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Ask the Mental Health Expert Archives 2001-2004

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Transition to a New Home

Q. I am a CASA (Court Appointed Special Advocate) worker, and my current "client" is an infant of 12 months. She has been in the care of a foster mother/family for the last 11 months, and is happy, and developing normally.

At this time the court must make the decision to leave the child with the foster family who wishes to adopt her, or to transfer her care to a maternal aunt, with whom she is unacquainted.

The aunt has spent little time with the infant, under supervised visit policies, although the interaction between the two has been appropriate.

What "harm" may be experienced by the infant with this proposed separation, which will result with the adoption by the maternal aunt & family, and is this a reversible upsetment? What symptoms might the child exhibit? and how does one appropriately respond to these difficulties?

A. That's a very tough question, based on the research literature on adoption, and even tougher when it comes to the particular child in question. A good deal may depend on the quality and nurturance of the proposed adoptive home.

But -- to back up a bit. It's certainly true that for a one-year old child, making a transition to a new (adoptive) home will present some significant emotional and psychological challenges, and may lead to some initial emotional or behavioral difficulties -- though previous contacts with the adoptive parent may mitigate some of these adjustment difficulties. The research on this subject is mixed.

In one study (Brand & Brinich, J Child Psychol Psychiatry 1999;40:121-9), results suggested that adopted and foster children were more likely to have mental health contacts than non-adopted children. However, the vast majority of adopted children showed patterns of behavioral problems similar to those of non-adopted children.

Another study (Smyer et al, Psychiatry 1998;61:191-205) examined 60 pairs of twins who were separated and reared apart. Few significant effects of adoption on the adult adjustment of the adoptees were found. The authors concluded that "the stress of adoption itself is mediated by the type of rearing environment provided by the adoption process." So, while I can't make predictions about the child in question, it's fair to say that in general, if the adoptive home is stable, nurturing, and permanent, most children adopted at age one will probably not show major psychological problems as a result of the adoption per se.

If problems do arise, they would best be dealt with via a referral to a mental health professional with expertise in childhood adjustment disorders.

March 2002

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