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Adjustment, Openness in Adoption, and Family Services: Findings from The Early Growth and Development Study 2 nd Annual Adoption Caseworker Forum Heart of Adoptions, Inc. Tampa, FL February 26, 2009. Leslie Leve, Ph.D. Oregon Social Learning Center Jody Ganiban, Ph.D.

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Adjustment openness in adoption and family services

Adjustment, Openness in Adoption, and Family Services:

Findings from The Early Growth and Development Study

2nd Annual Adoption Caseworker Forum

Heart of Adoptions, Inc.

Tampa, FL

February 26, 2009

Leslie Leve, Ph.D.

Oregon Social Learning Center

Jody Ganiban, Ph.D.

George Washington University


Overview of presentation

Overview of Presentation

  • Description of the Early Growth & Development Study (EGDS)

  • Early Results on Developmental Outcomes and the Adoption Process from EGDS

  • Implications for Prevention and Services for Adoptive Families


I early growth and development study

I. Early Growth and Development Study

  • 3 NIH grants to study adoption process and nature-nurture interplay with 560 linked adoptive families and birth parents

  • Domestic adoption placements

  • Adoption occurred within 3 mo. post-partum

  • Infant free of major medical problems

  • 3 major assessments for birth parents and 6 major assessments for adoptive families spanning infancy through 1st grade


Egds study design

Birth

Mother

Adoptive

Mother

Birth

Father

Adoptive

Father

Adopted

Child

EGDS study design

  • Adoption Triad:

    Birth mother/birth father, adoptive mother/father, & adopted child


Egds family of studies

EGDS Family of Studies

EGDS-Phase 1 (PI: Reiss)

Sept 2002- Aug 2007

n = 360 adoption triads

parenting, context, externalizing, internalizing, social competence, birth parent characteristics

3 mo to 6 mo

36- 48 mo

4 ½ yrs

Prenatal Period

9 mo

18 mo

27 mo

6 yrs

7 yrs

EGDS-School (PI: Leve)

Sept 2007 – July 2012

n = 360

New: Emergent literacy, executive functioning, HPA axis functioning

EGDS-Phase 2 (PI: Neiderhiser)

Sept 2007 – May 2012

n = 200 NEW + 360 from EGDS-Phase 1

New: 200 cases, DNA, enhanced measurement of birthparent experiences, prenatal exposures


Assessments

Assessments

  • In-person assessment with adoptive families at age 9-, 18-, 27-months, and age 4 1/2, 6, 7 years

  • In-person assessment with birth parents 3-6 mo., 18 mo., and 4 years postpartum

  • Data collected from parent questionnaires, interviews, home observations, children, teachers


Recruitment locations

Recruitment Locations

  • Three data collection sites in Phase I

    • Pacific Northwest (Oregon Social Learning Center)

    • Mid-Atlantic (George Washington University)

    • Southwest (University of California, Davis)

  • Two additional regions added for Phase 2

    • Midwest (University of Minnesota)

    • Southeast


Recruitment strategy

Recruitment Strategy

  • Agency Recruitment

    • Each data collection site identifies “local” agencies

    • Collects data on number and type of placements

    • Identify agency liaison once agency agrees to participate

  • 33 agencies in 10 states participated in Phase 1

  • 20 agencies participating in EGDS-Phase 2 (6 new agencies)


Demographics for bps and aps

Demographics for BPs and APs:


Demographics con t

Demographics (Con’t)

  • Adoptive Parents

    • 1% single

    • 84% AM, 86% AF married

    • 1% divorced/separated

    • 9% remarried

    • 5% AM, 4% AF cohabitating, committed rel.

