Disruption: The Myth of the Forever Family, Disabilities and Lack of Resources

Disruption. It’s a word that no one in the adoption world wants to talk about. Visceral reactions come out when disrupting families reach out for help. There is judgment and misunderstanding. Some think adoption agencies help. Others know better.

It is not something that only happens with foster care adoption….or adoption at all. Biological families disrupt. Why? Sometimes it is unpreparedness for mental disorders. Many times it has to do with the lack of resources for complex issues. This week we will be discussing disruption and asking for your help in a new project. To kick off this effort, we would like to refer you to some recent articles.

This June 2010 article frames the Myth of the Forever Family very clearly.

We strongly recommend that all PAPs and APs read this article by Dawn Friedman in  Brain, Child magazine found here.

One of the stories she discusses is as follows:

“Carol (name changed for privacy) and her husband, already parents to a six-year-old biological child, knew what conditions in his Caribbean orphanage were like because they were already in the process of adopting a special-needs child from the same program, a toddler girl named Lily. Gazing at Henry’s picture online in the photo listings for the orphanage, Carol felt led. Despite their small house, modest lifestyle, and single income, she felt like God was calling her to be Henry’s mother, too.

“The orphanage was so overcrowded,” Carol says, recalling her visit to complete the adoption of Lily.

“The children there are so starved for affection and you think, my house is so big! I could afford to take care of more children.”

That’s how she found herself back in less than two years, bringing home five-year-old Henry and his siblings, Isobel and Matthew.

Carol told me that all of her adopted children have histories of trauma. Her newest children raged and fought and struggled to learn how to live in a family. Henry was easier. He was a good kid, anxious for approval and able to show affection. She wasn’t worried about him. Not when her time was taken up in helping the other children who were having a much more difficult time adjusting. Then, one month into their new family configuration, things changed.

“We caught him sexually acting out,” Carol says simply. She and her husband reacted by establishing house rules. Supervision got tighter. No child could be in the bathroom with another child. They talked good touch and bad touch in the children’s native language and stopped having sleepovers. They looked into getting Henry counseling. He didn’t speak English yet, however, so they did their best to create a safe environment for all of the kids. They thought it was working until one of the older children caught Henry in another child’s room and his story didn’t quite add up. Carol sat him down and asked, “Hey buddy, do you have a secret?”

Henry had lots of secrets. He told her that he had been molesting his siblings for the past year. He described his behavior in detail and then told her about the orphanage, about the way he and his crib mate used to play this way. He told her about incidents that happened when she was in the room, when her back was turned. He told her how he got the other children to give in.

“It was extensive,” Carol says. “It was stuff I didn’t even know that a six-year-old was capable of.”

Carol called her state’s child protective services (CPS) department. They told her that unless the children were more than two years apart, it wasn’t considered abuse. At first she was relieved because she had been afraid that CPS would take her children away. She and her husband put the house on lockdown and kept Henry in their line of sight at all times. That is when he became “the angriest boy alive,” Carol says. Without the psychological outlet of the sexual abuse, her son became increasingly violent, raging two to four hours a day and threatening to kill the other children. They hid the knives and bought locks for all the doors. The behavior continued to escalate. Henry would threaten to force Carol to crash the car. He said he would bash her head in with a rock. The other children were terrified. Henry was scared, too. He knew he was out of control but didn’t know how to stop.

Carol looked for services to help Henry stay in their home and took him to experts in adoption and attachment across the state. Her days were taken up with phone calls, paperwork, and more phone calls. She worked their insurance for referrals, begged the school for resources and read up online. She took Henry to see a leading child neuropsychologist specializing in treating adopted children with severe issues. The consensus was that in order to get the long-term treatment he needed, Henry would have to leave.

Carol went back to working the phones until she found a residential treatment center with the ability to work with a six-year-old sex offender. A year and a half ago, Henry went to live at the facility, two thousand miles away. He will likely be there for at least another nine months. No one has told Henry this yet (his therapists say it’s not the right time to explain), but when he’s ready to leave the center, he won’t get to come home. Instead Carol has found another family who will take him, who will adopt him. He will become their son. “He can’t come home again,” Carol says.”

