When I was ~8, my parents adopted a ~6 year old girl, and it didn’t go particularly well (wrote a substack about it here)
(Up until today, I thought I was 6 and she was 4 - just checked with my sister and she had more accurate dates (she has the paperwork))
Yesterday, the family therapist I met with was like “yeah, it’s only in the last ~10 years that the government was properly offered support to families who go through with adoption”.
Learning about the systemic & policy factors at play in our story will be very destigmatising I think.
Great "systems view" rather than a cause-and-effect “my parents just massively fucked up” view
please tell me about child adoption in the UK from the 1990s onwards. I want to know about different eras, e.g., I have been told that in the last 10 years, the government has become much more proactive about offering families who go through adoption therapy. I want to know about things like success/failure rates, common issues, etc
please make a report about adoption in the uk in the present day, how it is framed, what support is offered, etc
please create a report about borderline personality disorder
I then tweaked these somewhat and added them to Anki
In the 1990s,
what was the major political concern
regarding children in the UK care system
that led to a policy drive to increase adoptions
{{c1::The problem of "drift in care",
where children languished for years in multiple temporary placements}}
|
What was the "dangerous disconnect"
in UK adoption policy during the 1990s and early 2000s?
{{c1::Policy aggressively pushed for more adoptions of children with complex trauma,
while professional understanding of trauma's neurobiological impact
was still in its infancy}}
|
What landmark 1990s study on childhood trauma
took years to filter into frontline social work practice
{{c1::The Adverse Childhood Experiences (ACEs) study}}
|
Before the 2000s,
what was the main focus of adoption practice in the UK
{{c1::Providing healthy infants for infertile couples}}
|
There a shift in UK adopt in the ~1990s
From
{{c1::providing infants}}
to
{{c1::finding homes for children in the care system}}
|
What caused the shift in UK adoption in the ~1990s
from providing infants to finding homes for children in the care system
{{c1::A sharp fall in the number of healthy infants
voluntarily relinquished for adoption,
due to factors like
available birth control
and reduced stigma of unmarried motherhood}}
|
What significant change
did the Adoption and Children Act 2002 make
regarding the eligibility of adopters
{{c1::It formally allowed unmarried
and same-sex couples
to adopt jointly
for the first time}}
|
What crucial statutory right
did the Adoption and Children Act 2002 grant to adoptive families
for the first time
{{c1::The right to request an assessment of their support needs at any time post-adoption}}
|
For over a decade after the 2002 Act,
why was the right to a support needs assessment
often considered a "hollow right"?
{{c1::Because the Act created the right to an assessment
but did not provide a dedicated budget
to fund the specialist services that were often recommended}}
|
What is the single greatest difference
in the support landscape for adoptive families today
compared to the 1990s/2000s?
{{c1::The existence of the Adoption and Special Guardianship Support Fund (ASGSF)
to pay for therapeutic services}}
|
What is the purpose of the Adoption and Special Guardianship Support Fund (ASGSF)
{{c1::To provide dedicated government funding
to local authorities
to pay for essential therapeutic services
for eligible adopted and special guardianship children}}
|
Re: adoption:
What is the difference between an adoption "disruption" and an "breakdown"
{{c1::Disruption - when a placement ends before the final adoption order is granted
Breakdown - when a placement ends post-adoption order}}
|
What is the estimated rate of adoption disruption or breakdown in the UK
{{c1::Between 3% and 9%}}
|
What are the two key risk factors
that dramatically increase the likelihood of an adoption breaking down
{{c1::
1 - The child being placed for adoption after the age of four
2 - A pre-adoption history of witnessing domestic violence or experiencing sexual abuse}}
|
A 2024 report on adoption disruptions
concluded the primary cause was
{{c1::a systemic failure of communication
and knowledge gaps
between
the adopters,
the professionals (social workers),
and the foster carers}}
|
A landmark 2024 report,
"{{c1::Pre-Adoption Order Disruptions in England}}"
provided a forensic analysis of 77 disruption cases
|
The landmark 2024 report on adoption disruptions was by
{{c1::Adoption England}}
|
The 4 distinct "manifestations of failure" outlined in the "adoption disruptions" 2024 report
{{c1::Not Said
Not Heard}}
{{c2::Not Known
Not Challenged}}
|
The 4 distinct "manifestations of failure" outlined in the "adoption disruptions" 2024 report
{{c1::Not Said
Not Heard}}
Not Known
Not Challenged}}
|
In the context of adoption "failure points",
what does "{{c2::Not Said}}" refer to
{{c1::When adopters conceal the severity of their struggles
due to fear, shame, or a desire not to be seen as a failure}}
|
What does the adoption "failure point" of "{{c2::Not Known}}" describe
{{c1::When critical information,
such as the full extent of a child's trauma-related needs,
was not properly assessed or communicated to adopters before placement}}
|
What is an example of the "{{c2::Not Heard}}" failure point in adoption practice?
