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Foli KJ, VanGraafeiland B, Snethen JA, Greenberg CS. Caring for nontraditional families: Kinship, foster, and adoptive. J SPEC PEDIATR NURS 2022; 27:e12388. [PMID: 35702024 DOI: 10.1111/jspn.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/18/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Information about nontraditional (kinship, foster, and adoptive) families is typically scattered or overlooked both in nursing education and nursing practice settings. Using a nursing-centric, population-focused lens, the current state of nontraditional families in the United States is briefly described. An overview of the challenges and psychological dynamics involved when a nonbiological parent assumes the role of caregiver is provided. CONCLUSION Based on the 2010 Census findings and other indicators, we now understand that nontraditional families and their children make up a considerable portion of the population. Nurses, regardless of level of practice, have the potential to positively impact health outcomes of nontraditional parents and their children. Knowledge of the formation and needs of nontraditional families can inform, and improve, culturally safe, trauma-informed nursing care. PRACTICE IMPLICATIONS This discussion is a first step in appreciating the formation of nontraditional families and the importance of trauma-informed, unbiased, nonstereotypic discourse in nursing care. By describing the heterogeneity of how families are built through kinship care, foster placements, and adoptive homes, nurses' assessments and interventions will be informed and through a lens of the high potential for past traumas. With this foundational knowledge, nurses interfacing with nontraditional families are better prepared to provide much needed support and relevant care for this unique population.
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Affiliation(s)
- Karen J Foli
- Purdue University School of Nursing, Johnson Hall of Nursing, West Lafayette, Indiana, USA
| | | | - Julia A Snethen
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Cindy Smith Greenberg
- College of Health & Human Development, California State University, Fullerton, California, USA
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Kelsall-Knight L. Qualitative exploration of lesbian parents' experiences of accessing healthcare for their adopted children in England. BMJ Open 2021; 11:e053710. [PMID: 34598991 PMCID: PMC8488731 DOI: 10.1136/bmjopen-2021-053710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore the experiences of lesbian parents accessing healthcare for their adopted children in England. DESIGN A qualitative inductive design, using narrative inquiry with a critical incident recall interview approach. Interviews were analysed using merged tools of critical event analysis and broadening, burrowing, storying and restorying. SETTING Participants were recruited from a British lesbian, gay, bisexual and transgender fostering and adoption charity. PARTICIPANTS Six lesbian adoptive parents with experience of accessing healthcare for their adopted children in England. RESULTS Following data analysis, five themes were identified: navigating heteronormativity, navigating healthcare settings and professionals and having an 'adopted' status, intersectional identity of lesbian-parented adoptive families accessing healthcare, reflective imagery of lesbian parents and adoptive families and professional expectations. Self-imposed strategies instigated by the parents to strengthen and protect their familial identities were also discovered. CONCLUSIONS The needs and challenges of lesbian adoptive families may be different to those of heterosexual and biological families when accessing healthcare. There was an undercurrent of discriminatory practice, shown by various healthcare professionals, and a lack of understanding of the adoption process, knowledge surrounding the child's history and legal stance with regards to parental responsibility. Further training is needed for healthcare professionals.
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Affiliation(s)
- Lucille Kelsall-Knight
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Lee H, Vogel RI, LeRoy B, Zierhut HA. Adult adoptees and their use of direct-to-consumer genetic testing: Searching for family, searching for health. J Genet Couns 2020; 30:144-157. [PMID: 32602181 DOI: 10.1002/jgc4.1304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/11/2022]
Abstract
Use of direct-to-consumer genetic testing (DTC-GT) is rapidly growing in the United States. Yet little is known about how specific populations like domestic and intercountry adoptees use DTC-GT. Adoptees often have little to no biological family history, which may affect how they use DTC-GT. This study aimed to examine adult adoptees' motivations to pursue DTC-GT, experiences completing a test, and reasons for not completing one. An online survey consisting of 41 closed-ended questions was distributed to domestic and intercountry adult adoptees in a snowball convenience method addressing seven areas: (a) demographics and adoption experience, (b) family health history, (c) familiarity with DTC-GT, (d) actual DTC-GT experience, (e) hypothetical DTC-GT experience, (f) health results, and (g) satisfaction with DTC-GT. Descriptive statistics were performed on participant demographics and adoption characteristics, and chi-squared and Fisher's exact tests compared demographics and adoption characteristics by familiarity with DTC-GT and completion of DTC-GT. A total of 117 adoptees met criteria and completed the survey. Adoptees were motivated to use DTC-GT to search for biological family (83.0%), verify race and ethnicity (72.3%), and find out where ancestors came from (66.0%). Most participants completed DTC-GT (80.3%); completion was significantly associated with searching for biological relatives (p < 0.01) and with older age (p = 0.05). For those who received health information (59.6%), 44.4% of participants reported talking with a health provider. Adoptees are using DTC-GT to search for biological relatives, confirm their ethnicity and ancestry, and gain information about their health. Genetic counselors and health professionals should be prepared to address DTC-GT with adoptees as nearly half discussed their results with providers; findings from this study provide insight into how this unique population uses DTC-GT, and the possibility of patient-centered, tailored care for adopted patients who do not have family health history.
