Abuse and deprivation in failing adoptions.

Twelve children seen in psychiatric consultation by the authors over a 3-year period were failing in their adoptive placements. All twelve had been adopted as older children (average age at adoption 5 1/2 years). Ten out of the 12 were males. A retrospective case review demonstrated that all the children shared several common characteristics: (1) a history of both neglect and abusive treatment during at least the first two years of life, (2) a behavioral pattern that was intermittently provocative and punishment seeking, and (3) an ability to elicit a sense of bewilderment and betrayal in the adoptive parents. Twenty-one months was the average duration of the adoption before the families sought the consultation. These adoptive families were all considered competent by the agencies involved. All had raised other natural and adoptive children successfully. Treatment offered by the authors seemed to be helpful in salvaging 4 of the 12 adoptive placements. The authors present these cases as a way of drawing attention to much needed research, both in better understanding the early attachment process in "older child" adoptions, and in better understanding the relative impact of abuse in influencing the child's subsequent attachment capacities.