Professional Documents
Culture Documents
Jane F. Gilgun
Susan Keskinen,
St. Paul, MN
Brandi Hill
Laurie Karp
Samantha Sherman
This paper presents two newly developed instruments to be used in adoption practice: The
Readiness to Adopt Self-Survey (RASS) and the Guided to Conversations with Prospective
Adoptive Parents (Guide). Both tools are to be used with parents who are thinking about
adopting children with special needs. The items of the tools parallel each other and are meant to
be used consecutively. First, prospective adoptive parents complete the RASS in their own time
and at their own pace. Then, adoption professionals interview the parents on the same items as
are on the RASS. The development of the tools is an application of the principles of evidence-
based practice which rests upon four cornerstones: best research evidence, clinical expertise,
client values, experiences, and preferences, and the personal and professional values and
experiences of practitioners.
The Four Cornerstones of Evidence-Based Practice in Action:
studies, family therapy, family life education, social work, child development, and the various
health disciplines such as nursing, medicine, psychiatry, public health, and geriatrics. Medicine
is the parent discipline of EBP, and medical practitioners have defined EBM as consisting of
three element: best research evidence, clinical expertise, and patient preferences, values, and
experiences. A group of medical practitioners advocate for the inclusion of the person of the
physician as a fourth element, suggesting that physician values, preferences, and worldviews
shape how they practice medicine. The first author recently concluded that EBP in social work
and other applied disciplines consists of these four elements, which she calls the four
instance, Patterson et al (2004) discussed possible applications of EBP to marital and family
therapy, Singh & Oswald (2004) published a two-part series on one approach to work with
children and families using principles of EBP, and Qureshi (2004) discussed the range of
meanings of the term evidence. Such discussions show the flexibility and fluidity of the
The present paper provides yet another application of ideas from EBP. We based the
(RASS) and the Guide to Conversations with Prospective Adoptive Parents--on the four
cornerstones of EBP. Specifically, the RASS and the Guide are based on research and theory
(best research evidence) qualitative interviews that we conducted with adoption professionals
(clinical expertise), and qualitative interviews that we conducted with adoptive parents (client
We assumed that our own values, worldviews, and experiences influenced what we
identified as meaningful from within these three sources of items and ideas (the person of the
practitioner). For example, three of the five authors worked in the adoption field for a total of
about 32 years and two drew upon their experiences as parents. We hoped that our personal
meanings were diverse enough to ensure that important areas related to adoptive parenting are
covered in the tools. Related articles demonstrate the development of clinical assessment tools
for work with children and families based on the four cornerstones (Gilgun, 2005a, 2004).
The RASS, as its title states, is a self-survey designed to help prospective adoptive
parents reflect upon their willingness and capacities to parent adoptive children with special
needs and to identify parents’ strengths as well as areas that require their further attention. We
recommend that prospective adoptive parents discuss their responses with partners and with
other significant persons in their family and social networks, especially the children already in
their homes.
interview that parallels the topics in the RASS. Adoption professionals conduct this interview
after parents have completed the RASS and have discussed their responses with significant
others. Adoption professionals can offer parents support, counsel, and referral for trainings and
other forms of self-development to prepare parents for welcoming children with special needs
Drafts of the first tools are completed. We are now planning on testing them for
usefulness and relevance and for their reliabilities and validity. The present paper is a report on
their development and the thought on which the tools are based.
