by Nancy Jennings

Several years ago the Jackson family adopted a five-year-old son. At the time of placement the adoption worker indicated that the child had suffered some early childhood abuse but the extent of the abuse and its possible effects on the child's future behavior was not known.

Almost immediately, the child's behavior was troubling. He would isolate himself from caregivers and peers, was physically aggressive towards others, and was frequently dismissed from school because of his behavior. Despite intensive therapy his behaviors escalated to such a point that they considered disrupting the adoption.

Gradually the Jackson's learned that their son had experienced constant and severe abuse from birth. He had lost the ability to trust caretakers or to care about the feelings of others. The agency also had neglected to disclose that their son had lived in nine foster homes before his adoption; each one disrupting because of his severe behavior problems.

Eventually high medical bills and extreme emotional duress led the Jackson's to sue the adoption agency on the grounds that they had withheld background information about their son because revealing it might have prevented him from being adopted.

Although the Jackson's is an extreme case, lawsuits by families claiming wrongful adoptions have been successfully argued in court. Many of these cases could have been avoided had the adoptive parents been properly prepared by being given appropriate background information and being prepared for what to expect. In fact, many adoption professionals think that full disclosure of non-identifying information should be required for all adoptions. This type of disclosure gives a family a clear understanding of what the child's past experiences were and how they may effect that child's future behavior. It allows parents to better care for their child.

A number of different factors may infuence the availability and presentation of background information to prospective families. These include agency policy, the worker's personal bias towards the case, the accuracy and amount of information gathered about the child's past prior to becoming available for adoption, and the worker's ability to synthesize information and present it prospective adoptive families in a way that will help them understand what implications a child's past may have on his/her future.

Successful wrongful adoption lawsuits have fallen into one of three categories:

• Intentional Misrepresentation: Deliberate misrepresentation of a child's health or background.
• Deliberate Concealment: Intentional failure to disclose a known material fact about the child's health or background.
• Negligent Disclosure of Information Regarding the Child's History or Prognosis: Voluntary provision of inaccurate information about a child's health or background.

In Michigan, the Family Independence Agency's adoption policy follows recent legislation, which specifically outlines the sharing of information with the selected adoptive family. It states that before an adoptive placement, the worker serving the family must provide them with information, that is reasonably obtainable, from the parents, relatives, guardian of the child, any person who had physical custody of the child for 30 days or longer, or any person who has provided heath, psychological, educational or other services to the child. The information required includes:

• Date, time and place of birth.
• Health and genetic history of the child, including prenatal information, health of child at birth, any subsequent medical, psychological, dental, or psychiatric examinations and diagnosis, nature of abuse or neglect that brought the child into care, and records of any health care provided to the child while in care.
• Health and genetic history of the child's biological family, including any hereditary or psychological conditions.
• Description of the child's family of origin, including child's given first name at birth; sex of any known siblings at time of adoption; school records; race and ethnic background of birth family; non-identifying information about the child's birth parents.
• Child's past and existing relationship with any relative, foster family, other individual or facility with whom the child has lived or visited on a regular basis.
• Levels of educational, occupational, professional, athletic or artistic achievement of child's birth family. Hobbies or special interest of the birth family.
• Circumstances of any judicial order terminating parental rights of biological parents.
• Length of time between termination of parental rights and adoptive placement.
• Any information necessary to documenting the child's eligibility for state or federal benefits.

Disclosure of background information about a child is an important part of preparing a recruited adoptive family. However, workers frequently forget the importance of sharing information and preparing the foster family or relative of a child when they are going to adopt.

The sharing of information can begin as soon as a family has been determined to be a serious match for a child. So as not to overwhelm a family, background information should be shared in increments. Both positive and negative information about the child should be presented to a family before the first meeting with the child. Additionally, families can prepare themselves by asking their worker for the following information about the child:

• Why did this child enter foster care?
• With whom has this child lived? If a child has lived in several out of home placements, why was this child moved?
• What is known about the prenatal and birth history of the child?
• What is this child's complete medical history, including genetic background?
• What attachments has this child formed during his or her lifetime?
• What adjustment problems has the child had in the past?
• What are the positive characteristics of the child? How does the child react to stress or change?

