- My child has special needs/behaviors that I can't handle. Where can I go for help?
- Where might I find a support group for me or my child?
- What post-adoption services are available in my area? How do they differ for different types of adoption?
- Why might I need respite care? Where can I find it?
- As a relative, am I eligible for financial assistance?
- I have a grandchild/adopted child who has special needs. Why wasn't I given a subsidy?
- I didn't adopt through the foster care system, but I really need help to meet the child's needs. Where do I turn?
- I want to disrupt this adoption. How do I do that?
- What is HIPAA and how does it affect me?
- How do I protect myself from and respond to allegations?
- Do I still have access to EPSDT services after adoption?
- How does Medicaid work for my child?
- What about educational and school issues? What are IEPs and does my child need one?
My child has special needs/behaviors that I can't handle. Where can I go for help?
The following are good places to go for help in your area:
Where might I find a support group for me or my child?
Visit the parent support group section of our site to search for groups in your area.
What post-adoption services are available in my area? How do they differ for different types of adoption?
First call the agency that placed your child. You can also your local department of human service (also called social services), as well as any private adoption agencies in your area. Support groups (see above) will be a great place to find another services. You can search the National Adoption Directory for more information.
Why might I need respite care? Where can I find it?
Sharon McCartney, in “Outside the Box: Where to Look for Respite Resources” writes, “The issues of grief, control, loss, and attachment that can lead to the behavioral and developmental problems particular to adopted children are well-known. Caring for a child with these problems can be both emotionally and physically taxing. Add to this the fact that many adopted children are also identified as children with special needs, and the demands of their care become even greater. Respite resources can ease the stresses of caring for an adopted and/or special needs child and many programs are available outside those developed by state child welfare systems.”
Some of the best sources to find respite care are your local parent support groups, your local foster are or adotion agencies, or the state or community foster adoptive parent association. You can also contact the ARCH National Respite Network and Resource Center at 800-473-1727.
For information about financial support for respite care for children adopted from foster care, visit the NACAC state subsidy profiles.
As a relative, am I eligible for financial assistance?
Support for relative caregivers varies from state to state. AARP, Child Welfare League of America, Children's Defense Fund, and Generations United have created fact sheets containing the most up-to-date state information related to grandfamilies, including:
Census data on the number of grandparent caregivers
A comprehensive list of kinship care family resources and services
State foster care policies for kinship caregivers
Information about key public benefits programs
State kinship care laws
To access these fact sheets, visit http://ipath.gu.org/State921334.asp or contact Generations United at 202-289-3979 or firstname.lastname@example.org.
I have a grandchild/adopted child who has special needs. Why wasn't I given a subsidy?
Adoption subsidy/adoption assistance is designed to encourage and support the adoption of children who were in the public foster care system. Is it not private or international adoptions.
If you adopted from foster care, our staff can help you—call 800-470-6665 or e-mail email@example.com.
I didn't adopt through the foster care system, but I really need help to meet the child's needs. Where do I turn?
The following are good places to go for help in your area:
I want to disrupt this adoption. How do I do that?
We encourage to get support before you make any decisions. The following are good places to go for help in your area:
You can also contact your local or state Department of Social Services, community family support organizations, children’s mental health programs, special needs organizations, or—if the child is adopted—an adoptive parent support group.
If these options have failed, typically parental rights cannot be terminated without a legal order of abandonment.
What is HIPAA and how does it affect me?
In Adoptive Families magazine, Mark T. McDermott wrote the following:
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-91, which also amended ERISA, extended the prohibition against discrimination to governmental employers. As a result, health insurance coverage for adopted children is now available to all families covered by group health plans as soon as those families assume financial responsibility for the child.
Several other things were accomplished by HIPAA. For example, HIPAA mandates that group health plans must offer the employee the right to enroll the new child in the plan immediately. Under prior law, immediate enrollment was sometimes not possible if the adopted child joined the family at a time when the employee was not eligible to elect coverage, i.e. when it was not “open season.”
In contrast to this positive side, HIPAA can also have a negative impact for adoptive families. As one legal expert asserts, HIPAA regulations are "chock full of ambiguities" concerning child welfare agencies' responsibilities under the law. Does HIPAA prohibit agencies from releasing identifiable health information about foster children to pre-adoptive and adoptive parents? Are child welfare agencies covered entities?
