M. Silver, K. Thirlwall, K Kinkade, J. Tosh, Northampton General Hospital

With thanks to Phil Maddock, Maggie Pitts and the Northampton Permanence Team

Risk and Resilience Factors in Adoptive Matching

The process allows professionals to consider the extent to which the family’s resources meet the needs of the child

In depth assessment of both the child and the potential adopters.

The ‘E’ Form* The ‘F’ Form*

Current Matching Procedure

Matching report*

Applicants approved as adopters

Child approved for adoption

Panel approves match*

Match is made

Completed a detailed audit of all the matches made between April 2003 and April 2005 (n=116).

Looked at all the ‘E’ forms, ‘F’ forms, matching reports and panel minutes.

Collected Social Worker ratings using a Likert scale.

185 variables in total, which gave a pen picture of the people involved, and the way forms are used

Statistical analysis to look for significant & predictive factors.

Method

The ‘E’ Form: Children Age Physical needs Emotional needs (inc intellectual impairments)

Racial/cultural background Family history Why removal became necessary Information regarding family contact

The Children 57 boys and 59 girls

Mean age 3y 6m (with 26% under a year old, but 16% over 7)

48% removed from parents before 1st birthday

Removed due to poor parenting and other factors:

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Series1 22% 24% 89% 9%

Unwanted Harmed Poor Parenting Poor Parental Mental Health

IN CARE THEMSELVES

MENTAL HEALTH PROBLEMS

SINGLE PARENT FAMILIES

ABUSED AS CHILDREN

LACKED EDUCATION

NEVER BEEN EMPLOYED

IN TROUBLE WITH LAW

HAD VIOLENT RELATIONSHIP

MOTHER FATHER

34 %

56 %

30 %

55 %

44%

29 %

29%

57%

17 %

29 %

9 %

10 %

15 %

36 %

35 %

2 %

The Birth Parents

Observations Young population Complex backgrounds & presentation

– 22% behaviour problems– 17% developmental delay– 21% health concerns– 20% emotional or mental health concerns

Facts not interpretation (eg impact of relationships)

Focus on physical rather than psychological – 96% describe child’s appearance– 65% describe their character– 39% describe their attachment history

Very little explicit reference to attachment

The ‘F’ Form: Applicants Family make up Culture Medical information Family history Social networks Personal references Values and beliefs Parenting experiences Motivations to adopt

The Applicants 49% are in their thirties 56% had been together over 10 years 96% applied as a couple 31% have birth children (often of one parent) 21% have an adopted or foster child already Not being able to conceive was the dominant motivating factor for

78% of the applicants, the rest adopt for moral reasons. 41% wanted to adopt a single child, 51% up to two, 8% up to

three children 65% wanted an infant if possible Gender did not matter to 77% of adopters Contact with birth parents was seen as off-putting

Adopter’s Backgrounds: Challenges

0%

5%

10%

15%

20%

25%

30%

Series1 2% 8% 10% 5% 5% 26%

In Care as child

Parent With Mental Health

Problems

Single Parent Family

Abused as a Child

Had Mental Health

Problems

Adverse Circumstance

s

Observations References and applicants only focus on

strengths (70% don’t explore weaknesses) Facts not interpretation or reflection (eg again

little about impact of own relationships) Matching reports explore

– Cultural/religious differences 75%– Physical demands of parenting 45%– Emotional demands vs needs 63%– Support structure around applicants 66%– Level of professional support needed 71%– Emotional demands of the children

67%– Attachment history of the child 44%– Attachment history of the applicants 20%

Type of Match

The way the match is made is not a significant predictors of success

(Χ2=3.02, p=0.07)

There is a trend for “project” matches to be more difficult, but significantly more complex/older children involved

(ANOVA: project matched children are older p<0.0005 and later removed p<0.0005)

Adopter’s Motive

Adopters’ motive is also not a significant predictor of success

(Χ2=3.30, p=0.07) There is a trend for “moral” adoptions to

be more difficult, but significantly more complex/older children are involved (ANOVA: moral adopters take older children p=0.01 with more behavioural problems p<0.0005 and emotional/mental health difficulties p=0.004)

Results of Correlation with Placement Success Rating

Analysis

Child’s age p<0.0005

Number of prior placements p=0.003

Birth mother’s care status p=0.006

Birth mother in violent relationship p=0.013

Birth mother in trouble with police p=0.001

Child harmed by parents p=0.006

Child has behaviour problems p<0.0005

Child has health concerns p=0.005

Results of Correlation with Placement Success Rating

Analysis

Adopters have birth children p<0.0005

Applicants have social support p=0.011

Applicants support each other p=0.001

Applicants prepared to make major lifestyle changes p=0.011

Social Worker’s confidence about the match* p<0.0005

Social Worker’s rating of adopters engagement with profs* p<0.0005

Social Worker’s rating of how challenging child is* p<0.0005

* retrospective, so unclear how objective these ratings are

Univariate AnalysisResults of Factorial ANOVAs

If the child is younger p<0.0005

If the child has had less prior placements p=0.007

If adopters evidence strong social support networks p=0.003

If adopters evidence mutual support/respect p=0.004

If adopters are prepared to make major lifestyle changes p<0.0005

If the Social Worker felt confident about the match* p<0.0005

If the Social Worker felt the adopters engaged with profs* p=0.016

If the child was removed from the birth family younger p=0.014

If applicants recognise both strengths and weaknesses ineach other p=0.018

MATCHES WERE MORE SUCCESSFUL:

If the child’s birth mother had grown up in Care p=0.006

If the child’s birth mother had been in trouble with police p=0.036

If the child’s birth mother was in a violent relationship p=0.012

If the child had been harmed by birth parents p<0.0005

If there were health concerns about the child p=0.005

If there were emotional/mental health concerns p<0.0005

If adopters have birth children p=0.002

If a prior placement broke down due to the child’s behaviour p=0.002

If applicant 1 has physical health problems p=0.010

Univariate Analysis

MATCHES WERE LESS SUCCESSFUL:

Results of Factorial ANOVAs

Multivariate Analysis 1Results of Multiple Regression

Variable Cumulative R2

Adopters have birth children 0.108

Adopters offer mutual support 0.176

Child’s physical health 0.233

Child’s emotional/mental health 0.275

Birth mother in trouble with police 0.318

Number of prior placements 0.338

Adopters’ physical health 0.358

Birth mother in violent relationships 0.378

Multivariate Analysis 2Results of Multiple Regression

Variable Cumulative R2

Birth mother in trouble with police 0.093

Child’s physical health 0.203

Adopters’ physical health 0.279

Child behaviour problems 0.340

Child involved in decision 0.369

Child’s mother grew up in care 0.403

Birth father in violent relationships 0.428

Interpretation of Regression

Forcing age as first variable accounts for 18.5% of variance

Adding other variables listed accounts for 49.5% of variance

Risk and resilience relates to both adopters and children, in a complex interplay

We match pretty well – 53% highly successful, 28% successful and 10% unsuccessful, 8% undecided

Implications

Awareness of risk & resilience factors More exploration of attachment

– Story stems?– Adult attachment interview?

More interpretation of facts Explicit consideration of relationship

with professionals, and SW “gut feeling”