Barbara Tizard (1977) Adoption: a second chance London: Open Books 0 7291 0191 6
Barbara Tizard has had a long-standing interest in issues of child development and the primary focus of this research was on the developmental progress of children who had spent a long period in a residential nursery. When she started the research, many people would have expected that the children would have been irreparably damaged by the experience. In fact, she found quite the opposite and threw a new light on adoption which, following the 1968 Abortion Act, was being transformed from a service for childless adults into a service for children.
In fact, adoption had always performed one service for children because, until the 1989 Children Act, any child born out of wedlock was illegitimate; so adoption within a family, which she mentions in Chapter 1, was a way of legitimising illegitimate children.
In the light of King et al. (1971), she also took a keen interest in staff-child interactions in residential care and the year before had addressed the FICE Congress in Aberdeen on this subject (Tizard, 1976).
Of the study group, about half were successfully adopted, just under half were restored to their families and a small number went into long-term foster care.
– Adoption has ceased to be a service for childless couples and has become a form of child care.
– Initial problems tend to be forgotten when placements are successful.
– The previous placement was more likely to be blamed if a child had problems.
– There was no obvious benefit gained from maintaining contact with the previous placement.
– Children previously rejected do not have problems making fresh attachments.
– All the children were over-friendly with adults, including strangers.
– The early adopted children showed gains in IQ, which appeared to be related to the experience of emotional attachment.
– Overall, the children showed no more problems at home than a control group.
– The adopted children and their parents interacted far more than the control group; the restored children and their parents somewhat less.
– The children presented more problems at school though, unlike the control group, they were the same as they presented at home.
– The children’s overall behaviour was no more difficult than other similar children but the restored children were more likely to have been referred for treatment for some sort of disturbance.
– There was continuity in behaviour reports over time.
– Teachers and parents agreed about the difficult behaviour but not about its severity.
– Unlike the controls both groups were more likely to have better relationships with younger children than with their peers.
– Most parents had difficulty talking about adoption to the children.
– The later adopted and restored children had similar experiences to the early adopted and restored but there was less agreement between teachers and parents on behaviour problems and the institution was more likely to be blamed for problems.
– Only one foster family took any trouble to address a child’s ethnic background but this did not appear to have any adverse effect on the others.
– Satisfaction with adoption was high.
– Long-term fostering left children confused but was most satisfactory when the foster parents behaved more like adoptive parents; adopting the `correct’ professional role was damaging to the child.
– Though early experiences affect later development, they do not do so in the ways described by Bowlby (1953).
– Adoption gets the best outcomes because natural families often have too many problems.
In Chapter 1 The changing face of adoption, she outlines the changing assumptions about families and how adoption has been variously used to assist in child-rearing and to pass on property; though introduced in England in 1926, it was uncommon before the Second World War. After the War adoptions rose to a peak of 25,000 in 1968 in England and Wales but, following the 1968 Abortion Act, by 1973 out-of-family adoptions had halved while family adoptions were increasing and now accounted for over 50% of adoptions.
Whereas adoption had initially been a service for childless couples and ‘good’ children had been ‘matched’ to a family, now it was a form of child care for which prospective adoptive parents had to provide evidence of the quality of care they would provide and be committed to rearing the child as their natural parents would have done.
She then reviews the literature, in particular, Rowe and Lambert (1973), the fostering literature (Trasler, 1960; George, 1970; Kadushin, 1970), the impact of Bowlby (1953), the study by Lewis (1954), which had almost immediately called into question Bowlby’s conclusions but had largely been ignored, and the more recent article by Clarke and Clarke (1976) reporting that, while early experiences have immediate effects, if they are not reinforced, they will fade in time.
In Chapter 2 The children and their natural families, she outlines the study. The children had been in residential nursery between the ages of two and seven; 30 had been adopted, 23 restored to their families and 8 placed in long-term foster care. The adopted and restored children were split between those who had been adopted or restored early or later.
All had been admitted before four months and stayed beyond two years; boys outnumbered girls but only because more boys were placed in care; one third were mixed race. Their mothers had mostly left school at school leaving age though some of the fathers were better educated. They were all illegitimate and most had been offered for adoption, though over half had not been placed because of `imperfections’ or ‘gaps’ in the child’s history; the remaining mothers had been unready to give them up, usually because they were older mothers, already had other children and hoped to resume their care. Most parents had complex problems which would not have been resolved by a single change in their circumstances.