In a February 17, 2004 Information Memorandum, HHS states that "[s]ome title IV-E child welfare agencies may be defined as health care providers." The memo concludes, however, that "HHS and the Children's Bureau cannot determine whether all child welfare agencies are subject to HIPAA's regulations."
In short, most state agencies have had to decide for themselves whether HIPAA regulations apply. Unfortunately, many agencies that try to follow HIPAA have begun to limit key medical information disclosure to pre-adoptive parents.
How do I protect myself from and respond to allegations?
- Know your limits. If you are not comfortable handling children with certain challenging backgrounds and behaviors, don’t set yourself up by bringing such children into your home.
- Learn all you can about each child before placement. You have a right to know about previous abuse and allegations. Ask: “Has this child been abused? In what way? Who were the perpetrators? Have there been any abuse allegations?” Get written documentation of any prior instances of physical or sexual abuse or false allegations their child may have made against other caregivers in the past.
- Make sure that men and boys in your house are never alone with a girl who has been sexually abused. Proactive precautions are very important in this situation, especially at the beginning of the placement. Talk with your partner and others in the household about this safety plan, and stay proactive.
- Give each sexually abused child his or her own bedroom. If a child’s boundaries have been invaded, he needs to re-learn proper boundaries.
- Be crystal clear about rules for dress, privacy, touching, etc. Caregivers must agree on house rules, boundaries, and consequences. Each child comes from a different culture of parenting, sexuality, sleeping habits, dress, touch, and more, and needs to learn what is appropriate.
- Never use physical discipline. Children with a history of physical, sexual, or emotional abuse often misinterpret physical discipline and an allegation is likely. Physical discipline can also undermine attachment.
- Avoid teasing, horseplay, wrestling, and suggestive language. These are acts of intimacy, and intimacy is just what abused children often resist. In addition, the child may get a different message than you intend during the close physical contact involved.
- Document sexual acting out in writing. Send reports to the child’s social worker and therapist. Then, if another incident comes to light, the worker and therapist can see that there might be a pattern to the child’s acting out that perhaps relates to past experiences.
- Document behavior patterns. When a child enters your home, use a calendar to record changes in the child’s behavior; inappropriate words or actions during birth parent visits; the child’s behavior following visits; the cause of scratches, bruises, or other injuries; and any patterns of behavior that seem to follow specific events or times of the year (like anniversaries of certain past events).
- Participate in a support group. Share the struggles and joys that are a part of our lives with those who can empathize and support you.
- Reserve personal time to reduce stress. Know what really pushes your buttons, and establish a calming plan. Post 20 calming tips on your refrigerator and model stress-reduction techniques for your children. Then, make plans for a weekly—yes, weekly—time away from the children.
- Become knowledgeable about your area’s child protection laws, county or agency procedures for investigation, and resources available to families.
- Develop a team approach with their social worker, pediatrician, psychologist or psychiatrist and check to see if they have experience with abuse survivors (or are willing to learn) and understand their child’s history.
- Know and accept their child’s vulnerabilities, behavioral patterns, and triggers.
- Participate in family therapy with their child; your child is learning to bond with you, and individual therapy alone may prevent that from happening.
- Discuss all problems openly with your children and don’t keep secrets. Talk about their children’s history of abuse and past false allegations and tell your children you plan to protect them and everyone in the family.
- Set clearly defined family rules, behavioral expectations, and consequences for misbehavior.
Handling False Allegations
- Try to stay positive. Assume that the charge will be proven false, and try not to presume guilt. Child protection has to investigate to make certain that the child is not being abused. The best thing you can do is cooperate.
- Document everything. Start a notebook to record details of every phone conversation, personal interview, and correspondence related to the allegation.
- Request copies of the written charge against your family, as well as the letter that formally states that the allegations were unfounded.
- Get a copy of your state’s foster care rules and laws pertaining to allegations and abuse, and learn about county or agency policies and procedures too. Find out what will happen during the investigation, what your rights are, and how you can appeal an investigator’s determination.
- Behave appropriately. During interviews, make your point and then stop talking. Speak with confidence, and be factual, honest, respectful, and business-like. Avoid emotional language when telling your side of the story. Try to be objective.
- Meet with people who are gathering information. If an investigator asks to meet with you, don’t keep her waiting. If you need to, bring along a friend or someone from your support group who can give you perspective on how the meeting went.
