2 years in orphanages, average age at adoptive placement was 23 months and 72% participated in the follow-up. Despite this poor early start, mid-life outcomes were commensurate with the comparison groups in terms of mental and physical health measures. Serious psychiatric and social difficulties were largely absent. Although the timing and extent of exposure to orphanage care did not influence outcome, participants' reports of poorer quality adoptive family experience and a negative view of their adoption were significantly associated with poorer mental health outcomes (difference in means = 0.76, 95% CI 1.33-0.19, p = .01; difference in means = 1.2, 95% CI 0.68-1.73, p = .01, respectively)., Conclusions: Moderately depriving orphanage care did not predict enduring adverse consequences in mid-life but subsequent poor adoption experience was associated with outcome., (© 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.)

The mental health of children in public care has received considerable attention in recent years. There are significant differences in the prevalence rates compared to children living at home and not in public care and these are added to by other adverse lifestyle issues. Considerable attention has been focused on the importance of stable and secure placements supported by access to a range of services including education, health and mental health. Identifying and classifying mental health needs proves to be challenging as the child's genetic inheritance, pre- and post-birth experiences, including maltreatment, interact with the uncertainty and delays commonly associated with child protection processes, action in the legal system and the difficulty in establishing secure and permanent placements. Clinical need is also related to the age of the child and the reasons they came into care and the length of time they remain. A case illustrating many of these issues, publicly reported in the court's judgement, is used as the basis for exploring the complexity for the identified child in understanding and making sense of their experiences as placement plans are made for them. These are used to explore the difficulties in establishing clinical protocols such as those recently published in the USA. Particular emphasis is given to the issues faced by children and their carers in establishing new family relationships which address the child's inheritance from their family of origin especially where these are traumatic and conflicted in origin.

The present study aimed to explore the impact of either being separated or adopted with sibling(s) on adolescent adoptees' emotional and behavioral development. Through a mixed method design, the study aimed to explore whether sibling placement had an effect on adolescents' internalizing and externalizing problems, as well as on the way they express and regulate their emotions in conflictual situations. Findings revealed that, although both groups of adoptees developed adaptive strategies to cope with challenging events, those placed with siblings were in general faring better than those placed alone. Being placed alone was, indeed, associated with clinical scores on the self-reported Youth Self Report (YSR) Total Problems' scale and to the greater use of maladaptive emotion regulation strategies. This highlights the significance of maintaining siblings' relationships when co-placement is not possible. [ABSTRACT FROM AUTHOR]

This study forms part of a major longitudinal research project collaboration between the Anna Freud Centre, Coram and Great Ormond Street Hospital, which set out to explore adopted children's and adoptive parents' outcomes and experiences from middle childhood through to adolescence. In this paper, 17 adoptive mothers of late adopted children, currently in early adolescence (aged 12 to 15 years), were interviewed. The focus of the study draws upon their worries and fears regarding their children during adolescence and as they approach adulthood. The Parent Development Interviews (PDI) were analysed using thematic analysis and generated five overarching themes: Vulnerability, Violence, Derailing opportunities, Autonomy and Anxieties about the birth family. This qualitative exploration provides strong evidence for how these parents reflected upon very concrete challenges and anxieties about their child's journey, including both their current context and anticipated outcomes. The overwhelming majority of research to date on this population examines negative outcomes quantitatively; this study adds an important qualitative layer of the parents' own perspectives. Plain Language Summary: This study draws upon the experiences of adoptive parents, all of whom were mothers, of late-adopted children, currently in early adolescence (aged 12 to 15 years). The study focused on their worries and fears regarding their children during adolescence and as they approach adulthood. Seventeen adoptive parents were interviewed using the Parent Development Interview (PDI) and the data were analysed using thematic analysis and generated five overarching themes: Vulnerability, Violence, Derailing opportunities, Autonomy and Anxieties about the birth family. This study provides strong evidence for how these parents identified and reflected upon very real challenges and anxieties about their child's journey including both their current lives and anticipated futures. [ABSTRACT FROM AUTHOR]

The article informs about the need for adoption support services and the legal obligation of adoption agencies to provide them. Topic include It discusses the importance of evidence-based assessments and multidisciplinary approaches in addressing the diverse needs of adopted children and families, highlighting a two-year funding program by the Department for Education to develop innovative support services.

The article discusses highlights of the sixth International Conference on Adoption Research held in Montreal, Quebec in July 2018. The conference set out the continuing significance of adoption as a policy and practice framework. The ambivalence that exists in most countries to the use of adoption for children in care has been identified. A keynote talk on a study about adoption disruption was given by Jesus Palacios from the University of Seville.

The Adoption Support Fund in England, which was rolled out on 1 May 2015, seeks to improve the lives of adopted children and their families by providing resources to fund therapeutic interventions for the child. Accessing the Fund requires that the needs of the child and family are fully assessed and the expected outcomes are identified. This raises questions about the use of standardised and validated assessment tools as a part of the process. This article reviews the benefits and challenges of using established instruments, such as the Common Assessment Framework (CAF) and the Strengths and Difficulties Questionnaire (SDQ), and considers the relevance of the Development and Well-Being Assessment (DAWBA) for adoption situations. It is argued that given the legal requirements to link need, services and outcomes, the importance of using validated assessment tools is strong. However, social workers need training to administer them and interpret the results. While using the SDQ should be firmly embedded in practice, the contribution of the DAWBA, although promising, requires further exploration. Social workers will also need training on how best to use it, and how to interpret the results and integrate these into a comprehensive assessment of the child and family. [ABSTRACT FROM AUTHOR]

Working directly with children in the family-finding process presents an additional challenge to social workers where the child is disabled. In My Shoes, an interactive compute interview, has been demonstrated as an effective communication tool with children who have a wide range of special needs. Jennifer Cousins and John Simmonds report on a project exploring its use with disabled children for whom a permanent new family was being sought. Social workers observed children using In My Shoes and then a group of 16 from four local authorities were trained in its use. They were subsequently supported in its use during family-finding and feedback was gathered on their experience of doing so. A number of them reported enhanced knowledge of the children they worked with, which informed family-finding. However, identifying disabled children with permanence as a plan proved, unexpectedly, to be a significant problem. This raises important questions about whether permanence planning for disabled children follows the same trajectory as for not-disabled children. The project team also found that engaging agencies in this exploratory project was challenging. Incorporating even positive practice tools such as In My Shoes (particularly those involving technology) was often a step too far for a workforce already struggling with huge demands. [ABSTRACT FROM AUTHOR]

Attachment theory and therapy have established themselves as major constructs in foster care and adoption practice. The depth of the explanatory power of attachment theory and research have done much to both identify the source of developmental difficulties in adopted and fostered children, and of the significant changes that can be made when these children are placed with `autonomously' classified carers. However, the power of the concept has also led to a proliferation of ideas, particularly therapeutic models that can, in some cases, stray a long way from the core of what is effective, safe and ethical clinical practice. Holding therapy is one of these models. The British Association for Adoption and Fostering developed a position statement on this practice, setting it within a broader framework of assessment and intervention. But like the model, the development of the position statement became controversial in its development. The article charts some of the critical issues and identifies the very significant dilemmas for parents and carers caught up in the maelstrom of challenging behaviours and disturbing feelings. The conclusion turns to one of the key components of an attachment-based idea: The critical importance of finding the space to think and to feel what the child is communicating without resorting to dangerous retaliation. [ABSTRACT FROM AUTHOR]