  • Birth Parents

    • 77% BM, 72% BF single

    • 8% BM, 22% BF married

    • 14% BM, 5% BF divorced/separated

    • 1% BM & BF remarried


Developmental research domains

Developmental Research Domains

  • Birth parents, adoptive parents, and children

    • Temperament and personality

    • Social context (stress, social support, economic circumstances, partner/marital relations)

    • Externalizing, internalizing, social competence

    • Alcohol & drug use and problems

    • Executive functioning and literacy

    • DNA and salivary cortisol samples

  • Adoptive parents only

    • Parenting

  • Birth parents only

    • Prenatal exposure to substances, toxins, stress


Clean up task designed to examine parenting and child compliance

Clean-up Task – designed to examine parenting and child compliance


Temperament task designed to examine child s frustration attention

Temperament Task – designed to examine child’s frustration/attention


Ii egds results

II. EGDS Results:

  • Contributions to general developmental theory

    • Understanding the contributions of genes &

    • parenting to children’s behavior and adjustment

B. Contributions to understanding the adoption

process

  • Adoption openness

  • Agency selection & services

  • What was helpful, what was hard


Adjustment openness in adoption and family services

Birth Parent’s

Externalizing

behavior

Infant’s risk for

Externalizing

behavior

BUT …

The size and significance of this association

depends on the adoptive mothers’ behaviors.

  • emotion regulation skills

  • tendency to structure child’s behavior

Leve et al. (in press). Infant pathways to externalizing behavior: evidence of

Genotype x environment interaction. Child Development.


Adjustment openness in adoption and family services

B. Contributions to understanding the adoption

process.

  • Openness:

  • Understanding the effects of openness on birth and adoptive parents

Ge et al. (2008). Bridging the divide: openness in Adoption and postadoption psychosocial adjustment among birth and adoptive parents. Journal of Family Psychology, 22, 529-540.


What was the level of openness in the adoption

What was the level of openness in the adoption?

65% report

Open adoptions

65% report

Open adoptions

% of Adoptive mothers

Very

Open

Very

closed

Closed

Semi

Open

Mod.

Open

Open

Quite

Open

Openness in the adoption

(1-7 rating scale, mother report when child is 9 months)

Ge et al. (2008)


Adjustment openness in adoption and family services

How satisfied are adoptive mothers with the information they have about the birth parents? (very stable; numbers here are at 27-months)

Birth Mothers

Birth Fathers


Adjustment openness in adoption and family services

How satisfied are adoptive fathers with the information they have about the birth parents? (very stable; numbers here are at 27-months)

Birth Fathers

Birth Mothers

Birth Fathers


Adjustment openness in adoption and family services

How does openness relate to post-adoption adjustment for Adoptive Parents?

Satisfaction with

adoption process

Degree of

Openness

Ge et al. (2008)


Adjustment openness in adoption and family services

How does openness relate to post-adoption

adjustment for Birth Mothers & Fathers?

Adjustment to

the process

Satisfaction with

adoption process

Degree of

Openness

Positive

Impression

Ge et al. (2008)


Adjustment openness in adoption and family services

Changes in Openness and Satisfaction

across Toddlerhood


Openness satisfaction with openness

Openness & satisfaction with openness

  • Most families report a moderate levels of openness and satisfaction with the adoption process throughout toddlerhood:

    • e.g., maintain periodic phone contact, visits, or mail exchanges

  • BUT .. openness and satisfaction with the adoption process decreased somewhat over time according to adoptive mothers, adoptive father, birth mothers, and birth fathers.


How would adoptive mothers change openness

How would adoptive mothers change openness?

18-months

27-months

9-months


How would adoptive fathers change openness

How would adoptive fathers change openness?

18-months

9-months

27-months


Adjustment openness in adoption and family services

B. Contributions to understanding the adoption

process.

  • Openness:

  • Understanding the effects of openness on birth and adoptive parents

  • Agency Selection:

  • How do parents select an agency to work with?


Why did the adoptive family select their agency

Why did the adoptive family select their agency?

  • On average, adoptive families looked at 3-4 agencies before selecting the one they used. The primary deciding factors were:

    • The agency’s philosophy about adoption, including openness, and the agency mission statement (83%)

    • The information received about the adoption agency from a packet, website, or meeting (69%)

    • Other people’s recommendation, word of mouth, or agency reputation (68%)

    • Geographic location of the agency (53%)

    • Agency staff (50%)


Why did the birth mother select their agency

Why did the birth mother select their agency?

