Adoption: An overview
- Elaine E Schulte, MD, MPH
Elaine E Schulte, MD, MPH
- Department of General Pediatrics, Cleveland Clinic Children’s
- Professor of Pediatrics, Cleveland Clinic
- Lerner School of Medicine
Many couples or individuals create or expand their families through adoption. Families may seek to adopt because of infertility, fetal loss, death of a child, or desire for more children. Pediatric health care providers may provide preadoption counseling to prospective adoptive parents, evaluate children after adoption, and/or provide ongoing care to adoptees.
This topic provides a general overview of adoption within the United States and describes the potential role of the primary care provider as an advocate for adopted children and their families. The recommendations below are largely consistent with those of the American Academy of Pediatrics Committee on Early Childhood and Council on Foster Care, Adoption, and Kinship Care [1,2]. Specific infectious disease and immunization considerations in children adopted from outside the United States are discussed separately. (See "International adoption: Infectious disease aspects" and "International adoption: Immunization considerations".)
General terms — General terms that are used commonly in adoption are defined below :
●Adoption – A legal (formal) mechanism that allows full family membership and privileges to children who were not born into the family .
Informal adoption occurs when the birth mother allows another person to take parental responsibility for her child without obtaining legal approval or recognition of that relationship.
- Jones VF, Schulte EE, Committee on Early Childhood, Council on Foster Care, Adoption, and Kinship Care. The pediatrician's role in supporting adoptive families. Pediatrics 2012; 130:e1040.
- Jones VF, Committee On Early Childhood, Adoption, And Dependent Care. Comprehensive health evaluation of the newly adopted child. Pediatrics 2012; 129:e214.
- Child Welfare Information Gateway Glossary. https://www.childwelfare.gov/glossary/glossarya/ (Accessed on August 04, 2016).
- Adoption Medicine: Caring for Children and Families, Mason PW, Johnson DE, Albers Prock L. (Eds), American Academy of Pediatrics Council on Foster Care, Adoption, and Kinship Care, 2014.
- American Academy of Pediatrics (AAP). Council on Foster Care, Adoption, & Kinship Care. http://www2.aap.org/sections/adoption/directory/map-adoption.cfm (Accessed on July 27, 2016).
- National Adoption Center: Open Records. Pediatrics 2014.
- Child Welfare Information Gateway. How to adopt. https://www.childwelfare.gov/topics/adoption/adoptive/ (Accessed on August 23, 2016).
- Bramlett MD, Radel LF. Commentary: Research possibilities using the national survey of adoptive parents. Adopt Q 2010; 13:292.
- Grotevant HD, Wrobel GM, Von Korff L, et al. Many Faces of Openness in Adoption: Perspectives of Adopted Adolescents and Their Parents. Adopt Q 2008; 10:79.
- US Department of Health and Human Services. The National Survey of Adoptive Parents (NSAP). Available at: http://aspe.hhs.gov/hsp/09/NSAP/index.shtml (Accessed on July 27, 2016).
- Vandivere S, Malm K, Radel L. Race, ethnicity, and gender. In: Adoption USA: A Chartbook Based on the 2007 National Survey of Adoptive Parents, The US Department of Health and Human Services, Washington, DC 2009. p.13.
- Brodzinsky D. The modern adoptive families study: An introduction. The Donaldson Adoption Institute. September 2015. http://www.adoptioninstitute.org/publications/the-modern-adoptive-families-study-an-introduction/ (Accessed on August 02, 2016).
- US Department of Health & Human Services. Children's Bureau. Adoption & Foster Care Statistics. http://www.acf.hhs.gov/cb/research-data-technology/statistics-research/afcars (Accessed on August 03, 2016).
- Administration for Children, Youth and Families. Office of Data, Analysis, Research and Evaluation. Recent Demographic Trends in Foster Care. www.acf.hhs.gov/sites/default/files/cb/data_brief_foster_care_trends1.pdf (Accessed on October 20, 2015).
- McKenzie JK. Adoption of children with special needs. Future Child 1993; 3:62.
