The Arbutus Review • Fall 2014 • Vol. 5, No. 1 Enhancing Ministry Service Provision: Adoptive Families’ Capacity to Care for Children and Youth with Special Needs Christina Yee* University of Victoria cyee@uvic.ca Abstract This literature review was conducted to explore what elements con- tribute to the success and disruption of children with special needs who are adopted into prospective families. Five prevailing themes emerged as important considerations when placing children and youth who are waiting to be adopted. These themes include: the characteristics of the child, the characteristics of the adoptive fam- ily, sibling placements, agency practices, and most importantly access to pre- and post-adoption supports and services. A general consensus among the voices of professionals and adoptive fami- lies in this area of practice concerns the significance of support- ing families before, during, and after the placement of children and youth with special needs to ensure permanency of placements. Identifying service needs and gaps in service delivery are therefore essential to ensuring safe, healthy, and successful adoptive expe- riences for children and youth with special needs. The findings of this report pose important implications for the adoption sector of *This research project was sponsored by the B.C. Ministry of Children and Family Development (MCFD) and was completed under the supervision of Dr. Gord Miller, from the University of Victoria, and sponsor’s Wendy Norris and Renaa Bacy from MCFD. The author would like to thank and acknowledge the Jamie Cassels Under- graduate Research Award through the Office of the Vice President Academic and the Learning and Teaching Centre at the University of Victoria for supporting her research. Finally, the author would like to extend her sincerest gratitude to her peers, professors, sponsors, friends, and family who without their support this work would have not been possible. 155 mailto:cyee@uvic.ca Yee the Ministry of Children and Family Development in the service provision of special needs adoptions. Keywords: adoptions; special needs; children and youth; success and disruption; service needs; permanency; MCFD; service provision I. Introduction In the field of child welfare and adoption, the concept “spe-cial needs” may have broad definitions. It can refer to “any childwho is difficult to place as a result of physical, mental, or behav- ioral disability, race, age, or membership in a sibling group” (Perry & Henry, 2009, p. 540). According to the B.C. Ministry of Children and Family Development (MCFD) (2014), there are approximately 1000 children in the permanent care of the Ministry who are waiting to be adopted at any given point in time. “Disruption rates reported for special-needs adoptions range from 8% to 47.4%” (Borgman 1981; Kadushin 1974, as cited in Westhues & Cohen, 1990, p. 143). The purpose of this report is to help illuminate the complex interplay of factors that influence adoption outcomes for children and youth with special needs following their placement into families. These factors are defined as: the characteristics of the child, the characteristics of the adoptive family, sibling placements, agency practices, and access to pre- and post-adoptions supports and services. The hope is that by identifying these emerging patterns in research, best practice deci- sions in service provision will be made regarding special needs adop- tions. This literature review is intended to aid service providers when looking at placement decisions. In addition to ministry workers, this research has interdisciplinary significance for professionals in social work, nursing, counselling, psychology, psychiatry and other related disciplines. The paper begins with an overview of the literature search strat- egy. Next, findings from the review are presented. Finally, the re- search is discussed in terms of its implications and significance to the MCFD, as well as to the children, youth, and families with spe- cial needs. The paper concludes with a discussion of limitations and 156 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 recommendations for future research. II. Literature search strategy The purpose of this literature review is to determine what factors contribute to or disrupt the success of adoption placements of chil- dren and youth with special needs. This review involved keyword searches of online databases (Academic Search Complete, PsycINFO, and Google Scholar), additional searches for other studies, screen- ing of abstracts, assessments of the methodological strength of these studies and, finally, integration of the findings. The search results are summarized in tables 1–3. The literature search process included the following major steps: • Development of keywords and search strategies • On-line searches of databases for potentially relevant articles • Screening of abstracts for relevance and usefulness • Review of the references sections of articles • Review of government departments and related links for addi- tional studies and or unpublished documents Table 1: Database: Academic Search Complete Search terms Results Special needs + adoptions 30 of 345 Special needs + adoptions + children 21 of 225 Special needs adoptions + Canada 1 of 