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The State of Knowledge Of Foreign Adoptions

A summary of the results of key international adoption research projects based in Scandinavia.

By Dr. Monica Dalen, Department of Special Needs Education, Faculty of Education, University of Oslo

Part 1 | Part 2 | Bibliography


Foreign Adoptions and Research

The adoption of foreign children started in Scandinavia around 30 years ago, and a total of around 65,000 children have been adopted into these countries. Sweden has the highest number, with 35,000 foreign adoptees. In second place comes Norway, with 15,000 adoptions and then Denmark with 13,000. Finland has the lowest number of foreign adoptees.

Research into international adoptions started at the beginning of the 1970s in those countries that were the first to adopt children from other countries (the USA and Sweden). As adoptions across national boundaries gradually became more and more common, this research work spread to many countries. International, scientific literature on adoption across national and race boundaries is, however, relatively recent and limited in scope compared with research literature on the adoption of children from the same country as the adoptive parents.

Target group and methodic approach

In most of the projects, the researchers have approached the adoptive parents. Only rarely have they started off with the biological parents. This can naturally be explained by the anonymity considerations that characterize all adoption activities. Often, no information is available, and at other times the biological mother will be unknown. This is particularly pronounced when it comes to foreign adoptions. The biological origins of many foreign adoptees are also unknown. It would undeniably be interesting to gain a closer insight into the circumstances that lead to children being put up for adoption and perhaps particularly into the biological mother’s thoughts, not only when she decides about the adoption but also later on in life.

Before the mid-1980s, it was rare for the adoptee to be used as the informant. In those cases where this happened, the children were relatively young, i.e. around 12 years old (Gardell 1979, Cederblad 1989, Kvifte- Andresen 1992). This is probably primarily due to the fact that the adoptees were not any older than this. During the 1990s, researchers in several projects have approached teenagers and young adults who have been adopted (Rørbech 1989, Dalen & Sætersdal 1992, Botvar 1995 and 1999, Cederblad et al 1994, Irhammar 1998, Sætersdal & Dalen 1999, Brottveit 1999).

In Scandinavia, it has also been common to approach teachers, doctors and other health-service personnel (Gunnarby et al 1982, Proos ET al 1992, Dalen & Sætersdal 1992, Kvifte- Andresen 1992, Moser 1997, Dalen & Rygvold 1999). Many projects have also had one, two or three target groups.

Most of the research projects have been carried out as interview surveys. This is natural when taking into consideration the fact that adoption is an emotionally charged issue. However, most of the projects have involved extremely structured interviews with relatively many informants (Kvifte- Andresen 1992, Cederblad et al 1994). Only a few have made use of in-depth interviews that require qualitative processing and analysis and which therefore cannot cover too many people. Over the past few years, however, more such studies have been conducted, particularly since the adoptees have become adults and can themselves tell us about their lives (Dalen & Sætersdal 1992, Irhammar 1997, Sætersdal & Dalen 1999, Brottveit 1999).

There are also many purely quantitative studies in which questionnaires have played a dominant role. By using such an approach, the researcher can reach out to large groups and compare information from various groups of informants. These surveys have focused on foreign adoptees’ general living conditions and quality of life, on their schooling and educational patterns and on more demographic information about themselves and their families (Pruzan 1977, Rørbech 1989, Dalen and Sætersdal 1992, Cederblad et al 1994, Botvar 1995 and 1999, Dalen & Rygvold 1999).

It has also become more common for researchers to follow up their informants through longitudinal studies (Simon & Alstein 1977, 1981, 1987 and 1996, Bagley 1991 and 1993, Dalen & Sætersdal 1992 and 1999, Botvar 1995 and 1999). As the adoptees gradually grow older, such studies will provide us with an insight into new periods of their lives. Taken together, these studies may give us an impression of what it is like to be a foreign adoptee in various phases of the adoptee’s life.