  • On average, birth mothers looked at about 2 agencies before selecting the one they used. The primary deciding factors were:

    • The agency’s philosophy about adoption, including openness, and the agency mission statement (68%)

    • The information received about the adoption agency from a packet, website, or meeting (64%)

    • Services offered, such as counseling, meeting other birth parents, or support group (50%)

    • Other people’s recommendation, word of mouth, or agency reputation (47%)

    • Agency staff (45%)


Adoptive parents satisfaction very or somewhat with services

Adoptive Parents’ Satisfaction (‘very’ or ‘somewhat’) with services

  • The information agency provided about adoption process (96%)

  • Education and support services (90%)

  • Ability to make recommendations for outside services like counseling (89%)

  • Staff responsiveness to requests (88%)

  • Skill of the staff (92%)

  • Policy about openness (98%)

  • Home study process, including the length of time it took to complete it (95%)

  • Matching process (95%)

  • Placement process (94%)

  • Post placement services (91%)


Services sought outside of the agency

Services sought outside of the agency

  • Legal services (19%)

  • Home study from a different agency (7%)

  • Infant care/parenting classes (4%)

  • Support group (4%)

  • Counseling (3%)


Adjustment openness in adoption and family services

B. Contributions to understanding the adoption

process.

  • Openness:

  • Understanding the effects of openness on birth and

  • adoptive parents

  • Agency Selection:

  • How do parents select an agency to work with?

  • Adoption Process:

  • What was helpful?

  • What was difficult?

  • How has adoption affected your life?


Agency services that were most helpful

Agency services that were most helpful

  • The matching/placement process

  • Educational classes

  • Orientation workshop

  • Specific social worker/staff member

  • Availability and support of agency staff

  • Counseling

  • Mediation with birth mother


Nicest or most important thing someone did during the adoption process

Nicest or most important thing someone did during the adoption process

  • Support from friends and family

  • Baby shower

  • The birth parents choosing us to raise their child

  • Friends and family providing meals

  • Friends and family babysitting

  • Friends and family sharing their experiences with adoption


The most difficult part of the adoption process

The most difficult part of the adoption process

  • Waiting for a child

  • Coming to the decision to adopt

  • The adoption process

  • General adjustment to new child (lack of sleep, siblings)

  • Coming to terms with infertility issues

  • Adoption paperwork

  • Cost

  • Dealing with a failed adoption(s)


How has your child affected your life mothers @ 27 months

How has your child affected your life? (mothers @ 27 months)

Marital Relationship

Other Children

Satisfaction With Life


How has your child affected your life fathers @ 27 months

How has your child affected your life? (fathers @ 27 months)

Marital Relationship

Other Children

Satisfaction With Life


Iii implications for prevention and services

III. Implications for Prevention and Services

  • Most challenging parenting issues

  • Desired services

  • Format of services


What months have been the most challenging to parent

What months have been the most challenging to parent?


What months have been the most challenging to parent1

What months have been the most challenging to parent?


What do adoptive parents think are the most challenging issues as parents 1 st year of life

What do adoptive parents think are the “most challenging issues” as parents (1st year of life)


What do adoptive parents think are the most challenging issues as parents 2nd year of life

What do adoptive parents think are the “most challenging issues” as parents (2nd year of life)


What do adoptive parents think are the most challenging issues as parents 2nd year of life1

What do adoptive parents think are the “most challenging issues” as parents (2nd year of life)


Desired adoption specific parenting services

Desired Adoption-Specific Parenting Services

  • Talking to child about adoption (how/when)

  • Contact with birth parents (how much/how to manage)

  • Transracial and cultural issues (how to educate)

  • Blended families (how to discuss with your children)

  • Stigma/responding to others’ questions


Agency services families wished the agency had provided

Agency services families wished the agency had provided

  • More/better education about the adoption process

  • More/better support groups

  • More parenting education

  • More staff accessibility

  • Support groups pre-placement

  • More support for birth mothers


How often wanted some advice about parenting

How often wanted some advice about parenting?

