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The Fate of the Adopted Child SULA WOLFF from the Department of Psychological Medicine, Royal Hospital for Sick Children, Edinburgh

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The Fate of the Adopted Child SULA WOLFF from the Department of Psychological Medicine, Royal Hospital for Sick Children, Edinburgh Arch Dis Child: first published as 10.1136/adc.49.3.165 on 1 March 1974. Downloaded from Review article Archives of Disease in Childhood, 1974, 49, 165. The fate of the adopted child SULA WOLFF From the Department of Psychological Medicine, Royal Hospital for Sick Children, Edinburgh Problems of adoption research far from shying away from such ventures, in fact Until quite recently adoption was considered to be revealed themselves as willing and interested such a delicate social transaction that outcome research subjects. studies were attempted only on self-selected Other difficulties in the interpretation and subjects. McWhinnie (1967), for example, studied usefulness of the results of adoption research then adults whom she recruited by asking general became apparent. These are twofold. First, as practitioners to canvas patients known by them to with all long-term longitudinal studies, the factors have been adopted. Clearly, not all adults on these found to determine outcome of adoption in people doctors' lists had revealed their adoptive status and who are now adults relate only to the circumstances certainly only a proportion of these in fact agreed to which existed when these particular people were take part in McWhinnie's study. The finding that children. Public attitudes to illegitimacy, family only 21 of the 58 people studied were well or fairly size, one-parent families, and to adoption are well adjusted at the time of follow-up may reflect the changing. The choice of whether or not to place a adverse effects of growing up adopted. It is more baby for adoption may be determined by quite likely, however, to be a measure of the personality different considerations now than 30 years ago. difficulties of that special group of adopted people The selection of adoptive children and of adoptive who were well known to their doctors because of parents, the quality of infant care before adoption, frequent surgery attendances, who chose to reveal and the procedures used in the adoption process may their adoptive status to their physician, and who, have changed radically in three decades. Studies of http://adc.bmj.com/ finally, were so involved still with this aspect of their the outcome of adoptions that took place in the lives as to volunteer to participate in adoption 1940s are unlikely to be really helpful in our decision research. Studies of selected samples of adopted making now. In contrast, outcome studies in people, e.g. comparisons between adopted and childhood have a great deal more to offer in terms of nonadopted attenders at child psychiatric clinics practical relevance, despite the fact that the ultinite (Borgatta and Fanshel, 1965), or in psychiatric future of the children studied remains uncharted. inpatient units for children and adults (Simon and A second difficulty in the interpretation of the Senturia, 1966), or studies of adopted people who findings of adoption research is that comparisons of on October 6, 2021 by guest. Protected copyright. chose to look up their birth certificates in order to adopted children with other children cannot control trace their true parents (Triseliotis, 1973), provide for the initial processes of selection, that is, the information only about selected aspects of adoption, self-selection of mothers who offer their babies for failing to give an overall picture of outcome. adoption and the selection of babies by adoption In Norway, where much personal information is societies. This is the chief difficulty in interpreting available for statistical purposes on a national basis, the results of the British Child Development study it was found that people adopted in the late 1930s which is a source of much information about the had had no more mental hospital admissions or future of illegitimate children (Crellin, Kellmer- criminal convictions 25 years later than the general Pringle, and West, 1971; Seglow, Kellmer-Pringle, population (Bratfos, Eitinger, and Tau, 1968). and Wedge, 1972). Perhaps as a result of changing public attitudes and The questions we would really like answered are also of the impetus to adoption research by research the following. First, when a mother has an workers who are themselves adoptive parents a illegitimate baby is it better for the baby to be number of personal follow-up studies of unselected adopted than for the mother to assume its care? adoptions have now been done. Adoptive parents, That is, is adoption better or worse than other forms 165 Arch Dis Child: first published as 10.1136/adc.49.3.165 on 1 March 1974. Downloaded from 166 Sula Wolff of child care for the illegitimate ? Secondly, there Three major studies have clarified this issue. is a group of questions relating to the adoption Helen Witmer and her associates in Florida (1963) process itself. Is there an optimal time for compared 