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

At the time adoption papers were signed, adoptive parents of 2,589 adoptive placements made in California from mid-1988 through mid-1989 were asked by their social workers about their interest in participating in a longitudinal study of adoptions. A total of 2,238 families (86%) agreed to participate. Approximately two years after placements, questionnaires were mailed to all families (2,058) with usable addresses, and 1,269 families (62%) returned the questionnaires. Because some of these families had adopted more than one child during the time of the study, 1,396 children are in the sample. Of the total number of children, 563 had been adopted independently (that is, without the initiation but with the final approval of an agency), 514 through a public agency, 95 via a private agency, and 87 via an inter-country agency placement. The auspices of 10% of the adoptions (137) could not be classified because of missing data.

Overall, this study is the first prospective adoption study that compares drug-exposed and non-drug-exposed children. Compared to all the adoptions in the state in the same year, our sample underrepresents relatives (10% in our sample and 21% in the overall sample) and underrepresents African-American children (13% versus 21%) in the general adoption population in California.

State data files provided background and demographic information about the adopted children, birthparents, and the adoptive parents; about the type of adoption; and about whether a subsidy was provided, whether the adoptive parents were also the foster parents, and whether the children had any special problems.

In the mailed questionnaire, the adoptive parents were asked a multitude of questions about the child and the adoptive family. The instrument surveyed child and parent information (health problems, demographics), family constellation and support, the decision to adopt, knowledge of child's background, knowledge of birthfamily, the adoption process, the child's placement (if school age), the child's score on a behavioral problem index (the Problem Behavior Inventory), foster parent adoptions, postadoption services, and satisfaction with the adoption.

Parents were asked to indicate whether their child had been prenatally exposed to drugs. Questions included: Before the placement were you aware that the birthparents had been using drugs at the time of the child's birth? Before you agreed to the placement what did you know of the birthmother's drug use during pregnancy (circle all that apply: don't know, mother smoked, mother drank alcohol, mother took drugs)? Before you agreed to the placement were you aware that the child had been exposed to drugs before birth? Table 1 shows the frequencies for these items.

Children were classified as drug-exposed if parental responses to all three of the questions resulted in an indication of known prenatal drug exposure (indications of prenatal smoking and alcohol use were not used). A total of 320 (22.9%) children were selected by this method. Another 456 (32.7%) of the children were classified as non-drug-exposed because their parents identified no such indicators. Children whose parents indicated at least once (but fewer than three times) that they were drug-exposed or for whom parents indicated "still unknown" regarding their drug exposure were classified as "unknown." This group (620) was the largest (44.4%). There were significant differences among the adoption agency auspices, with the public agencies making the highest percentage of drug-exposed placements (37%) but also having the lowest percentage of children whose drug exposure was unknown (27%). Independent adopters were least likely to report that their child was drug-exposed (4%) but had a high percentage of children whose drug exposure was unknown (59%). Parents who completed private agency adoptions reported 12% drug exposure and the highest percentage of unknown (65%).