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Affiliation(s)
- Heewon Lee
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA.,Cancer Risk Management Program, M Health Fairview, Minneapolis, MN, USA
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie LeRoy
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Heather A Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
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Khan R, Brewer G, Archer J. Genetic Relatedness, Emotional Closeness and Physical Aggression: A Comparison of Full and Half Sibling Experiences. EUROPES JOURNAL OF PSYCHOLOGY 2020; 16:167-185. [PMID: 33680176 PMCID: PMC7913027 DOI: 10.5964/ejop.v16i1.1620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 01/28/2020] [Indexed: 12/02/2022]
Abstract
Two studies investigated whether perceived closeness of siblings, and aggression between siblings, were associated with genetic relatedness. In following Hamilton's rule, we predicted that as the coefficient of relatedness between siblings increased, emotional closeness would also increase while conflict would decrease. Contrary to the predictions, we found no effect of genetic relatedness in Study 1 when we compared participants' (n = 240) ratings of emotional closeness; participants also reported significantly higher levels of conflict with full siblings than with half siblings. In Study 2, participants (n = 214) also reported a higher frequency of physical aggression with full siblings than with half siblings. These findings were contrary to the prediction from Hamilton's rule. We discuss them in relation to parental investment in biological and non-biological offspring.
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Affiliation(s)
- Roxanne Khan
- School of Psychology, University of Central Lancashire, Preston, United Kingdom
| | - Gayle Brewer
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - John Archer
- School of Psychology, University of Central Lancashire, Preston, United Kingdom
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Torres-Gomez B, Alonso-Arbiol I, Gallarin M. Attachment to Parents and Aggressiveness in Adopted Adolescents: A Multi-Sample Comparison Study. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30 Suppl 1:46-54. [PMID: 30379380 DOI: 10.1111/jora.12463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examined adopted adolescents' levels of attachment security to parents and aggressiveness as compared to those of community nonadopted adolescents and of clinical nonadopted adolescents. Three different subsamples participated (n = 262): 101 community nonadopted adolescents (48.5% girls), 80 community adopted teens (65.0% girls), and 81 nonadopted counterparts (35.8% girls) who participated in a treatment program for youth with behavioral problems. There were no differences between community groups in attachment security or aggressiveness, whereas clinical nonadopted adolescents showed less attachment security and more aggressiveness than the other two groups. The implications of these results are discussed in terms of the potential healing impact that living with adoptive families could have on adopted teenagers' risk of maladaptive outcomes.
