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The common response to abuse in adoptive families

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Whenever a child dies at the hands of its adoptive parents, the various news outlets that cover such crime,  often ask "experts" from organizations like the Evan B Donaldson adoption institute, the Joint Council on International Children's Services and even the National Council for Adoption for commentary. The response usually has the following pattern: "abuse in adoptive families is rare and without minimizing the tragedy we should look at how well adoptive families are being screened and consider that the vast majority of children adopted end up with loving parents that treat them well".

This well rehearsed response seems to satisfy both the journalists and the audience at large, but on closer examination, it has little validity.

Abuse in adoptive families is rare

There are several problems with this statement. First of all abuse rates in general are hard to establish. A literature review of 23 studies into the prevalence of sexual abuse of children found rates varying from 3% to 37% for males and 8% to 71% for females. So the highest estimate is about a factor 10 larger than the lowest estimate. Based on that it is fair to conclude that abuse prevalence studies are a bad predictor for abuse rates. At best, these studies can be used to compare various groups, but even then there are serious pitfalls.

The statement "abuse in adoptive families is rare" has to be taken relative to have any meaning. If not, abuse in adoptive families would be rare simply because adoptive families are rare in comparison to non-adoptive families. So somehow we have to compare the abuse rates in adoptive families to the abuse rates in non-adoptive families, but doing that, in several ways amounts to comparing apples and oranges.

The number of non-adoptive families is much larger than the number of adoptive families, which makes sampling a daunting task. It is not only difficult to find a representative sample of adoptive families (on which we will return later), it is even more difficult to find a large enough sample of adoptive families in which abuse happens to establish a reliable abuse rate. The lower the prevalence of abuse, the larger the sample size has to be.

Finding adoptive families in itself is not without difficulty. It makes sense, in order to establish an abuse rate, to try and find adoptees and ask them about abuse rather than to find adoptive parents and ask them if they have ever abused their children. But how are we going to find adoptees? Some outcome studies for example "randomly" contact people in the hope to find as many adoptees as possible.

There is a problem with that approach because every "random" selection is in fact based on a systematic procedure. One could either randomly pick addresses and conduct a home interview, or one could randomly pick telephone numbers and ask for cooperation. In either case it will omit the population that cannot be reached by that means. There are several reasons why the population of adoptees, in that respect, is different from the population of non-adoptees. There are indications that adoptees are over-represented in the population of psychiatric patients and in the population of children being placed in residential treatment centers and boarding schools. So randomly visiting homes or calling telephone numbers will never reach that population. It may well be that in those omitted groups the abuse rate differs from the abuse rate of adoptees that can be found by a "random" selection.

Another approach taken by at least one adoption outcome study relies on contact information provided by a small number of large adoption agencies. There are several pitfalls to that approach. The first question that comes to mind is: "how reliable are agencies in providing contact information?". Adoption agencies benefit from positive outcomes of a study, so how can we guarantee there is no pre-screening of the information provided? Another issues with this approach has to do with the small number of agencies involved. Each agency has its own adoption procedure, some are more rigorous than others in their screening procedure. The very small sample size of agencies makes systematic errors most likely. Each agency also has a specific market approach. Some agencies are more focused on domestic infant adoption, others mainly deal with adoption from foster care or inter-country adoption. Finally, with this approach, independent adoptions are entirely omitted.

Thus far, we have only talked of the sampling issues involved in the establishment of an abuse rate in comparison to non-adoptive families, but there are more difficulties. Adoptive families differ from non-adoptive families in several ways. First of all the mean annual income of adoptive families is much higher than the mean annual income of the population at large. Also, religious affiliation in adoptive families is stronger than in the population at large. This makes it difficult to compare the group of adoptive families to the group of non-adoptive families, because of the socio-economic differences.

There is also reason to believe adoptees will respond differently when asked about abuse in their family than a non-adopted person would. Some adoptees may resent their placement and therefore say they were abused when that was not the case, some adoptees may be afraid to admit to abuse, fearing it will disrupt their family relations (even when asked anonymously). Both scenarios are likely and we simply don't know if the two cancel each other out, or if one dominates over the other.