13 Special needs adoptions + permanency 3 of 12 Special needs adoptions + foster care 4 of 59 Special needs children + adoption outcomes 5 of 37 Adoptive families + special needs children 15 of 82 Adoptive families + caring for children with special needs 2 of 6 Characteristics of adoptive family + special needs adoptions 3 of 18 157 Yee Table 2: Database: PsycINFO Search terms Results Special needs + adoptions 14 of 231 Special needs + children + adoptions 12 of 171 Adoption outcomes + special needs 3 of 46 Adoptive parents + special needs children 8 of 91 Permanency + special needs adoptions 1 of 5 Characteristics of adoptive families + special needs children 8 of 29 Agency practices + special needs adoptions 1 of 6 Table 3: Database: Google Scholar Search terms Results Adoptive families + capacity to care + children with special needs 11 of 33,000 Adoption outcomes + children with special needs 14 of 504,000 Permanency + adoptive families + children with special needs 22 of 11,900 Adoptive families + children with special needs + disruption 25 of 20,700 Success + disruption + adoption + special needs children 12 of 81,000 III. Summary of elements that influence adoption outcomes From the broad sample, ten articles were selected for analysis based on their cumulative rating according to the criteria below: 158 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 • Rating 1: Provides an abundance of data to document factors that contribute to the success or disruption of adoption place- ments. Research and or evaluative designs were present in the literature. • Rating 2: Practice implications are identified, well-supported by credible research, and are sustainable in nature. • Rating 3: The information provided in the report has been repli- cated and can be found in one or more other articles. The articles that were awarded all three ratings were considered Ex- emplary, an article that was awarded two ratings was considered Prob- ably Effective and an article with just one rating was considered Pos- sibly Effective. Table 4 presents a summary of the ratings of articles in the sample. Table 4: Article sample ratings Article Rating Denby, Alford, & Ayala (2011) Exemplary Perry & Henry (2009) Exemplary Zosky, Howard, Smith, Howard, & Shelvin (2005) Exemplary Reilly & Platz (2004) Exemplary Egbert & Lamont (2004) Exemplary Erich & Leung (2002) Probably effective McGlone, Santos, Kazama, Fong, & Mueller (2002) Probably effective Rosenthal & Groze (1994) Probably effective Westhues & Cohen (1990) Probably effective Barth, Berry, Yoshikami, Goodfield, & Carson (1988) Probably effective Denby, Alford, and Ayala (2011) use qualitative inquiry to learn from prospective parents of nine different families their experiences of the adoption process including their motivations, expectations, prepa- 159 Yee ration, and experiences. Perry and Henry (2009) identify elements that make the placements of children with special needs successful, including adoptive parent expectations, experience with disabilities, preparedness and education needs, resources, and support systems. Zosky, Howard, Smith, Howard, and Shelvin (2005) study the aid of adoption preservation services in the prevention of negative adoption outcomes. Reilly and Platz (2004) explore the post-adoptive service needs of families adopting children with special needs. Two hundred forty-nine (N = 249) special needs adoptive families representing 373 children from the state of Nevada responded to a mailed survey to identify unmet service needs and the relationship of post-adoption service utilization to positive adoption outcomes. Egbert and Lamont (2004) utilize both qualitative and quantitative data in a study to de- termine what factors contribute to adoptive parents’ preparation for adopting children with special needs. Erich and Leung (2002) address the impact of previous types of abuse experienced by children and sibling adoption on family functioning. McGlone, Santos, Kazama, Fong, and Mueller (2002) focus on understanding the nature and ex- tent of parental stress among adoptive parents of children with spe- cial needs; five stress categories were identified: child characteristics, parent-child interactions, family cohesion, parental adjustment, and adoptions service issues. Rosenthal and Groze (1994) conduct a lon- gitudinal study on adoptive families caring for children with special needs and assessing change on several measures of adoption outcome. Westhues and Cohen (1990) analyze the differences in functioning be- tween families able to sustain special-needs placements and families in which they disrupted. Barth, Berry, Yoshikami, Goodfield, and Carson (1988) examine the complexities of older child adoptions and sibling placements as means of understanding why adoption disrup- tions occur. 