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Arribas-Ayllon M, Clarke A, Shelton K. Professionals' accounts of genetic testing in adoption: a qualitative study. Arch Dis Child 2020; 105:74-79. [PMID: 31296598 PMCID: PMC6951235 DOI: 10.1136/archdischild-2019-316911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/03/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore social workers' and medical advisors' accounts of genetic testing in adoption. METHODS A qualitative study using semi-structured interviews to gather in-depth accounts of retrospective cases. Data were analysed thematically to identify professionals' knowledge and expectations. RESULTS Twenty professionals working in adoption services (including 8 medical advisors and 12 social workers) participated in this study. Social workers adopted an essentialist (single-gene) model to discuss genetic testing in relation to past cases. They assumed that testing was a generic procedure for detecting the presence or absence of a specific aetiology, the results of which were believed to be definitive and mutually exclusive. By contrast, medical advisors were circumspect and agnostic about the meaning of results, especially in relation to chromosomal microarray testing. Whereas social workers believed that genetic testing provided clarity in assessment and therefore assisted adoption, medical advisors emphasised the uncertainties of testing and the possibility that prospective adopters might be misled. Medical advisors also reported inappropriate requests to test children where there was a family history of a genetic condition, or to confirm or exclude a diagnosis of fetal alcohol spectrum disorder in children presenting with non-specific dysmorphic features. CONCLUSION Recent advances in genetic technologies are changing the ways in which professionals understand and tolerate uncertainty in adoption. Social workers and medical advisors have different understandings and expectations about the clinical utility of genetic testing. These findings have implications for social work training about genetic testing and enabling effective communication between professional groups.
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Affiliation(s)
| | - Angus Clarke
- Medical Genetics, University of Wales College of Medicine, Cardiff, UK
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Jones VF, Schulte EE, Springer S, Szilagyi MA, Forkey H, Greiner MV, Harmon D, Lee P, Nalven LM, Sagor LD, Thackery JD, Waite D, Zetley LW. Comprehensive Health Evaluation of the Newly Adopted Child. Pediatrics 2019; 143:peds.2019-0657. [PMID: 31036671 DOI: 10.1542/peds.2019-0657] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children who join families through the process of adoption, whether through a domestic or international route, often have multiple health care needs. Pediatricians and other health care personnel are in a unique position to guide families in achieving optimal health for the adopted children as families establish a medical home. Shortly after placement in an adoptive home, it is recommended that children have a timely comprehensive health evaluation to provide care for known medical needs and identify health issues that are unknown. It is important to begin this evaluation with a review of all available medical records and pertinent verbal history. A complete physical examination then follows. The evaluation should also include diagnostic testing based on findings from the history and physical examination as well as the risks presented by the child's previous living conditions. Age-appropriate screenings may include, but are not limited to, newborn screening panels and hearing, vision, dental, and formal behavioral and/or developmental screenings. The comprehensive assessment may occur at the time of the initial visit to the physician after adoptive placement or can take place over several visits. Adopted children can be referred to other medical specialists as deemed appropriate. The Council on Adoption, Foster Care, and Kinship Care is a resource within the American Academy of Pediatrics for physicians providing care for children who are being adopted.
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Affiliation(s)
- Veronnie Faye Jones
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Louisville, Louisville, Kentucky; and
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Przybylski AK, Weinstein N. Digital Screen Time Limits and Young Children's Psychological Well-Being: Evidence From a Population-Based Study. Child Dev 2017; 90:e56-e65. [PMID: 29235663 DOI: 10.1111/cdev.13007] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is little empirical understanding of how young children's screen engagement links to their well-being. Data from 19,957 telephone interviews with parents of 2- to 5-year-olds assessed their children's digital screen use and psychological well-being in terms of caregiver attachment, resilience, curiosity, and positive affect in the past month. Evidence did not support implementing limits (< 1 or < 2 hr/day) as recommended by the American Academy of Pediatrics, once variability in child ethnicity, age, gender, household income, and caregiver educational attainment were considered. Yet, small parabolic functions linked screen time to attachment and positive affect. Results suggest a critical cost-benefit analysis is needed to determine whether setting firm limits constitutes a judicious use of caregiver and professional resources.
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Foli KJ, Hebdon M, Lim E, South SC. Transitions of Adoptive Parents: A Longitudinal Mixed Methods Analysis. Arch Psychiatr Nurs 2017; 31:483-492. [PMID: 28927513 PMCID: PMC5657499 DOI: 10.1016/j.apnu.2017.06.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/20/2017] [Accepted: 06/04/2017] [Indexed: 11/29/2022]
Abstract
As adoptive parents create a new family, they face myriad changes both pre-and post-placement of their child. The aim of this study was to describe parent perceptions and depressive symptoms during this transition via reports collected with an online survey. Using content analysis, we analyzed a total of 110 responses from 64 parents at three time points: 4-6weeks pre-placement, and 4-6weeks and 5-6months post-placement. Five main themes were revealed: Transition from uncertainty to a new normal; unique experiences related to adoption; rest/fatigue: out of balance; life stressors; and faith/spirituality. Two subthemes were also identified: previous losses (pre-placement) and joy and love (post-placement). During the transition from pre-to post-placement, adoptive parents experience a unique passage, with both challenges and strengths exclusive to this group of parents. While acknowledging the commonalities of some parenting experiences, healthcare and adoption professionals should recognize the unique dynamics that adoption brings to families.
