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It's MORNING EDITION, from NPR News. I'm Steve Inskeep.

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And I'm David Greene. When we hear the word "adoption," many of us think of babies. But in fact, most adopted children in the U.S. are from foster care, and they're older - from toddlers to teens. Many of these children have endured trauma, and advocates say their families need more support to cope with that. Here's NPR's Jennifer Ludden.

JENNIFER LUDDEN, BYLINE: Foster adoptions have doubled in the past 15 years. The bump came after policy changes gave states financial incentive to place children with permanent families. The federal government's also waged an aggressive ad campaign.

(SOUNDBITE OF TV ADVERTISEMENT)

UNIDENTIFIED ACTOR: (as Dad) Mark! Anna! (Trying to catch breath)

LUDDEN: In this TV spot, a frantic dad comes running up to school, to deliver the bag lunches he forgot to pack.

(SOUNDBITE OF TV ADVERTISEMENT)

UNIDENTIFIED ANNOUNCER: You don't have to be perfect to be a perfect parent, because kids in foster care don't need perfection. They need you.

LUDDEN: Such encouragement has helped persuade parents to adopt more than 50,000 foster kids each year - parents like Carlton Hadden and Ronnie Roebuck.

CARLTON HADDEN: Come over here. Come on. Come on.

RONNIE ROEBUCK: Come on, boo-boo-boo.

(SOUNDBITE OF DOG BARKING)

LUDDEN: Dog walking, dinner and daily life in their Maryland home now revolves around their adopted son, Phillip. The two men met Phillip when he was 9, the median age of those adopted from foster care. Since toddlerhood, Phillip had cycled through some 10 different foster placements. Roebuck says early on, the boy told them,"I have major issues."

ROEBUCK: And I said, "Phillip, we all do; trust me." But during that time, I clearly remember thinking that I wanted to have a therapist in place - for all of us, because it's an adjustment.

LUDDEN: And, he says, therapy has made all the difference. Phillip had been acting out. His behavior had even landed him in special education. Since being adopted, Phillip says he's talked through a lot of that in counseling sessions.

PHILLIP: Like school issues and what's happened in the school, and how am I working things out in school.

ROEBUCK: Hadden says the three have also had group therapy, and that helped Phillip.

HADDEN: He really connected, I think; saw us as a unit. And the therapist kept coming back to, you guys are a family now.

LUDDEN: Phillip just turned 13. Roebuck says he's much better behaved, is doing well academically, and is excited about school. The family's even considering adopting another child. But without all that counseling...

ROEBUCK: It would have never worked.

HADDEN: Right.

ROEBUCK: We would have been totally lost, and we would have done what thousands do. They take them back.

DEBBIE RILEY: We're seeing, across the country, a rise in disruptions.

LUDDEN: Debbie Riley heads CASE - the Center for Adoption Support and Education - in Maryland.

RILEY: Families are calling and saying, I can't do this - and putting children back into care.

LUDDEN: Riley's been at the forefront of helping adoptive families, for more than a decade. Her group provided Phillip's therapist. She says too many families are left to fend on their own, and are not prepared to cope with the effects that neglect, abuse and abandonment may have on a child - even years later.

RILEY: It may make them have difficulty connecting with others. It could result in childhood depression; you know, their spirits can be broken. And then you put them into what looks like a healthy family and all of a sudden, things look pretty crazy.

LUDDEN: And when parents do look for help, Riley says many mental health professionals have no experience with adoption issues. She trains therapists across the country, to promote what she calls adoption competency.

Adam Pertman, of the Adoption Institute, says there's a big need for other kinds of support as well.

ADAM PERTMAN: That family needs respite. That family probably needs some support to get the kids to their therapist. And we're not doing that very well.

LUDDEN: Some state foster-care systems do offer such services - along with phone counseling, parent coaching, mediation, and group therapy for teens. There can be subsidies for lower-income families. But tight budgets are always a challenge, and Pertman says a number of programs have been cut back. Mostly, he'd like to see a change in attitude.

PERTMAN: We have to stop thinking about adoption solely as child placement, and understand it as a process that requires supports and services to facilitate family success.

LUDDEN: Matching a child to a family, he says, is really just the beginning.

Jennifer Ludden, NPR News.

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