foster children placed for adoption from public social service agencies has almost doubled, from
28,000 to 51,000 (Testa, 2004). Despite this, the numbers of children eligible for adoption far
exceeds those who are placed. For instance, as many as 128,000 children were eligible and in
foster care in 1999. These children, sometimes called “children who are left behind,” tend to be
children of color who on average are a few years older than children who are adopted (Green,
2003), and they often have more serious behavioral, emotional, and medical issues than children
who have been placed in adoptive homes. In December 2003, President Bush signed into law the
Adoption Promotion Act of 2003, which extended a bonus program to state and county agencies
for each special needs adoption they facilitate. This extension will likely result in a continuation
The term children with special needs has many meanings but in general indicates
children with behavioral and emotional issues that are far more challenging than typical parents
have capacities for meeting (Terlin-Watt, 2001). Other characteristics of children with special
needs include health conditions that require specialized care, sibling groups, children with
histories of abuse and neglect, child exposed to drugs, alcohol, and other toxic substances
prenatally, older children, and children of color (Bower & Laws, 2002: Green, 2003; Reilly &
added to descriptors of special needs children: children who are at risk to develop behavioral,
emotional, or physical challenges resulting from the social, psychiatric, and medical histories of
birth and sometimes in early childhood, these children may not show the social, psychiatric, and
medical conditions documented in their parents’ histories, but such histories suggest the need for
increased medical and psychological care, such as periodic neurological exams, to ensure their
continued healthy functioning. As Reilly and Platz (2003) found, the challenging behaviors that
adopted children show may not appear until years after the placement. Examples are fetal
alcohol spectrum effects and childhood mental illnesses whose symptoms may not be evident at
Children who are considered special needs typically have more than one of these
experience have documented the higher likelihood of adoption disruptions among children of
special needs than among children who have a conventional status (Leung & Erich, 2002). Given
the challenges these children present to adoptive families, adoption professionals throughout the
country have a sense of urgency to recruit and prepare prospective adoptive parents who can
respond to these children effectively and thus provide these children with permanency, love, and
a sense of belonging to family and to communities that we believe is the birthright of every child.
Our professional experiences in special needs adoption have taught us a great deal about
children with special needs. These children have varied life experiences that typically include
trauma; that is, life events that overwhelm their capacities to cope with, adapt to, or overcome
the effects of these events. In addition, many children with special needs have neurological
issues that may result in emotional and behavioral difficulties. Physical limitations such as
being the targets of abuse and neglect themselves, and suffering the death of one or both parents,
often in tragic circumstances, such as murder or drug overdoses. Children sometimes witness the
murder of their parents or other murders, such as those when drug deals go wrong.
Abuse and neglect and other adversities can affect children’s behaviors and functioning if
they have not received help from adults to cope with, adapt to, or overcome the effects of these
negative life events (Gilgun, 2005a). For instance, children who have been sexually abused may
have problems with bowel and bladder control, act out sexually, or touch other children
inappropriately. There is some research evidence that children who act out sexually are
particularly difficult for adoptive families to parent, and therefore disruption rates are very high
for these children (Sandmeier, 1988; Smith & Howard, 1994). Children who have been
neglected often have difficult issues, such as food issues that can include eating until they vomit,
hoarding food, stealing sugar items, not eating or being very picky eaters.
Many special needs children have difficult attachment behaviors, meaning that they
cannot give and receive affection in ways that parents expect and want. Some of the challenges
related to attachment styles include inconsistency toward adoptive family members characteristic
for adoptive parents, and fear and withdrawal reactions when parents attempt to show affection
(Albus & Dosier, 1999). These behaviors are typical of inhibited attachments. It takes
consistency, emotional maturity, and clear expectations, among many other qualities, for parents
to gain the trust of children with attachment issues and for the children to feel they are part of the
family.
The children may require special education services at school, counseling for past trauma,
or medical assistance for lasting physical conditions. This can take a great deal of time and
requires that parents have jobs and schedules that are flexible enough for them to keep the many
appointments that children could have. Not only must families be prepared to allow outside
services into their lives, but they learn to deal with sometimes intrusive comments and questions
about their children and themselves and to know that sometimes they will be blamed for the
behaviors of their children. Adequate preparation also includes helping parents understand that
love, commitment, and willingness to seek help are significant components of satisfaction with
In addition, we have seen the importance of good working relationships between adoptive
parents and adoption professionals. Professionals can offer counsel, emotional support, and
referrals to workshops, trainings, and psychological and medical services. They can educate
parents about policies and programs that will support their parenting. Some parents have
difficulties working with adoption professionals and with seeking help for their children, perhaps
out a sense of pride. We believe that when parents struggle with their children and don’t reach
out for help early on, then the problems can get much worse. The stability of the adoption and
satisfaction with adoption are at greater risk the longer parents delay seeking outside help.
