This article briefly reviews a small number of outcome studies for adopted and fostered children, concentrating particularly on the progress of older-placed children. A transactional model of children’s development is introduced to explain the different pathways taken by children post placement. In this model transactions occur between children and their social environment which co-determine their developmental progress. The model is applied to children placed for adoption and foster care who have had a pre-placement history of abuse, neglect or rejection. Many of these children are also diagnosed as suffering a disorder of attachment. These disorders are the result of early relational trauma experienced in the context of an attachment relationship. The disturbed behaviours of many of these children place great demands on the parenting capacities of adoptive parents and foster carers. The therapeutic work of the Keys Attachment Centre, which specializes in treating children with disorders of attachment, is outlined. A case example is given illustrating the types of behaviour associated with attachment-disordered children and the kinds of intervention developed by therapists specializing in this field.
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