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Growing Support
13. Fostering and adoption of young children
When families are under stress or parents are unable to care for their children, whether temporarily or long term, then the children may be placed with foster carers or adopters. Not so long ago in Britain young children were placed in residential nurseries, as still occurs in many parts of the world. Nowadays it is extremely rare in the UK for a child under 3 to be placed in any kind of residential institution, except in a hospital when inpatient medical care is required.
For the most part, children in foster care return to their original families, often soon, but sometimes later. Currently, short-term placements in particular tend to be viewed more in terms of respite, shared care or family support, rather than substitute care (Aldgate and Bradley 1999). In contrast, adoption is a permanent alternative, as can sometimes be the case with foster care.
The evidence is that both foster care and adoption tend to be more successful for young children than older ones. This accords with attachment theory and common sense, since young children have had less time for problems in their original family to affect them and are more able to re-attach to new carers or parental figures. Both prospective foster carers and adopters are carefully assessed and so are likely to be particularly suited to looking after children. Despite the current emphasis in adoption practice that adopters can come from diverse backgrounds, the majority of baby adopters still appear to be 'middle class' (Castle et al 2000).
Fostering young children
Studies of fostering outcomes have often focused on the type or duration of the fostering (e.g. short term, long term, permanent, specialist), rather than particular age groups. Nevertheless, considerable information is available about placements of young children.
Most young children in foster care stay for short periods (up to 6 months, but often only a few days or weeks) before returning home or in a minority of cases moving on to another placement or adoption (Rowe et al 1989). Over three-quarters of such placements are successful, using a range of criteria. Children who are fostered and return home before they are 2 are more likely than older children to have a successful return (Sellick and Thoburn 1996). Multiple moves in care have been found to affect children's attachments and behaviour adversely, though a single move can be helpful (Millham et al 1986; Cleaver 2000).
The evidence about longer-term placements is that the younger the child at placement and the fewer the identified behaviour difficulties, the greater the chance of the arrangement proceeding as planned. Indeed, there may be a greater risk of placements going on beyond their planned duration than ending prematurely (Berridge and Cleaver 1987; Kelly 2000). In the study by Rowe et al 1989, only 4 per cent of planned long-term placements for children under 4 years 'broke down' within a year, compared with over one-third of the placements of 14-15 year olds.
Adoption of young children
From the 1950s to the 1970s most children who were adopted were aged under 2, but this is no longer the case. The numbers of babies placed for adoption has fallen markedly, while a smaller increase in the placements of older children has occurred, so the latter are now in the majority (Hill and Shaw 1998). Evidence from the period when baby adoptions were common indicates that the vast majority have formed good attachments with their adoptive parents and turned out very well in many respects. The NCDS follow-up of children born in 1958 showed that those who were adopted had good outcomes as regards physical and cognitive development. They quite rapidly overcame generally poor ante-natal and early histories to do as well as other children in advantaged material circumstances (Seglow et al 1972; Maughan et al 1998). Other studies have shown that the majority of children adopted as babies do well, but an above average minority develop behavioural or psycho-social problems, particularly in adolescence (Bagley 1993; 1998).
Adoption breakdown rates tend to be low compared with those in residential and foster care (Triseliotis et al 1997). Moreover, disruption of placements are much less for children placed at an early age. Around 5 per cent of infants placed for adoption are likely to have to leave their home during childhood, though rather more will have unhappy experiences (Sellick and Thoburn 1996). A recent study of 52 children adopted as infants found that all were still living with their adoptive parents at 6 years (Castle et al 2000). As earlier research had shown, the children were above average in cognitive assessments and socially well adjusted. Adoptive parents were nearly all well satisfied. The great majority of adoptive placements that do break down do so before an Order is granted (DH 1999).
Age at placement and pre-placement appears to affect outcomes. The retrospective study by Howe (1997) indicated that young adults who had the best outcomes and most settled experiences of growing up in the adoptive family had been placed before 6 months and had not experienced instability or rejection in early life. Similarly the long-term follow-up study of Romanian children has shown that outcomes are almost invariably positive in the first few years, but those who arrived after the age of 24 months have done less well (Groothues et al 1998; DH 1999).
Quaternary prevention
According to the scheme of prevention developed by Hardiker et al (1996) outlined in section 2, one of the primary aims of shared and substitute family care arrangements is to 'prevent' or minimise negative consequences arising from the separation of children from their birth families. Research has identified a range of factors which appear to affect children's experiences. Careful recruitment, preparation and the availability of adequate and sensitive post-placement social work support have been identified as key factors (Triseliotis et al 1995; Sellick and Thoburn 1996). Contact with birth relatives is generally helpful for children's current wellbeing, self-esteem and identity, as well as the prospects of return home, though in situations of extreme rejection or abuse this does not apply (Cleaver 2000). When parent-child relationships are poor, sibling relationships can often mitigate children's sense of loss and isolation (Kosonen 1994).
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