- Communicate with your partner. Allegations, especially those of sexual abuse, can really drive a wedge between partners. The husband thinks, “How could they think I would do something like that?!” The wife wonders, “Could it possibly be true?!” If not openly discussed, these questions can pull couples apart just when they need each other’s support the most.
- Know your rights. Don’t be afraid to appeal, request a waiver, and learn how the grievance procedure works. If need be, hire legal counsel, especially for sexual abuse allegations.
Do I still have access to EPSDT services after adoption?
This will vary state to state. To find out, contact the Medicaid person in your state. This contact is listed in question 8 of NACAC’s state subsidy profiles.
How does Medicaid work for my child?
Children who are eligible for federal and state adoption assistance programs are automatically eligible for Medicaid benefits (states may choose to provide another type of coverage for state-funded children as long as the coverage is identical to Medicaid). Medicaid benefits transfer across state lines if families move.
For more information on specific benefits or how to obtain the card in your state, visit NACAC’s state subsidy profiles.
What about educational and school issues? What are IEPs and does my child need one?
Seeking Special Educational Services
The U.S. public education system is required to accommodate all children, no matter what their needs. Free, Appropriate Public Education (FAPE) was first authorized through the Education for All Handicapped Children Act of 1975 (P.L. 94-142), and one key to making FAPE a reality is the Individualized Educational Plan (IEP), a customized set of goals and strategies to help each child learn.
In Canada, each province administers educational policy, and sets the rules for children’s educational plans. Any parent in Canada can request a plan for his or her child, even if the child does not have serious special needs.
Under U.S. federal law, IEPs can be developed for children who are found to have “mental retardation, a hearing impairment including deafness, a speech or language impairment, a visual impairment including blindness, serious emotional disturbance…, an orthopedic impairment, autism, traumatic brain injury, another health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services.” (IDEA, 1997 Regulations, Subpart A, §300.7) Young children who are experiencing developmental delays may also qualify.
The process works as follows:
Step 1: Identification — Anyone who knows the child—including a parent, teacher, or physician—can refer a child for evaluation if he or she suspects that the child has a special need. The earlier the intervention, the better, so it is important not to take a wait-and-see attitude.
Step 2: Evaluation and Assessment — A team of experts (identified commonly as an IEP team, a multi-disciplinary or M-team, or an individual program review committee or IPRC) assess the child, and if the team determines that the child has exceptional educational needs, an IEP is created. Parents are an important part of planning the IEP. They meet with the evaluators to discuss evaluation findings and determine how to best meet the child’s educational needs. Depending on age and the nature of the special needs, the child can be included in meetings too.
Step 3: Placement in the Least Restrictive Environment — If the child meets certain criteria, the school system offers a special program, placement, or services that can meet the child’s needs in the “least restrictive environment.” In most cases, children are in a regular classroom with an array of special services. A special class for all or part of the day is another possibility, as is an allotment of time spent in a resource room with a specialist, or having an aide to help the child manage in the regular class. Services may include physical, language, or occupational therapy, or monitoring by medical personnel.
Step 4: Monitoring and Modification — After a plan is in place, teachers and parents must monitor the child’s performance. As needed, the IEP team can modify the plan to provide additional services or move the child to a different setting.
IDEA and Education
In 1997, the Education of All Handicapped Children Act was amended and reauthorized as the Individuals with Disabilities Education Act (IDEA). Changes and clarifications in IDEA:
- mandate that services be tailored to the child’s individual needs instead of his or her disability category
- require that IEP teams consider all factors, including a child’s behavior, that impede learning
- outline discipline procedures and services that children must receive when removed from school
Inclusion—also known as mainstreaming—is clearly the trend for children with special educational needs, but it is not the best idea for all children. Judy Grove, the Adoption Council of Canada’s executive director, has eight children—six who joined the family through adoption. “There is no one-size-fits-all approach,” Judy asserts. “A lot depends on what you perceive the child’s disability to be. When children have developmental delays, normalization and higher expectations can be helpful. Other disabilities may be best served in more segregated environments.”
