Key Questions (Edexcel A-Level Psychology): Revision Notes
International Adoption
International adoption refers to the adoption of children across national borders, typically from developing countries to more affluent nations. This practice raises important questions about child welfare, attachment, identity, and long-term developmental outcomes. The evidence base draws primarily from longitudinal studies, quantitative surveys, and interviews with adoptees, adoptive parents, and professionals.
Background and trends
In 2001, an estimated 34,000 children from over 50 countries were adopted internationally, representing a 79% increase from previous statistics (Daugherty-Bailey, 2006; UNICEF, 2003). However, between 2004 and 2011, international adoptions declined to 23,626. This decline was linked to stricter international adoption laws in countries such as China and Russia (Selman, 2009).
The significant decline in international adoptions between 2004 and 2011 reflects a global shift toward stricter regulation and increased emphasis on domestic adoption solutions within origin countries. This trend continues to shape current adoption practices.
Major origin countries include China, Ethiopia, India, South Korea, Ukraine, and Vietnam. These nations account for most international adoptees.
Major receiving countries include the USA (responsible for approximately 50% of all international adoption cases), Spain, France, Italy, Canada, Netherlands, Sweden, Norway, Denmark, and Australia.
Research into international adoption remains relatively recent and limited in scope compared to research into domestic adoption within the same country as the adoptive parents.
The English and Romanian Adoptee (ERA) project
Major Study: The English and Romanian Adoptee (ERA) Project
Researchers: Professor Michael Rutter and Professor Edmund Sonuga-Barke
Participants: 165 children adopted into the UK from Romania before the age of three, mostly in the early 1990s. These children were compared to a control group of adopted children from the UK who had not lived in institutions.
Background: Most children had spent their early lives in institutional care in Romania, where conditions ranged from poor to abysmal. This provided an opportunity to examine the effects of extreme early deprivation.
Aim: To examine the extent to which children could recover from extreme deprivation in early life when subsequently placed in a safe, nurturing family environment during middle childhood.
Methodology: The ERA project is a longitudinal, multi-method study. Children were assessed at ages 4, 6, 11, and 15 years using various psychological and developmental measures.
Key Findings:
The study demonstrated that these children made substantial improvements in psychological functioning following successful adoption. Children who experienced nurturing family environments showed remarkable recovery from their early adverse experiences.
However, a notable minority of those adopted after the age of six months continued to experience problems. Approximately one-third of Romanian children placed for adoption after six months of age experienced difficulties that required intervention from educational, psychological, or psychiatric services.
Specific Challenges (children adopted after six months):
- Autistic-like qualities: Some children displayed behaviours characteristic of autism spectrum conditions
- Attachment difficulties: Problems forming secure emotional bonds with adoptive parents
- Social functioning problems: Difficulties with appropriate social interactions and relationships
Despite these challenges, the study concluded that the vast majority of families successfully made the adoptions work, even though many of these children had been considered unacceptable for domestic adoption in the UK.
Evaluation:
Strengths:
- Longitudinal design allows examination of long-term outcomes and developmental trajectories
- Inclusion of a control group enables comparison and strengthens conclusions
- Multi-method approach provides comprehensive data
Weaknesses:
- Children came from particularly extreme conditions, which may limit generalisability to other international adoptions
- Focus on one specific origin country (Romania) and one receiving country (UK)
- Cannot establish definitive causal relationships due to ethical constraints on experimental manipulation
Quantitative results
Children adopted after six months demonstrated several challenges that required careful attention and support from adoptive families and professionals.
Critical Finding: Children adopted after six months showed significantly higher rates of:
- Autistic-like qualities: Behaviours characteristic of autism spectrum conditions
- Attachment difficulties: Problems forming secure emotional bonds
- Social functioning problems: Difficulties with appropriate social interactions
This highlights the critical importance of early placement in adoption outcomes and the need for specialized support for children adopted after six months of age.
Research methodology in international adoption
Focus on adoptive parents
Research has largely focused on adoptive parents rather than biological parents. This is because information from biological parents is rare, primarily due to anonymity considerations that characterise adoption. This is particularly noticeable in foreign adoptions, where the biological origins of many children who have been adopted are unknown.
Research has therefore concentrated on:
- Teenagers and young adults who have been adopted
- Experiences of teachers, doctors, and other health service personnel
- Interviews with adoptive parents and families
The lack of biological parent data represents a significant limitation in international adoption research. Most studies must therefore rely on adoptive parent reports, professional observations, and self-reports from adoptees themselves. This affects our understanding of genetic and prenatal factors that may influence outcomes.
Study designs
The majority of research projects have been conducted as interview surveys. Only a few studies have utilised in-depth qualitative interviews to gather detailed experiential data. Quantitative studies have focused on foreign adoptees' living conditions, schooling, and demographic information about themselves and their families.
