By Susanti Sarkar
Lauren Davis, a mother from North Carolina, first met Ayden when he was just 7 weeks old and
had been transferred to a local hospital.
She spent the next two months visiting him in the neonatal intensive care unit. She and her
husband hoped to adopt the little boy whom Davis describes as “medically complex.” Ayden
continued to have health battles as he grew older, including chronic lung disease, a swallowing
disorder that resulted in a feeding tube and six surgeries — procedures that would have cost the
family thousands of dollars every month.
In many states, Ayden’s medical care would have been funded under Medicaid, as part of an
adoption subsidy package given to parents who bring other people’s children into their families.
But in North Carolina, Ayden did not easily qualify. At the time, he was under the age of 6, and
not part of an overrepresented ethnic or racial minority, or part of an adoptive sibling group.
Davis said that at the time, she felt helpless. Everyone at her state’s Department of Health and
Human Services, was “giving her the runaround.” And eventually, they stopped responding.
So she did some research and called Josh Kroll, project coordinator of the Adoption Subsidy
Resource Center at Families Rising, formerly known as the North American Council on
Adoptable Children. Kroll helped the worried mother put together the required documents and
present a successful application to the department.
Without that help, Davis said, providing for Ayden’s needs would have been difficult if not
impossible. For example, his immunoglobulin therapy (to help his immune system) alone costs
as much as $5,000 to $10,000 per month. The couple adopted Ayden in May last year.
“There’s so many other needs that he has and that he will potentially have as he grows older,”
Davis said of her adopted son, who is now 3 years old. “It wouldn’t have changed our minds.
We would have adopted him with or without Medicaid.”
But there was no clear guidance, she added, and the couple “just had to figure it out on our
own.”
This all-too-common predicament can be avoided, adoption experts say.
State government child welfare departments can connect parents with outside sources, usually
private foster care or adoption support agencies, that provide an array of services including
financial advice, respite care, periodical support groups and connections with medical experts.
But it’s up to the adoptive parents to accept that help.
In Davis’s case, assistance from Kroll and his organization made all the difference. The family
also received help from a local project she learned about through her church, where Davis was able to connect with other adoptive parents “to be able to get together and share our frustrations
and our hearts because there’s not a lot of people that understand what this is and what this
looks like.”
Prevention, Not Panic
“They say for every forever home, the kids are happy and they live happily ever after. But that’s
not necessarily the case,” said Samantha Callaghan, director of Adoption and Kinship Support
Programs at New Alternatives for Children. Callaghan understands the lengthy process of
adopting a child is not necessarily the hardest step.
The New York City child welfare organization focuses on services for children with special
needs. Its post-permanency programs provide families with a social worker who can support
adoptive parents as they manage behavioral or developmental challenges their children may
experience, guiding them in how to navigate such complexities.
The group also offers support groups and community gatherings for adoptive families to share
their experiences. Parents can receive help obtaining public assistance and maintaining
connections with siblings.
The problem? Seeking post-adoption support is often completely voluntary, and many parents
choose not to take advantage because they are ready to be system-free and simply start
enjoying family life.
“Adoption finalization happens and it’s a moment of celebration,” Callaghan said. “But it’s also
mixed with feelings of happiness, sadness, loss, grief and confusion for not only the children but
for the biological parents.”
So she emphasized the importance of ongoing support. The assistance can be vital, particularly
when an adopted child has special needs.
Callaghan and other adoption specialists said chaos can ensue when families are suddenly left
without key support systems who had been previously vigilant in their lives when they were
connected to a social services agency: social workers, case planners, lawyers, education
specialists and doctors.
The earliest days can be the most challenging.
“They think, ‘finally I don’t have to adhere to home visits. I don’t have five to 10 providers
coming into my home’,” she said. “However, I think that the time between an adoption
finalization and the child achieving permanency is a very crucial time because that’s when
they’re going through the adjustment period.”
