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Stage 2

This stage of the study followed up adopted children and their adoptive parents and adult birth relatives with the children were in middle childhood.

The study explored how the children were getting on in their adoptive families, how adults and children experienced the contact arrangements, and whether post adoption contact arrangements for having any impact on children’s emotional and behavioural development.

The families in the study all had a plan for some form of open adoption. We focussed on two different types of contact with adult birth relatives (mostly parents and grandparents). One type was face-to-face contact where the adopted child has meetings with their birth relatives. The other type was indirect contact – where letters and sometimes photos or cards are exchanged between adopted parents and birth relatives, via the adoption agency.

The study revealed children’s views about adoption birth family contact and illuminated the family dynamics of post adoption contact across birth and adoptive families.


The study addressed the following research questions:

  • Had contact arrangements progressed according to the plans made when children were adopted, or these arrangements changed over time?
  • How did children, adoptive parents, and birth relatives feel about the contact that they were having?
  • Which contact arrangements were working, and why?
  • What did the children feel and understand about their adoption?
  • How open were adoptive parents in terms of thinking about and talking with their child about adoption?
  • How accepting were birth relatives of the adoption, and how were birth relatives getting on with their lives after the adoption?
  • How were children getting on in terms of their emotional and behavioural development, and were there any differences between children having direct contact versus those having indirect contact?


  • We carried out in-depth interviews with adoptive parents from 62 families, 72 birth relatives (from 61 birth families) and 43 adopted children.
  • We carried out semi structured interviews including activities with the adopted children. Interviews included the use of David Brodzinsky’s ‘Understanding of Adoption’ scale and a visual map children could use to show their feelings of closeness to birth and adoptive relatives.
  • We asked adoptive parents to complete questionnaires about their child's emotional and behavioural development using the Achenbach‟s Child Behaviour Checklist (CBCL), and Goodman’s Strengths and Difficulties Questionnaire (SDQ)
  • We developed a rating scale to measure how open adoptive parents were to talking and thinking about adoption (their Adoption Communication Openness)
  • We asked birth relatives to complete a questionnaire about their psychological symptoms experienced in the last week (the Derogatis Brief Symptom Inventory -a 53-item self report symptom inventory that can identify an individual’s psychological symptom status).
  • The data were collected between 2002 and 2004 when the children were in middle childhood (the mean age was 8 years, most children were in the 7-9 year age range).

Key findings

  • Almost all children felt they were loved and that they belonged in their adoptive family. This was true regardless of the contact arrangements with birth relatives.
  • Some children experienced problems outside the family (usually at school) related to teasing from other people about being adopted.
  • Children in this study did not yet have a full understanding of adoption. Many children were curious about their birth family. A wide range of feelings (both positive and negative) were expressed.
  • Children generally accepted whatever contact they had as normal and ordinary. Children involved in ongoing contact arrangements generally valued the contact. If they expressed any dissatisfaction this was usually related to contact that was not happening.
  • About three-quarters of children were doing well in terms of their emotional and behavioural development. Children who had problems in these areas tended to be those who were older at placement and had more difficult backgrounds.
  • No differences were found between children who had face-to-face contact and those who did not in terms of their emotional and behavioural development. Neither did the openness of adoptive parents relate to children's emotional and behavioural development.
  • Adoptive parent satisfaction with face-to-face contact was generally high, with adoptive parents usually reporting that this contact was either positive or neutral/unproblematic for their child. They often described meetings as being low-key and like seeing a distant relative.
  • Adoptive parent satisfaction with indirect contact was more mixed, with many adoptive parents finding letters hard to write and finding the response (or lack of response) from birth relatives disappointing. Children were not necessarily being included in letter contact.
  • Adoptive parents varied in terms of how open they were to talking and thinking about adoption, and understanding every party’s perspective on adoption. Adoptive parents involved in face-to-face contact tended to be more open than those involved in indirect contact.
  • About half of birth relatives had accepted the adoption and supported the adoptive parents. The remaining birth relatives were either resigned or angry. Grandparents were more likely to show positive acceptance than birth parents, and birth relatives involved in face-to-face contact were also more likely to show positive acceptance compared to those who had no face-to-face contact.
  • Almost all birth relatives felt that having any form of contact was better than having no contact. Contact could be a very mixed experience of birth relatives however. Some birth relatives did not keep up meetings or respond to letters for both practical and emotional reasons.
  • Contact plans made at the time of placement had often changed in the years following adoption and both increases and decreases in contact were found.
  • Both face-to-face and indirect contact worked best where both the adoptive parents and birth relatives could empathise with each other, think about the child's needs, and relate to each other in a constructive and collaborative way.
  • Where indirect contact was planned, a one-off meeting between the adoptive parents and birth relatives was usually highly valued by both parties, and increased the chance that indirect contact would be sustained over the years.