160 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 IV. Analysis 1. Characteristics of the child Articles analyzed: Egbert & Lamont, 2004; Westhues & Cohen, 1990; Perry & Henry, 2009; Zosky, Howard, Smith, Howard, & Shelvin, 2005; Barth, Berry, Yoshikami, Goodfield, & Carson, 1988; Erich & Leung, 2002 The literature indicates that several factors may influence special needs adoption outcomes. One factor is the age at which the child or youth is taken into care, and the age at which he or she is placed for adoption. Older children (defined as those above the age of three) are more likely to have had multiple placements throughout their lives than younger children. It can also be more difficult to find place- ments for older children, because most adoptive parents prefer in- fants and younger children. Children of varying ages may have histo- ries of emotional, physical, and sexual abuse and neglect. These expe- riences may contribute to challenging behaviours, such as acting out, lying, tantrums, defiance, profanity, vandalism, aggression, drug use, and attachment difficulties that result in adoption disruptions. Other emotional and psychological challenges, such as eating disorders and suicide threats, may also play a role in unsuccessful placements. Pre- natal or postnatal exposure to substance abuse during critical points in development can impact a child’s ability to adapt, their mood, be- havioural nature, distractibility, and acceptability. These are addi- tional behavioural challenges that adoptive parents may face in the adoption setting. 2. Characteristics of the adoptive family Articles analyzed: Denby, Alford, & Ayala, 2011; Mc- Glone, Santos, Kazama, Fong, & Mueller, 2002; Rosenthal & Groze, 1994; Egbert & Lamont, 2004; Perry & Henry, 2009 161 Yee Adoption outcomes are further influenced by various characteristics of adoptive families. Parental preparation and readiness for adop- tion are defined by the caregivers’ expectation for the adoption and their understanding of the reality of caring for a child with special needs. Furthermore, practical experiences and personality attributes of adoptive parents contribute to their understanding of the complex- ities and challenges of caring for a child or youth with special needs. For example, practical experiences, such as personal experience and or work experience with physical, mental, behavioural, and or cogni- tive disabilities, will enhance one’s ability to empathize with the task of caring for a child with extra support needs. Personality attributes that may lend to better care include the ability to accept a child’s con- dition and differing abilities, flexibility, adaptability, patience, com- mitment, and level of social, familial, and professional support. Moti- vational desires to provide permanent care for a child and to provide the child with nurturance, love, and stability are more likely to in- crease adoption success. Furthermore, parents who are of an older age at the time of adoption are perceived to be better prepared for the adoption experience due to potential experience in facing and re- solving crises, in addition to their overall maturity level. That being said, overall positive physical and mental health of adoptive parents will lead to better outcomes. Foster parents experience greater levels of preparedness in comparison to newly adopting parents as a result of previous experiences. A family’s ethnic background, cultural be- liefs and values may influence family perspective and parenting ap- proaches in caring for a child or youth with special needs. Moreover, religious affiliation has been associated with successful placements. Finally, financial stability influences a family’s willingness and ability to access professional supports and services when they are needed. 3. Sibling placements Articles analyzed: Erich & Leung, 2002; Barth, Berry, Yoshikami, Goodfield, & Carson, 1988 162 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 Sibling placements refers to the placement of a group of birth sib- lings together in a single placement. This is a common practice that is highly ideal as it helps to regulate attachment disruptions from birth parents; however, research shows that sibling adoptions are as- sociated with a greater likelihood of adoption disruption. It is also difficult to find adoptive families who are willing to adopt more than one child, as raising sibling groups require additional energy, time, fi- nances, and skills which may affect the quality and stability of family functioning. 4. Agency practices Articles analyzed:Westhues & Cohen, 1990; Egbert & Lamont, 2004; Reilly & Platz, 2004; Zosky, Howard, Smith, Howard, & Shelvin, 2005 Placements are most likely to disrupt when children have had mul- tiple placements throughout their lives, have experienced a longer break between being freed for adoption and being placed, and when children have had different workers involved in the various aspects of adoption work. Successful placements result from positive and collab- orative parent-agency relationships where open communication and information is exchanged about the child’s history and the adoption process. This allows parents time to develop feelings of preparedness to care for a child or youth with special needs to adapt to their role as an adoptive parent. A positive parent-agency relationship can fa- cilitate better obtainment of information and training that can better inform parents of the adoption process and expected challenges that may arise. Prior to adoption placements, there are certain practices which an agency can employ that may increase adoption success. Providing the family with adequate information about the child is key. This en- tails completing thorough evaluations of the child before placement, identifying any effects of prenatal substance exposure and the sever- ity of medical and behavioural challenges, and communicating these to prospective families. Following placements, it is important to con- 163 Yee tinue to support families by conducting follow-ups and providing ac- cess to ongoing educational opportunities to facilitate parents’ con- tinual acquisition of the support, expertise, and skills necessary to understand and manage their children’s emotional and behavioural challenges. 