March/April, 1999

Preparing Children for Permanency

by Nancy Jennings

When Shonda was four years old, her biological parents' rights were terminated due to severe physical abuse and neglect. Shonda was placed with her younger brother, Tyler, in her first of many foster homes.

After six months Shonda was removed at the foster parents' request due to acting out behaviors, including sexual misconduct against Tyler. The foster parents decided to keep Tyler, and after another four months adopted him. They did not feel they could adequately parent Shonda, and declined to adopt her even after repeated attempts and requests to keep her and Tyler together.

Shonda spent the next seven months with Mrs. Winston, an older woman who agreed to take Shonda on an emergency basis. Mrs. Winston's health was failing, and when Shonda returned home from Kindergarten one day, the social worker was there waiting for her with all of her belongings packed in a black plastic garbage bag. It was time to move to another home.

The Reilly's loved Shonda, and after 13 months decided to adopt her. They facilitated regular visits between Shonda and Tyler, and for a while, she blossomed. Her grades improved, and her relationships within the family flourished. At six years old, Shonda was becoming quite the little lady. Everyone, including her social worker, noticed dramatic changes in her behavior and attitude.

During the last visit with Tyler before the adoption was final, the Reilly's discovered Shonda again acting out with her brother. While they had known about the previous sexual abuse, they thought the problem had resolved itself. Uncomfortable with the idea of sexual abuse in their home, the Reilly's rescinded their request to adopt Shonda, and she was once again suddenly removed from a stable, loving placement.

Due to her previous acting out behaviors and the fact that the social worker was unable to find a foster family who would accept a child who needed constant attention, Shonda was placed in a residential treatment facility. Over the next two years, she continued to talk with her social worker about a "forever family," and was looking forward to a permanent home.

Three years after her disrupted adoption with the Reilly's, and five years after she had originally come into care, Shonda's social worker located a foster family who had experience with sexually abused children, and felt confident they could parent this child. But after everything Shonda had been through, the worker was concerned about making this move right and permanent.

Children in the system have often been subject to a number of surprise moves, usually beginning with the time they are removed from their birth (or caretaking) family. It is essential, then, that subsequent transitions occur slowly and honestly, with the child or children given as much advance notice of the move as possible.

Planned transitions can be far less harmful to children than abrupt moves. The stronger the relationship to the caregivers, the more difficult the separation will be. Preplacement visits are essential to making the transition from one foster home, or residential center, to a permanent home as easy as possible.

Obviously, there are times when an emergency move is necessary or required. Only under extreme circumstances should a child be abruptly removed from a placement. Every loss adds to the psychological trauma a child experiences. This, in turn, may cause delays in childhood development.

It is not only up to the child's social worker to help make a transition easier; it is important for the foster family (or residential center, if appropriate) to help the child make the transition into the permanent family. Even though it may be painful for the foster family to have the child to move to a new home, that foster family can play a vital role in helping the transition go smoothly.

In order to maintain some continuity in what is probably a chaotic life, the child should be able to take with them important and sometimes sentimental items, including:

Many foster families have ceremonies when a child moves to a new family. For example, when children moved from a particular foster home, this foster family would invite the adoptive family over for a celebratory dinner The child would plan the menu, and ask each family to include something they liked. The child would also help in the preparation of the meal. After a wonderful dinner and special dessert, the foster family would present the adopting family with a loaf of bread made by them, as well as a gift for the child a framed picture of the entire foster family, including the child. In many cases, this foster family stayed in contact with the child long after he or she had moved into their permanent placement, and summer "family reunions" for the foster family usually include several "extended" families.

Preplacement Visits

There are several reasons for preplacement visits, including:

Preplacement visits should be viewed as an opportunity to begin addressing the fears, anxiety and worries that the child is, or will soon be, experiencing. If a child has had several moves in his or her lifetime, they may often view the placement as "just one more place to live."

Most children will be anxious at the thought of moving into a permanent home, even if they already know the family and seem comfortable with them. If the family already has a child or children in the home, the level of anxiety may be even higher.

The first step in helping a child prepare for a move is to lessen any anxiety they may be feeling whether it is obvious anxiety, or not. It is therefore especially important for the foster family and social worker to support not only the child, but the new family and the move in general. If the child is receiving strong, positive input about the new family and the reason for the move, the child is less likely to be anxious or afraid.

On the other hand, if the foster parent and/or social worker make it evident to the child that the move isn't desired or appropriate, or that it is up to the child to "make the placement work," the child will only feel more distressed, and will likely act out in negative ways to "test" the placement.

Preplacement visits may also be the time when the child starts grieving for the family he or she is leaving behind. If the child has had several placements, or has not had an opportunity to deal with past grief, the child may also become overwhelmed by loss issues. It is important that both the foster and adoptive families are able to recognize the child's grief, and help him or her accept their feelings of loss as natural. It is also important that foster and adoptive families do not take any acting out behavior on the part of the child personally, as this transition period is a difficult time of adjustment.

Postplacement Visits

If the child has resided with the foster family for a long time, or has a close bond with them, postplacement visits should be strongly encouraged. In that way, the child can move into a new home without feeling abandoned, or believing they did something wrong to cause the foster family to "send them away," thereby bringing about the move.

Postplacement visits can be used to:

Postplacement visits can help alleviate a child's diminished feelings of self-worth. If a child has no contact with their birth family or subsequent caregiving families, they may wonder what they have done wrong and what's wrong with them that these families didn't want them. Telling a child, "They loved you, but . . ." may only create a sense of confusion: "If they loved me, why didn't they want me?" It is important to allow contact between the child and previous placement families to ensure a gradual transition of loyalties to the new family, as well as to prove to the child that they have done nothing wrong, and that they are not being "sent away."

While many adoptive families may see a strong relationship between the child and foster family as dangerous or intrusive, it is important these families understand the bond that has been created between the child and their caregivers. To expect a placement to occur in a matter of days or even weeks, after few preplacement visits and no follow-up contact, could be detrimental to the permanency of the placement, and could cause the child to act out in negative, sometimes aggressive ways.

Moving into an adoptive placement does not have to be exceedingly painful for the child. To ensure the stability of the placement, families and workers must work together to do what is best for the child during what is certain to be a difficult and often confusing time.

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.

Age: 0-1 Years

The child has no concept of permanent loss, and may cry, fret and show other signs of being unhappy.

Possible Effects: Now - Sense of security and trust in adults could be undermined; regression to an earlier stage of development. Later - Grows up feeling that the world owes him/her; trouble trusting others; learning problems.

What Adoptive Parents Can Do: Keep up the same routines the child had; record information so that it will be available to the child when he/she gets older.

Age: 1-3 Years

May see loss as reversible; may cry or appear uninterested in toys, food and activities.

Possible Effects: Now - Regression to an earlier stage of development; May stop talking or not start talking when appropriate age; may become too independent or too dependent.

What Adoptive Parents Can Do: 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.

Age: 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.

Possible Effects: Now - 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." Later- Blames him or herself for the loss; has problems developing a positive self image.

What Adoptive Parents Can Do: 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.

Age: 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.

Possible Effects: Now - Lack of energy to do things; chronic grief. Later - Ongoing problems in school; problems knowing right from wrong.

What Adoptive Parents Can Do: 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.

Age: 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.

Possible Effects: Now - 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. Later - Suicidal behavior; antisocial behavior.

What Adoptive Parents Can Do: 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.

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