Older children (older at removal) experience more delays with adoption, and in the foster care system in general, than do infants and toddlers.

Male children wait longer in foster care than female children.

African-American children experience more delays in timely adoption than other children.

Medium level of evidence

One large, longitudinal multi-state study indicates that the exit rate to adoption for African American children was .64 of the rate for white children.

Sibling groups have been identified as high risk for nonadoption. However, in two studies, siblings who are together in the system experience fewer delays to adoption.

In a study of placement outcomes for 3,873 children, those under the age of one at removal were most likely to be adopted (32%). Children between one and two were reunified (60%) more often and adopted (12%) less often. Children between three and five were more likely achieve permanency through reunification than adoption.

Data analyses. Compare adoption rates (either by using a data reporting system or by reviewing cases) for:

• Very young children (0-3), young children (5-12), and older children (12-18).
• White children and children of color (make a combined variable). Then compare African American, Native American, Asian American, Hispanic/Latino, and White children, respectively.
• Male children vs. female children.

Agency culture. Assess agency culture around adoption. Do some staff still consider physically or emotionally disabled children, older children, sibling groups, or African American children unadoptable? Additionally, what criteria are being used to assess adoptive family suitability? Foster families, gay and lesbian parents, racially different parents, older parents, working class parents, and single parents should not be categorically dismissed as unsuitable parents. Increase staff recruitment and placement training if necessary.

Recruitment. If not already established, create formal interagency coordinating mechanisms with other adoption agencies to facilitate "special needs" adoptions. Collaborate with community groups in the African American community (and other communities in which there are hard-to-place children). To read about a successful program, go to: http://www.onechurchonechild.org. If possible, create specialized adoption programs tailored to the needs of your hardest-to-adopt populations. Full-time media/marketing positions in the agency have been associated with more successful recruitment campaigns.

Best workers. Identify workers who show success facilitating hard-to-adopt children. Have them join an advisory group to improve adoption outcomes for these children and their families.

Fost-Adopt. Foster care adoptions, while still controversial among some practitioners, are becoming more common, especially for older child adoptions. Outcomes are as positive as non fost-adoptions, and fost-adoptions are less likely to disrupt than non-foster care adoptions.

High level of evidence

Disabled children experience more delays in adoption than non-disabled children. The more severe the disability, or the greater the number of disabilities, the longer the wait.

Medium level of evidence

Delays in the adoption of children with disabilities have been linked to caseworker attitudes about the adoptability of children or the suitability of certain adoptive parents.

One study found that agencies that provided workers with assistance in recruitment and placement training were more successful in placing hard-to-place children.

A study of 147 children found that the presence of emotional problems and developmental delays predicted long term foster care as the most likely permanency goal, while children with medical or physical disabilities were more likely to have adoption as their permanency goal.

Data analysis. Run data analyses comparing rates of timely adoption for:

• children with identified disabilities and children with none;
• children by type of disability

Training. Ensure that staff members have adequate training and understand the various types of disabilities children face and the services they and their families need. Some of these include:

• specialized health care for physical disabilities
• educational testing to diagnose and treat learning disabilities
• special education advocates to ensure that children receive appropriate, timely IEPs and other educational services
• mental health treatment for emotional and behavioral issues
• behavioral assistants to help parents reinforce new behaviors
• respite services for parents
• support groups for children and parents of children with similar disabilities.

Support Groups. http://www.adoptionsolutions.com is a website with listings of area contacts for peer-led adoptive family support groups. Adoptive Families magazine also has support group listings. Go to: http://www.adoptivefamilies.com/.

Consult. Work with disability advocacy groups to understand how to better facilitate permanent, timely placements for these children. A clearinghouse website for issues affecting children with special health care needs can be found at: http://www.ncemch.org/CSHCN/Parent.htm.

Other selected web resources:

• The Beach Center on Disability: http://www.beachcenter.org/
• Parents Helping Parents: Helping Children with Special Needs: http://www.php.com/
• Family Resource Center on Disabilities: http://www.ameritech.net/users/frcdptiil/index.html
• Family Voices: http://www.familyvoices.org/
• Parent Educational Advocacy Training Center: http://www.peatc.org/
• Children with Disabilities: http://www.childrenwithdisabilities.ncjrs.org/
• National Information Center for Children with Disabilities: http://www.nichcy.org/
  

Research has shown that children who enter care for non-abuse and non-neglect reasons are more likely to be adopted in a timely manner.

