Child adoption outcomes are influenced by child's behavior and parents' expectations (Haugaard & Hazan, 2003). Pre-adoption risk factors, such as prenatal alcohol, tobacco and/or other drug (ATOD) exposure, male sex, sexual abuse, and multiple out-of-home placements have been linked to increased externalizing (acting out) behaviors that are difficult to manage and are most closely associated with adoption disruption (Barth, 1991, 2001 Rosenthal & Groze, 1991; Smith & Howard, 1999). However, adoption researchers have found that positive outcomes (fewer externalizing behaviors) are possible for children who have been exposed to pre-adoption risk factors, suggesting that adoptive families provide protective environments that allow healing (Barth, 1991, 1993; Barth & Brooks, 2000). The current study sought to increase understanding of the influence of these pre-adoption risk factors on adoption outcome with attention to the influence of prenatal alcohol, tobacco, and/or other drug (ATOD) exposure. Results indicated that pre-adoption functioning was significantly influenced by prenatal ATOD exposure, but post-adoption adjustment was not. Structural equation modeling then was used to analyze both the direct and moderating influences of the identified risk factors on the relationship between the child's pre-adoption functioning and post-adoption adjustment. Negative influences of the risk factors on the child's externalizing behavior, individually and additively, in both direct effects and moderation analyses, were not found, with one exception. The only model to have a statistically significant effect was the moderation analysis containing the interaction of all four risk factors. Child development, child welfare, addiction professionals, and adoptive families will find this information to be of value in their quest to facilitate successful adoptions and growth of healthy children and families.