Implications for practice

  • Consider contact on a case-by-case basis. The study showed that contact in its various forms can work out in a variety of ways; it can have benefits for everyone involved, but can also be disappointing or emotionally challenging. Children's contact with birth relatives should be carefully considered on a case by case basis. The type of contact considered should be based on this individual assessment, and views that face-to-face contact is "difficult" and letterbox contact is "easy" need to be questioned. Don’t forget to consider the role of grandparents.
  • Assess relevant factors. When considering contact there should be a focus on what is hoped to be achieved for the child (for example to provide them with information they can use to make sense of their identity, or to maintain or develop important relationships). The strengths and limitations of the individuals involved, and how these may change over time, should be considered. The capacity of both adoptive parents and birth relatives to support each other’s different roles in the child’s life is crucial.
  • Set up contact to succeed.  Where indirect or direct contact is planned, try to set up a carefully supported meeting between birth relatives and adoptive parents. Keep this meeting apart from the child's "goodbye" visit, and from the introductions between the child and adoptive parents, as these other events are also highly emotional. This type of meeting could be useful even sometime after the placement.
  • Support and review contact plans. Contact arrangements often change after the adoption, and systems to review and support contact should be in place. Although the focus of contact must be the needs of the child, contact has an emotional impact on adults as well; where contact is very difficult for adults it is likely to be difficult for children. It is important to understand the needs and feelings of adoptive parents and birth relatives as well as children, and to support all three parties.


Download the 2 page research briefing

Or the longer 13 page research summary

Neil, E. (2013). The mental distress of the birth relatives of adopted children: ‘disease' or ‘unease'. Health and Social care in the Community, 21/2, 191-199

Neil, E. (2012). Making sense of adoption: integration and differentiation from the perspectives of adopted children in middle childhood, Children and Youth Services Review, 34, 409-416. Making sense of adoption abstract.

Neil, E. (2009). ‘The corresponding experiences of adoptive parents and birth relatives in open adoptions'. In Wrobel, G. and Neil, E. (Eds.) International advances in adoption research for practice. Chichester: Wiley.

Young, J. and Neil, E. (2009). ‘Contact after adoption'. In G. Schofield and J. Simmonds (Eds.) The Child Placement Handbook: Research, Policy and Practice. London: British Association for Adoption and Fostering.

Neil, E. (2007). Post adoption contact and openness in adoptive parents' minds: consequences for children's development. London: British Journal of Social Work- Advance Access: doi: 10.1093/bjsw/bcm087.

Neil, E. (2007). Coming to Terms with the Loss of a Child: The Feelings of Birth Parents and Grandparents about Adoption and Post-Adoption Contact, Adoption Quarterly, 10 (1), pp. 1-23. Coming to Terms with the Loss of a Child abstract.

Neil, E. (2004). The "Contact after Adoption" Study: indirect contact and adoptive parents' communication about adoption. In E. Neil and D. Howe (Eds.) Contact in Adoption and Permanent Foster Care: Research, Theory and Practice. London: British Association for Adoption and Fostering.

Neil, E. (2004). The "Contact after Adoption" study: face-to-face contact. In E. Neil and D. Howe (Eds.) Contact in Adoption and Permanent Foster Care: Research, Theory and Practice. London: British Association for Adoption and Fostering.

Young, J. and Neil, E. (2004). The ‘Contact after Adoption' study: The perspective of Birth Relatives after non-voluntary adoption. In E. Neil and D. Howe (Eds). Contact in Adoption and Permanent Foster Care: Research, Theory and Practice. London: British Association for Adoption and Fostering.

Neil, E. and Howe, D. (2004). Conclusions: a transactional model for thinking about contact. In E. Neil and D. Howe (Eds.). Contact in Adoption and Permanent Foster Care: Research, Theory and Practice. London: British Agencies for Adoption and Fostering.