We also recognize that sometimes the help is not adequate as Huston and Kramer (1998)
found and that some children may overwhelm the resources of adequate families, an outcome
that is well-documented in research (Reilly & Platz, 2003). Thus, we know from experience that
some adoptions don’t work out as planned, even when parents and professionals make best
While the challenges cannot be minimized, children with special needs in many ways are
no different from other children in that they can be appealing, fun, full of joy and a sense of
adventure, and wonderful to be around. They offer adoptive parents opportunities to share their
lives with children, the satisfaction of watching children change and grow, and the sense of
purpose that comes with parenting children. Also, many adults thrive on their identities as
parents.
Thus, the satisfactions of parenting children with special needs most often far outweighs
the challenges. We know this from our professional experiences, and research backs us up, in
that most adoptions of children with special needs are intact. Though the research is more than a
decade old, the highest rates of disruption at about 14% (Barth & Berry, 1988) are among older
children (who are special needs by definition). Among children with special needs adopted at
any age, the disruption rates are about a percentage point higher (Groze, 1986). This means that
at least 85% of special needs adoptions succeed. As services to adoptive families become more
widely available, these disruption rates have decreased (Barth & Berry, 1988).
In summary, our professional experience leads us to believe that 1) children with special
needs may present special challenges but also enormous satisfaction, 2) that personal, couple,
and family qualities are crucial to adoption satisfaction, 3) that parenting requires the help of
family and social networks, and 4) that adoptive families benefit when they engage with
supportive services and take advantage of the subsidies and supports that most families are
entitled to.
adoptive parents for the placement of children with special needs. For example, more than 25
years ago, Fox (1979) described a small, community-based program whose purpose was to
prepare foster and adoptive parents for children with special needs. Nelson (1985) showed that
agency preparation of prospective adoption parents is a significant factor in how well children
with special needs do in adoption placement. Although there has been little research on
parents and their support networks associated with satisfaction with adoption and rates of
This research, too, has long history. More than 20 years ago, Cohen (1984) found that
parental unrealistic expectations about the children and their own capacities were associated with
both dissatisfaction with adoption and disruptions of the adoptions, findings that others have
replicated and elaborated (Barth & Berry, 1988;, 1995; Kagan & Reid, 1986). Reilly and Platz
(2003), for example, found that the more appropriate were parental expectations, the more
satisfaction parents had with their children and the more positive the impact was on marriage and
family life. About 10% of their respondents, however, stated that the impact of the adoption on
their marriages was mostly negative and close to50% said the impact had been positive. About
two-thirds said the overall impact on their family life had been positive. Reilly and
Platz (2003) reasoned that better preparation of adoptive parents for special needs children and
the more adequate the information that agencies provide about particular children placed in their
homes, the more positive adoptions will be for children, families, and marital relationships.
Other researchers have also pointed out the detrimental affects of parental rigidity in parenting
styles (Barth & Berry, 1988; Kagan & Reid, 1986; Groze, 1996; Reilly & Platz. 2003).