5. Access to supports and services Articles analyzed:Reilly & Platz, 2004; Zosky, Howard, Smith, Howard, & Shelvin, 2005; Egbert & Lamont, 2004; Perry & Henry, 2009 A common theme across the literature was the significance in which an adoptive families’ access to pre- and post-adoption supports and services played in determining adoption outcomes. Placements are more likely to succeed when parents receive pre-adoption education and training in caring for children and youth with special needs. De- pending on the child or youth, providing families with specialized training that caters to the unique difference of each child and youth can also increase levels of preparedness. Moreover, providing par- ents with strategies for coping and dealing with stressful situations that may arise and connecting them with health professionals will ul- timately enhance adoption success. After placement decisions have been made, agencies can continue to provide ongoing financial, med- ical, emotional, and respite support for families. Post-adoption, fami- lies also benefit from connecting with other adoptive families of chil- dren with special needs who share the same experiences as they do. V. Discussion 1. Factors in successful placements Research provides evidence that there have been both long-term suc- cesses as well as failures in the adoption placements of children and youth with special needs (Perry & Henry, 2009). The important task is 164 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 to understand what contributes to successful and unsuccessful place- ments, to explore what makes for good therapeutic relationships be- tween adoptive children and families, and to determine the agency’s role in supporting families during this process. Five prevailing factors surfaced from the literature reviewed that can be considered impera- tive when placing children and youth with special needs into prospec- tive adoptive families. The themes were not identified in all pieces of work that were reviewed, but rather amalgamated by the researcher of this report as common patterns and themes found amongst the ex- isting research in this area of practice. As illustrated in Figure 1, these key factors consist of: the characteristics of the child, the characteris- tics of the adoptive family, sibling placements, agency practices, and the families’ access to pre- and post-adoption supports and services. Each of these factors are then elaborated upon in order to explain what is specifically entailed. Adoptive families from many walks of life have the capacity to provide good permanent homes to children and youth with special needs when they are adequately prepared and have been provided with the supports and services necessary for success. As divulged in the characteristics of the child, the process of adopting and placing a child or youth with special needs is a complex, stressful, and delicate process. This process is complicated by the desire to avoid adoption dissolution given the fragility of relationship history and frequent experiences with attachment disruptions experienced by children in the child welfare system (Zosky, Howard, Smith, Howard, & Shelvin, 2005). For adoptive families and parents, special-needs adoptions are generally believed to be stressful and challenging life processes (Barth & Berry, 1988; Groze, 1996; Groze & Gruenewald, 1991). In or- der to cope with the stressors and challenges faced by adoptive fam- ilies, special needs families rely on a host of available resources and supports before, during, and after placements. Even after placements have been made with best practices to ensuring adoptive families’ lev- els of preparedness for adoption, challenges post-adoption can con- tinue to arise and manifest due to the escalation of new demands and changes to the overall family system (McGlone, Santos, Kazama, 165 Yee Figure 1: Elements that influence special needs adoptions. This context chart illustrates the five prevailing themes that contribute to the success or disruption of adoption outcomes. Branching off of each one of the themes are elements that make up each of these themes. 