Effects of Adoption from Foster Care

When examining the effects of adoption and foster care on children who were in the foster care system, there are two key takeaways:

1. The early trauma and stress that children in foster care experience can have a number of negative psychological and developmental effects, which, if left untreated, can last into adulthood.
2. The permanent adoption of a foster child into a loving and consistent family, combined with the correct therapies and care, can have lifelong benefits for those children — even reversing some of the damage caused by early trauma and stress.

The negative effects that current and former foster youth can experience are hard for professionals and caregivers to think about. However, it’s important to learn about the potential impact of early childhood traumas so that the appropriate care and support can be provided for these children, giving them the opportunity to go on to live happy and healthy lives.

Here are some of the most common questions about the effects of foster care on children who are, or were, in care:

How Does Foster Care Affect Youth Waiting to Be Adopted?

For a child, life in temporary foster care placements or institutionalization is developmentally detrimental, despite all the love and effort of foster parents and foster care professionals. A permanent home with loving, consistent caregivers is the best place for a child and has a reparative effect on children’s developing brains. 

Children enter foster care due to some degree of neglect and/or abuse, so they have experienced trauma outside of the trauma caused by removal from original caretakers and homes. According to the National Conference of State Legislatures, “It is estimated that 90 percent of children in foster care have been exposed to trauma, and a  comprehensive review of children entering foster care in one state revealed that one in four exhibited trauma symptoms requiring treatment.”

The trauma experienced by those children affects the brain and leads to lasting emotional effects. The emotional and mental needs of these children have been noted by the National Survey of Child and Adolescent Well-Being. That survey found that children in foster care: 

• Have high levels of mental health needs, and those needs are rarely met.
• Stay in foster care longer if they have mental health disorders, rely more on expensive residential treatment placement, experience more moves in care, have higher involvement with the criminal justice system and have poorer educational outcomes.
• 80% require mental health intervention and services due to developmental, behavioral or emotional issues.
• Utilize mental health services at five to eight times the rate of other Medicaid-eligible children.
• Have higher rates of mental and behavioral health disorders than children in the general population.
• Are more likely to use multiple psychotropic medications than children that are not in the child welfare system.
• Have two to eight times the rates of various psychiatric medications prescribed in comparison to other Medicaid-eligible children.

Additionally, a child’s relationships and attachments to temporary and permanent caretakers can be affected, which can exacerbate difficulties they may experience in foster care. 

Not all former foster children will have lifelong challenges, and the children who do face challenges to overcome are not “damaged goods.” It’s important to remember that all children who have been in foster care are ready to go on to have a happy and healthy childhood, and can absolutely thrive as adults. With the loving and steady families they deserve, all children can succeed. 

How Does Adoption and Foster Care Affect Children Biologically?

Many hopeful parents are nervous that a child’s time in foster care, or the experience of adoption itself, can have a lifelong physical impact for that child. It’s not uncommon for prospective adoptive parents to ask their professional, “What are the biological effects of adoption and foster care? How does adoption and foster care affect children physically, and would my adopted child suffer from physical setbacks as a result of their adoption or their time in foster care?”

The biological effects of adoption and foster care have been studied, and depending on the type of adoption, most children seem to experience few physical effects other than any health conditions they may have already been predisposed to. Rather, it’s typically the psychological damage that children may have experienced that can lead to physical issues.

According to the National Conference of State Legislatures, “Trauma and neglect can cause excessive amounts of the cortisol hormone to be produced, resulting in toxic stress, which disrupts developing brain circuits. This kind of prolonged activation of the stress response systems can not only disrupt the development of brain architecture and other organ systems, but can also increase the risk for stress-related disease and cognitive impairment well into the adult years.”

As a result of that prolonged exposure to stress-related hormones and general parental neglect, “Children in foster care have disproportionately high rates of physical, developmental, and mental health problems. During the first 3 to 4 years of life, the anatomical brain structures that govern personality traits, learning processes, and coping with stress and emotions are established, strengthened, and made permanent. If unused, these structures atrophy. The nerve connections and neurotransmitter networks that are forming during these critical years are influenced by negative environmental conditions, including lack of stimulation, child abuse, or violence within the family. It is known that emotional and cognitive disruptions in the early lives of children have the potential to impair brain development.”