The restored children tended to come from a higher class background and, where the parents were married, the child was restored; more non-white children were restored but fewer were adopted. “[F]requent visits is perhaps the best indicator of the mother’s interest in her child” (Tizard, 1977, p. 27).
In Chapter 3 Early institutional experiences: the children at two, she describes the nurseries’ attempts to provide a stimulating environment, the generous staffing and the good physical environment but the poor continuity of care; though student nurses had to stay for three years, they often moved from group to group. Personal relationships were discouraged though some used a `special nurse’ system.
Testing showed that the children’s intellectual development was slightly retarded; they tended to be shy and clingy but in other respects they were no different from a control group of London children living at home.
In Chapter 4 The adoptive parents: thirty couples, she describes the adoptive couples; half were infertile couples, two were ex-special nurses who had married and the rest already had children.
Half the children had waited at least a year for a home because of administrative delays but the white girls were placed most quickly; only those adopted by the special nurses had been specially chosen.
In Chapter 5 Settling into a new home: the early adopted children, she describes the experiences of the 24 early adopted children placed before the age of four. While the parents felt they had not been not told enough, they tended to forget problems they had mentioned to the social worker at the time. The children with neutral or favourable reports when at nursery had tended to settle better. Some children were worried about being sent back to nursery; those who had visited to see matron or a friend were no longer worried about being sent back. Most adoptive mothers saw no problem with the institutional care, only those where there had been behaviour difficulties.
One third of adoptive mothers did not regret missing the early years though ten would have liked to have had the child earlier, including those where the child presented behaviour difficulties.
Four children who had experienced foster home rejection quickly formed new attachments though two were very demanding and attention seeking.
In Chapter 6 Restoration: children who return to their natural families between two and four years, she describes the 15 children restored before the age of four; most had been restored later than the adopted children and the decision had often been made suddenly after a long period of indecision.
Most were materially less well off than when in the nursery; some had rarely been visited in the nursery and, with the restoration usually sudden rather than gradual, most had presented initial difficulties followed by a gradual improvement, though some parents reported no improvement. The children’s fear of return and the parents’ views of the nursery were similar to those of the adopted children and their parents.
All the parents thought that they had made the right decision but nine thought that being in the nursery had damaged the child and some felt guilty that they could not love the child as they could their others; two thought they had been wrongly persuaded to take the child back.
In Chapter 7 The adopted and restored children at the age of four and a half years, she describes the initial follow-up.
The adopted children were living mostly in middle class families with three in skilled working class families; the restored children’s situations were more varied but the adopted children were certainly better off.
All the children were universally friendly with adults, their fear of strangers having disappeared in the nursery. Though the average IQs of the two groups had been the same at the outset, the adopted children’s average was now 115 and the restored 100. The adopted children were more co-operative but two thirds of the restored children refused at least one test.
Overall the adopted children presented fewer problems than the control group of London children but were more attention-seeking and stranger-friendly; even those who had had the most adverse nursery reports now presented fewer problems than the London children. The restored children presented more problems but otherwise were mostly similar to the adopted children and no more difficult than the London children.
The adopted children were more affectionate than other children including towards strangers, while the restored children were more affectionate and more clingy and showed a clear preference for their own mother.
Overall the restored children were more attention-seeking and demanding and the adopted children in a more advantageous position with no signs of permanent institutional damage.
In Chapter 8 The earlier adopted and the earlier restored children at the age of eight 1: Parent-child activities: results from testing and reports from teachers, Barbara Tizard describes the later follow-up.
One adoptive family had emigrated and two didn’t want anything to do with the agency; one family had divorced and only three children were still ‘only’ children. Two restored families had emigrated, two refused to take part, one child was back in care and one was living with grandparents; most were in better conditions. One of the London control group had emigrated.
The adopted children and their parents engaged in more play and helping activities than the London control group who did more of this than the restored children and their parents.
The average IQs of the restored group were now 103 and of the adoptive group 115. Most children behaved `normally’ during the test compared with the London control group.
