Adverse childhood experiences influence physical and mental health in later life. Pre-adoption adversity stems from insufficient medical care, malnutrition, maternal separation, neglect and abuse, or early deprivation in institutional or foster care. Little is known about how adverse pre-adoption experiences are related to parent-child relationships and current needs of parents of adopted children. This study identified groups of pre-adoption adversity and their association with child adjustment, parenting difficulties, and current needs in adoptive families.
Data were drawn from the Modern Adoptive Families Study (Brodzinsky, 2015), which included 1,616 parents in foster care, private domestic adoption, or international adoption. Respondents were mostly Caucasians (90%), mothers (87%), married (71%), and college educated (70%).
Pre-adoption adversity was measured by seven dichotomous items (e.g., prenatal exposure to drugs or alcohol, abuse, neglect, foster care, orphanage life). Child adjustment was measured by two items (current educational adjustment and current psychological adjustment) using a 5-point Likert-type response set, with higher scores indicating better adjustment. Parenting difficulties were measured by a 1-item 5-point response set (1 = much more difficult than expected to 5 = much easier than expected). Parent current needs were measured by one item about the impact of trauma on the child, using a 5-point Likert-type response set (1 = not important to 5 = extremely important).
Latent profile analysis (LPA) using Mplus (v. 8) was conducted to examine factors of pre-adoption adversity. Using SPSS (v. 25), chi-square tests and analyses of variance were calculated to examine associations of pre-adoption adversity groups with demographics, child adjustment, parenting difficulties, and current needs in adoptive families.
LPA with a 4-class solution resulted in the best model fit (lowest AIC, BIC, adjusted BIC, and significant likelihood ratio tests): orphanage (Group 1; 23%, n = 371), a group of adoptees most of whom had been placed in an orphanage; neglect, malnutrition, and prenatal exposure to drugs (Group 2; 7%, n = 105), the majority of adoptees who had adverse experiences such as neglect, malnutrition, or prenatal exposure to drugs; multiple adversities and foster homes (Group 3; 20%, n = 316), adoptees who had experienced neglect, physical abuse, sexual abuse, prenatal exposure, and multiple foster homes; and prenatal exposure to drugs and alcohol (Group 4; 51%, n = 824), adoptees who had been exposed to drugs or alcohol.
Adoptees in Groups 2 and 3 had lower educational adjustment than adoptees in Groups 1 and 4. Parents in Groups 2 and 3 reported more difficulty than expected in raising their adoptees and had higher needs in understanding about the impact of trauma on their adoptees.
Conclusions and Implications
These results suggest that multiple pre-adoption adverse experiences, such as maltreatment and multiple foster home placement, influence adopted children’s behavior, education adjustment, and parenting needs. Unsecure attachments of adoptees in pre-adoption have negative impacts on parent-child relationships and parental needs of post-adoption services. Post-adoption services should focus on diverse needs of adoptive families, in particular for adoptive families of children who have had multiple adverse pre-adoption experiences.