Adopted children missing out on mental health treatments

January 22, 2014, King's College London
Adopted children missing out on mental health treatments

Common disorders, such as ADHD or conduct disorder, are being 'grossly under-identified' amongst adopted and fostered children, according to a new study by King's College London. Instead, clinicians are over-identifying more complex 'attachment disorders', and as a result children are missing out on appropriate treatments.

The findings are published today in the journal Child and Adolescent Mental Health.

Researchers reviewed 100 consecutive referrals from across the UK to the National Adoption and Fostering Service, a specialist service based at the South London and Maudsley NHS Foundation Trust (SLaM).They compared the referral letters with each child's within the service, and to the expected rate of disorders from national data.

Best current estimates of the prevalence of for adopted or fostered children are based on the mental health of 'looked after children' (children in the care of the state)who have significantly higher rates of common disorders such as , Attention Deficit Hyperactivity Disorder (ADHD), learning problems and neurodevelopmental disorders compared to children in birth families.

The researchers found that disorders were over diagnosed among adopted and fostered children whereas common disorders, such as conduct problems, ADHD, anxiety or autism were under diagnosed.

Attachment problems were mentioned in 31% of the referrals. Upon clinical assessment, only one child was identified as having potential attachment symptoms but this was for a child in the 69% not initially identified with attachment problems.

Only 4% of referrals identified but rates of conduct disorder were approximately 10 times higher in the national data. In the clinical assessment, common disorders were diagnosed much more frequently than attachment disorders, with conduct disorders diagnosed 13 times more frequently than attachment disorders.

Attachment disorders occur when infants and young children have not had the opportunity to form attachments to their primary caregivers, usually because of grossly inadequate childcare, or extremely frequent changes in caregivers. Whilst disruptions to early caregiving are almost always present in adopted or looked after children,attachment disorders are relatively rare. Unlike more common mental health disorders, there are no evidence based treatments for attachment problems.

Dr Matt Woolgar, lead author of the paper from the National Academy of Parenting Research at King's College London's Institute of Psychiatry, and consultant clinical psychologist at the National Adoption and Fostering Service at SLaM, says: "There is real confusion around the term 'attachment disorder'. Clinicians appear to be using this diagnosis to try and capture the complex mental health problems that adopted or fostered children often have. It seems that clinicians may be making the diagnosis based more on the assumptions due to the child's history, rather than because of specific symptoms. In doing so, the danger is that they are blinded to some of the more straightforward diagnoses, like ADHD, or conduct disorders, for which there are good, evidence-based treatments. As a result, children are missing out on the treatments they need."

Explore further: One in five U.S. kids has a mental health disorder, CDC reports

More information: Woolgar, M. et al. "Attachment disorders versus more common problems in looked after and adopted children: comparing community and expert assessments." Child and Adolescent Mental Health. 2014. DOI: 10.1111/camh.12052.

Related Stories

One in five U.S. kids has a mental health disorder, CDC reports

May 16, 2013
(HealthDay)—As many as one in five American children under the age of 17 has a diagnosable mental disorder in a given year, according to a new federal report.

Continued increases in ADHD diagnoses and treatment with medication among US children

November 22, 2013
A new study published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) found that an estimated two million more children in the United States (U.S.) have been diagnosed with attention-deficit/hyperactivity ...

Children and adolescents with eating disorders clinically distinct

January 13, 2014
NEW paediatric research suggests that children and adolescents with eating disorders display significant differences in clinical presentation, lending further support to research which has found eating disorders differ across ...

Mental-health disorders growing faster among kids than adults

November 27, 2013
(HealthDay)—Young people are increasingly more likely than adults to be diagnosed with a mental health disorder, according to a large new study.

Children of older dads more likely to suffer mental illness, study shows

January 22, 2014
(Medical Xpress)—Children with older fathers are more susceptible to mental health disorders a University of Queensland (UQ) study has found.

Most teen mental health problems go untreated

November 18, 2013
More than half of adolescents with psychiatric disorders receive no treatment of any sort, says a new study by E. Jane Costello, a Duke University professor of psychology and epidemiology and associate director of the Duke ...

Recommended for you

Study: No evidence to support link between violent video games and behaviour

January 16, 2018
Researchers at the University of York have found no evidence to support the theory that video games make players more violent.

Study listens in on speech development in early childhood

January 15, 2018
If you've ever listened in on two toddlers at play, you might have wondered how much of their babbling might get lost in translation. A new study from the University of Toronto provides surprising insights into how much children ...

Study suggests people dislike you more for humblebragging than for regular boasting

January 12, 2018
A team of researchers from Harvard University and UNC-Chapel Hill has conducted a study regarding humblebragging—in which a person boasts about an achievement but tries to make it sound less boastful by minimizing it—and ...

Can writing your 'to-do's' help you to doze? Study suggests jotting down tasks can speed the trip to dreamland

January 11, 2018
Writing a "to-do" list at bedtime may aid in falling asleep, according to a Baylor University study. Research compared sleep patterns of participants who took five minutes to write down upcoming duties versus participants ...

Study identifies brain circuit controlling social behavior

January 11, 2018
A new study by researchers at Roche in Basel, Switzerland has identified a key brain region of the neural circuit that controls social behavior. Increasing the activity of this region, called the habenula, led to social problems ...

Tamper-resistant oxycodone tablets have no impact on overall opioid use

January 11, 2018
The introduction of tamper-resistant opioid tablets does not have an effect on rates of opioid use or harms at a population level, according to a new study led by the National Drug and Alcohol Research Centre (NDARC) at UNSW ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.