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Affiliation(s)
- Karen J Foli
- Purdue University School of Nursing, Johnson Hall of Nursing, 502 N. University Street, Room 234, West Lafayette, IN 47907, United States.
| | - Megan Hebdon
- Radford University School of Nursing, Waldron Hall, Radford, VA 24142, United States
| | - Eunjung Lim
- Office of Biostatistics & Quantitative Health Sciences, University of Hawaii John A. Burns School of Medicine, Biosciences Building, Suite 211, 651 Ilalo Street, Honolulu, HI 96813, United States.
| | - Susan C South
- Purdue University Department of Psychological Sciences, 703 Third Street, West Lafayette, IN 47907, United States.
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Bramlett MD, Radel LF. Factors Associated with Adoption and Adoption Intentions of Nonparental Caregivers. ADOPTION QUARTERLY 2016; 20:5-24. [PMID: 26949328 PMCID: PMC4774051 DOI: 10.1080/10926755.2016.1149534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Data from the 2011-2012 National Survey of Children's Health and the 2013 National Survey of Children in Nonparental Care were used to fit a multinomial logistic model comparing three groups to those who never considered adoption: those who ever considered, but are not currently planning adoption; those planning adoption; and those who adopted. Adoption may be more likely when the caregiver is a nonkin foster parent, a foster care agency was involved, and/or financial assistance is available. Those with plans to adopt but who have not adopted may face adoption barriers such as extreme poverty, lower education and being unmarried.
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Affiliation(s)
| | - Laura F Radel
- U.S. Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation
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Affiliation(s)
- Thomas May
- Medical College of Wisconsin, Milwaukee, Wisconsin
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12
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"We don't know her history, her background": adoptive parents' perspectives on whole genome sequencing results. J Genet Couns 2014; 24:67-77. [PMID: 25011977 DOI: 10.1007/s10897-014-9738-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/11/2014] [Indexed: 12/30/2022]
Abstract
Exome sequencing and whole genome sequencing (ES/WGS) can provide parents with a wide range of genetic information about their children, and adoptive parents may have unique issues to consider regarding possible access to this information. The few papers published on adoption and genetics have focused on targeted genetic testing of children in the pre-adoption context. There are no data on adoptive parents' perspectives about pediatric ES/WGS, including their preferences about different kinds of results, and the potential benefits and risks of receiving results. To explore these issues, we conducted four exploratory focus groups with adoptive parents (N = 26). The majority lacked information about their children's biological family health history and ancestry, and many viewed WGS results as a way to fill in these gaps in knowledge. Some expressed concerns about protecting their children's future privacy and autonomy, but at the same time stated that WGS results could possibly help them be proactive about their children's health. A few parents expressed concerns about the risks of WGS in a pre-adoption context, specifically about decreasing a child's chance of adoption. These results suggest that issues surrounding genetic information in the post-adoption and ES/WGS contexts need to be considered, as well as concerns about risks in the pre-adoption context. A critical challenge for ES/WGS in the context of adoption will be balancing the right to know different kinds of genetic information with the right not to know. Specific guidance for geneticists and genetic counselors may be needed to maximize benefits of WGS while minimizing harms and prohibiting misuse of the information in the adoption process.