Teachers reported both the adopted and the restored children as having more problems in school than a contrast group in school and the London control group; half were more attention-seeking from teachers and strangers; the restored group had fewer friends than the adoptive group and presented ‘control’ problems.
In Chapter 9 The earlier adopted and the earlier restored children at the age of eight 2: Parents’ reports, she compares the above with the parents’ reports and with an additional contrast group of 20 younger middle class mothers; the original working class control group had been selected because the children were all originally working class.
The London group were seen as less difficult and the adoptive children as more difficult but no more difficult than the children of the middle class contrast group; they were however still over-friendly to strangers. There was generally continuity in whether a child was described as difficult or not.
Most of the problems with the restored children had disappeared or been reduced but they were still more anxious and aggressive than the other children and two thirds had been referred to a doctor or psychiatrist.
The teachers and the parents agreed on the problem behaviour but not on its severity; though children often behaved differently at school and home, the adopted children did not, something which Bohman (1970) had also found. In fact, the psychologists had not encountered any differences in behaviour between the adopted children and the controls, suggesting that the teachers’ responses were situational; a child in constant need of attention creates problems at school.
In Chapter 10 Attachments to parents and others: earlier adopted and earlier restored children, she reports that the adopted children’s expressions of affection were more like those of normal children and about the same percentage did not get on with their adoptive fathers as the London control group but most had good relationships with them. Fewer of the restored children had affectionate relationships with their parents and both the adopted and the restored children were no more dependent than the controls.
Both the adopted and the restored children had less good relationships with their peers but better relationships with siblings/younger children; whereas the controls tended to have peer friends and quarrel with siblings, the opposite was true of the adopted and restored children. She notes that Koluchova (1976) and Freud and Dann (1951) both report that severely deprived children do make peer relationships and wonders whether their results came about because the nursery children had been encouraged to look to adults rather than to their peers.
In Chapter 11 Links with the past: ‘talking’ about adoption, and the parents’ assessment of the nursery years, she discusses how the adoptive parents handled telling the child they were adopted; three had not explained it and six were anxious about the child saying they had another mother. Only three, all with black fathers, had been told about their fathers, perhaps because of the need to explain the facts of life. Adoption was rarely discussed and mostly not mentioned to neighbours unless it was necessary.
Some parents kept nursery memories alive and some visited while some special nurses wrote; otherwise the children had few recollections. A few were disturbed if they drove past nursery and there was no apparent benefit from the nursery contact. Five children who had regular contact used going back to the nursery as a threat while one parent had made a threat in anger and one as a joke; otherwise it was not mentioned.
Overall the adoptive parents resisted talking about the natural parents or the nursery and most parents said there had been no, or only initial, problems in coming from the nursery; one fifth said the nursery had had adverse effects.
The restored children and parents mostly never mentioned the nursery and it was not used as a threat; half the parents saw the nursery as a cause of difficult behaviour. More than the adoptive parents, they regretted missing the child’s early years but overall they thought their parent-child relationships were better.
In Chapter 12 Children adopted and restored after the age of four and a half, she describes the experiences of six adopted and eight restored children placed after four and a half.
One adoptive parent refused take part. There were more boys because girls were adopted most quickly; they had mostly not been adopted because of lack of consent, though one because of epilepsy; they were adopted by skilled working class and middle class families who had not intended to adopt children as old as this.
Only four of the parents of restored children agreed to interview; one had emigrated, one child was back in care and two refused. All had refused to give up the child for adoption; two were living on social security and the families had various problems; generally the children had been slower to use ‘Mum’ and ‘Dad’ than the adopted children and three had resented the move.
The adoptive parents were reluctant to talk about adoption, the children had clearer memories of the nursery and most had had contacts though they found it painful to talk about it. One family had joked about a return. Most of the natural parents were reluctant to talk about the nursery.
The adopted children were accepted into the wider family and the difference in time spent with children by adoptive parents and by natural parents was greater than with the earlier adopted group; adoptive parents were generally more tolerant of dependent behaviour.
Only one adoptive child’s IQ had increased; the others’ had declined. Two of the restored children’s were the same and two had seen considerable decline. Of course, the later adopted children had mostly been at school rather than receiving attention at home.
The children behaved normally during the IQ test but most were reported as having difficulties by teachers; only one adoptive and one restored mother agreed with the teachers’ assessments.