Callaghan stressed how essential psycho-educational workshops can be for parents, helping
them best manage children who may exhibit aggressive or dysregulated behaviors. Immediately
after their biological parents’ rights are terminated can be a particularly difficult time for kids, she
added, resulting in new behaviors such as running away or refusing to go to school.
“A lot of our kids, they have abandonment issues, and they think, ‘Are you going to abandon me
too? Are you gonna give up on me now?’” Callaghan said.
That’s why she stressed adoptive parents must get connected with a local nonprofit that
supports adoptive families, like the one she works for in New York City. And the connection
should be made early on after the adoption, not once problems have begun to spiral out of
control, threatening the permanency of the adoption.
Callaghan said her team often receives calls from parents in the midst of a crisis, when the
situation is close to becoming unmanageable.
“Family circumstances change over time,” she said. But in many cases she reflected on, “I wish
they had been connected to us earlier to prevent potential challenges, like a dissolution or
disruption.”
To correct this, Callaghan’s organization and others like hers advocate for greater visibility right
from the start, handing out information pamphlets in family courts, partnering with child welfare
agencies and disseminating critical information to mental health clinics and schools —
anywhere foster children and their potential adoptive parents may frequent — and through
judges and attorneys in family courts.
“These are the professionals who interact with adoptive families daily — yet the families who
often leave the courtroom after an adoption finalization are left with zero resources,” Callaghan
said.
Asking for Help
The Georgia Center for Resources and Support is among the groups offering help to post-
adoptive families. The center provides regional assistance in different parts of the state.
Debra Brown, a resource adviser at the organization serving several counties including Fayette
and Monroe, said she and her colleagues try to reach out to parents immediately before
adoptions are finalized.
“Most of the time, families wait until everything gets out of control, and then they will call us and
request services, instead of continuing the education of parenting,” Brown said, echoing her
New York peer.
An adoptive parent herself, Brown explained that what helped her the most with her teenage
children was keeping abreast of trainings, diagnoses and interventions and taking her kids to
counseling — from the very beginning. Advisers with the Center for Research and Support
direct parents to therapists near them, and to regional adoption coordinators at their local
Department of Children’s Services who can assist with financial aid. They can also get
connected to free classes and local “café chats” with adoption experts and other adoptive
parents, allowing participants to learn and join in important discussions about how to navigate
things like transracial adoptions, seeking quality mental health care and handling behavioral
challenges.
In some states, government agencies are also stepping up, even after children are released
from state custody.
The South Carolina Department of Social Services is in its second year of contracting with
Flourishing Families, a private organization providing support services for adoptive families. This
year, more than half of the families who were referred by the state agency took part in services
that include crisis consultation, support groups and family coaching.
“We know that children who experience the incredible trauma and the grief and loss that they do
through having to experience foster care are going to have an ongoing need for support for
some time,” said Dawn Barton, the department’s director of permanency management. She
described her agency’s ultimate post-adoption goal as “family preservation.”
Barton recalled several cases where adoptive parents became overwhelmed at their child’s
behavioral and mental health challenges. If the adoptee ends up in a psychiatric residential
treatment facility, some families are unwilling to take them back and they re-enter foster care as
a result, exacerbating trauma and instability.
“At that point families are frustrated, they’re tired. Some of them are fearful,” she said. “And that
doesn’t necessarily lead to the best outcomes.” But adoptive families should not despair, she
and other adoption experts noted.
Adoption professionals and adoptive parents underscored the ongoing priority nationwide to
make post-adoption and peer support more accessible and available to adoptive households —
from the earliest stages of family court involvement to more seasoned stages of family life.
“When you drag a child through foster care, the struggle is never over. They are born into
trauma,” Davis said. “And I think it’s really important to be able to connect with other foster
parents and adoptive parents to be able to work through those struggles.” •
Susanti Sarkar is a New York-based reporter at The Imprint covering child welfare. She has
previously covered inequities in health care and education, politics and climate change, and
graduated with a master’s degree in investigative journalism from Northwestern University’s
Medill School of Journalism. She can be reached at [email protected].
