Assessing the Field of Post-Adoption Services: Family Needs, Program Models, and Evaluation Issues. Evaluation Issues. 2.1.5 Outcomes

11/01/2002

Outcome evaluations are the least common of all evaluation types. Among challenges inherent in outcome evaluations are the difficulty of demonstrating effects, particularly for less intensive interventions, and the lack of a clear point at which outcomes are to be measured. Although outcome evaluations are not necessarily appropriate for all interventions, there is likely to be increasing pressure on PAS programs to document their effectiveness, and increasing interest within the field in comparing alternative service delivery approaches.

A variety of measures have been used for outcome assessment, including clinical assessments, events such as adoption disruption or out-of-home placements, goal attainment, or subjective assessments by workers or parents. Exhibit 2-7 summarizes several approaches to outcome assessments.

Exhibit 2-7.
Examples of Outcome Evaluations
Program Measures Data Collection Method
Adoption Crossroads, Massachusetts
  • Goal attainment for information and referral calls
  • Client self-reports
Adoption/Guardianship Preservation Program, Illinois
  • Child functioning
  • Out-of-home placement
  • Clinical assessments
  • Interviews with program staff
  • In-depth case reviews and caseworker interviews
  • Parent feedback forms
Casey Family Services Post-Adoption Program, New England
  • Child functioning
  • Family functioning
  • Worker assessments
Medina Children's Services, Washington
  • Out-of-home placement
  • Case records
MENTOR Crisis Intervention Service, Georgia
  • Child functioning
  • Family functioning
  • Disruption or dissolution
  • Case records
  • Clinical assessments
Post-Adoption Resources for Training, Networking, and Evaluation Services (PARTNERS), Iowa
  • Out-of-home placement
  • Clinical assessments

Child and family clinical assessments offer detailed measures of child and family outcomes for more intensive interventions, with the opportunity for pre/post comparison. There is no consensus yet on which measures are best suited to the needs of adoptive families, as shown in Exhibit 2-8.

Exhibit 2-8.
Clinical Assessments Used in PAS Evaluations
Type of Assessment What It Measures Evaluation Use of Assessment
Achenbach Child Behavior Checklist (CBCL)
  • Problem behavior
  • Child competence (rarely used)
Adoption/Guardianship Preservation Program, Illinois

Post-Adoption Resources for Training, Networking, and Evaluation Services (PARTNERS), Iowa

Adoptive Family Preservation program, Virginia

Child Adolescent Functional Assessment
Scale (CAFAS)
  • Level of disability
MENTOR program, Georgia
Child Welfare Family Risk Assessment
  • Family risk
Post-Adoption Resources for Training, Networking, and Evaluation Services (PARTNERS), Iowa
Cline/Helding Adopted and Foster Child Assessment (not standardized)
  • Emotional health
  • Giftedness
  • Problems (e.g., fetal alcohol syndrome/effect, depression/conflict)
Adoptive Family Preservation program, Virginia
Current Feelings About Relationship with Child
  • Relationship with child
  • Feelings about parenting
Adoptive Family Preservation program, Virginia
Family Adaptability and Cohesion Scale
  • Family dynamics
  • Family cohesiveness
Post-Adoption Resources for Training, Networking, and Evaluation Services (PARTNERS), Iowa
Global Assessment of Functioning (GCF)
  • Levels of symptoms and functioning
MENTOR program, Georgia

The use of child self-reporting assessments, though not reported in any of the evaluation efforts, is a potential evaluation tool. The National Survey of Child and Adolescent Well-Being, sponsored by the Administration for Children, Youth and Families, has developed a module for adopted children (and those in guardianship placements). Although the instrument was not developed for clinical use and is not standardized, it has been used to collect self-reported data on topics including the following:

  • Child's involvement in adoption decision-making process
  • Child's feelings about being adopted (for children aged 6 and older)
  • Contact with biological family members

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