The adoptive parents were more likely to believe that the child had been affected by the nursery than the adoptive parents of the earlier adopted children; all the parents of the restored children thought their children had been affected.
Overall early institutional rearing did not prevent the development of attachments even though not all restored children made them because adoptive parents recognised the children’s needs whereas natural parents did not; even though the later adopted did not make the same gains as the early adopted, most made attachments.
In Chapter 13 Special problems of adopted mixed race children, she outlines the experiences of the seven mixed race children; one family refused to be interviewed.
Few had black friends and most parents were not positive about the child’s origins; they found it difficult to explain the situation to the child and only one tried to teach the child about their own culture.
The adoptive parents failed to see a problem and the children resented any black classification but in practice it was not yet a major problem for most.
They were the most gifted group but otherwise did not differ from the white group; half were not told they were mixed race; in practice the only child troubled by his colour was a restored child. Perhaps they had no concept of themselves as black.
She concludes that it is probably more important for children to be reared by parents who love the child than by parents of their own colour.
In Chapter 14 The parents’ satisfaction with the adoptions: twenty-five couples, she notes that fifteen said they loved the child as their own and eight had reservations and compares her findings as to whether they would recommend adoption to a friend with those of Kadushin (1970); the percentages, with ten saying yes and fourteen having reservations, were similar but age was not significant in her study.
Of the three who doubted whether the child had strong feelings for them, one said they would not have done it if they had known while two admitted reservations. Six others admitted to having doubted the decision in the past but not now. Looking back, of the three one failure was perhaps predictable but the other two were not.
There were no significant differences between satisfied adoptive parents and those with reservations though Kadushin (1970) had found that age was significant; however, his study involved placements of 5–12 year olds. There were no problems over the children with low IQs.
With one exception, the parents’ responses had been consistent throughout the interviews.
In Chapter 15 Long-term fostering as an alternative to adoption, she considers five children, four of whom had been restored and returned to care, who had been placed with long-term foster parents. There were no other foster children in the families; two were working class and three middle class.
One child had been taken as an alternative to adoption; his natural mother visited and there were behaviour problems at home and at school. One had been restored and then fostered with a couple with a baby of their own. One had been restored but, when a foster mother discovered he was being mistreated, he was placed with her for a week and refused to go home. One had been placed with an experienced foster mother who maintained links with the natural mother but the child was confused and misbehaved while insisting that she would only stay with the foster parent. One had been placed with an experienced foster parent of younger children who both maintained contact with the family and tried to foster pride in being black while being as committed to the child as if he were her own.
In other words, three out of the five acted like adoptive parents which might have raised problems if the foster parent fell ill and did raise them in pretending to be `Mum’ and `Dad’ when they could not be, which made the children confused. However, the foster parent who fulfilled the professionally approved role had had a devastating effect on the child.
In reality, the constant uncertainty about the natural parents’ intentions was disturbing for the children and it was difficult to justify parents being allowed to do this.
In Chapter 16 The success of adoption after infancy, she summarises the key results:
– Stability of placement was 100% for the adopted children and 87% for the restored.
– Placement satisfaction was 88% which may be higher than for natural parents because the adoptive parents were more highly motivated than natural parents and there was a high level of parent-child interaction.
– Mutual attachment was experienced by 80% of adoptive parents but by only seven out of thirteen parents of restored children; five out of thirteen said they were close to the child but only three out of eight restored children with a step- father said they got on with him.
– IQ and attainments: earlier adopted children showed an increase in IQ.
– Except for over-friendliness to strangers and attention-seeking, adopted children are no different from the comparison groups but two thirds of the restored children had been referred to a doctor or psychiatrist for behaviour problems.
– None of the children’s behaviour was acceptable in school but that was even more so with restored children.
– The children’s age on leaving the institution was not significant. The most important factor was the time available to parents; restoring children to families with lots of young children is not a good idea.
In Chapter 17 The effects of early institutional experience: is ‘mothering’ essential in the early years? she notes that Bowlby (1953) had been ethno-centric in his research and ignored the nature of institutions at the time. Even though the children in her study had had no stable carers, there had been no intellectual impairment by four; they had different problems from children at home, being more clingy and in some cases attention-seeking.
The restored children were over four times more likely than the adopted children to be referred to a child guidance clinic but there was no evidence of insecure attachments to adoptive parents.