Medium level of evidence

In a study of New York's hardest to place children, 54.4% entered the system for neglect, 34% for abuse, 18.2% for multiple forms of abuse, and 9.1% for parents' inability to care for them.

Another study found that 83% of children who were adopted in less than two years had no history of abuse or neglect and 82.5% of children in foster care for more than two years did have a history of abuse or neglect.

Case review. Do a case review of randomly selected cases to determine:

1. if children without a history of abuse and neglect experience timelier adoptions;
2. the factors contributing to children with abuse and neglect histories experiencing delays in placement (staff attitude, lack of treatment foster care placements, etc.); and
3. which types of abuse or neglect cause children to experience the greatest delays.

Target services to these groups to improve adoption rates.

Prompt appropriate treatment. Ensure that children entering care with either neglect or abuse histories receive prompt, appropriate treatment for trauma issues. Foster care placement can increase posttraumatic stress symptoms, particularly if the child has no control over his or her fate or surroundings.

Treatment foster care. To maintain an adequate number of trained, treatment foster care families, allocate sufficient funds for a comprehensive treatment foster care program or contract with local agencies who provide treatment foster care. Children with severe abuse and neglect histories should be placed with parents who understand neglect, post traumatic stress, and trauma reenactment symptoms and who can manage these symptoms without resorting to punitive parenting styles or disrupted placements.

Staff and parent training. Make sure that staff and foster or adoptive parents understand symptoms of posttraumatic stress (including identification with the aggressor and trauma reenactment). Staff must understand the child's symptoms sufficiently to explain to foster parents why the child reacts to certain things, people the way s/he does. Foster and adoptive parents need to be given a clear, realistic idea of a child's potential behavior from the very beginning of the placement to avoid further stigmatizing the child. Some behaviors may be very difficult for staff to talk about and for parents to manage (children acting out sexually with other children, for example). Children with these behaviors may need specialized treatment. Ensure that staff can facilitate the most appropriate referrals, treatments, and placements based on an understanding of the child's mental health needs.

Appropriate resources. Work with local mental health providers to ensure that adequate, appropriate services are available in the community once the child has been placed.

In a large study of 2238 adoptive families, adoptive parent ethnicity was strongly correlated with timely adoption. Adoptions by white parents (of both white and nonwhite children) were finalized more quickly than those of nonwhite adoptive parents.

Medium level of evidence

In a study of 302 adoptive families of special needs children, more children in the home, participation in religious activities, and less-educated fathers were associated with higher adoptive family functioning. Minority families who adopted minority children also had higher family functioning.

The income of adoptive parents has been found to be negatively associated with intact adoptions. Thus, the lower the income, the more intact the adoption.

Single parents have better than average success rates with children who are nine or older when adopted.

Parents with very high expectations may be less likely to succeed with older children who have learning disabilities.

Assertive Action. Two researchers whose study confirmed the well-known disparity between timely adoption rates of African American children and white children in a Colorado Expedited Permanency Program suggest an "assertive" stance for front-line workers, supervisors, and managers with regard to racial/ethnic disparities in practice, including disparities in time to legalization for white vs. nonwhite adoptive parents:

"At the direct services front-line level, these findings point to a strong need for assertive social work practitioners who are fully aware of the trend and prepared to implement steps to overcome potential time lags for African American children from the onset of the case. At the management level, the findings also underscore the need for honest conversation leading to strategic interventions at many points in the child welfare system." (Potter and Klein-Rothschild, 2002, 145.)

Race and Socioeconomic Status. Conduct data analyses in your agency (or present available research from other studies to staff) on adoption outcomes by income, race, etc. to dispel myths about the suitability of only white, middle class parents (if these myths exist).

Expectations. Supervisors and managers should encourage workers to communicate openly with adoptive parents about potential difficulties in managing their child's learning disabilities, problematic behavior, and/or emotional problems resulting from trauma (sexual, physical, emotional abuse) or loss. Parents may need to adjust their expectations and be more realistic about parenting roles and definitions of ultimate success in the placement. Parents who adopt children with special needs may need to come to terms with the potential that their adopted child may not be capable of forming a strong attachment. Also, home life may not be characterized by harmonious relationships or warm, mutual affection. Also, some children may need to be in more structured environments during periods of their childhood and adolescents. According to the North American Council on Adoptable Children, if adoptive parents can provide stability, consistency, advocacy for the child's needs, and reliability, they should be considered highly successful.