Advantages of quantitative approaches: Results can be generalised to the wider population. Longitudinal studies provide useful insight into new chapters of children's lives.
Longitudinal Study: Norwegian-Vietnamese Adoption Research
A Norwegian study by Dalen and Sætersdal (1992) examined teenagers who had been adopted from Vietnam. Several children in their sample were considered to have serious identity problems. They commonly expressed a desire to be Norwegian and to be perceived as Norwegian. Many were anxious about being associated with immigrants and refugees.
Follow-up Findings: When the sample was followed up ten years later, the problems that were most important in late adolescence were no longer relevant to them. Participants were now more interested in issues related to their partners, establishing a family, their education, and careers (Sætersdal and Dalen, 1999).
Key Insight: This demonstrates that identity concerns in adolescence may be temporary and that adopted individuals can successfully integrate multiple aspects of their identity over time.
Clinical populations and behavioural outcomes
A disproportionately large share of adoption research is based on parents or children who have sought psychiatric or psychological help. Brinich (1990) and Brodzinsky (1990) noted that adoptees are over-represented among clinical populations.
Critical Finding on Clinical Populations
International adoptees face significantly higher rates of behavioural and mental health challenges:
- More behavioural problems at home and in school
- Referred to mental health services twice as often as non-adopted children (Juffer and Van Ijzendoorn, 2005)
- Children from Sri Lanka and Colombia showed more behaviour problems than domestic adoptees (Juffer, 2006)
Vulnerable Period: Children in middle childhood seemed to understand the concept of adoption, and this awareness made them especially vulnerable to stress.
Important Implication: Parents and internationally adopted children should be adequately supported by adoption agencies and social services to manage these challenges effectively.
Several surveys indicate that when compared with non-adopted children, international adoptees present with more behavioural difficulties. This pattern highlights the need for preventive support and early intervention services.
Scandinavian research findings
Scandinavian studies suggest that children who have been adopted from abroad are adopted into relatively stable families, with divorce rates among adoptive parents being comparatively low.
Family stability data
| Family type | Percentage stating parents divorced (ages 15-19) |
|---|---|
| Foreign adoptees | 15% |
| Norwegian-born teenagers | 25% |
The data from Botvar (1999) shows adoptive families demonstrate greater stability than the general population.
Sibling composition
The study also found differences in sibling arrangements:
- 14% of foreign adoptees are only children (compared to 6% of Norwegian-born children)
- 57% have adopted siblings
- 10% have both adopted and non-adopted siblings
- 19% have only Norwegian-born siblings
This represents a positive trend, as these parents are more likely to have prior experience of working with children and be educated in subjects such as psychology (Botvar, 1999; Dalen and Rygvold, 1999). The presence of siblings, particularly adopted siblings, can provide important peer support and shared understanding of the adoption experience.
Children who need additional help
Age at adoption and physical health
Many international adoptions take place when the child is under one year old. According to Scandinavian research, only approximately 10-15% of adopted children were in poor or extremely poor physical shape at the time of adoption.
Adoptions from countries affected by war and extreme suffering naturally have a higher percentage of children suffering from poor health.
Early adjustment difficulties
Studies from the 1980s and 1990s documented that children experienced considerable difficulties during the initial adjustment period (Hallden, 1981; Cederblad, 1982; Blucher-Andersson, 1983; Berntsen and Eigeland, 1987; Dalen and Sætersdal, 1992).
Common Early Adjustment Challenges
Physical symptoms:
- Difficulty sleeping
- Eating difficulties (either refusal to eat or overeating and complete focus on food)
Emotional and behavioural responses:
- Signs of anxiety and insecurity
- Becoming anxious when the mother disappeared from sight
- Reacting with fear to strangers
These responses are normal reactions to significant life transitions and typically diminish with time and appropriate support.
"Elbow children"
Important Concept: "Elbow Children"
McRoy and Jenkins (1988) coined the term "elbow children" to describe children who commonly pushed their parents away, as if using their elbows to maintain physical distance.
Some problems were linked to language and communication barriers. However, most children found it relatively easy to make themselves understood with the help of gestures and simple words and phrases.
This behaviour is understood as a defence mechanism related to early attachment disruptions and typically improves as the child develops trust and security in the adoptive family.
Timeline for adjustment
Studies found that between three and twelve months after placement, these adjustment difficulties diminished substantially.
Important contextual note
It is important to recognise that these studies were carried out some time ago, when adoption associations were still developing their professional and specialist work. In recent years, there has been much greater commitment to providing information, teaching, and guidance for adoptive parents.
