Abstract
OT increasingly supports a family and caregiver support perspective and service provision relevant to cultural, personal, and social contexts. A descriptive needs assessment of adoptive parents found that children’s mental health correlated with support seeking, but no perceived relationship was found between mental health and contextual factors such as racial discrimination. Implications include interdisciplinary collaboration with a focus on parent education and support.
Primary Author and Speaker: Sheryl Ryan
Adoptive families experience complex challenges. Adoptees have higher rates of mental health issues, disabilities, and challenges related to first family search and reunion, racial discrimination (transracial adoption), and cultural loss across the lifespan. With 2-4x the rate of suicide attempts as non-adopted people, adoption scholarship makes a strong connection between mental health and search and reunion, racial discrimination, and cultural loss. Post-adoption support is often under-utilized. Occupational therapy scholarship has examined sensory processing, self-regulation, and educational outcomes among adopted children but has not considered adoption from a family and caregiver support perspective, or viewed adoption-related service provision in terms of cultural, personal, and social contexts. The purpose of this study was to conduct a needs assessment of adoptive parents of minors (0-18 years) to determine rates and relationships between parental stress, child mental health, disability, search and reunion, racial discrimination, and cultural loss, in order to inform recommendations for occupational therapy services in post-adoption support. The study is mixed methods and includes a cross-sectional descriptive survey and qualitative interviews. This presentation reports on the survey findings. (Qualitative analysis will be completed prior to April 2021). The original online survey (n = 135) results were analyzed for rates, measures of central tendency, and correlations. Results indicate that children’s mental health is the primary cause of parental stress and support seeking, followed by disabilities. Over 51% of parents felt a current need for post-adoption support, with 35% reporting mental health and 30% reporting disability concerns. The most prevalent mental health issues were anxiety, attachment, behavior, and depression. The most prevalent disabilities included Attention Deficit Hyperactivity Disorder, speech or language delays, and learning disabilities. The strongest correlations were between need for post-adoption support, mental health related stress levels (r = .40, p < .00001), and using counseling therapy (r = .51, p < .00001). There was not a similar correlation for disabilities, although parents sought services, including speech or language therapy (67%), special education (67%), medication (61%), and occupational therapy (59%). Parents reported much lower levels of stress related to search and reunion, racial discrimination, and cultural loss. Although 36% of respondents indicated their child had experienced racial discrimination, parents reported the lowest relative stress levels related to being a transracial adoptive family. Results support prior studies describing mental health and disability related challenges for adoptees. This study contributes knowledge that concern about mental health issues primarily motivates parents to seek post-adoption support. While prior scholarship directly relates mental health with the cultural, personal, and social contexts of search and reunion, racial discrimination, and cultural loss, results seem to indicate that adoptive parents do not view these aspects of adoption as being related to their children’s mental health. Prior scholarship has shown that adoptive parents frequently undervalue the broader contextual impact on children’s wellness. Further qualitative inquiry is required to understand the contextual meanings that parents attribute to their children’s mental health challenges. Implications for occupational therapists include: thorough evaluation of mental health as well as disability needs for adopted children in pediatric practices, a focus on parent education and support, and interdisciplinary collaboration to meet the complex needs of adoptive families.
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