Continuity is crucial for children. Josa Young looks at a pilot scheme, which can take a child through fostering to adoption with the same parents.

Adoption in the UK is widely seen as a shambles. There are 2000 children in England and Wales spending up to three years hanging around in care (often with multiple foster families), waiting for adoption. Meanwhile, 1200 families want to adopt.

Disrupted attachments in early life are known to damage children emotionally, and make it difficult for them to form proper relationships as adults. On average, children adopted in 1998 were 14 months old when they went into care, and two and a half years old before they were finally adopted. Adoptions did rise by 10% in that year, but only 4% of those in care were adopted.

The older the child, the more damage done, and the more challenging he or she will be to adopt. Up to 20% of adoptions fail and the child is returned to care, which has a bad name these days.

Revelations of abuse in children’s homes going back years have at last forced the government to act
In February 2001, Tony Blair took personal charge of a review of adoption policy. The government will now set up a national adoption register to match potential parents with children, and establish national standards. An Adoption and Permanency taskforce will attempt to clear the huge backlog waiting for adoption and enforce the national standards.

Research found wild variations in proportions of children adopted in different authorities. Sutton in south London achieved a commendable 20% passed for adoption, while Lambeth has a dismal 1% adoption rate. Attachment difficulties were the least of these children’s problems.

At last, some imagination has been injected into the debate
The old system of shunting children around foster homes for months before they hit the pay dirt of an adoptive family can be modified. Why not make one follow the other in the same family, thus eliminating damaging disruption? In a pilot scheme called concurrency adoption, initially in Manchester, London and Brighton, potential adoptive parents are offered a new format.

Babies are placed with new parents, who foster them, knowing that the relationship has a good chance of becoming permanent. If the courts decide the birth parent, in spite of training from the social services, is still unable to offer a safe and loving home, the concurrent parents can adopt. The time scale is very important – the courts should make final decisions within six to nine months. Concurrency adoption has been used successfully in the US for 15 years for children up to the age of eight. In the UK, currently, children are entering the scheme up to the age of two.

The decision to join the project as a foster parent is a tougher one than just choosing to adopt
Yes, you usually receive a very young baby – in short supply these days. But, and it is a big but, you might have to hand her or him back to the birth parents or other members of the birth family at some point.

Coram Family, a charity related to Thomas Coram’s Foundling Hospital, organises adoptions for babies and children from all over the country. The Coram Concurrency Planning Project, led by Gill Gray, has been set up with Islington and Camden social services. While the potential adopters foster the child, the social services look into the birth family – not just the parents, but also other relations who might be willing to take on the baby. To prevent drift, the courts must decide at the beginning of the process just how long it will go on for – usually, between six and nine months. This eliminates a lot of the uncertainty, but still must be a tense time for everyone. ‘I used to wonder who on earth these people were, and where we would find them,’ says Gill Grant. ‘But they turn out to be self-selecting and are always people who can focus on what is in the child’s best interests.’

Rigorous selection and training weed out anyone with any illusions
But there are enormous advantages to joining the scheme as well: ‘There aren’t that many babies available for adoption in the UK. Concurrency appeals to people keen to take on a very young child,’ says Gill.

She adds the warning that the babies are nearly always born to mothers who are either drink or drug-addicted. For instance, a baby exposed to heroin in the womb needs to spend six weeks being detoxed on methadone – adoptive parents are encouraged to start up the relationship in hospital. Babies exposed to cocaine are extremely irritable, and foetal alcohol syndrome has unpredictable effects. It is impossible to know what neurological damage and behavioural problems lie in the future. There are exceptions. Perfectly healthy girls have been known to love the attention they receive when pregnant, but are unable to cope with the babies.

As one potential adoptive mother who turned the option down pointed out, you have to be a brave and special person to contemplate losing the baby you hoped to adopt. If this does happen, there is nothing to prevent you from being offered another baby under the scheme, as you will have proved yourself capable. Generally, concurrency babies have a 60-80% chance of being adopted, so the odds are in the adoptive parents’ favour. In the Manchester concurrency project, only one child out of 11 placed with potential adopters was returned to its birth family.

During the assessment period, the birth family has contact with the baby, up to three times a week, during which time they’re encouraged to learn parenting skills. More contact would be disruptive and would put too much pressure on the young baby. Treatment and counselling for problems with alcohol and drugs are also provided. No one is left in any doubt that the conclusion of the process will be adoption, unless the birth parents can make the enormous changes necessary to bring up a child.

Concurrency adoption is the last chance saloon for the birth family – but definitely five-star
‘There is so much hope for these babies,’ says Gill. ‘Having been adopted at such a young age, their life chances are maximised and they often go on to exceed all expectations.’