Adoption can be a great way to expand a family and for a child to find a permanent, loving home. But some people may fear that adopted children will be more at risk for mental health and behavioral disorders than non-adopted children. Is this fear warranted? Studies of infant adoptions have found that there is little difference between the occurrence of mental health disorders between non-adopted and adopted individuals; however, several things can impact the likelihood of adopted children developing mental and behavioral health issues.
Prenatal Concerns
The first environment a child ever experienced, the womb of their biological mother, can have an impact on their behavioral health needs later in life. If alcohol or substances were abused by the birth mother or if she was under a large amount of stress, this can have a lasting impact on the child. For this reason, it is ideal, when possible, for adoptive parents to know the circumstances that a birth mother was experiencing while pregnant.
Genetic Conditions
A child can also inherit a predisposition toward certain conditions from their birth parents. This does not necessarily mean that a child will develop that diagnosis. It only means that the likelihood of it occurring is higher than in people who don’t have a blood relative with that particular concern. If the child experiences abuse, neglect or high levels of stress, their chances of developing the condition increase further. While it may not be possible for adoptive parents to get a full medical history with mental health from a child’s birth parents, as much information as can be obtained can be helpful. Medical science also continues to advance, and genetic testing may be able to provide information that is not already known.
Trauma
One of the largest factors that influenced the likelihood of an adopted child developing mental or behavioral health concerns was their exposure to trauma. Trauma exposure was especially likely for children who experienced multiple placements prior to adoption that might have included things like:
- Physical, emotional or sexual abuse
- Neglect
- Parental abandonment
- Incarceration of a parent
- Divorce or separation of caregivers
- Death/loss of a caregiver
- Witnessing domestic violence
Foster children are at especially high risk for developing post-traumatic stress disorder (PTSD), particularly if they have been sexually or physically abused. Whenever possible, adoptive parents should attempt to obtain records from the courts and child protective services that might help them to know what traumas their child may have experienced before entering their home.
Signs of Trauma
Though adoptive parents may not be provided with a complete history of the child they are adopting, it may be possible to recognize if trauma is likely to have occurred by observing whether the child’s behavior includes the following:
- Parentified behavior (child acts like an adult, taking on excessive burden for the household or other family members)
- Nightmares or flashbacks
- Avoidance of certain people or places
- Jumpiness or a sense of constantly being vigilant
- Numbness or lack of emotional expression
- The child seeing themselves as guilty or to blame for circumstances outside their control
The Good News
While there may be factors that could increase an adoptee’s likelihood of developing a mental or behavioral health condition, there are also ways that adoptive parents can help them to recover:
- Education – parents can read and attend training sessions about childhood mental illness, trauma, and how to parent children who suffer from either.
- Therapy – the best type of therapy for a specific child may depend on their age, developmental level, and specific diagnosis. Family therapy may also prove beneficial in some cases.
- Inpatient treatment – in more extreme cases, a child may require a period of residential care to help them develop the skills they need to manage their condition.
- Trauma-informed schools – parents can work with their child’s school to ensure that they are utilizing trauma-informed practices and that their staff are trained to understand the impact of trauma on children.
- Trauma-informed professionals – parents can select pediatricians, therapists, and other providers who are knowledgeable in trauma-informed practices and do their best to limit trauma triggers in their interactions with patients.
- Medication – this treatment option should be approached carefully. Foster care youth have been historically over-medicated for mental health concerns. Medication can be helpful but must be used in conjunction with individual and family therapy, trauma-informed care, and teaching the child coping skills to manage their behavior. Many young people choose to discontinue their meds, either temporarily or permanently, upon entering adulthood or may have to do so involuntarily if they are ever without insurance, so ensuring that they have other ways to manage their mental health is extremely important.
If you have additional questions about how to help adopted children manage their mental health, the caring team at Highland Hospital in West Virginia is happy to help.