- Rosenthal JA. Outcomes of adoption of children with special needs. Future Child 1993; 3:77.
- Child Welfare Information Gateway. Trends in US adoptions: 2008-2012. https://www.childwelfare.gov/topics/systemwide/statistics/adoption/ (Accessed on August 23, 2016).
- Bramlett MD, Radel LF. Adopted children wth special health care needs: Characteristics, health, and health care by adoption type. ASPE Research Brief. US Department of Health and Human Services. Washington DC, 2008. https://aspe.hhs.gov/report/adopted-children-special-health-care-needs-characteristics-health-and-health-care-adoption-type (Accessed on August 04, 2016).
- Bramlett MD, Radel LF, Blumberg SJ. The health and well-being of adopted children. Pediatrics 2007; 119 Suppl 1:S54.
- Bryant CA. Nursing the adopted infant. J Am Board Fam Med 2006; 19:374.
- Wittig SL, Spatz DL. Induced lactation: gaining a better understanding. MCN Am J Matern Child Nurs 2008; 33:76.
- American Academy of Pediatrics. Medical evaluation for infectious diseases for internationally adopted, refugee, and immigrant children. In: Red Book: 2015 Report of the Committee on Infectious Diseases, 30th ed, Kimberlin DW, Brady MT, Jackson MA, Long SS (Eds), American Academy of Pediatrics, Elk Grove Village, IL 2015. p.194.
- Hagen JF, Shaw JS, Duncan PM. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed, American Academy of Pediatrics, Elk Grove Village, IL 2008.
- American Academy of Pediatrics (AAP). Healthy Foster Care America. Available at: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-foster-care-america/Pages/default.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token (Accessed on July 29, 2016).
- Juffer F, van Ijzendoorn MH. Behavior problems and mental health referrals of international adoptees: a meta-analysis. JAMA 2005; 293:2501.
- Weitzman C, Albers L. Long-term developmental, behavioral, and attachment outcomes after international adoption. Pediatr Clin North Am 2005; 52:1395.
- Szilagyi MA, Rosen DS, Rubin D, et al. Health Care Issues for Children and Adolescents in Foster Care and Kinship Care. Pediatrics 2015; 136:e1142.
- Jellinek MS, Murphy JM, Burns BJ. Brief psychosocial screening in outpatient pediatric practice. J Pediatr 1986; 109:371.
- Briggs-Gowan MJ, Carter AS. Social-emotional screening status in early childhood predicts elementary school outcomes. Pediatrics 2008; 121:957.
- Squires J, Bricker D, Twombly E. Ages and Stages Questionnaire: Social-Emotional, 2nd ed, Brookes Publishing, Inc, Baltimore, MD 2004. Available at: http://www.brookespublishing.com/resource-center/screening-and-assessment/asq/asq-se-2/ (Accessed on June 08, 2010).
- Brodzinsky DM, Singer LM, Braff AM. Children's understanding of adoption. Child Dev 1984; 55:869.
- Hersov L. The Seventh Jack Tizard Memorial Lecture. Aspects of adoption. J Child Psychol Psychiatry 1990; 31:493.
- Schwartz EM. Problems after adoption: some guidelines for pediatrician involvement. J Pediatr 1975; 87:991.
- Nickman SL, Rosenfeld AA, Fine P, et al. Children in adoptive families: overview and update. J Am Acad Child Adolesc Psychiatry 2005; 44:987.
- Harwood R, Feng X, Yu S. Preadoption adversities and postadoption mediators of mental health and school outcomes among international, foster, and private adoptees in the United States. J Fam Psychol 2013; 27:409.
- General terms
- Types of adoption
- MEDICAL EVALUATION
- - Medical evaluation
- - Early adjustment issues
- - Other mental health issues
- - Developmental delay
- - Special-needs children
- DEVELOPMENTAL STAGES OF ADOPTION
- COMMUNICATING ABOUT ADOPTION
- LONG-TERM DEVELOPMENTAL AND BEHAVIORAL OUTCOMES
- INDICATIONS FOR REFERRAL