Choices of issues

There are interesting differences between North America, the UK and the rest of Western Europe when it comes to the choice of issues on which the research has focused. In countries with colored minorities, researchers have been particularly interested in the adoptees’ ethnic sense of belonging, identity and self-confidence. This is naturally linked to the political debate on adoption across national and race boundaries that has taken place in these countries. Although many of the projects have had a comprehensive perspective, the ethnic sense of belonging has held a dominant position (McRoy & Zurcher 1983, Gill & Jackson 1983, Simon & Alstein, 1977, 1981, 1987 and 1996, Grotevant & McRoy 1988).

Research in the rest of Western Europe seems to have had a far more psychological starting point, and the problems researchers have been interested in have grown with the adoptees. During the first few years after foreign adoptions started, researchers in Scandinavia were more concerned with studying the initial period of adaptation in the adoptive family, with particular emphasis on the children’s mental and physical developments (Schielderup-Mathiesen & Nytrøhaug 1977, Hallden 1981, Cederblad 1982, Gunnarby et al 1982). Once the children grew slightly older, the researchers started to become interested in their language development and learning progress (Hene 1987 and 1988, Berntsen & Eigeland 1987, Hoksebergen et al 1987, Dalen & Sætersdal 1992, Kvifte-Andresen 1992). During the past few years, the focus has been on the teenage years and the adoptees’ sense of identity, and many projects have concentrated on these issues (Dalen & Sætersdal 1992, Irhammar 1998, Sætersdal & Dalen 1999, Brottveit 1999).

On the whole, we can say that researchers in western Europe and particularly in Scandinavia have focused on a wide range of areas in the adopted child’s life, while in the USA/UK, they have focused more narrowly on ethnicity and their sense of belonging. In countries where racism and a dislike of strangers is common, research activities are easily pushed towards politically sensitive problems. In those countries where the population is more ethnically homogenous, the researchers have been able to concentrate more calmly on studying adoption related to more psychological problems linked to separation, early attachments and later adjustments.

Research in Various Social Contexts

It can be difficult to give a correct picture of the adoption research that has been carried out, since international adoption research has been carried out in very different contexts and at different times. In the same way, adoption practice and legislation vary from country to country and from culture to culture. The historical and socio-political developments in many countries therefore make a comparison of the research results from different parts of the world and epochs rather doubtful.

Even comparative analyses of closely related countries, such as Norway and Sweden, can be problematical. In Sweden, for example, as distinct from Norway, private adoption agencies are allowed and single people can adopt children. It is obvious that comparisons with other countries that are more removed from Scandinavian conditions will be even more doubtful, although this is occasionally carried out in large overview articles (Demick and Wapner 1988, Hersov 1985 and 1990, Silverman and Feigelman 1990, Tizard 1991, Simon and Alstein 1996).

The Relationship Between Clinical and Epidemiological Surveys

A disproportional large share of adoption research is based on clinical material, i.e. on parents or children who have sought psychiatric or psychological help (e.g. Brinich 1990, Brodzinsky 1990, Cederblad 1989, Grotevant and McRoy 1988, Kats 1990, Seglow et al 1972). Several surveys indicate that adoptees are over-represented among such clients. However, the results are contradictory and do not give any uniform answer to the question of whether adopted children with psychological problems are over-represented in society or whether they show a specific psychopathology. Naturally, applying clinical findings to the normal population will always be problematical.

It is therefore important that we also have results that are based on surveys carried out on normal populations. A few such studies have been carried out over the past few years (Rørbech 1989, Verhulst et al 1990, Dalen and Sætersdal 1992, Botvar 1995 and 1999, Cederblad et al 1994). The epidemiological studies are based on a great number of figures that are usually obtained through surveys that take the form of questionnaires and structured interviews. The advantage of such studies is that the results can be generalized to apply to larger groups. At the same time, it is important to be aware that the results obtained from such studies are often based on average targets. If the empirical material is studied in more detail, it has been proved that the result may hide a wide range within the target group in question. Despite the fact that such surveys are extremely valuable, one must for that reason be careful about using the results uncritically.