Qualities associated with satisfaction with parenting children with special needs include
effective parenting skills and the quality of the marital relationship (Rosenthal, Groze, &
Aguilar, 1991), adoptive families’ positive ratings of family functioning (Erich & Leung, 1988),
emotional closeness and flexibility and adaptation in family roles (Rosenthal et al, 1991),
parents’ participation in religious activities (Erich & Leung, 1998; Nelson, 1985), parental
capacities to manage their own emotional responses to children (Kagan & Reid, 1986), and
Post-placement services (Barth, Berry, Goodfield, & Feinberg, 1986; Groze, Young, &
Corcran-Rumppe, 1991) and parents’ willingness to engage with these services (Terling-Watt,
2001) are also factors in satisfaction with adoption and disruption rates. Parents sometimes have
problems finding adequate and appropriate services, which can affect adoption satisfaction
In summary, the research literature in combination with our practice experiences shows
that adopting children with special needs presents challenges, that families who do well with
these adoptions have identifiable qualities, that supportive services can have positive effects on
adoption, and that preparation of parents for the adoption of children with special needs may
increase satisfaction with adoption, may increase the positive impact on marriage and family life,
Strengths-Based Perspectives
primarily upon research on resilience (Luthar, 2003), which directs practitioner attention to
positives as well as negatives within family systems (Gilgun, 1996; 1999a; 1999b; 2002a, 2002b,
2005a). Thus, we assumed that the most helpful parental self-assessments would focus on
positive qualities associated with satisfaction with adoption rather than with predictors of
negative outcomes.
(Cicchetti & Rogosch, 2001; Shields & Cicchetti, 1998), the first author’s research on adults who
have experienced adversities (Gilgun, 1990, 1991; 1996, 1999a; Gilgun, Klein, & Pranis, 2000),
and our practice experience with adoptive parents and children eligible for adoption, we
hypothesized that parental capacities for self-regulation of their own emotions and cognitions
More research has been devoted to factors accounting for disruptions and other negative
outcomes than to qualities associated with positive outcomes (Reilly & Platz, 2003). The present
research and self-survey and structured interview guide that resulted from this research are initial
attempts to identify the positive characteristics of adoptive parents and post-placement services
that are present in families who are satisfied with their experiences with adoption.
Method
A total of 56 adoptive parents and 24 service providers participated in focus groups and
individual interviews. The parents were caring for about 150 adoptive children with various
special needs, such as fetal alcohol syndrome, attachment issues, conduct disorders, learning
disabilities, and medical issues. About one-third of the European-American parents had adopted
African-American children. The sample was primarily white, married, and middle class.
Twenty-four parents -- 21 women and three men-- participated in five focus groups,
while 34 parents, 28 women and seven men, participated in individual interviews. Four of these
interviews were with both parents. The remainder of the interviews were with single parents or
the mothers in two-parent marriages. All but two of the individual interviews were in-person and
face-to-face. Two were by telephone. Ten adoption professionals participated in two focus
groups and 14 participated in individual interviews. All but two of the adoption professionals
were women. They had between one and 22 years experience as adoption professionals. The
focus groups were about two hours in duration, while the interviews were about 90 minutes long.
Five of the seven focus groups were co-led by members of the research team, and two were led
We used a semi-structured interview guide. For the adoptive parents, the questions included
How long have you had adoptive/adopted children in your home? What kinds of issues did
these children have when first placed? What kinds of issues do they have now?
Did you initially think there was a good match between you and the children who were
placed in your home? Do you now think there was a good match between you and the children
who were placed in your home? Did you need extra help in terms of developing skills to deal
with your adoptive child(ren)? If yes, did you get the extra help? Did this help make a
difference? For the adoption professionals, the question included How would you characterize
children with special needs? How important is your relationship with adoptive parents and the
adoptive children to the success of the adoption? What does a successful adoption look like?
How do you know a successful adoption when you see one? What factors foster a successful
adoption?
The facilitators took extensive notes during the focus group and expanded upon them
later. Three of the seven groups were also tape recorded and the tapes transcribed verbatim. The
individual interviews were tape recorded and transcribed, although two of the interviews did not
result in usable tapes because of technical difficulties. Four additional interviews were not tape
recorded because the interviews took place in public places that had substantial background
noise. The interviewers also took extensive notes and expanded upon them later.