Mothers

Fathers


Top 3 areas where parenting information would be helpful mothers @ 27 months

Top 3 areas where parenting information would be helpful (mothers @ 27 months)

Disciplining

Managing Toddler Emotions

Temper Tantrums


Top 3 areas where parenting information would be helpful fathers @ 27 months

Top 3 areas where parenting information would be helpful (fathers @ 27 months)

Disciplining

Managing Toddler Emotions

Sleep Issues


Adjustment openness in adoption and family services

Other areas where help information and services would be helpful (at least 1/3 of mothers said information would be ‘helpful’ or ‘very helpful’)

  • Enhancing child’s strengths (46%)

  • General child development (43%)

  • Adoption issues (42%)

  • Child compliance (40%)

  • Child hitting, biting (39%)

  • Child whining (38%)

  • Child temperament (37%)

  • How to play with child (34%)


How would you like to receive parenting resource information

How would you like to receive parenting resource information?

Mothers

Fathers


How often would you like services

How often would you like services?

Mothers

Fathers


Summary

Summary

  • Most adoptive parents, and especially mothers, would like more information about parenting

  • Areas where information and services are most desired are: discipline and child behavior, general child development, strength building, and adoption

  • Adoptive families would prefer these services be delivered as an as-needed or monthly basis

  • Mailed information, information from a doctor or pediatrician, or parenting website are the most desirable formats

  • 0-2 months, 10-12 months, 18 months, and 24-months are times when parents report the most challenges


So where do we go from here what kinds of services and programs might be beneficial

So where do we go from here? What kinds of services and programs might be beneficial?

???


Key components of evidence based programs for infants toddlers and preschoolers

Key components of ‘evidence-based’ programs for infants, toddlers, and preschoolers

  • Teach warm and sensitive (but firm and consistent) parenting

  • Strength-building

  • Prevention-based

  • Work within the multiple contexts that families and children interact in (home, school, community)

  • Include both a child and caregiver components

  • Include parenting groups for social support

  • Weekly service delivery

  • Video-based feedback


What about adoptive families

What about adoptive families?

  • No evidence-based programs have been evaluated specifically for adoptive families, although there are evidence-based programs for foster parents

  • Unique needs of adoptive families may include:

    • generally well-educated and invested in parenting

    • uncertainties about child’s genetic background

    • transracial and cultural issues

    • blended families

    • interface with birth parents

    • talking to child about adoption/their background

    • attachment


Additional future research directions

Additional Future Research Directions

Birth parents who are rearing their own children

Applying for a grant to study the children of the birth parents in EGDS

Translate interviews

Allow recruitment of a Spanish-speaking population

Health, eating habits, and obesity

Applying for a grant to study how families, prenatal influences, and genetic factors affect children’s health

Continue to assess EGDS families in adolescence


Adjustment openness in adoption and family services

The EGDS Team

Jenae Neiderhiser (PSU)

Leslie Leve (OSLC)

David Reiss (GWU, Yale)

Xiaojia Ge (UMN)

John Reid (OSLC)

Danny Shaw (U Pitt)

Laura Scaramella (UNO)

Linda Mayes (Yale)

Jody Ganiban (GWU)

Phil Fisher (OSLC)

Rand Conger (UC Davis)

Consultants:

Joel Gelernter (Yale)

Joan Kaufman (Yale)

Steve Petrill (OSU)

Steve Suomi (NICHD intramural)

Over 30 participating adoption agencies across the US

EGDS-Phase I & EGDS-school: R01 HD042608 (co-funding by NIDA & OD)

EGDS-Phase II: R01 DA020585 (co-funding by NIMH & OD)

Too many recruiters & interviewers to name

Amy Whitesel

Danielle Guererro

Cristin McArdle

David Martin


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