166 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 Fong, & Mueller, 2002). Some of the challenges that adoptive fam- ilies encounter include: difficulties in establishing family cohesion, navigation of the challenges of obtaining required services, increased demands resulting in decreased personal time, and feelings of grief re- sulting from the loss of “expected” child and life goals (Perry & Henry, 2009; McGlone et al., 2002). In a study done by Reilly and Platz (2004), financial and medical support is the most frequently cited need by parents who are generally satisfied with services in this area (Zosky et al., 2005). Counseling and in-home supports were reported as ne- cessities that were frequently unmet. Other positive influences on family functioning include support groups with other adoptive fam- ily, parent and child support and activity groups, services to help families plan for their child’s future, family preservation services, and adoption-sensitive mental health services (Rosenthal, Groze, & Mor- gan, 1996). Overall, research suggests that access to pre- and post- adoption supports and services are regarded by adoptive families as an instrumental contribution to the long-term success of placements. Inherent to the population of children and youth who are waiting to be adopted in the child welfare system are a set of risk factors that can negatively affect adoption placements unless families are well- informed and adequately prepared for the potential challenges that may arise (Simmel, 2007). “In the field of foster care and adoption, the term “special needs” can refer to any child who is difficult to place as a result of physical, mental, or behavioral disability, race, age, or mem- bership in a sibling group” (Perry & Henry, 2009, p. 540). Children who are adopted through the child welfare system are often signifi- cantly challenged by adjustment issues; they may have unique psy- chological scars and relational deficits as a result of their past experi- ences, and these scars and deficits may vary widely (Zosky, Howard, Smith, Howard, & Shelvin, 2005). The characteristics of the child can include both internal and external problematic behaviours and both types of behaviour may indeed add to the stress placed upon adop- tive families. Existing histories of physical, emotional, and or sexual abuse and neglect may also greatly affect a child’s behaviour as well as the manner in which this behaviour is exhibited in a new family 167 Yee setting. Additionally, children and youth in the child welfare system often share common experiences of attachment difficulties, namely the experience of coping with the loss of biological parents as well as the loss of any previous foster parents or adoptive parents where attachments may have been formed (Zosky et al., 2005). Attachment disruptions pose significant challenges to the adoptive family as well as to the child’s ability to bond and develop a relationship; attach- ment disruptions are manifested as disruptions in interpersonal skills (Smith, Howard, & Monroe, 2000, as cited in Zosky et al., 2005). The research here demonstrates that adoptive parents experience stress due to these communication difficulties and the lack of disclosure and withdrawal has been identified as problematic (McGlone, Santos, Kazama, Fong, & Mueller, 2002). Adoptive families and adoptee children and youth can come from anywhere amongst a variety of unique backgrounds and experiences in life. It is essential, therefore, to form an understanding of all these possible combinations of characteristics, both in the children and in the adoptive families, in order to evaluate the “goodness of fit” be- tween them. Although some characteristics of adoptive families have long been identified as contributing factors to the success of adoption placements, it is important to note that the characteristics of adoptive parents have begun to broaden over the years (Rosenthal, Groze, & Curiel, 1990; Schwartz, 2008; Wright & Flynn, 2006, as cited in Denby, Alford, & Ayala, 2011). Single parents, same-sex couples, minority parents, and unmarried live-in partners have all been recognized as distinctive characteristics of prospective adoptive families (Schwartz, 2008, as cited in Denby et al., 2011). But while every one of these cir- cumstances can have an effect on adoption success, it is parental pre- paredness most of all which seems to affect the outcome of caring for a child or youth with special needs. Parental preparedness can alter- natively be defined as a sense of readiness, and this sense of readiness is derived in part from: the age of the caregivers, their socioeconomic status, their ability to cope, their health and well-being, their cultural background, their family composition and functioning, and the lev- els of support that adoptive families receive (Perry & Henry, 2009; 168 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 Wessthues & Cohen, 1990). Two other key measures of preparedness are the adoptive parents’ expectations for the adoption as well as their understanding of the reality of parenting a child or youth with com- plex needs (Egbert & Lamont, 2004). It is important to recognize the increase of stress and strain that adoptive families can face after adop- tion; thus, assessing a prospective families’ level of preparedness in multiple domains is crucial. An overload in parenting stress can lead to an inability to cope, which in turn may result in adoption disrup- tion. According to the Adoptive Families Association of British Colum- bia (2014), more than 50% of B.C.’s waiting children are part of a sib- ling group that must be adopted together. What becomes apparent, and problematic, is that a dearth of literature exists regarding sibling placements and their impact upon either an adoptive family’s func- tioning