Finally there is the issue of what would be acceptable. Adoptive families are not the same as biological families, because they are formed on the premise that an adoptive family is more capable of caring for a child than a biological family. So in that respect adoptive families should do better than biological families, but how much better should they do? Can we quantify what would be an acceptable abuse rate for adoptive families? What abuse rate allows for calling it rare?

Screening of adoptive families

The notion of safety of adoptive families is usually supported by the screening process involved. Home studies and criminal back ground checks are an integral part of the adoption process and are used to make the claim that adoptive families are carefully selected. There are several issues with this claim, which all boil down to one simple conclusion: there is no evidence base for the efficacy of adoption home studies. Home studies are performed but there is no evidence it actually differentiates between potentially abusive adopters and families that will treat children right. Even stronger: we don't know if home studies differentiate at all.

One of the unknowns with regard to home studies is the pass-fail ratio. We know that several unsuitable adopters pass home studies, but we don't know how many unsuitable adopters fail the test. We don't even know if any unsuitable adopters fail the test. Yet there is some room for speculation here.

Every test no matter how well performed results in false negatives and false positives. A home study therefore will result in people being disapproved that would make reasonably good adoptive parents, while it will also approve  some adoptive families that will end up being abusive. The latter group (the false positives) we know. There are known adopters that end up abusing children. False negatives (reasonably good potential adoptive parents that don't pass a home study) are hard to find. So far we have not found a single blog, or forum on the internet where PAP's complain they failed a home study while they believe of themselves they are suitable candidates. So without knowing the pass-fail ratio, there is some indication this ratio could be very high. When that is the case the conclusion should be that home studies have little discriminating value and their efficacy to screen potential adopters is low.

Even when failing to pass a home study, potential adopters have the possibility to shop for another opinion. In every state there are hundreds of licensed social workers allowed to perform a home study, so for those persistent enough, there is always the possibility to find that one social worker who doesn't see the potential dangers. There is no registry of home studies, so every subsequent social worker asked to perform a home study is unaware of any previous attempts to seek approval for adoption.

Altogether, the claim abuse in adoptive families is prevented through thorough screening can not be made. There is no evidence for that claim and there are several indications home studies may not be as effective as we hope they are.

The vast majority of children adopted end up with loving parents that treat them well

The final argument made when confronted with abuse in adoptive families is more an emotional appeal than a real argument. As an argument it is even incorrect. The negation of an abusive family is a non-abusive family, which does not necessarily imply a loving family that treats their children right. For every abusive adoptive family it's certainly possible to find an adoptive family that is very loving towards their children, but it is equally possible to find a family that is non-abusive, yet cold and indifferent, or pushy and demanding, or any other characteristic that makes the family an unpleasant place to be.

We simply don't know if children end up with loving families or not. Based on pretty unreliable figures we may assume that many children end up in non-abusive homes, but that doesn't mean those families are automatically loving. It doesn't even mean the placement was appropriate, all it says is that children are not being abused.

There is another aspect that makes this statement false, the underlying assumption the child did not have a loving family before adoption. While some adoptees indeed come from horrible families and end up finding a loving family to live with through the act of adoption, this is not the case for all adoptees. Some don't come from horrible families at all. Some children are taken from their families because of a false assumption by child protective services the family is a potential danger. Some children are relinquished because parents were lead to believe they were not suited to take the responsibility of raising a child. There are several scenarios where a child ends up being adopted, where such was totally unnecessary.

As much as it is nonsense to claim children are always better off in their original family, it is equally nonsensical to claim children are always better off in their adoptive families.

So the knee-jerk response when confronted with abuse in adoptive families as given by the "experts" has very little basis. It is also highly defensive, as if the good name of adoption is being tarnished when evidence arises it is not picture perfect. An appropriate response would be to acknowledge the abuse and look at the circumstances which made it possible a child was placed in an abusive family. Of course that would mean taking responsibility for decisions made. It would also mean acknowledging that adoption is not always picture perfect, nor can we expect it to be. In that sense it would be unrealistic to demand that no abuse ever happens within adoptive families, but we can at least ask of the professionals working in the field to make their best possible effort to prevent it. As it stands now, there is still a lot of room for improvement. For starters we could investigate the efficacy of home studies and learn what works and what doesn't. As long as screening has no evidence base, we might as well replace it by waving a magic wand and hope for the best.

by Kerry and Niels on Thursday, 04 June 2009