The fieldnotes and the transcripts were coded, first, to identify the major categories for
the APAC, and then re-coded to test the validity of the codes already identified, as well as to
modify and add to them researchers identified evidence that pointed to these changes. We
followed the procedures of open, axial, and selective coding as outlined in Strauss and Corbin
Thus, our analytic approach can be considered deductive qualitative analysis (Gilgun,
2005b, 2004), which is a form of analysis that begins with a guiding conceptual framework that
provides researchers with sensitizing concepts, while at the same time directs researchers to seek
evidence that contradicts and thus expands emerging understandings. The results are findings
that are well-grounded in the research material and that are comprised of concepts whose
Results
Interviews with adoptive parents and professionals not only confirmed much of our own
practice experience and findings of research cited in this present paper, but they also identified
other categories important to parenting children with special needs and fleshed out what was
already known. We identified six main categories that organized 28 subcategories for both the
RASS and the Guide. The six main categories are 1) parenting, 2) personal qualities, 3) family
and social networks, 4) values, expectations, and beliefs, 5) creating healthy environments, and
6) when you and your family need extra help. Figure 1 lists the categories and subcategories.
The first tool we developed was a prototype for what is now the Readiness to Adopt Self-
Survey (RASS). We wanted a tool for parents to complete as way for them to do some self-
reflection without fear of being judged. Adoptive parents often feel vulnerable when they are
seeking children. The Guided Conversation is an interview protocol that adoption professionals
conduct with parents after the parents complete the RASS. The tools would work together and
could be the bases of trainings and other ways of preparing adoptive parents. We believe that
the RASS and the Guide cover many important areas , and, thus, adoptive parents would be
prepared for the adoption of children with special needs if the two tools are used well.
The Self-Survey
At this point in our understanding of the RASS, we would like adoption agencies to make
the tool available to parents who are considering adoption. They can fill out the tool at their
leisure, reflect upon the implications of the qualities that adoptive parenting call for, and search
out resources to help them think through, and if they choose, to prepare to become adoptive
parents of children with special needs. The tool will be widely available on various websites on
the internet. Adoption agencies can also place the tool in their packet of information they give to
We will encourage couples to discuss their responses with each other so that they can be
as clear as possible about each other’s motivations, strengths, and areas that require attention.
The survey will be completely anonymous. In order to test the reliability and validity of the tool,
the program will generate a table of the data from the responses to the RASS. No names will be
We will set up a program so that parents can save their responses and return to the tool at
a later time. When they complete the tool, the program will generate a brief report on their
strengths and areas that require more attention. Users will need a user name and password so
that they can go back to the form they were filling out. Users will get a report for each of the
categories of the RASS. The report will score the 4’s and 5’s as “you’re doing well here. The 3
mean you have to think about this. The 1’s and 2’s will mean that you have more work to do.
We will test the web version of RASS before we make it widely available.
There are many ways adoptive parents can further develop their capacities, such as on-
going parenting education and education about the various issues that children with special needs
bring with them; in-depth conversations with spouses and partners about their willingness and
capacities; discussions with extended family and friends who might provide supportive help to
parents; consultations with experienced adoptive parents, and sometimes psychotherapy to work
We quickly saw the potential for a structured interview that paralleled the self-survey.
Such an interview could lead to in-depth conversations about parenting issues and the need for
support and special services in many cases. The Guide is long, as is the RASS, and may require
several interviews to complete. Adoption agencies typically cover many of the categories in the
Guide. Therefore, we encourage adoption professionals to adapt the Guide to their practice.
Both tools normalize the need for services, support, and further education. This is
important because parents may view help-seeking as signs of their personal weakness and
inadequacy. Many of the personal qualities highlighted in both instruments are qualities that can
be developed through adoptive support groups and on-going training and education.