In short, the stress of being placed in foster care, in addition to any trauma they endured before that, affects a child’s developing brain, and then it often manifests itself physically.

However, with the love and patience of permanent families and the additional support of professionals, children who have experienced negative physical effects from past trauma can absolutely catch up to their peers and go on to have healthy lives.

What Are the Effects of Foster Care and Adoption on Adult Foster Children?

For adults who were in foster care or who were adopted through foster care, any lasting effects will vary depending on each person’s situation and experiences. However, the constant and early exposure to the stress-induced cortisol hormones can have lasting physical effects as well as psychological impact. 

Into adulthood, children and youth who have undergone traumatic experiences like those experienced in foster care are disproportionately more likely to suffer from:

• Depression and suicide
• Asthma
• Addiction, including alcoholism and drug abuse
• Increased likelihood of developing cancer, lung disease, diabetes and heart disease
• Obesity and eating disorders
• Unintended pregnancies and adolescent pregnancy
• Early initiation of smoking
• Struggles with trust, bonds and attachment insecurity 

Therapeutic and preventative measures should be taken as early as possible with children in foster care to avoid lasting negative effects into their adult lives. If you’re an adult who was in foster care, and you’re struggling with lasting negative effects, there are support options and adoption-competent therapists who may be able to help you address issues — don’t hesitate to reach out.

Children and teens who became part of a loving, stable, permanent family through adoption benefit as adults and throughout the rest of their lives. Adopted adults are able to receive the financial, emotional and mental support from their (adoptive) parents that everyone needs as they go out into the world on their own, and fare better than people who “aged out” of the foster care system and weren’t able to receive that permanent support network of a family.

Ways to Combat the Negative Effects of Foster Care and Adoption

There is good news. The permanent adoption of youths into loving and supportive families can actually reverse some of the damage that may have been done, and the beneficial effects of adoption have been seen in children of all ages, including well into the teenage years. All children (and adults) have the ability to heal from the psychological and physical damage of trauma when provided with the proper care, love, consistency and support. This often means utilizing the help of experienced professionals.

Foster care professionals, foster parents and adoptive parents should work with adoption-competent specialists to address issues before they become worse or have the potential to continue affecting a child into their adulthood. Adults who were in foster care may also benefit from working with adoption-competent therapists to address any lasting negative effects that may be impacting their lives.

The California Clearinghouse on Evidenced-Based Programs in Child Welfare studied therapeutic measures that can help former and current foster children who suffer from negative effects. Their recommendations include combinations of:

• Trauma-Focused Cognitive Behavioral Therapy (TFCBT): This method addresses children’s behavior as a result of traumatic experiences, with the aim of improving behavioral problems. It also addresses parenting and caretaker skills and communication with their child. Key components include cognitive therapy, behavioral therapy and family therapy for children ages 3 to 18 and their families or caretakers. 
• Multi-Systemic Therapy for Child Abuse and Neglect (MST): This practice aims to reduce out-of-home placement, improve parent and youth mental health function and increase social support for families who have come to the attention of child protective services due to serious physical abuse or neglect. It is most commonly recommended for families with children between ages 6 and 17, who are either in foster care or in the home. 
• Parent-Child Interaction Therapy (PCIT): This is a form of intervention which is intended to decrease behavioral problems such as defiance and aggression in children aged 2 to 7. It also aims to increase children’s social skills and improve the relationship between children and their parents or caretaker.

There are many types of therapeutic methods that may help improve negative effects of early trauma in foster and adopted children. Finding what works best in your situation can take time. Parents and caretakers should work with their child’s caseworker and with adoption-competent therapists to explore the methods that work best for their family. 

Despite the negative effects that trauma and multiple temporary caregivers can have on children in and adopted from foster care, there are treatments that can help these children heal, and help their caregivers provide them with the care and support that is needed. If you and your child are struggling with negative effects from his or her time in foster care, reach out to your child’s caseworker for support and guidance now.