It is also important to consider the adopted children’s problems compared with the general situation of children in society. Demographic cross-section surveys are a useful corrective here. Any evaluation of the way children and teenage foreign adoptees have adapted to society must always be compared with the way other groups have adapted.

Follow-up studies are necessary

In adoption research, it is particularly important to remember that conditions during one period of life can change during the next, and that research results from cross-section surveys carried out during one phase of life do not automatically show what will happen during the next phase (Clarke and Clarke 1977 and 1988, Figley and MacCubbin 1983, Filipp 1981, Gallangher and Vietze 1986, Magnussen 1988, Sommerschild and Grøholt 1990). Individual, genetic differences interacting with protective mechanisms in the environment may lessen the risk of serious pathology. This is also the case with strongly disadvantaged risk groups, although it is difficult to predict which factors determine the symptoms in adulthood (Garmezy and Rutter 1985, Kadushin 1967 and 1970, Magnussen 1988, Rutter 1988, Venable 1989).

Bohman and Sigvardsson’s (1980 and 1990) surveys of “invisible” Swedish adoptees at the ages of 11, 15, 18 and 23 years provide a reminder of how dangerous it can be to make what may be a negative finding for one age group into an eternal truth or prediction for future developments. In a survey of 624 adopted children, Bohman and Sigvardsson find, for example, that as 11-year-olds, all of 26% of them could be classified as “problem children”. In a retrospective article (1990) they state that ”at this stage of our study, we drew the conclusion that children of unwanted pregnancies were at a substantial risk of maladjustment during earlier school years”. In later follow-up surveys, they find that these facts have changed and the adoptees were ”in no way worse” than the rest of the population.

Dalen and Sætersdal (1992) interviewed teenagers who had been adopted from Vietnam when they were around 20 years old. Several of them had at those time serious identity problems. Their main desire was to be Norwegian and to be perceived as Norwegian by those around them, since this gave them the social status they wanted. For that reason, many were anxious about being associated with immigrants and refugees because these groups were often assigned a low social status. However, when the researchers met the same people again after ten years, the picture had changed (Sætersdal and Dalen 1999). The problems that were most important when they were in their twenties were no longer so important to them. For example, they had a far more relaxed attitude to their own appearance and to immigrants and refugees. They were now more interested in issues related to their co-habitants, establishing a family and, not least, their education and professions.

Adoptive Families

Family and Settlement Patterns

Adoptive families are stable families. Compared with families that have their own biological children, the percentage that get divorced is far lower. This also applies to families who have adopted children from abroad, and the same tendencies are confirmed in several Scandinavian surveys (Rørbeck 1989, Dalen & Sætersdal 1992, Kvifte-Andresen 1992, Cederblad et al 1994, Botvar 1995 and 1999). In the latest Norwegian survey carried out, Botvar (1999) finds that 15% of the foreign adoptees between the ages of 15-19 years state that their parents are divorced. The equivalent figure for Norwegian-born teenagers is 25%. Adoptive families also have a stable settlement pattern. Only a small percentage (around 20%) move house while the children are growing up, and most of those who move only do this once and usually within the same geographical area (Dalen & Sætersdal 1992, Cederblad et al 1994).

Sibling Relationships

According to the latest Norwegian survey in this field (Botvar 1999), there are twice as many only children among foreign adoptees (14%) compared with Norwegian-born children (6%). The majority, 57%, states that they have adopted siblings, 10% have both adopted and non-adopted siblings, while 19% only have Norwegian-born siblings. These main trends are confirmed by other previous surveys (Rørbech 1989, Dalen and Sætersdal 1992, Cederblad et al 1994, Botvar 1995). The percentage of adopted children who have no siblings is, however, slightly lower in Sweden (10%) and Denmark (12%) than in Norway (Cederblad et al 1994, Rørbeck 1989).

