Our service is about designing treatments around individual children and their families. There is no one disorder or condition or problem that all adopted or fostered children have. Our motto is “adoption is not an illness – it is an opportunity” if supported and nurtured effectively as and when needed [more on that in other blogs…]
We think that a lot of the time when parents and carers and schools and services get stuck it is because organisations forget that these children and young people are individuals, with different and diverse needs. Losing sight of the individuality increases the chance that any help offered fails to unleash the therapeutic potential of a stable and sensitively attuned family life.
As an example, the list of conditions we have assessed over the last year or so in our clinic reads like a shopping list of problems and includes [but is not restricted to]:
Foetal Alcohol Disorders; Autism Spectrum Disorders; Epilepsy; ADHD; Sensory Integration Issues [which may or may not be part of a broader autism phenotype]; Neuropsychological Problems; Tic Disorders; Chromosomal Abnormalities, Genetic Problems and Behavioural Phenotypes;
Behavioural Problems and Conduct Disorders; Parenting Assessments; Attachment: Disorders, Problems & Issues in their wide diversity of understanding; Forensic Issues and Risks; Sexual Abuse and inappropriate behaviour; Child Sexual Exploitation and Risk of Sexual Harm to others
Trauma of both simple and complex aetiology [origins] with varied presentations and comorbidities [i.e., other co-occurring and complicating disorders].
Depression (i.e., Mood Disorder), with or without Self-Harm and Suicidal Ideation, alongside the active management of risk including in-patient admission to, and discharge from, specialist services; emerging Personality Disorders
Anxiety disorders including Separation Anxiety Disorder, as well as generalised anxiety [worry], social phobia (shyness) and ‘simple’ phobias.
Educational attainment issues including Specific Learning Disabilities such as Dyslexia; Global Learning Disability in its own right; problems with language development and understanding.
And crucially, a whole host of other non-psychiatric problems such as peer relations; social skills; emotional understanding; toileting [soiling and wetting]; hygiene; eating, feeding and hording/gorging; sleep…which can often be more important to children and their families than traditional, formal mental health diagnoses – but which may not get easily identified or treated in some non-specialist adoption & fostering services.
We can assess all these different issues under one roof in our clinic, but not in a one-size-fits-all way, squeezing all children into the same box. For example, in one month we assessed three toddlers in a row, each with fetal alcohol disorders. But they were so different from each other and needed quite different family contexts - all three were assessed by us pre-adoption to help with family finding, so that prospective adopters could know as much as possible about the children they were going to welcome into their homes and what sort of support they might need before they adopted them. Children are individuals– even ones who have the same disorders, “same” experiences, come from the same families, same headline issues…[more on this in later blogs].
Adopted and fostered children and young people are different from each other. They need personalised services and not one-size-fits-all approaches. They may also need different things, at different times, at different intensities and different urgencies, and quite possibly from different services, as part of their journey into and out of the care system. This need to keep an open mind, to keep thinking about difference, individuals, and developmental changes can make accessing the right services at the right time difficult for children, young people and their families.
This blog will discuss some issues we have come across relevant for thinking about the care of adopted and looked after children, young people and their families - and most of all thinking about how to keep their individuality at the heart of the picture; and how the evidence can help us do that.