{{c1::When professionals are overly optimistic
about an adopter's capacity to cope,
or when adopters fail to grasp the daily reality
behind professional jargon used to describe trauma}}
|
In adoption practice, what does the "{{c2::Not Challenged}}" failure point refer to
{{c1::When red flags,
like clashes in parenting styles between foster carers and adopters,
are identified by professionals
but are not addressed or mediated}}
|
What metaphor is used
to describe the tangible, physiological changes in the brain and nervous system
that children adopted from care carry with them
{{c1::An "invisible suitcase"}}
|
How does early life trauma
typically affect the amygdala in a developing child's brain
{{c1::It can become overdeveloped and hyper-reactive,
leaving the brain in a constant state of high alert (hypervigilance)}}
|
What is the function of the {{c2::prefrontal cortex}},
and how is its development impacted by early life trauma
{{c1::It is responsible for executive functions
like emotional regulation and impulse control;
trauma can disrupt its development, leaving it underdeveloped}}
|
What theory posits that
the initial separation from the birth mother
is a profound, pre-verbal trauma
that imprints a fundamental sense of abandonment
{{c1::The theory of the "primal wound"}}
|
What is attachment trauma?
{{c1::A trauma that occurs
when a primary caregiver is a source of fear, pain, or neglect,
teaching the child that those who should protect
them are dangerous or unavailable}}
|
BPD is characterised by (4 things)
{{c1::pervasive instability in
moods,
interpersonal relationships,
self-image,
and behaviour}}
|
What is considered the absolute core fear
that drives the behaviours associated with BPD
{{c1::Frantic efforts to avoid real or imagined abandonment}}
|
In BPD
What is the term for
the pattern of alternating between extremes of
{{c1::idealisation and devaluation in relationships}}?
{{c2::Unstable and intense interpersonal relationships}}
|
What is the critical link
that connects the trauma of adoption
to a heightened risk for developing BPD
{{c1::The core fear of abandonment in BPD
directly mirrors the "primal wound" of abandonment
experienced through relinquishment}}
|
According to the biosocial model,
what two factors interact to cause the development of BPD
{{c1::An interaction between a biological or genetic vulnerability
and a chronically invalidating environment in childhood}}
|
Why can a child develop BPD
even within a loving and secure adoptive home
{{c1::Because the external reality of a loving home
does not erase the child's internal reality
and pre-existing neurological wounds
from early trauma}}
|
There is a significant and controversial overlap in symptoms between
BPD and {{c1::cPTSD}}
|
What was the nature of post-adoption "support"
typically offered by the state in the UK during the 1990s
{{c1::It was minimal
and largely revolved around access to birth records
or intermediary services for letterbox contact,
not therapeutic support}}
Filling in the gaps from the above
Reviewing the above, and making new flashcards as needed
What does the acronym ACE stand for in the context of the landmark public health study
{{c1::Adverse Childhood Experiences}}
|
What year was the ACE study published
{{c1::1998}}
|
The ACE Study established
{{c1::a dose-response relationship}}
between
{{c2::the number of ACEs}}
and
{{c2::the risk of negative adult outcomes}}
|
What core idea does the "dose-response" finding
from the ACE Study demonstrate
{{c1::The more ACEs an individual has,
the higher their risk for negative health outcomes}}
|
The ACE survey grouped ten types of childhood adversity
into what three main categories
{{c1::Abuse,
Neglect,
and Household Dysfunction}}
|
List the five types
of household dysfunction
measured by the ACE Study
{{c1::Parental separation
Domestic violence
Substance misuse
Mental illness
Incarcerated household member}}
|
What was the most revolutionary aspect of the ACE Study's findings
{{c1::It linked childhood adversity
directly to long-term physical illnesses
and leading causes of death,
not just mental health issues}}
|
The ACE Study helped to explain
the biological pathway from childhood adversity to adult illness
by popularising what concept?
{{c1::Chronic, toxic stress}}
|
What is the primary mechanism
by which toxic stress
is thought to cause long-term health problems
{{c1::By disrupting healthy brain development
and dysregulating the nervous, endocrine, and immune systems}}
|
Approx n of participants in the original ACE Study
{{c1::Over 17,000}}
|
The population studied in the original ACE Study
was primarily from what demographic group
{{c1::White, middle-class, educated individuals
with health insurance}}
|
Why was the demographic makeup of the original ACE Study's participants
so significant for its findings
{{c1::It showed that ACEs were a widespread public health issue,
not confined to marginalised or "at-risk" populations}}
|
According to the original ACE Study,
what % of participants
reported at least one ACE?
{{c1::~66%}}
|
According to the original ACE Study,
what % of participants
reported four or more ACEs
{{c1::~16%}}
|
The ACE Study moved the understanding of childhood trauma
from a {{c1::purely psychological}} issue
to a {{c1::public health}} issue
|
How an ACE score is calculated:
{{c1::By asking a person to answer "yes" or "no"
to ten specific questions about their childhood
Each "yes" answer adds one point to their score,
for a possible total ranging from 0 to 10}}
|
A person with an ACE score of {{c1::4}} or more
Has a significantly increased risk of attempting suicide
by what factor compared to someone with a score of 0
{{c1::12-fold increased risk}}