Attachment relationships are the cornerstone of healthy psychological adjustment. Children's initial attachments, formed within the first year of life, are usually with their parents, although, with later development, these emotional bonds broaden to include siblings, extended family, peers, teachers, and others. When effective, attachment relationships provide children with a sense of security, trust and confidence, allowing them to explore and interact with the physical and social world, as well as offering them a safe haven where they can be comforted and emotionally "refueled" in times of stress. Research has found that young children who are more securely attached to their caregivers not only show more positive social-emotional adjustment during infancy but in later life as well. For example, infants who are more securely attached to caregivers have been found to be more empathic, compliant and socially-skilled in early and middle childhood, compared to insecurely attached infants, possess more positive self-esteem and demonstrate fewer behavioral and emotional difficulties. There is also evidence suggesting that the quality of early attachments may affect adjustment patterns in adulthood, including the way in which individuals parent their own children.

Psychologists believe that the success or failure of early attachments affect young children's beliefs and expectations about relationships. In turn, this "internal working model" or representation of relationships, influences the way children interact with others and evaluate themselves. Thus, securely-attached children come to see the world generally as a safe place, and other people as sources of nurture and support. They also tend to view themselves as worthy of attention from others. Conversely, insecurely-attached children more often view the world as unpredictable and threatening, others as unavailable, insensitive, or harsh, and themselves as unworthy of being nurtured.

Adopted children, like their non-adopted peers, develop attachments in predictable ways and are profoundly influenced by the quality of the relationships they form with the people in their lives. Research from our laboratory at Rutgers University suggests that, for infancy-placed adopted people, the degree of security in mother-infant attachment to adoptive parents among preschoolers generally has been found to be quite high, as well as strongly correlated to psychological adjustment during this period.

As adopted children enter the school-age years, another component of their attachment system becomes increasingly important as well as predictive of their psychological adjustment-namely, the extent and quality of their emotional investment in birth parents. In the preschool years, when most youngsters are first told about their adoption, there is relatively little understanding of what this family status means. Children may label themselves as being adopted, and talk about being born to another set of parents, but their capacity to comprehend the implications of being adopted is limited because of their cognitive immaturity. Emergence into the school-age years, however, brings with it substantial changes in children's ability to reason about the world around them-including the world of adoption. These changes have profound implications for how children view adoption, their birth parents, and themselves.

As children enter the elementary school years, they become increasingly proficient problem-solvers. The growth of logical thought, increased sensitivity to the perspectives of others, and the effects of schooling, among other factors, facilitate this process. School-age adopted children, when dealing with adoption information - particularly information related to their relinquishment - are now less likely to automatically accept explanations provided by their adoptive parents. Instead, they often question why alternative options were not chosen by the birth parent. "If my birth mother was poor," a child might ask, "Why didn't she get a job?" "Why didn't you [adoptive parents] give her money so she could keep me?" "If she was all alone and had no one to help her, why didn't she get married, or have her mother help so she could keep me?" "If she didn't know how to take care of a baby, why didn't someone teach her?" These simple solutions for the complex problems faced by the birth parent represent the child's efforts to understand, and to resolve, the sense of confusion associated with his or her origin and the birth parents' decision regarding adoption placement.

Another factor influencing children's adjustment to adoption is the way they comprehend the concept of family. As children enter the school-age years, their understanding of what constitutes a family undergoes important developmental changes, which in turn complicates their feelings about being adopted. For example, before 6-7 years of age, most children define a family primarily in terms of geographical and affectional criteria. In other words, family members are those individuals with whom one lives and shares loving feelings. In contrast, there is little appreciation of biological connectedness as a criterion for family membership during this developmental phase. Around 7-8 years of age, however, children begin to recognize that families are usually defined in terms of biological relationships. Realizing that they are not tied to their adoptive parents by birth, but do have birth parents elsewhere, many school-age children begin to show considerable curiosity about the birth parents and their connection to them. "What do they look like and where do they live?" they may ask. "Do they have any other children.... Can I meet them?" These are but some of the questions that arise when children begin to explore their connection to their birth family at this time.

Finally, another cognitive achievement that affects the child's attitudes and adjustment to adoption during middle childhood is the development of logical thought. With regard to adoption, this achievement helps to sensitize the child to the issue of relinquishment and adoption-related loss. For example, early efforts to discuss adoption with preschool children usually focus on the process by which the adoptive parents brought the child into their family. In contrast, little information is typically shared with young children about the birth family and the circumstances of the relinquishment. However, as children move into the period of logical thinking-beginning roughly around 6-7 years of age-they spontaneously realize that to have been "chosen" by the adoptive parents, they first had to have been "given up" by someone else-the birth parents. Thus, children now begin to understand adoption not only in terms of family building, but also in terms of family loss. It is this experience of loss that often gives rise to the adjustment difficulties in adopted children at this time.

In their struggle to understand and cope with adoption issues, school-age children begin to develop an elaborate mental and emotional life related to their birth parents. Filled with facts and fantasy, hopes and desires, beliefs and expectations, children's internal representations of the birth parents, and their connection to them, often become a focus of considerable attention and emotional investment during this developmental phase. Although the connection to the birth parents may only be on a fantasy level, especially for those youngsters who were placed very early in life and have no actual memories of their relinquishment, this stage is nevertheless of considerable importance in relation to the child's emotional well-being and feelings about self. School-age adopted children show a wide range of emotional adjustment: some are doing quite well, have positive feelings about themselves, and view their adoption experience in mostly positive ways; others show considerable adjustment difficulties, as well as diminished self-worth, and have considerable confusion, pain, and anger in relation to their adoption.

Although adoption adjustment is influenced by a host of factors, attachment history and the way children view their birth parents and the circumstances of their relinquishment are key components in this process during middle childhood. When children have a history of reasonably secure relationships with adoptive parents, siblings, extended family, and others, it contributes to a more optimistic and positive view of the world, promotes a greater sense of being in control of one's life, and facilitates more effective coping strategies and better use of support systems in times of stress. Conversely, a history of insecure attachments produces a more pessimistic view of the world and undermines psychological adjustment. Along the same lines, when adopted children have a more positive view of their birth parents and feel more connected to them, emotional adjustment is enhanced. When birth parents are viewed in a negative light, however, or the child has difficulty in accepting his connection to them, emotional well-being is undermined.

Parents of school-age adopted children play an important role in helping their youngsters cope with adoption issues during this period. By creating a family environment characterized by open, honest, and non-defensive communication about adoption issues, parents not only provide their children with the opportunity and freedom to explore their feelings about the birth parents, and perhaps to form an emotional connection to them, but they also affirm the normality of this process. Finally, because of the importance of the birth family in the mental and emotional life of school-age adopted children, it is extremely important to help them to find a supportive view of their origins, and especially the circumstances of their relinquishment. This task often challenges adoptive parents, either because of a lack of information about the child's background or because the information available is difficult to deal with and/or violates the parents' value system. Although there are no easy answers for adoptive parents in these circumstances, it is extremely important to emphasize the necessity of helping children feel positive, or at least comfortable, with their origins. Children's emotional well-being is tied to their self-esteem. In turn, self-esteem emerges out of children's experiences and relationships with others. Adopted children are influenced not only by relationships within their adoptive family, but also by they connections-even fantasy based connections-to their biological family. In short, for adopted children to feel worthy as human beings, they must feel that they come from some-thing worthwhile. As parents and mental healthy professionals, it is our responsibility to help adopted children achieve this goal: to feel emotionally connected to, and proud of, both the adoptive and biological family.

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