McKesson Clinical Reference Systems: Pediatric Advisor 2002.1

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Approximately 120,000 children are adopted each year in the United States. Children with physical, developmental, or emotional handicaps who were once considered unadoptable are now being adopted ("special needs adoptions.")

Parents with an adopted child wonder whether, when, and how to tell their child that he or she is adopted. They also want to know if adopted children face special problems or challenges.

Child and adolescent psychiatrists recommend that a child be told about the adoption by the adoptive parents. Children should be told about their adoption in a way that they can understand.

There are two different views on when a child should be told about the adoption. Many experts believe the child should be told at the youngest age possible. This approach provides the child an early opportunity to accept the concept of being adopted. Other experts believe that telling a child too early may confuse the young child who can't really understand the information. These experts advise waiting until the child is older.

In either case, children should learn of their adoption from the adoptive parents. This helps give the message that adoption is good and that the child can trust the parents. If the child first learns about the adoption, intentionally or accidentally, from someone other than the parents, the child may feel anger and mistrust towards the parents. He or she may view the adoption as bad or shameful because it was kept a secret.

Several excellent children's storybooks are available in bookstores that help parents tell their child about being adopted. Children have a variety of responses to the knowledge that they are adopted. Their feelings and responses depend on their age and level of maturity. Some children may deny the adoption or create fantasies about it. Frequently, adopted children hold onto beliefs that they were given away because they were bad, or they may believe they were kidnapped. If the parents talk openly about the adoption and present it in a positive manner, these worries are less likely to develop.

All adolescents go through a stage of struggling with their identity, of wondering how they fit with their family, their peers, and the rest of the world. This struggle may be even more intense for children adopted from other countries or cultures. In adolescence, the adopted child is likely to have an increased interest in his or her birth parents. This open curiosity is not unusual and does not mean that he or she is rejecting the adoptive parents. Some adolescents may wish to learn the identity of their birth parents. Adoptive parents can respond by letting the adolescent know it is okay to have such interests and questions, and when asked should give what information they have about the birth family with sensitivity and support.

Adoptive parents often have questions about how to deal with the circumstances of adoption. These parents need support from mental health and health professionals.

Some adopted children may develop emotional or behavioral problems. The problems may or may not result from insecurities or issues related to being adopted. If parents are concerned, they should seek professional assistance. Children who are preoccupied with their adoption should also be evaluated.