Both tools also may help adoption professionals to normalize the need for services and
the turmoil that can occur in adoptive families. We have seen some adoption professional
respond to such turmoil as the fault of the parents or of the children. The Guide and the RASS
assume that many children with special needs pose difficulties to adoptive parents, and they
Some of the items are likely to provoke strong and sometimes difficult emotional
reactions in adoptive parents. Thus we recommend that the Guide be administered over two to
three interviews, that parents be informed that they don’t have to answer questions that they
don’t want to answer, and that not answering particular questions may simply mean that they are
not suited for particular kinds of children but that they may fit well with other children who are
in need of adoptive families. Adoption professionals can adapt the Guide to suit the policies and
The following are items from the first category of the RASS.
PARENTING
Identity as a Parent
___ I want to be a parent.
___ My partner wants to be a parent
___ I understand that parenting means giving up some things that are important to me.
___ I understand that parenting entails great rewards and some heartache.
___ When I adopt, I will have a strong sense that the children are my children.
Commitment
___ When I make a decision to adopt a child, I am making a commitment for life.
___ I understand that adopting children entails risks and that there are no guarantees about how
the children will turn out.
___ I can help my adopted children handle the sometimes harsh realities, such as their histories
of separation and loss.
___ I will remain committed to my children if new information about them comes to light, such
as their being more traumatized than I originally thought.
1. The most important quality that adoptive parents have is their desire to be
Identity as a parents. What are your thoughts about wanting to parent adoptive children?
Parent 2. If you have a partner, what does your partner say about wanting to be a parent?
Are you satisfied that you both want to be parents? What kinds of issues have
you talked over with your partner?
3. Parenting entails giving up some things that are important to you. What do
you think you may have to give up? What do you think will make it
worthwhile if you do have to give up some things? How can you ensure that
you keep up with activities and interests that are important to you?
4. Parenting may bring you heartache as well as rewards. What kinds of
heartache might parenting bring? What rewards do you anticipate?
5. Parenting can bring up strong emotions and memories in you. Some are
pleasant and some are painful. What positive emotions and memories do you
think you’ll have when children come into your home? What painful emotions
and memories might come back? Do you have a plan for how you will handle
these emotions and memories? If yes, what is your plan?
6. Do you think that the children you will adopt will be your children? What are
your thoughts about how this will work for you?
7. Parents who have troubled relationships with their own parents can still parent
effectively. To do so, they must be able to talk about and think about their
own parents without becoming emotional and agitated, or without thinking it
doesn’t matter. What kind of relationship do you have with your own parents
now? When you were growing up?
The tool is so new that there are undoubtedly many more uses for them that we will discover as
Discussion
Given the numbers of children eligible for adoption and the incentives that the federal
government provides to public child welfare agencies, it is likely that the numbers of special
needs children who will be placed for adoption will continue to rise. As well-documented both
in the research literature and by adoption professionals and adoptive parents, realistic
expectations and in-depth preparation for parenting children with special needs is key to
adoptions that prevail and that are satisfying to parents and to the children. The RASS and the
Guide, based on the experiences of adoptive parents and adoption professionals, are designed to
promote self-reflection and action on the part of adoptive parents by focusing on documented
qualities associated with adoption satisfaction. The Guide may also educate adoption
professionals about important areas to consider in preparing adoptive parents for special needs
children, though this tool replicates some agency practice. Both tools are intended to help
prospective adoptive parents identify their strengths and areas that require further work and to
Finally, we view the development of the RASS and the Guide as an example of evidence-
based practice in action. Both tools are based on research and theory (best research evidence)
qualitative interviews that we conducted with adoption professionals (clinical expertise), and
qualitative interviews that we conducted with adoptive parents (client preferences, values, and
experiences).
Figure 1: The Parallel Categories of the RASS and the Interview Guide
PARENTING
Identity as a Parent
Commitment
Authoritative Parenting
PERSONAL QUALITIES
Sense of Humor
Emotional Capacities
Resilience
FAMILY AND SOCIAL NETWORKS
Teamwork
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