Statistics from the Article

“Adoption termination is the industry’s dirty little secret. It’s especially secretive in international adoption. Studies of adoption termination, as reported by the Child Welfare Information Gateway report, “Adoption Disruption and Dissolution” (2004), usually focus on foster-care cases. This research, done by child welfare academics and advocates, estimates that ten percent to twenty-five percent of all adoptions terminate either before finalization (disruption) or after (dissolution). It’s hard to say whether or not the numbers in international adoptions are similar, but the kinds of challenges that terminate domestic adoptions are certainly present in many international ones. According to the Evan B. Donaldson Adoption Institute, in their 2004 research review, “Adoption Stability & Termination,” adoptions fall apart when kids have behavioral and emotional problems that overwhelm parents and when appropriate supports and services are not accessible. There are specific indicators of an adoption that runs a higher risk of failure, such as those in which children have been in foster care for more than three years, have experienced sexual abuse, arrive in a sibling group or have had prenatal drug or alcohol exposure.”

“According to the Child Welfare Information Gateway website—a project of the U.S. Department of Health and Human Services—some of the same factors that put a family at risk for adoption termination also put children at risk for abuse, such as the presence of physical, cognitive, or emotional disabilities in a child. In their report “A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice” the HHS Office on Child Abuse and Neglect says that “parents who maltreat their children report experiencing greater isolation, more loneliness, and less social support.”
“Is it really realistic to think that every adoption will work out?” asks James, of the Attachment and Bonding Center. “People go to a foreign country and come home with a virtual stranger. And, on the child’s part, they are moved so abruptly from one country to another. There are going to be cases in which the parents or the adoptee simply cannot adjust.”

The Matching of Child to Family

“The other challenge is fitting the right kids to the right parents. Matching families is an elusive art, and hard-pressed social workers in the foster-care system don’t always have the time or the ability to focus on choosing the best placements.

In international adoptions, the matching process varies. Parents may get placed with the child at the top of a list. Other programs match kids to parents who orphanage program administrators think resemble them. Then, too, parents often fall in love with photo listings, like Carol did with Henry’s. It’s one reason agencies use such photos. In many international adoptions, there is little to no history on any given child, yet parents are expected to commit to a specific boy or girl based on a picture (one that’s sometimes months or even years old) and scanty records that are often poorly translated.
“With a lot of kids, especially the foreign adoptions, parents fall in love with a videotape,” says Valentino. “They don’t know they’re falling in love with a child who has been horribly sexually abused.”

Carol says the agency she worked with is a typical “do-gooder” agency whose best intentions for the child sometimes run roughshod over the families who adopt them. She understands their imperative to get families for needy kids.

“[The agency] thinks it’s better to get the child out of the country and then you can deal with whatever the child’s problems are. But they are so unrealistic,” she says. “You get the child, but you can’t get services for the child. I know of at least five disruptions that have happened from this agency in a three-year time span because the kids are traumatized and the orphanage is crap. But the agency doesn’t care. Their intention is good, but they don’t have any idea what they’re doing.””

Unrealistic Expectations and Lack of Support Services

“Laura (not her real name) is a licensed professional counselor in the Midwest working with a legal practice that specializes in adoption. The practice gets a lot of criticism, Laura says, because their services include helping parents terminate adoptions and supervise “re-placements”; she asked that I not use her real name or identify the practice.

While Laura and her husband make their living in part because some adoptive families fall apart, she is sharply critical of the parents who use their services. Laura told me in an e-mail interview, “There should be nothing a child does that would cause a parent to ‘get rid of them.’ There are millions of biological kids out there making bad choices and their parents never get rid of them.”

Laura is making the same assumptions that most of us laypeople make. In fact, some parents do “get rid of” their biological children and for the same reasons that they send their adopted kids away. According to the U.S. General Accounting Office (the GAO is the investigative arm of Congress), in 2001, more than 12,700 children were deliberately placed in the child welfare and juvenile justice systems. Most of them have a diagnosed mental illness. While the GAO report didn’t differentiate between adopted kids and kids living with their biological parents, it’s clear that parents who can’t help their children sometimes give them away to someone that they hope will. Addressing the report, the National Alliance for the Mentally Ill, a grass-roots advocacy organization based in Arlington, Virginia, wrote that families are forced to give up custody of their children when they cannot handle their behavior and when they have run out of resources.