There is increasing evidence that three months is an insufficient period of time to provide post-placement services.

Medium level of evidence

Research suggests that post-placement services need to be provided for at least 6 months following placement.

One study found families struggling with the possibility of disruption an average of 9 years after finalization, evidence that post-placement and legalization services are crucial for maintaining placement stability.

The precipitants of adoption disruption include: assault, running away, and noncompliance of latency and adolescent children. Mechanisms must be established for dealing with the potential of disruption in the high-risk adolescent years.

One study found that parent satisfaction with adoption reaches its low point during the years from 12 to 18., confirming this need.

In one study, case-workers said that respite services, intensive parent training, post-placement services, more effective recruitment techniques, higher subsides, better interagency cooperation, better staff training,& better photolisting would improve adoption rates.

Pre- and Post-Placement Services: To insure both timely and permanent adoptions, pre- and post-placement services are needed.

1. Workers should take an open approach to matching children and parents.
2. Workers need to provide accurate information-preferably in a group format-for families before they accept children in their homes.
3. Help adoptive families develop expectations so they are not wildly beyond what their adopted children can meet.
4. After the adoption is finalized, the agency should maintain close contact with the family for at least six months to insure continuity.
5. Subsidies should be provided to parents.

For more info on post-adoption services go to: http://www.calib.com/naic/parents/post.cfm

Adolescent Years. Services should be provided to high-risk placements throughout adolescent years, when disruption potentials are highest.

Post-legal Services. The North American Council on Adoptable Children (1984) issued this list of post-legal services to be provided in the year following legalization:

1. individual and family counseling;
2. intermediary in legal matters;
3. workshops on topics such as transracial and intercountry adoptions;
4. support groups;
5. classes;
6. retreats;
7. social events;
8. intermediary in "adoption triad" matters, such as specifics of visitation;
9. professional consultation;
10. information;
11. films and other materials for distribution;
12. research on evaluation of services as well as other postlegal concerns.

A caution: Monies for post-placement adoptive services, recruitment, and family preservation services are pooled under ASFA. Careful assessments should be made to determine if one program is being given short shrift. High adoption rates may come at the expense of low reunification rates. Likewise, money should not be given to post-adoption services at the expense of recruitment.

In a national study, the characteristics of the most successful agencies for hard-to-adopt children were: commitment to adoption of hard-to-place children at all levels within the agency, and adoption supervisors who ensure that their workers are staying on top of the adoption case plan.

Two studies identified caseworker attitudes as fundamentally determining timely adoption. When caseworkers held negative attitudes about the adoptability of some children, these children tended to experience delays in their placement.

Medium level of evidence

In a study of minority families who had adopted or applied to adopt foster children, participants reported that they were made to feel uncomfortable because of their race. Almost half reported that caseworker attitudes were "too white middle class."

In a study of caseworker attitudes in New York state, 44% of caseworkers regarded placement with gay/lesbian couples as inappropriate, 41% thought homes with other children inappropriate; 42% thought transracial adoptions inappropriate; and 35% regarded single-parent homes to be inappropriate.

100% Adoptability. Create a culture in which all children are regarded as adoptable until proven otherwise. Establish this clearly among management and supervisors. Ensure that front-line staff are getting this message by instituting adoption case plan reviews and team or individual case reviews.

Reward Success. Identify and reward workers who consistently facilitate hard-to-place adoptions. Have these workers serve on a committee to improve worker training.

Placement Training. Ensure that caseworkers have adequate training (on developmental, learning, physical and behavioral disabilities) to accurately assess a child's functioning and needs and to connect adoptive parents with appropriate resources to manage problem behaviors, etc.

Cultural Competence. Assess your agency's level of cultural competence. Go to this website for agency assessment resources:
http://ojjdp.ncjrs.org/Safefutures/culturalprof.html

Language Barriers. How many children/families served by your agency speak Spanish or another language as their first language? Where there are large numbers of non-English clients, take measures to insure that your agency has enough workers who speak this language. Language competence will assist with recruitment as well as both inracial and transracial adoptions.

Recruitment Training.

• Meet with all staff to brainstorm ways to increase the pool of recruitment strategies.
• Discuss attitudinal barriers to adoption recruitment.
• Make known the recruitment strategies you expect workers to utilize for hard-to-place children.
• Share information that single parents, gay and lesbian parents, older parents, and parents with other children have all been shown to provide quality parenting and positive outcomes. See Pecora, et al., 2000 for a comprehensive review.
• For a bibliography on transracial adoption, click here
• Communicate that using the characteristics of ethnicity, sexual orientation, and marital status as evaluative criteria in adoption screenings for children with no other resources violates both the Multi Ethnic Placement Act and the Adoption and Safe Families Act.
  

