title: Deinstitutionalisation, international adoption and the effects on the child
Creators: name: Chou, Shihning
Publisher: name: University of Liverpool Repository
Year: 2023

description: The primary question of this PhD study is the role of international adoption in deinstitutionalising young children (under 5). From an attachment theory and the child rights perspective, this PhD study first explored the potential problems with the current practices in international adoption by comparing the conduct of international adoption agencies operating on the internet. It found that at least 38% of the agency websites examined were in breach of the UNCRC and the Hague Convention. It then explored the relationship between international adoption and institutional care and how international adoption may impact on the progress in the deinstitutionalisation of children. Contrary to popular belief, the research found that international adoption is associated with the increase or maintenance of institutional care. The study went on to examine the current practices in the deinstitutionalisation of children in Europe, comparing them to a 10 Step good practice model for transforming children's services. The results tentatively suggest that countries with better community support services were more likely to meet the standards set out in the model. As child abandonment has been identified as one of the main reasons for the high numbers of children in institutional care or placed for international adoptions in the first place, a case study of Romania and a narrative literature review were carried out to explore the extent of the problem and the preventive strategies. In Romania, the main causes of child abandonment by the family were identified as; very serious economical problems, mothers' lack of formal education, lack of specialised services at the level of local communities, poor sexual education, homelessness and teenage parenting. The rate of child abandonment in maternities was calculated to be 1.8% of live births. A pilot study in three maternity units found that the two that introduced social workers saw marked reduction in the number of abandoned children whereas the number in the one without a social worker remained the same.The literature review found that there has been a lack of clear definitions on this social issue and a lack of unified recording system for abandoned children. Therefore, it is difficult to estimate the true extent of the problem. Reasons often observed for abandonment were poverty, young or single parenthood and the lack of welfare and services for parents in serious financial difficulties or found it hard to cope with the demands of the child(ren). To explore possible effects community services have on deinstitutionalised children, a follow up study of the children deinstitutionalised back into family based care, the integral part of community services, were carried out in Romania. Significant differences were found in all aspects of physical and psychology care and carer sensitivity received by the children between children who grew up in their own families, those who were deinstitutionalised into a foster or adoptive family and those who were returned to their biological families. The results showed that the quality of care received by fostered/adopted children was rated the highest on all items. This tentatively suggests that children who were de institutionalised and placed in foster and adoptive families are likely to receive better quality of parenting and have a better chance of rehabilitation and catch up with their peers. It may indicate that the selection process of surrogate families has been relatively successful. Finally, a systematic review comparing the psychosocial outcomes of internationally adopted children to adopted or non-adopted children within the host countries were carried out to shed light on the effects of international adoption on children. The results indicate that internationally adopted children who were not exposed to institutional care on a long term basis can recover well from their early adverse experience and catch up with same age children in the host countries in terms of development and cognitive functioning. However, information on international adoptees prior experience was poorly reported and difficult to verify. No study reported the assessment results that led to the decision on international adoption. Thus, it is not possible to determine whether international adoption was the most appropriate placement for those children.