Employment Status

Adoptive parents are not representative of parents in general. All the surveys carried out in Scandinavia show that working-class families are under-represented among adoptive families (Rørbeck 1989, Kvifte-Andresen 1992, Cederblad et al 1994, Botvar 1995 and 1999, Dalen & Rygvold 1999). Botvar (1999) compares the father’s occupation in both adoptive families and families with their own natural-born children and finds that the humanistic-social middle level is particularly heavily over-represented among adoptive fathers. According to this survey, every fourth foreign adoptee has a father working in the health, social-welfare and education sector. We also find the same tendency among the adoptive mothers (Dalen & Rygvold 1999).

The fact that so many adoptive parents have occupations that mean they often come into contact with children and teenagers and with the welfare services may be positive for the children, since these professions require the parents to be educated in subjects such as psychology and pedagogics. In addition, we know that many adoptive parents take part in courses arranged by the various adoption associations. For that reason, the families should have relatively good financial and educational resources. The parents’ high level of education may, however, also have a negative effect on such things as the adoptees’ learning and motivation, which we will come back to later.

Motives for Adopting

Hoksebergen (1987) uses the terms ”internally-oriented” and ”externally-oriented” adoptive parents. He puts those who are involuntarily childless in the first group, while the second group comprises parents that adopt due to their political convictions. He believes that adoptions due to ”abstract ideals” run a greater risk of failure than those based on childlessness and a strongly expressed desire to have a child.

Trisiolotis (1988) uses the terms ”child-centered” and ”parent-centered” motivation. He claims that adoptions far too often take place on the infertile couple’s terms, and that the child’s primary needs often come second. According to Trisliolotis’s terminology, the Scandinavian adoption policy has been extremely ”parent-centered”. An intense desire to have a child, rather than an idealistic wish to help needy children, has been felt to be the best guarantee for a successful adoption relationship. The result of such an attitude is that around 90% of all those who presently adopt a child state involuntary childlessness to be their motive. These may be couples who cannot have their own children or couples that want more children in the family (Dalen and Sætersdal 1992, Rørbeck 1989, Cederblad et al 1994, Botvar 1995).

Nowadays, there are many indications that this attitude is changing and that the opportunity to adopt is being extended. New adoption legislation allows single people to adopt and whether other groups should have the same rights is also the subject of discussion.

New fertility techniques and bio-technological innovations will naturally also affect adoption applicants. No one can predict the consequences of the medical developments in this field. The demand for children may fall and adoptive parents may be recruited from other social levels. Perhaps prospective adoptive parents will adopt for more ideological, political and religious reasons.

The Adopted Children

The average age of an adopted child at the time of adoption has fallen considerably over the past 20 years. In 1980, the average age was 2.3 years, while it is now around 1 year (Proposition to the Odelsting no 63, 1997-1998). Just over half of all the children now adopted from other countries to Norway, for example, are under one year old. Most of the children now being adopted come from Asia and South and Central America.

Most of the foreign adoptees, between 60-70% and usually around 65%, are girls. (Dalen and Sætersdal 1992, Kvifte-Andresen 1992, Botvar 1995 and 1999)

The First Period Spent With The Family

Research on the child’s health when he or she arrives to stay with the adoptive family has often differentiated between the child’s physical and mental health (Hofvander 1978, Gardell 1979, Hallden 1981, Gunnarby et al 1982, Proos et al 1992, Berntsen & Eigeland 1987, Dalen & Sætersdal 1992). Most surveys show that the health of most of the adoptees is satisfactory when they come to live with their new families. Only around 10-15% was in bad or extremely bad physical shape. Adoptions from countries affected by war and extreme suffering will naturally have a higher percentage of children suffering from poor health, a fact that was confirmed in Dalen and Sætersdal’s (1992) survey of the war children from Vietnam. Even though conditions in the donor countries have improved for many of the children now given up for adoption, new adoption countries whose conditions are revealed to be extremely poor are constantly appearing. Adoptions from countries in Eastern Europe are examples of such a development.