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Cvijetic S, Baric IC, Satalic Z, Keser I, Bobic J. Influence of nutrition and lifestyle on bone mineral density in children from adoptive and biological families. J Epidemiol 2014; 24:209-15. [PMID: 24646813 PMCID: PMC4000768 DOI: 10.2188/jea.je20130094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background The precise contributions of hereditary and environmental factors to bone density are not known. We compared lifestyle predictors of bone density among adopted and biological children. Methods The study comprised 18 adopted children (mean [SD] age, 14.0 [4.1] years) with their non-biological parents and 17 children with their biological parents. Bone mineral density (BMD; g/cm2) was measured at the lumbar spine, total femur, and distal radius. Nutritional intake was assessed by food frequency questionnaire. Information on smoking and physical activity was obtained by questionnaire. Results Intakes of all nutrients, corrected for energy intake, and all lifestyle characteristics except sleep duration were similar in biological children and their parents. As compared with their parents, adopted children had significantly different energy, protein, and calcium intakes and physical activity levels. In a regression model, BMD z scores of adopted children and their parents were significantly inversely associated at the spine and total femur, whereas BMD z scores of biological children and their parents were significantly positively associated at all measurement sites. The greatest proportion of total variance in BMD was accounted for by calcium intake among adopted children and by parental BMD among biological children. Conclusions For some lifestyle characteristics and nutrient intakes, the differences between parents and children were more obvious among adoptive families than among biological families. The most important lifestyle predictor of bone density was calcium intake.
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Abstract
Each year, more children join families through adoption. Pediatricians have an important role in assisting adoptive families in the various challenges they may face with respect to adoption. The acceptance of the differences between families formed through birth and those formed through adoption is essential in promoting positive emotional growth within the family. It is important for pediatricians to be aware of the adoptive parents' need to be supported in their communication with their adopted children.
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Ward BW. Adoptive parents' suspicion of preadoption abuse of their adopted children and the use of support services. Child Care Health Dev 2012; 38:175-85. [PMID: 21545629 DOI: 10.1111/j.1365-2214.2011.01245.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adopted children have a higher risk of developmental, mental, behavioural and social problems compared with non-adopted children, and their use of postadoption support services is of interest. Little attention has been given to the impact of preadoption abuse on the use of these services, and therefore this study examines whether or not adoptive parents' suspicion of preadoption abuse has a significant impact on the use of support services by adopted children. METHODS Data from the National Survey of Adoptive Parents, a US nationally representative survey of adopted children, were used to examine parents' suspicion of preadoption abuse and its effects on the use of postadoption support services by children aged 6-17 years (n = 1411). Statistical analyses were used to examine the relationship between suspected abuse and the use of support services while controlling for characteristics of the adopted child and adoptive parents/household. RESULTS Seven out of 10 adopted children have used some form of support service, and a larger percentage of 6- to 12-year-old children suspected of experiencing preadoption abuse used a support service compared with children not suspected of experiencing abuse. Significant relationships existed between various types of suspected preadoption abuse and the use of different types of postadoption support services. These relationships may go unaccounted for when only examining if any preadoption abuse occurred, or if any support service was used. CONCLUSIONS The type of preadoption abuse suspected appears to play a modest role in predicting the type of postadoption support services used by an adopted child. Giving further attention to understanding the relationship between different types of preadoption abuse and types of postadoption support services may help better understand the problems and difficulties experienced by adopted children.
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Affiliation(s)
- B W Ward
- Division of Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
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Abstract
Children who join families through the process of adoption often have multiple health care needs. After placement in an adoptive home, it is essential that these children have a timely comprehensive health evaluation. This evaluation should include a review of all available medical records and a complete physical examination. Evaluation should also include diagnostic testing based on the findings from the history and physical examination as well as the risks presented by the child's previous living conditions. Age-appropriate screens should be performed, including, for example, newborn screening panels, hearing, vision, dental, and formal behavioral/developmental screens. The comprehensive assessment can occur at the time of the initial visit to the physician after adoptive placement or can take place over several visits. Adopted children should be referred to other medical specialists as deemed appropriate. The Section on Adoption and Foster Care is a resource within the American Academy of Pediatrics for physicians providing care for children who are being adopted.
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Abstract
Using the 2003 National Survey of Children's Health, this paper examines the physical and mental health of children by family structure. Children in step, single-mother, or grandparent-only families had poorer health than children living with two biological parents. Adjusting for demographic differences reduced observed disparities, although children living in single-mother or grandparent-only families still had poorer health than children living with two biological parents. Adjusted estimates showed that children in single-father families generally did as well as (for mental health) or better than (for physical health) children living with two biological parents.
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Affiliation(s)
- Matthew D Bramlett
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
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