or upon the post-adoptive behavior of the children (Erich & Leung, 2002). Barth, Berry, Yoshikami, Goodfield, and Carson (1988) have noted that although it is preferable to place siblings together in the same adoptive family, placement disruption often occurs as a result. In the best interests of those children, sibling placements help better manage the effects of attachment disruption from bio- logical parents (Erich & Leung, 2002). However, such sibling place- ments require additional time, energy, and skills on the part of adop- tive parents. These additional requirements often result in additional stress which may in turn have adverse effects on family functioning and placement stability. Another type of situation parallel to sibling placements is the example of multiple special needs children, not part of a sibling group, being placed with adoptive families. The existing research in this particular area of special needs adoption is limited; however, in one study conducted by Glidden, Flaherty, and McGlone (2000), larger families (five or more) rearing multiple adopted chil- dren with special needs enjoyed greater levels of parental satisfaction and adjustment in comparison to conventionally-sized families (four or fewer). There are certain practices that an agency can employ to con- tribute to the success of adoption outcomes; these practices can greatly 169 Yee help to ensure the permanency of adoption placements for children and youth with special needs. Research suggests that practice vari- ables play an influential role in the success and failure of special needs adoptions. In particular, practice variables are effective as a way of preparing adoptive parents in having realistic expectations re- garding adoption and also by providing families with pre- and post- adoption supports. As well, gaining an understanding of some of the challenges that agencies have historically presented to adoptive families can help to guide the development of areas needed for fur- ther support. This gaining of historical understanding has proven useful in both successful and disruptive adoption experiences. In re- spect to agency practices, “several studies link inadequate or inaccu- rate background information on the adoptive child to increased risk of disruption or lower parental satisfaction with the adoption” (Ur- ban Systems, 1985, as cited in Rosenthal, Groze, & Morgan, 1996, p. 164; Barth & Berry, 1988; Rosenthal & Groze, 1992; Schmidt, Rosen- thal, & Bombeck, 1988). Other practices that have been associated with adoption disruption include barriers to post-placement services, and insufficient pre-adoptive training (Groze, 1994, 1995, as cited in Reilly & Platz, 2004). Measuring parental satisfaction with the adop- tion process is one of several ways to determine the positive or nega- tive outcomes of special needs adoptions (Reilly & Platz, 2004). Prac- tice issues may further contribute to disruptions when: children have had multiple placements throughout their lives, have experienced a longer break between being freed for adoption and being placed, and those who have had different workers involved in the various aspects of adoption work (Westhues & Cohen, 1990). 2. Research implications The findings elucidated from this literature review pose important implications for the adoption sector of the Ministry of Children and Family Development. These findings are highly relevant to the min- istry’s service provision when placing children and youth with spe- cial needs. Congruent across almost all domains of the literature re- 170 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 viewed is the evidence, in regard to special needs adoptions, for pro- viding ample pre- and post-adoption supports and services. These supports and services should be tailored to the unique needs of each adoptive family, child or youth. In support of this conclusion, we see that successful adoption outcomes are positively correlated with a parent’s preparedness for adoption (Egbert & Lamont, 2004). We can conclude then, that parental preparedness is the most critical charac- teristic of prospective adoptive parents. Preparation enhances cop- ing, which in turn supports the adoptive family’s ability to adapt to their new family system and effectively address issues that arise in the adoption setting (Egbert & Lamont, 2004). Ultimately, this re- quires agency practices that work to best support adoptive families in succeeding in their adoption; these are practices that provide suffi- cient information regarding the child, and offer services both during and long after placements in order to maximize sustainability. There- fore, accurate identification of the characteristics possessed by chil- dren or youth in the child welfare system is of great importance. Such proper identification informs the adoptive parents of what to expect of their child and it correctly gauges whether prospective parents are prepared to handle such challenges. Furthermore, given the varying and unique characteristics that children, youth, and families’ exhibit, it is important to not just define “goodness of fit” along the lines of physical attributes, but to also factor in the parents’ experiences and motivations (Denby, Alford, & Ayala, 2011). Lived