So how do the children react psychologically to the change? The results of the first research projects, which particularly focused on the adoptees’ reactions during the first period spent with their new families, were practically identical. They showed that the children had a very difficult time (Hallden 1981, Cederblad 1982, Blucher-Andersson 1983, Berntsen and Eigeland 1987, Dalen and Sætersdal 1992). The kind and extent of the problems varied slightly according to the age of the child when adopted. Many children found it difficult to sleep, and going to sleep in particular was a problem for several families. For others, the greatest problems were related to food and eating. Some children did not want to eat at all, while others overate and were completely focused on food. Most of the children showed signs of anxiety and insecurity. They wanted to lie in their parents’ bed, became anxious every time their mother disappeared from sight and reacted with fear to strangers. Their parents described them as clingy. Some of the children had inexplicable emotional reactions, such as a sudden outbreak of anger, a crying fit during which they were practically inconsolable and a complete rejection of human contact at times. This last way of reacting was reminiscent of what Grotevant and McRoy (1988) describe as so-called ”elbow children”. These children were difficult to make contact with and literally pushed their parents away. Such reactions were particularly challenging for many parents because they knew how important this first interaction was for the child’s further development. Some problems were also linked to language and communication, but most of the children found it easy to make themselves understood with the help of gestures and simple words and phrases (de Geer 1992, Berntsen and Eigeland 1987).

The parents felt they were relatively well prepared for the fact that the child might have some physical complaints. However, many said they were not entirely aware of all the mental problems the child had. It is important to state here that the first surveys were carried out in the 1980s, when the adoption associations were developing their professional and specialist work. Later surveys have not focused to the same extent on the initial period spent with the family. Thus we do not know if we would have had the same results today. However, it is easy to believe that today’s adoptive parents are better prepared for the fact that the child may have mental adjustment problems as well. This is largely due to the fact that the adoption associations and authorities have made a much greater commitment to information, teaching and guidance over the past few years.

All the research projects that have focused on the initial period spent with the family show that, after a period of between three and twelve months, the adjustment difficulties diminish. For most of the children, these difficulties disappeared entirely but for some children this took a while longer. However, the situation gradually improved even for those children with the greatest problems.

Children Who Are Particularly At Risk And Strategies For Coping

Some of the adoptees have had an extremely difficult time in their native country due to war, violence, abuse, malnutrition and other lack of care. Naturally, these children will be very challenging at first. A follow-up survey of the war children from Vietnam has been carried out in Norway (Dalen and Sætersdal 1992, Sætersdal and Dalen 1999). The results of this survey confirm that the initial period was particularly demanding. The parents tell of three-year-old children who weighed seven kilos and were just skin and bone. These children had diarrhea and festering abscesses and many were entirely apathetic and showed no reactions to joy, anger or sorrow.

The Vietnamese children make up an extreme group that can serve to show how the interaction between a very damaged child and new careers starts up and is developed. Interviews with the parents of the Vietnamese children show that the child’s poor physical and mental state actually helped the attachment process. The damaged child affected the parents strongly, in the same way as a newborn child starts off emotional reactions due to his or her helplessness and total dependence on care and love. The Vietnamese children’s defenselessness reinforced and intensified the emotional attachment between the parents and children in a way that may otherwise be difficult to achieve with other adoptees who arrive in a more normal physical condition for their ages. What else can one do with a three-year-old that weighs seven kilos and physically and mentally functions like a baby than take the child in one’s arms, hold him or her close, carry the child ”day and night”, literally put the child to one’s breast and give him or her all the closeness and security they are capable of accepting?

Many adoptive parents say they feel it is difficult to ”force” themselves on a child who rejects them and does not want contact, although this may be necessary to show that ”you’re my child now”. The adoptive parents of the Vietnamese children had to communicate with their children at a far earlier level of development than their ages indicated due to the children’s helplessness. Such experiences are thought provoking and may make us more aware of the importance of recapturing a lost baby period.

Continued on next page.

Part 1 | Part 2 | Bibliography

© 1992, 2001 Dr. Monica Dalen

Monica Dalen's 1992 Ph.D. dissertation focused on international adoption in Norway. Since 1992, she has been a professor in Education at the University of Oslo, Norway.
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