Child Fatality Cases in Intercountry Adoption: Patterns and Tendencies

Purpose:  There is a substantial body of literature that focuses on deaths of biological children at the hands of their parents, but very little is known about fatalities of adopted children. This study addresses the ultimate risk in child placement, fatality, in the context of international adoption, which has not been studied previously. The researchers explored patterns among cases of fatalities in families with international adoptees, provided theoretical explanations of the fatalities, and offered suggestions for improving policy and practices in international adoption. 

Methods: Because the sensitivity of the topic limits available sources of information, the authors performed a wide variety of media searches in order to collect a sample for a qualitative analysis, adapting methods established by other researchers of child fatality (viz., Barth & Hodorowicz, 2011). The researchers collected a sample of 34 cases of fatalities of internationally adopted children that met the selection criteria (adoptions other than Russia to the US, which the authors explored in a previous study [Authors, in press]). Of the 34 cases considered here, 81% occurred in the United States, 5% in Canada, and the remainder in five other, mostly European countries. The largest proportion of the fatalities occurred in the USA. This is due to various factors including but not limited to: English-language search engines that underrepresent literature in other languages; undercounts and misclassification of child fatality cases in the literature and official documents of some countries (e.g., Crume et al., 2002; Dubowitz, 2007; Papenfuss, 2013); often closed records not accessible by the public, and the United States being the country that adopts the largest number of children in general.

Findings: The largest group of the child deaths involved children younger than 5 years old placed recently and along with siblings. The leading causes of deaths were head trauma (37%), shaken-baby syndrome (13%), and fractures and internal injuries (13%), with poisoning being least prevalent (3%). The largest group of perpetrators was mothers (39%), followed by cases in which both parents were accused (22%). Fathers, siblings, or non-family members as perpetrators represented the remainder of the cases. In most instances, placing agencies and other involved parties were not identified in sources of information available to the researchers. Of the cases for which the investigators were able to identify placing agencies, most were founded less than 20 years before a child’s fatality occurred. Older and well-established agencies were involved in five of the fatality cases. Two agencies were closed during the fatality investigation or shortly thereafter.

Conclusions and Implications: Although, not without limitations, the study is extremely valuable because it provides information that is not addressed in the existing literature, exposes multiple gaps in research knowledge of such cases, and emphasizes the value researching the statistically rare phenomenon of adoption fatalities. Not only does it increase understanding of risk factors that may reduce the risk for international adoptees, it provides a basis for developing effective practices and new directions in adoption research.