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Evaluation of adoption of the intellectually handicapped: a retrospective analysis of 137 cases.

The current shortage of babies for adoption has led increasingly to the adoption of infants with evident as likely handicaps. An analysis of 137 infants surrendered for adoption over a period of thirty years who suffered from some degree of intellectual handicap provides information on the outcome of this type of adoption. An objective rating scale was used to examine the relationship of the child in the adoptive family (or in the foster family if this was the alternative to adoption). It was shown that a third of the adoptees had a good or belonging relationship in the family. In less than a quarter the relationship had failed badly. The remainder had problems which were being handled in a satisfactory manner, considering the difficulty of the situation. The measured variables which worsened the outcome were a severe or profound degree of retardation, the presence of a genetic disorder in the child, increasing age and difficult behaviour, particularly when a child of borderline or dull normal intelligence was placed with an "intellectual" family. The knowledge of the natural parents family medical history, even in the presence of a genetic disorder, favoured the adoptive relationship. The presence of a congential anomaly in the child led to deferral of adoption but did not increase the likelihood of institutionalisation in this series. All these families required continuation of advice and support and suitable facilities for the care and education of the child.