After summarising alternative explanations for the results, she concludes that some early experiences affect later development but IQ, for example, is more likely to be affected by a child’s level of attachment and any acceleration is likely to be less the older the child is; though a child’s initial relationships may affect later ones they do not in the way described by Bowlby.
She notes that Bohman (1970) had found that adopted children had fewer problems at 15 than at 11 and she raises the problems caused by the professionalisation of child care which can lead to increased staff turnover as staff go for training or seek promotion.
In Chapter 18 The place of adoption in social policy, she notes that “no comparable larger scale study exists” (Tizard, 1977, p. 233) but that this one shows that adoption has the best outcome because natural families often have too many problems. She notes the disadvantages of long-term fostering compared with the devotion of adoptive parents, the insecurity, anxiety and conflicts of loyalties that fostering brings.
She outlines the current assumptions underlying social work attitudes to adoption and asks: to whom does child belong? A child needs someone who can offer security; it isn’t adequate to allow parents to interfere in this.
This study was being undertaken at around the same time as the first phase in the study by Wiener and Wiener (1990) which concluded that stable adoption offers the best outcome for children and it identifies the high motivation of adoptive parents and the high level of parent-child interaction as the key factors. Wiener and Wiener also found that returning children home had the least satisfactory outcomes because they tended to be less stable and because services tended to be withdrawn when the child went home. Tizard also suggests that the parents of restored children had unrealistic expectations of the amount of attention their children needed after their stay in the institution and were often already over-burdened with the responsibilities of caring for other children, unlike the adoptive families for whom the child was often an only child for at least some period.
She does not develop her finding that frequent visits reflected the mother’s interest but, in the light of Taylor and Alpert (1973) and Fanshel and Shinn (1978), this does suggest that sustaining parents’ interest should be a priority, as it was for Clare Britton in her work with evacuees (Winnicott and Britton, 1957).
Though the children who had been in care had certain behaviour difficulties and relationships which were different from their peers, they did not present any more difficulties than other children, except in the school context where the teachers found their attention-seeking behaviour frustrating. This raises the question as to whether the difficulties looked after children have in school might be better addressed by changing teachers’ attitudes and approaches in the classroom.
Tizard spends some time exploring the memories the children might have had of their past and appears surprised at how little they remembered. However, we now know that memory does not become stable until around the age of seven; younger children only retain fragmentary memories and the more substantial `memories’ that they think they have of that period are developed as a result of listening to older people talking about events in their childhood (British Psychological Society Research Board, 2008).
Tizard is also surprised that most children and parents avoid addressing issues of ethnicity and that the mixed race children reject any classification as black; however, Vaughan (1987) suggests that ethnic minority children are more likely to identify with the majority group at this age and with their own group in adolescence.
Tizard suggests that professional expectations about talking to children about adoption are unrealistic, in part because parents are unwilling to talk to children about the facts of life. In one sense, the parents were being realistic because Goldman and Goldman (1982) found that even Swedish children whose sex education started at the age of seven did not really understand the mechanisms of reproduction until their teens, at around the same time as children in Australia, the UK and US.
The finding that the expected relationship a foster parent might have could be damaging to the child raises a much wider issue, whether the prescriptions that social workers make for relationships are drawn from male prescriptions that emphasise individuation and devotion to impersonal ideals rather than relationship and interdependence (Gilligan, 1993). Since the adopted children benefited from a high level of parent-child interaction and the foster children who had relationships more like an adoptive relationship benefited most, there must be questions about the traditional expectations on foster parents. As Robertson and Robertson (1971) found, offering children a positive relationship did not harm and certainly enhanced the relationship that the child with a less positive relationship with her mother had when she returned home.
Tizard shares with Wiener and Wiener (1990) the concern about a small number of parents whose indecision may harm the child and whom social workers seem unwilling to confront. Though she ends with the conclusion that adoption is the best outcome because natural families have too many problems, this still begs the question whether some of the problems which she identifies would be better addressed by improving support for families in order to deal with these problems as prescribed by the UN Convention on the Rights of the Child or whether, even if one does this, there will still be a small number of parents who will never make decisions which are in the best interests of their children and, if so, how one can identify these parents and deal with their behaviour.
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