A Trauma-Informed Conceptual Framework for Understanding Family Adjustment to Special Needs Adoption

Background and Purpose: There is increasing emphasis on the role of trauma in the lived experience generally, and in particular in the experiences of special needs children in the foster care system. However, research that informs understanding and programming that prioritizes the role of trauma in the experiences of these children, in particular those adopted out of the system is scarce. Children adopted from foster care tend to fare worst on a variety of well-being indicators compared to other types of adoption. Adoptive parents face significant challenges attempting to meet the needs of this population which threatens the stability of the adoptive placement, and places children at risk of re-entering the foster care system. A body of research has emerged attempting to explain the adjustment challenges experienced by adoptive families however, the impact of childhood trauma is largely presumed in the literature rather than explicated as a phenomenon that shapes experiences of adoptive families across contexts. In this study, we conducted a scoping review to identify gaps in the literature related to the role of trauma in the adjustment of adoptive families of special needs children, and contributed a conceptual framework grounded in the literature that adds trauma explicitly to an ecological systems model.

Method: Scoping review was used to identify literature that explicates the role of trauma in the adjustment of families adopting children from foster care. The search included five databases: Social Services Abstracts, Social Work Abstracts, PsycInfo, SocIndex, and Sociological Abstracts. Key word searches were conducted for the following terms using Boolean logic: "special needs" OR "older child" OR "public child welfare" OR "foster care" AND adopt* AND trauma*. The initial search yielded 166 results. Empirical peer-reviewed journal articles that explicitly examined the role of trauma in the adjustment of families adopting children from foster care met inclusion criteria. Following three additional phases of screening to determine if articles met inclusion criteria, seven articles were retained as the final sample for review. These articles were analyzed through in-depth examination and data extraction to identify common themes and gaps in the literature.

Results: Based on the findings of this scoping review, a clear gap was identified. Generally, the majority of studies evaluated an intervention for adopted families. However, in all of the studies, trauma was presumed rather than operationalized as a construct, and none of the studies elucidated how trauma effects adjustment to adoption at various levels of the ecosystem. The conceptual framework presented here is designed to fill this gap by explicating the particular impact of trauma within the microsystem, mezzosystem, exosytem, and macrosytem of the adopted child.

Conclusion and Implications: The scoping review anchors the conceptual framework which was developed to provide a foundation for systematic research in this area, with the ultimate intention of informing implementation of effective, trauma-informed pre-and post-adoption services that increase the likelihood of stability and familial adjustment, as well as foster successful adoptions while preventing the further traumatization of vulnerable children.