The Future of Children, Princeton - Brookings: Providing research and analysis to promote effective policies and programs for children.

The provision of accurate background information about the child is critical to success in adoption. Some prospective parents may consider adopting a child with special needs when they really desire a "healthy" infant. Such placements are clearly high risk. Prospective adoptive parents should be cautioned that: older children are hard to change and that the expectation that they can be molded into what the parents want them to be is unrealistic; these children may never overcome the effects of years of neglect and abuse prior to the adoption; and gratitude from children should not be anticipated, more likely and more often they will be angry. Adoption should be undertaken only by parents who can love the children for what they are, and who will expect these children to become nothing more and nothing other than what they are when they are placed.⁵⁷

Financial adoptive subsidies may well be the most important postadoptive service. In one study, 98% of special needs families favored subsidies, at least in selected circumstances.⁶⁵ Of Oklahoma families receiving adoptive subsidies, 95% rated these subsidies as "essential" or "important." The Oklahoma families rated the helpfulness of about 30 different services including counseling, support groups, adoption education seminars, respite care, school services, and many others. Financial subsidy and medical services received the highest ratings.⁶⁶ One study suggests that financial subsidies mitigate the risk of disruption for adoptions that possess a number of high-risk characteristics.⁵ Subsidies have been integral in opening adoption opportunities to minority and low-income families and to foster parents, all groups that have experienced distinctly positive outcomes.

As the special needs adoption field matured, practitioners increasingly recognized that adoption issues do not disappear at the time of adoptive placement but instead persist at least until the adoptee reaches maturity. Hence, an array of postadoption services has been developed. The balance of research suggests that individual and family counseling services help only some families.⁶⁷ Programs to educate therapists regarding the particular dynamics and goals of special needs adoption should make these services more successful. On balance, adoptive parents evaluate parent groups and contact with other adoptive parents as quite helpful, perhaps more so than therapy services.⁶⁸ Important unmet service needs for families who have adopted developmentally disabled children include respite care, life planning, support groups, and babysitting for other children in the home.⁶⁷ The success experienced to date in intensive family preservation services⁶⁹ suggests that these services are instrumental in preventing adoption disruption.⁴ The behavioral problems experienced by many children adopted when older suggest the need for provision of parenting skills classes emphasizing behavioral management.⁵ The importance of effective coordination of services—subsidy, legal matters, specialized therapies or assessments, timely referral—by the social worker cannot be overestimated.¹⁸