Caseworkers with a social work education and more experience tend to facilitate more timely permanence for the families they serve.

In one study, adoption workers without a social work degree (BSW or MSW) were less effective in achieving timely permanence for children because they lacked the knowledge and resources required to coordinate services and connect families with needed resources.

In another study, researchers found that the more caseworkers a child had, the less likely that child would achieve timely permanence.

Staff recruitment and retention. Increase recruitment and retention of highly trained workers to avoid high turnover rates. Advertise jobs accurately-with detailed job descriptions. Provide supportive supervision. Allow workers' maximum autonomy and decision-making authority whenever possible. Recognize good performance. Workers with BSW or MSW degrees report greater job satisfaction and have lower attrition rates.

Reorganize infrastructure. If possible, restructure service delivery at the agency, county, or state level to provide the greatest continuity

Organize. Organize to oppose ongoing state efforts to deprofessionalize the child welfare labor force.

Improve morale. Work to improve the respect accorded workers at all public interfaces by educating media, courts, and other professionals about positive outcomes.

Group supervision. Insist on regular group/team supervision to maintain professional development and morale.

Specialization in recruitment within larger agencies was an important contributor to successful adoption rates in one study. This specialization included full-time media/marketing persons to organize and carry out recruitment campaigns.

A significant barrier to adoption at the agency level is inadequate recruitment efforts (especially for minority adoptive parents) and unwillingness to place children transracially.

Examine Adoption Recruitment. Identify recruitment needs and obstacles to recruitment. How does recruitment currently take place in your agency? Are there full-time positions devoted to adoption campaigns? Can there be? Are workers following through on recruitment strategies already in place? Does your agency need to work with community groups (such as in the One Church, One Child program, now in 20 states)? Could you partner with community groups to start a new program for hard-to-adopt children? For more ideas:

• http://www.calib.com/naic/index.cfm
• http://www.nacac.org/recruitingfamilies.html

Increase Transracial Adoptions. Trans or cross-racial adoptions have not been found to be detrimental to children, especially when cultural needs are taken into account early in adoption planning. Assess agency barriers to these adoptions and work to change policy, procedure, and culture in your agency to ensure that more waiting children have timelier permanency (keeping in mind the cultural needs of the child at all points in the process and connecting the child and adoptive parents to appropriate resources).

Medium level of evidence

One reason often given for the delay in placements of African American children is lack of prospective adoptive parents. However, one study found that when family composition, income, and age are controlled for, African American families adopt at four times the rate of Caucasian families.

Targeted Recruitment. According to several studies, targeted recruitment for children with special needs is effective. Public and private agencies may have been hesitant to create or use specialized minority adoption recruitment programs, but there is evidence that specialized programs are more likely to make successful adoptive placements for African American children then traditional programs. One possible step to improve adoption outcomes is to increase targeted recruitment efforts for children with special needs among minority families and other potential adoptive parents. Some resources:

• http://www.calib.com/naic/faqs/five.cfm
• http://www.nacac.org/recruitingfamilies.html

Media, Websites, Adoption Fairs. Use these recruitment techniques to present specific children who are awaiting adoption.

High level of evidence

A lack of community resources available to foster and adoptive parents lengthened the time children waited for a permanent placement.

Collaboration. Work to improve relationships with other providers in the community.

Grant writing. Partner with other agencies to garner funding and resources.

Demonstration programs. Develop innovative service delivery and program strategies and utilize Title IV-E waivers to fund them. Read about respite care demonstration programs for adoptive parents of children with special needs:

• http://www.calib.com/naic/pubs/h_respite.cfm

Lobby. Support local, state, and national advocacy organizations (like the Child Welfare League of America) in making social service funding a priority.

Cost effectiveness. Demonstrate the overall cost effectiveness of providing adoption resources to families by showing the cost offsets of prison, long-term health or congregate mental health care, etc. States serious about adoptions could increase subsidies to adoptive parents.

Medium level of evidence

Cases with timely court hearings (i.e. less time between filing the petition and adjudication) were more likely to achieve timely permanence than cases without that characteristic.

Collaborate. Work with judges to facilitate more timely adoptions. Work to have more judges hired if necessary