484 adopted children with an equal adoption ? Do the circumstances of pre-adoption number of nonadopted. Only a very slight care matter ? What features in the baby and in the difference in emotional adjustment was found prospective adopters make for success? What between the two groups, and this was entirely due to procedures in the adoption process itself promote or an excess of psychiatric disorder among children hinder a good outcome? placed in their adoptive homes after the age of 1 month, especially if adoption had been preceeded by a period of institutional care or by multiple place- Emotional and educational adjustment of ments. Overall, 80% of adoptions were entirely adopted children satisfactory. The suggestion that adopted children as a group Michael Bohman (1970) studied 168 10- and may be more disturbed psychiatrically than other 11-year-old children in Stockholm placed through children came from the findings in Britain and the main public adoption agency with nonrelatives. America that among child guidance clinic attenders He compared these children and their families with a many more children are adopted (between 5 and representative sample of Stockholm schoolchildren 13%) than in the population at large (generally of the same age studied a few years earlier by using between 1 and 2%) (Borgatta and Fanshel, 1965; the same methods and questionnaires. Bohman's Triseliotis, 1970; Bohman, 1970). It was not main findings were that as a group adopted children, surprising to find an excess of emotional disorder in especially boys, displayed more nervous disorders a group of children of families who have had to face such as restlessness, poor concentration, and conflict a number of exceptional stresses. The parents have with peers, but had no excess of antisocial behaviour. had to come to terms with their infertility; they have While adoptive parents reported few behaviour had to endure an often arduous evaluation problems, teachers assessed more adopted children, procedure; and they have had to cope with the especially boys, as maladjusted than controls (22 O/ difficult task of disclosing to their child his adoptive of adopted compared with 12% of control boys). status. Adopted children have had to accommodate Difficulties with reading and writing were commoner to the idea of two sets of parents, one of whom gave among the adopted of both sexes than among the them up, and to uncertainties about their origins and controls, and were related to pre- and perinatal identities which may never be resolved. Both complications. Though problem children were over-represented in the adopted group, only 2 cases parents and children have had to adapt to their http://adc.bmj.com/ minority status in society. of markedly severe behaviour disorder were found. Possible genetic or other constitutional dis- These results need to be viewed in relation to the advantages of children placed for adoption were at environment provided for the children by their one time not thought to prejudice outcome, since it adoptive parents. Socially and materially these has been found repeatedly (e.g. by Skeels and families were superior to those in the control group, Harms, 1948) that the socially and culturally and in addition adoptive parents expressed more advantageous environment provided by adoptive positive attitudes than other parents to a variety of parents engenders intellectual capacities in adopted aspects of their lives. On the other hand, just as in on October 6, 2021 by guest. Protected copyright. children resembling more those of their adoptive the control group, 1 child in 6 had already lost one of than of their true parents. That the intellectual his parents through death or divorce during the first ability of adopted children does not quite match that 10 years of his life. Clearly, the screening of nonadopted children reared under similarly procedures of potential adopters had not succeeded favourable conditions, and that intellectual or, more in ensuring a particularly secure family life for the accurately, educational acceleration can occur at adopted child. some cost will be discussed below. The National Child Development Study of a Despite the known stresses of adopted children representative sample of British children born in one and their parents, one could not be sure whether the week of 1958 allowed comparative studies of a high proportion of adopted children among number of special groups of children, among them psychiatric clinic attenders reflected a true excess of the illegitimate and the adopted. The findings pathology or indicated rather the greater uncertainty published so far relate to outcome of these children of adoptive parents or their more ready recourse to at the age of 7 years (Crellin et al., 1971; Seglow et helping agencies, since all these parents had already al., 1972). Comparisons between adopted children experienced a social work contact. and controls from the rest of the national sample Arch Dis Child: first published as 10.1136/adc.49.3.165 on 1 March 1974. Downloaded from The fate of the adopted child 167 gave results very similar to Bohman's (1970).
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