While Laura is critical of families who seek her practice’s services, she does agree that support and education is vital for success. “Sadly, love and commitment can be conditional with adoptive parents,” she says. “Many of the families were not prepared properly, or did not receive accurate information about the child to make an educated decision to adopt. Also, they may not have had the right motivations to adopt or they do not have realistic expectations of the child.””

What is “normal” for these children?

“It’s easy to pathologize children who have experienced trauma and loss, to focus on the stories of Russian children gone bad and foster-care kids who become violent. Social worker Kim, however, says it’s vital to understand that a deprived environment shapes children. Like Tiruba, the parents who are able to successfully parent challenging kids can see the person behind the behaviors and are able to adjust their expectations.

“We do have to recognize that for most kids who have had multiple placements there is tremendous loss and there are tremendous survival skills that these children have developed. They wouldn’t have survived without these,” she says. “Unfortunately when we try to place them in an adoptive home and their parents have this expectation that they can relax and be normal, well, we need to reconceptualize this idea of what a normal child is.”

Citing her work with parents adopting from foster care, Kim says that parents need to be given a “safety plan” before their children come home detailing who they will call if they need help and what services exist in their area. She also recommends that parents connect with a knowledgeable therapist ahead of time so they aren’t searching for an appropriate counselor post-placement when they may already be overwhelmed.”

Lack of Resources for Severe Behavioral Disabilities

One myth we would like to put to rest today is that insurance covers mental disabilities and therefore no PAP or AP should give a second thought to this. Biological families face the same issues.

“Even though similar sentiments can be heard in statehouses nationwide, Illinois fares particularly poorly caring for its residents with disabilities, advocacy groups say.

In its 2011 state analysis, United Cerebral Palsy ranked Illinois 48th for providing services. By comparison, Michigan is third, Minnesota 14th and Wisconsin 20th. The University of Colorado’s Coleman Institute of Cognitive Disorders also puts Illinois near the bottom for funding autism spectrum disorders, while the National Alliance on Mental Illness gives Illinois a D.”

Two stories

“Last year, a residential school in Quincy in western Illinois discharged emotionally disturbed students with Individual Care Grants because the state had not paid their bills. Rather than allow Tim to suffer a similar fate, the family is prepared to leave Barrington and establish residency in Wisconsin, where the pockets are perceived as deeper.

“He has achieved stability for the first time since age 4,” Hickey said. “With supports, he can be a productive member of society. Without it, he’s a threat.”

Patrice Evans also looked north for answers. When her son was diagnosed with autism before his 3rd birthday, her clinician delivered this sobering pronouncement: If your child isn’t effectively communicating by age 5, he never will.

“I hung up that phone and a week later, our house was on the market,” said the mother of three boys.

By relocating from Grayslake to Kenosha in 2006, Geoffrey, now age 7, could qualify for three years of intensive therapy. “He’s made tremendous gains. … It’s a once-in-a-lifetime gift.”

In Grayslake, the same treatment would have cost the family at least $88,000 a year — none of it paid for by the state or health insurance. Perhaps that is why about one-third of the parents in the Kenosha-area autism support group are Illinois refugees, said Farrah Sonnenberg, Geoffrey’s service provider.”

“Charles Fox, a Northbrook special-education lawyer, cites the 75 percent unemployment rate among people with disabilities as just one example.

“We either pay on the front end … or we’ll take the blows in other ways.”

If you are adopting, are you willing to move to another state in order to get care for your child? This is something that adoption agencies will not be discussing with you. Prepare yourself and be open to what you may have to plan for.

Parents of disabled children giving up on Illinois
[Chicago Tribune 5/28/11 by Bonnie Miller Rubin and Monique Garcia]

REFORM Puzzle Piece