experiences that adoptive families have provided us with have helped us to gain invaluable knowledge. We have learned that “post-adoption services can be instrumental in helping parents weather the storm of caring for a special needs adopted child and in the pre- vention of adoption failure” (Zosky, Howard, Smith, Howard, & Shelvin, 2005, p. 2). With that said, important questions still need to be asked in this area of practice: what are the barriers to providing families with consistent supports and services, before, during, and after place- ments? Why has this been expressed in the literature as an ongo- ing need? In order to support adoptive families, and their adopted children and youth in this area, what can we do to overcome these 171 Yee barriers and work around any obstacles that may be in the way? It is evident that further research is required in addressing and taking action upon these gaps in service delivery, especially now that they have been identified as critical needs. Why is there a lack of pub- lished literature in this area pertaining to the Canadian population of children and youth with special needs waiting to be adopted? With an overrepresentation of Indigenous children and youth in the child welfare system in Canada, are adoptive parents educated when there is a disparity in culture between the child or youth and the adoptive family? If so, how are they educated? Other directions for future research resulting from the literature review suggest the need to fur- ther explore sibling placements and its impact on adoption outcomes given the substantial number of sibling groups who are waiting to be adopted in Canada. As service providers, it is essential to continue to ask these questions and others that may arise in order to identify and address any service needs that may be lacking and gaps in service delivery that are present. To further expand the literary review’s scope in the future, it may be valuable to look into evaluation and assessment models con- cerning special needs adoptions that already exist and consider how they might inform further research in this area. Berry, Propp, and Martens (2007) explored the use of intensive family preservations services (IFPS) with adoptive families. In their findings, IFPS mod- els have promising outcomes for families who have problems with child behaviour (Berry, Propp, & Martens, 2007). The use of multiple regression analyses helped determine factors that were predictive of the family’s ability to remain intact after a certain period of time after services were seized. Conversely, other researchers such as Yampol- skaya, Sharrock, Armstrong, Strozier, and Swanke (2014) used latent class analysis to determine subgroups of children who have served in out-of-home care. These subgroups helped to understand the various profiles of children that influence permanency outcomes. Considera- tion and utilization of such models and tools for future research will enrich the understanding of the needs of children, youth and families in this area of practice. 172 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 3. Research limitations A literature review of this nature is, of course, limited to what re- search is available. Pointedly, there is still not enough research avail- able on the factors that contribute to the success or disruption of adopting children and youth with special needs. It is important to acknowledge that no literary search criteria was used specifically to search “Best Practices” regarding data collection methodologies that are currently used to assess and identify the needs for children with special needs. Additionally, certain factors which influence adoption outcomes, such as the impact of single parent adoptive families as opposed to adoptive families with two parents, are under-studied as well. This want of material limited the findings of this report. Like- wise, employing a search methodology was necessary in order to con- duct this type of research, but search methodologies have their own constraints. The geographic scope of this literature review, as well, presents limitations; the majority of the studies and articles that the researcher found and reviewed were established in the United States. Consequently, the findings may not be completely generalizable to other populations, including Canada’s. In addition, the research that was utilized to inform this literature review was chosen and deter- mined solely by the researcher’s evaluation of the breadth of the ar- ticles. Finally, the research was obtained and retrieved from only a select few of the available on-line databases. VI. Conclusion The general consensus of professionals and adoptive families in this area of practice is that there is a fundamental need to support families before, during, and after the placement of children and youth with special needs. Crucial to pre-adoptive placement supports is the abil- ity to provide families with a thorough overview of the background of their child. This overview includes what the characteristics of the child are, what challenges adoptive families should expect, and the provision of specialized training to deal with challenges as they arise. Additionally, the encouragement of preparation on the part of the 173 