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Inter-country Adoption of Children with Special Needs:

Inter-country Adoption of Children with Special Needs: The Changing U.S. Experience and Best Practices. Context: Review of Inter-country Adoption (ICA) Trends to U.S. 1990 – 2009/10 Survey of U.S. ICA Agencies Children with Special Needs 2008 Service Needs and Best Practices.

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Inter-country Adoption of Children with Special Needs:

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  1. Inter-country Adoption of Children with Special Needs: The Changing U.S. Experience and Best Practices Context: Review of Inter-country Adoption (ICA) Trends to U.S. 1990 – 2009/10 Survey of U.S. ICA Agencies Children with Special Needs 2008 Service Needs and Best Practices

  2. # Placements to U.S. Korea Romania Peak w/Kaz/Ukr Ethiopia Guatemala Viet/Camb Russia China

  3. Country of Origin Trends of Inter-country Adoption to the U.S. 1990-2010 Adoptions to the U.S. UKR/KAZ

  4. Volatility • Crisis “mix” in all countries separation of parents: • Institutionalization: CIS/CEE • Abandonment: China • Stigma: Korea • Extreme poverty/health: Guatemala and Ethiopia • “Market” forces & lack of safeguards • Closures: : Romania, Vietnam, Guatemala • Slowdowns, Greater Restrictions: everywhere • Changing socio-economic/cultural, & child welfare trends/policies • Not necessarily = less institutionalization

  5. Definition of Children with Special Needs in Adoption Practice The degree of difficulty in finding a capable permanent family; “wait time” UNCRPD: l/t impairments in interaction with barriers, hinder participation with society on equal basis Factors include: • Heath • Quality of Information • Processing times • Age • Gender • $ ?

  6. Gender of Inter-country Adoptees to U.S. 2004 & 2009 65% +6500 # Placements to U.S. 56% +1660 8070 7221 35% 44%

  7. Gender for Select Countries of Inter-country Adoptees to U.S. 2004 & 2009 Adoptions to U.S.

  8. Gender Analysis Recent Trends 2004 & 2009 Preference in adoption for females in adoption, boys wait longer Greater availability of females in the adoption process (exception Korea) Ratio of females adopted drops from 65% to 55% (China) Relative improvement for males China: nearly double (94% growth) Ethiopia: 50/50 More females adopted in country of origin Adopting families in receiving countries must be open to either gender

  9. Age of Inter-country Adoptees to U.S. 2004 & 2009 # ICA Placements 23% 2994 52% 6580 40% 9195 25% 3208

  10. Age for Select Countries of Inter-country Adoption 2004 &2009 Adoptions to U.S.

  11. Age Analysis Recent Trends: 2004 & 2009 • Preference for younger children, infants • Availability: Biggest drop >1 years: 65%; • 1-4 years = 35% drop • Greater % older children in ICA • >5 years: 15% to 23%, 2008 = 2009 • (approx. 2700 adoptions) • + Younger children being adopt in co’s of origin • + Less market forces (Guatemala, Vietnam) • + Ukraine 5> : doubled to 457 adoptions • + China 5>: more than doubled to 367 • + Ethiopia 5>: largest with 536 • + Top 25: 19 have grown in absolute #s for >5 • since 2004 • - Children’s “wait times” growing (China, Kor) • Russia: far fewer 5> - 78% • Closures: adverse impact on older & other • children with special needs

  12. Inter-country Adoption: Children with Special Needs SurveyJoint Council for International Children’s Services: 25 AgenciesICA placements for agencies= 4,736, or 28% of all ICA to the U.S. in 2008 Definitions of Children with Minor Special Needs A condition that does not necessarily significantly impair the child’s functioning, such as • small holes in the heart, heart murmurs • low birth weight, prematurity • Hep B carrier • missing or extra digits • Strabismus Conditions effectively controlled by medication Definitions of Children with Moderate to Major Special Needs • Conditions requiring intensive treatment for a period of years during childhood • Conditions requiring life-long management • Conditions prohibiting the child from living independently as an adult

  13. Special Needs Minor to Major 15 countries = 20% or more ICA placements, including… China 59% Haiti 45% India 29% Korea 27% Vietnam 25% Russia* 25% Kazakhstan 24% (U.S. 21%) Overall % for inter-country adoption is approximately 29% Moderate to Major Special Needs 13 countries = 10% or more ICA placements, including … China 43% India 22% Haiti 20% Korea 15% Russia* 15% Vietnam 13% (U.S. 13%) Overall % for inter-country adoption is 18% CIS countries Average age of 4 at placement, longitudinal study over 4 years, 82% had at least one “disability” relating to communication or learning, 42% ADHD Source: Beverly, et.al. (2008) Language, Speech, & Hearing Services in Schools

  14. Services to Children with Special Needs Agencies (varied capacities, reduction) Hague accreditation: social workers, pre-adoption training 36 specialized ICA clinics relating to inter-country adoption in 22 states Pre adoption assessment of information Post adoption service Adoption and fostering a specialty in AAP Web-based resources Adoptive Family Associations EEAC,PNPIC,FCC,FRUA,LAPA & Adoptee orgs Insurance and government gaps

  15. Studies on ICA: health, development and behavior • “…IA children are at risk, and a significant minority experience long-term difficulties in one or more domains.” • “ research documented impressive recovery and resilience in IA children, even those adopted at later ages from extremely deprived institutional backgrounds.” J.A. Welsh, et. Al. • Interventions for Internationally Adopted Children and Families: • A Review of the Literature Child and Adolescent Social Work Journal, June 2007 • Critical factors • Poverty, social disorganization, trauma, • institutionalization, cultural change, disability • Age at adoption • Type of care received prior to adoption • Length of time in care

  16. Major Challenges Cultural differences Child protection systems and capacities Child development assessments Access & reporting Pre-adoption preparation and training Post-adoption support network in receiving countries Care and training continuum in COOs and RC’s Coordinated interdisciplinary approach in receiving countries (esp. behavioral) Inter-country adoption instability

  17. Best Practices for Quality Care of Children with Special Needs Benefitting from Adoption • UNCRPD: social vs medical model, rights approach • Such as inclusion and access • Hague Convention key principles: • “Subsidiary” principle • Information: Transparent and Accurate • (pre-adoption info vital) • Accredited and trained service providers • (considerable post adoption capacities) • Home study and plan, follow-up • Culture • Early Intervention and appropriate care models • Confidentiality incl respectful family recruitment • Consent and opinion of children, youth, adoptees • Continuum of care plan, common training • Multi/interdisciplinary services approach (ed, medical, social services) • Efficient/effective processing and matching

  18. Conclusions ICA to U.S: important and significant for children with special needs Massive ICA drop: less impact on children with special needs, however adverse impact with country closure Age: older = greater special needs, greater %s Gender: %’s improving for males Child protection system development in countries of origin Greater integrated support in receiving countries

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