The UK Hong Kong Adoption Project
Long-Term Study: UK Hong Kong Adoption Project
Researchers: Feast, Grant, Rushton and Simmonds (2013)
Participants: 72 girls adopted from orphanages in Hong Kong during the 1960s
Background: The women were mostly abandoned as infants and spent between 8 and 72 months in orphanages in Hong Kong. Although they experienced a reasonable quality of physical and medical care, they lacked consistent one-to-one care and stimulation.
Methodology: The study used qualitative analysis of face-to-face interviews with the women, conducted approximately 50 years after their adoption.
Positive Outcomes:
The findings were overwhelmingly positive regarding long-term psychological outcomes:
- Family life that can provide nurture, care and stimulation can counteract the negative impact of a poor start in life
- Psychological outcomes 50 years on were commensurate with matched groups of adopted and non-adopted women born in the UK
- Well-being and life satisfaction did not appear to differ from comparison women
- No evidence of severe difficulties in adult social relationships or poor self-esteem
Negative Experiences:
- Virtually all women reported some experience of racism or prejudice in both childhood and adulthood
- Experiences ranged from playground name calling during childhood to serious racist attacks in adulthood
Conclusions:
The authors concluded that the quality of the adoptive home is an important contributor to well-being as adults. The orphanages in Hong Kong appeared to have provided a much better level of care than those in Romania, which may explain why this group of women seem to have fared considerably better.
However, the study also suggests that "the challenges and complexities of inter-country adoption should not be underestimated."
Evaluation:
Strengths:
- Very long-term follow-up (50 years) provides rare insight into lifetime outcomes
- Qualitative methodology allows for rich, detailed understanding of lived experiences
- Comparison with matched groups strengthens conclusions
Weaknesses:
- Sample limited to one specific cohort from one country
- All participants were female, limiting generalisability to male adoptees
- Historical context (1960s adoptions) may not fully apply to contemporary adoption practices
Support for families
Current challenges
A recent report entitled 'A Changing World' (2013) collated information from:
- 1500 adoptive parents
- Adoption professionals in the USA and other 'receiving' countries
- Countries of origin
- Senior policy makers in 19 nations
Current Challenges Facing International Adoption
The report reveals a concerning picture of international adoptions:
For children in origin countries:
- More children are remaining in orphanages for longer periods of time
- This extended institutionalisation is causing increased developmental and psychological harm
- Many countries of origin, including large ones such as China, are increasingly allowing the inter-country adoption of children with special needs, older children, and/or children in sibling groups (to be adopted together)
For adoptive families:
- Many adoptive families are struggling to cope with their adopted child's needs
- Families often do not know where to turn for support
These findings emphasise the urgent need for improved support systems and better preparation for both origin and receiving countries.
Recommendations
The report strongly recommends several improvements to international adoption systems:
For countries of origin:
- Provide more complete and accurate diagnoses and records on medical and mental health issues
For receiving countries:
- Offer more training and resources to help countries of origin improve their child welfare and adoption systems
- Provide better preparation, services and support for adoptive families before, during, and after adoption
Evaluating international adoption research
It can be difficult to give a definitive picture of international adoption research, as studies have been carried out in very different contexts.
Complexity of International Adoption Research
Variability factors:
- Adoption practice and legislation vary substantially from country to country
- The historical, social and political context impinges on the overall picture
- Different origin countries provide different levels of care in institutional settings
- Different receiving countries provide different levels of support for adoptive families
These variations make it challenging to draw universal conclusions about international adoption outcomes. Research must always be interpreted within its specific cultural, historical, and political context.
Clear conclusion: Despite this complexity, evidence consistently shows that internationally adopted children fare better when adoptive parents are adequately supported by adoption agencies, social services and other key organisations.
Key Points to Remember:
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International adoption peaked at 34,000 children in 2001 but declined to 23,626 by 2011 due to stricter laws in countries like China and Russia.
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The ERA project demonstrated that children can make substantial recovery from early deprivation when placed in nurturing family environments, though those adopted after six months often face ongoing challenges.
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Internationally adopted children are over-represented in clinical populations and are referred to mental health services twice as often as non-adopted children, highlighting the need for adequate support systems.
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Long-term outcomes can be very positive, as shown by the UK Hong Kong Adoption Project, where adoptees showed psychological well-being comparable to non-adopted individuals 50 years later, though experiences of racism were nearly universal.
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Current challenges include children remaining in institutions longer, insufficient support for adoptive families, and inadequate medical records, emphasising the need for better preparation, training and ongoing support from adoption agencies and social services.
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The critical period of three to twelve months after placement is when most adjustment difficulties diminish, highlighting the importance of intensive support during this time.
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Quality of the adoptive home is consistently identified as an important contributor to long-term well-being and successful outcomes.