Yee adoptive family and making a network of support available to them both contribute greatly to successful outcomes. Moreover, through accurately assessing parenting experiences and the overall charac- teristics of adoptive parents, and by comprehensively evaluating the level of children’s needs, agencies can successfully determine which placements will allow a “goodness of fit” between the two. By utiliz- ing these practices, agencies maximize adoption success (Egbert & La- mont, 2004). While placement decisions are being made, and in their aftermath, it is important to continue to support families and address emerging issues; indeed these issues may otherwise threaten the like- lihood of adoption success. To this end, facilitating the adoptive fami- lies’ awareness of, and access to, pre- and post-adoption supports can foster enhanced preparation. As well, it can potentially impact place- ment outcomes, significantly and positively. Finally, unmet service needs can critically undermine the quality and stability of adoption placements (Reilly & Platz, 2008). The task of identifying any service needs and gaps in service delivery is therefore essential to ensuring safe, healthy, and successful adoptive experiences for children and youth with special needs. 174 The Arbutus Review • Fall 2014 • Vol. 5, No. 1 References Adoptive Families Association of BC (2014). About Adoption. Re- trieved March 27, 2014, from https://www.bcadoption.com/about- adoption Barth, R., Berry, M., Yoshikami, R., Goodfield, R., & Carson, M. (1988). Predicting adoption disruption. Social Work, 33(3), 227–233. Berry, M., Propp, J., & Martens, P. (2007). The use of intensive fam- ily preservation services with adoptive families. Child & Family Social Work, 12(1), 43–53. Denby, R., Alford, K., & Ayala, J. (2011). The journey to adopt a child who has special needs: Parents’ perspectives. Children & Youth Services Review, 33(9), 1543-1554. Egbert, S. & Lamont, E. (2004). Factors contributing to parents’ prepa- ration for special-needs adoption. Child & Adolescent Social Work Journal, 21(6), 593–609. Erich, S. & Leung, P. (2002). The impact of previous type of abuse and sibling adoption upon adoptive families. Child Abuse & Neglect, 26(10), 1045. Glidden, L., Flaherty, E., & McGlone, A. P. (2000). Is more too many? Adjustment in families with adopted Children with developmen- tal disabilities. Adoption Quarterly, 4(1), 67–80. McGlone, K., Santos, L., Kazama, L., Fong, R., & Mueller, C. (2002). Psychological stress in adoptive parents of special-needs children. Child Welfare, 81(2), 151–171. Ministry of Children and Family Development (2014). Adoption. Re- trieved August 27, 2014, from http://www.mcf.gov.bc.ca/adoption/ index.htm Perry, C. & Henry, M. (2009). Family and professional considerations for adoptive parents of children with special needs. Marriage & Family Review, 45(5), 538–565. Reilly, T. & Platz, L. (2004). Post-adoption service needs of families with special needs children: Use, helpfulness, and unmet needs. Journal Of Social Service Research, 30(4), 51-67. Rosenthal, J. & Groze, V. (1994). A longitudinal study of special-needs 175 https://www.bcadoption.com/about-adoption https://www.bcadoption.com/about-adoption http://www.mcf.gov.bc.ca/adoption/index.htm http://www.mcf.gov.bc.ca/adoption/index.htm Text Box http://dx.doi.org/10.1111/j.1365-2206.2006.00426.x Text Box http://dx.doi.org/10.1016/j.childyouth.2011.03.019 Text Box http://dx.doi.org/10.1007/s10560-004-6406-4 Text Box http://dx.doi.org/10.1016/s0145-2134(02)00374-5 Text Box http://dx.doi.org/10.1300/j145v04n01_05 Text Box http://dx.doi.org/10.1080/01494920903050938 Text Box http://dx.doi.org/10.1300/ j079v30n04_03 Yee adoptive families. Child Welfare, 73(6), 689–706. Rosenthal, J., Groze, V., & Morgan, J. (1996). Services for families adopting children via public child welfare agencies: Use, helpful- ness, and need. Children And Youth Services Review, 18(1-2), 163– 182. Simmel, C. (2007). Risk and protective factors contributing to the longitudinal psychosocial well-being of adopted foster children. Journal Of Emotional & Behavioral Disorders, 15(4), 237–249. Westhues, A., & Cohen, J. (1990). Preventing disruption of special- needs adoptions. Child Welfare, 69(2), 141–155. Yampolskaya, S., Sharrock, P., Armstrong, M., Strozier, A., & Swanke, J. (2014). Profile of children placed in out-of-home care: Associ- ation with permanency outcomes. Children & Youth Services Re- view, 36, 195–200. Zosky, D., Howard, J., Smith, S., Howard, A., & Shelvin, K. (2005). Investing in adoptive families: What adoptive families tell us re- garding the benefits of adoption preservation services. Adoption Quarterly, 8(3), 1–23. 176 Text Box http://dx.doi.org/10.1016/0190-7409(95)00059-3 Text Box http://dx.doi.org/10.1177 /10634266070150040501 Text Box http://dx.doi.org/10.1016/j.childyouth.2013.11.018 Text Box http://dx.doi.org/10.1300/j145v08n03_01 Introduction Literature search strategy Summary of elements that influence adoption outcomes Analysis Characteristics of the child Characteristics of the adoptive family Sibling placements Agency practices Access to supports and services Discussion Factors in successful placements Research implications Research limitations Conclusion