There are several methods agencies may use to present information to a family that can safeguard against confusion for all parties involved. They include having both the family and worker take notes during disclosure sessions and discussing what they feel are the important points (copies of both notes should be give to the family and kept in the child's file at the agency); tape recording meetings with families; or providing the family with case documents with identifying information removed.

Adoption is a lifelong process. Properly preparing families by providing them with background information about a child's past experiences and how they may effect the future behavior of a child are important first steps in any good adoption. Revisiting these issues during supervision and even after the adoption is completed is also important in keeping families together.

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What is Cerebral Palsy

Cerebral palsy is the term used to describe a collection of disorders which prevent the child from controlling their muscles normally. The most common form, spastic cerebral palsy, causes the muscles to be abnormally and continuously contracted, or tight. One quarter of all children with cerebral palsy have spastic cerebral palsy involving all four limbs (quadriplegia), but it can affect just the arms, just the legs (diplegia), or one side of the body more than the other (hemiplegia). The other main type, dyskinetic cerebral palsy, causes slow writhing movements, often more in the arms and face than the legs. Both types can occur in the same child.

There are many causes of cerebral palsy. It used to be blamed on lack of oxygen during a difficult delivery, but this causes less that 10% of cases. Usually it is due to an abnormality of brain development or damage to the developing brain from one of a wide variety of causes during pregnancy. Prematurity is a major factor: birth weight under 3 pounds increases the risk twenty fold. In about one quarter of cases, no cause can be found. although the damage is usually present at birth, five to 10% of cases are caused by damage in early childhood from a brain infection or trauma. Because cerebral palsy is caused by a brain injury in the past, and because brain tissue does not heal, the disability does not get progressively worse or better. Because the cerebral palsy is just one manifestation of brain injury, it is not surprising that these children typically have other disabilities. Intelligence, hearing, vision and speech can be affected. One third of children with cerebral palsy have normal intelligence, but still are likely to have learning disabilities. About one third develop a seizure disorder, usually by the age of two.

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The Effects of Loss

Depending on the child's age, loss may cause a number of different effects. Foster parents can be very valuable tools in helping the child make the transition into an adoptive home.

From the Parents As Tender Healers curriculum, Spaulding for Children's National Resource Center

	Possible Effects					What Adoptive
Age		Now		Later		Parents Can Do
0-1 Years The child has no concept of permanent loss, and may cry, fet and show others signs of being unhappy		Sense of security and trust in adults could be undermined; regression to an earlier stage of development.		Grows up feeling that the world owes him/her; trouble trusting others; learning problems.		Keep up the same routines the child had; record information so that it will be available to the child when he/she gets older.
1-3 Years May see loss as reversible; may cry or appear uninterested in toys, food and activities.		Regression to an earlier stage of development		May stop talking or not start talking when appropriate age; may become too independent or too dependent.		Keep routines the same; say things like, "It's okay to miss your mommy and daddy;" don't pressure the child to do things he or she was doing before the loss.
3-5 Years Knows that a loss has happened, but often sees it as temporary or reversible; is very curious and may ask sensitive questions with matter-of-factness; may feel abandoned.		May feel that he or she caused the loss by thinking "bad things" or "wishing things would change" - magical thinking; has trouble understanding "good" vs. "bad."		Blames him or herself for the loss; has problems developing a positive self image.		Encourage the child to express his/her feelings through play; provide ways for the child to remember the people and places he/she is separated from; reassure the child that you will take care of him or her.
6-12 Years Now understands that a permanent loss cannot be reversed; often feels responsible for the loss, may see it as punishment for something he/she has done or thought; often hides his/her feelings about the loss, carrying on as if nothing has happened; feels vulnerable and different from others.		Lack of energy to do things; chronic grief		Ongoing problems in school; problems knowing right from wrong.		Encourage the child to talk about his/her feelings and don't be judgmental; give the child clear information about the loss to reduce his or her feelings of responsibility and/or guilt.
13-18 Years Understands that a permanent loss cannot be reversed; does not blame himself/herself as much for the loss; learns to understand how this loss will affect him/her in the future.		May feel hopeless, out of control, different from others; may have school problems; may show fear, unhappiness, anxiety, denial or trouble getting close to others.		Suicidal behavior; antisocial behavior.		Be open and honest when he or she asks questions; encourage him/her to talk about his/her feelings; be available, but allow the child time alone; involve the child in making decisions about his or her future.