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November is National Adoption Month: Supporting individuals with autism in foster care and post-adoption contexts

On a personal note, I don’t have a child with autism, but this topic holds a most special place for me because two of my own children are adopted. Addressing this topic represents the intersection of my professional and personal heart. Here in North Carolina, there were approximately 17,000 children placed in foster care in 2019, and this number has increased across the last decade. Of those children, a growing number are identified with autism. Some research suggests that children with autism are at greater risk for foster care placement than children without autism or than children with other developmental disabilities (Cidav, Zie, & Mandell, 2018).

Children in foster care and post-adoption situations understandably experience sadness, uncertainty, anger, and fear, even if they are in very happy and loving homes. For some, this ebbs and flows, and very strong feelings may arise when they (and we) least expect it. Many are also dealing with the direct and indirect effects of trauma.

These effects come in many forms, some of which are not so easily recognized as stemming from traumatic life experiences. It may be more difficult for mental health professionals to assess and identify trauma among individuals with autism who may have significant social communication and coping challenges.

Some individuals with autism might struggle to convey emotions to others (through language or other symbolic forms of communication), to ask questions, and to get affirmation that they need in order to feel more secure and calm. It may also be more difficult for some with autism to understand the why behind their situation – why did I have to leave my home and move in with another family, when will I get to see my biological family, or why was I adopted?

For children in foster and post-adoption contexts, it essential for caregivers to establish safe, calm and caring environments that are generally predictable and well-structured. It is important to empower the child with ways to safely express their wants, needs, frustrations and fears. The child requires many authentic opportunities to assert their choices and preferences. The child needs to be proactively taught calming and coping strategies that work for them. Building self-advocacy in all its forms is a central focus. Of course, this is also very true for children with autism in these (and all) contexts. Addressing these fundamental needs and goals requires that we find the particular starting points and strategies that are most responsive to the individual’s autism core features and their lived experiences.

It is also critical that we look at challenging behavior through the right lens. In the midst of meltdowns and tense moments, here are just a few guidelines:

  • It’s not personal, even if it feels that way.
  • Avoid characterizing behaviors in overly simplistic (he is just trying to get attention) or subjective terms (she is trying to manipulate me; he wants to get under my skin).
  • Consider both the immediate events that may have triggered the behavior, and also consider the underlying factors and history that play a critical role.
  • A few reflection questions:
    • What is the child communicating in this moment and through this pattern of behavior?
    • What is the unmet need, fear, or confusion that this behavior(s) expresses?
    • What skills do we need to teach so that s/he can better communicate, self-advocate and/or cope next time?
    • What strategies and accommodations do we need to proactively and consistently apply to support this child’s needs?
  • Remain the calm in the storm. Try to avoid emotionally reacting to the behavior itself. In this moment, the individual is struggling to cope, they may need us to help them regulate, and they need us to be steady.
  • Validate their feelings using rationed language and non-verbal signals that they will understand.
  • Be present for them but give physical space as needed and when safe to do so; and give them time, without placing any demands, and without too many instructions/questions.

 

Of course, these guidelines are just the tip of the iceberg. We receive inquiries from professionals and families in need of resources and strategies to support this population.  The Autism Society of North Carolina is here to help:

  • Social narratives on foster and adoption topics: We have developed examples of social narratives addressing such topics as moving in with a foster family adoption, and biological parents. Of course, it is critical to note that these social narratives are very likely to require modification to address the individual’s level of understanding and their particular situation. Click here for the social narratives.
  • Webinar: On November 17, we hosted an online webinar, Supporting Individuals with Autism in Foster and Post-Adoption Contexts. The recording is available in our library.
  • We also offer in-depth workshops and coaching to professional groups (e.g., school systems, provider agencies) that are tailored to the group’s particular needs. To learn more, contact clinical@autismsociety-nc.org
  • Telehealth consultation: Our Clinical Department offers a telehealth-based Rapid Response Clinical Consultation service, provided in any county in North Carolina. This service is funded by Medicaid, the Innovations Waiver under Specialized Consultative Services, various private health insurances and other sources. To learn more, contact Dr. Aleck Myers at amyers@autismsociety-nc.org.
  • Are you a foster or adoptive parent to a child with autism in need of help accessing services in your local community, understanding the IEP and 504 plan processes, planning for the future, and more? Connect with one of our Autism Resource Specialists to receive parent-to-parent support https://www.autismsociety-nc.org/talk-with-a-specialist/

Below are just a few of the many resources available on adoption and trauma:

  • The Center for Adoption Support and Education (C.A.S.E.): A national leader in mental health services for foster care and the adoption community. https://adoptionsupport.org/
  • Bessel van der Kolk – One of many leaders in research on and treatment of trauma, offering a range of resources including publications, podcasts and more. https://www.besselvanderkolk.com/
  • Prevent Child Abuse North Carolina — This website provides information about the effects of trauma, neglect and resiliency. It also offers tools to recognize physical and child sexual abuse and much more. https://www.preventchildabusenc.org/
  • Children’s Advocacy Center of North Carolina (CACNC) – Provides advocacy by bringing the professional to the child, aiming to reduce the need for children and their families to navigate complex systems and services via many different portals. https://cacnc.org/

 

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