Schools in the U.S. may also grant special services to home-schooled kids or to children attending private schools. If parents in these circumstances suspect that their child has exceptional needs, they can ask the public school for an evaluation. If special services are warranted, and the parent convinces a hearing officer that the public school did not make FAPE available, then the school may have to pay for an approved private school. Public school systems in the U.S. and some Canadian provinces can also provide services to children in hospitals, residential treatment centers, and in the child’s home if the child is homebound.
Sometimes a child’s physical or mental impairment hinders her work in a regular class, but the child does not meet the criteria for exceptional education services. In these situations, Section 504 of the Rehabilitation Act dictates that U.S. public schools provide accommodations to address the child’s disability.
Section 504 accommodations relate directly to the child’s disability. Schools may, for instance, modify rules, policies, or practices; remove architectural or communication barriers; or provide assistive technology. In terms of education, a child who has Section 504 protections has access to the same free and appropriate education as children who are not disabled.
Compared to IDEA—which has set rules and enforceable timelines—Section 504 guidelines are much less specific. For example, IDEA specifies that parents must receive written notice of all meetings and a copy of the IEP. Section 504 does not include either requirement.
Questions for Parents to Ask Regarding Special Needs Services
- How will my child benefit by receiving special needs services?
- What academic, physical, social, and emotional concerns do the teachers and I have regarding my child?
- What kinds of tests will be administered to determine whether or not my child qualifies for services?
- What kind of help will my child receive? How often? From whom? In what way?
- How will my child’s school day schedule be affected in order to receive help?
- How will special needs services affect my child’s learning time with peers?
- Will we also discuss my child’s strengths and abilities, as well as concerns?
- What areas of learning will be focused on and how will growth be measured?
- How will we be involved in the IEP plan?
- How will we all know when progress is made?
- What will be expected at home and at school?
- How will we know if things are going well or not?
Being Your Child’s Educational Advocate
- Be prepared. Before school starts, think about what you and your child need to talk about so that he can respond to issues that may be raised at school. Give your child the tools he needs to respond to comments from classmates. Be prepared to respond to difficult situations that may arise.
- Be proactive. If you want it known that your child is adopted, inform each new teacher. Meet with the teacher at the beginning of the school year. Use your judgment about how much history is appropriate to share.
- Be an educator. Provide teachers and administrators with positive adoption language, as well as an explanation of why it is important to use positive language.
- Be realistic. Remember that teachers are responsible for working with a classroom of children. Certainly the teacher will work to meet your child’s individual needs, but at the same time that teacher is teaching a community of learners, each one having important needs too.
- Define success. Children develop at their own pace, sometimes excelling with high academic achievement and sometimes struggling to achieve at grade level. Be open to highs, lows, and plateaus in learning, and be prepared to support your child through all three stages.
- Be an advocate. Find out about the services that your child may be entitled to, including special education services, one-to-one or small group help from paraprofessionals, and other tutoring possibilities.
- Be supportive. Let your child know that you are there for her, and that you want her to enjoy school. Also make it clear that you will work with her school to increase the appropriateness of assignments, educate teachers on adoption issues, and be available to explain adoption to classmates and other families, if desired.
- Work as a team. Establish a partnership with your child’s teacher, counselor, social worker, and principal.
- Continue to learn. As you live and grow with your children, new information is often revealed to you. For example, sometimes suspicions of past abuse and neglect in older adopted children may be revealed as truth.
- Join a parent support group. If you have drifted from a group, either re-connect or find another one that suits your needs. Who better than other adoptive, kinship, and foster parents to support you as you advocate for your child in school?
- Plan for the future. If you sense that your child might be moving into a difficult age, check ahead to see if there are teachers in the upcoming grade level who understand adoption.
Finding Additional Resources
Center for Adoptive Families’ training manual, Adoption Awareness in Our Schools: A Training Curriculum, is available for $25.00. Contact:
Center for Adoptive Families
5750 Executive Dr., Suite 107, Baltimore, MD 21228
410-869-0620 or 301-439-2900 • firstname.lastname@example.org
FAIR’s Adoption and the Schools manual can be ordered for $25.00 plus $5.00 shipping and handling. Contact:
Families Adopting In Response
P.O. Box 51436, Palo Alto, CA 94303
650-328-6832 • email@example.com • www.fairfamilies.org
Louisiana Adoption Advisory Board, Inc.
P.O. Box 2332, Baton Rouge, LW 70821
225-342-6832 • www.laab.org