Adoptions of newborn children should be finalized in four months so that secure attachments can form, advises an APA position statement approved by executive action last month.

Moreover, the final adoption "should be inviolate and subject to disruption only under the same criteria applied to disruptions in a biologically intact family," says the position statement. These criteria are separation, death, divorce, or loss of parental rights due to abuse or neglect, according to Joseph Mawhinney, M.D., chair of APA's Council on Children, Adolescents, and Their Families.

"The purpose of the time limit is to preclude lengthy court proceedings where the infants are taken from their adoptive parents," said Mawhinney, who is also director of child and adolescent services at Bayview Mental Health Systems in San Diego.

The executive action by APA's president, speaker, and medical director was necessary to meet the deadline for providing input into a legal case in California, said Mawhinney. He will submit APA's position statement with a letter to the court that will hear the case this spring. The Board of Trustees last month deferred the position statement to its March meeting because of time constraints.

Mawhinney told Psychiatric News that four months is a reasonable time for the birth parents to make a competent decision. If they reverse their decision, any legal challenges should occur quickly and be resolved within that period.

The adoptive parents in the lawsuit, Mark and Stacey A., requested APA's opinion on decision making in newborn adoptions after the birth mother challenged the couple's legal adoption in court when the baby was 6 months old, said Mawhinney.

A court denied the birth mother's claim of parental rights because she had not contacted the adoptive parents within 90 days of relinquishing the infant, which the law considers abandonment.

The birth mother is appealing the case. "The child is over 3 years old now and at risk of removal from the only parents he has known," said Mawhinney.

APA's position is that newborn adoption decision making should be made in the child's best interest based on the current knowledge of child development.

Mawhinney commented, "A definitive and differential attachment occurs by 3 months of age. Anxiety and stress caused by separation from the primary caregiver builds from there and peaks at age 2 to 3."

"The child can't developmentally deal with grief over such separation and loss until age 4, and it would be unthinkable to remove a child then," said Mawhinney.

In the California case, the adoption proceeded after the biological father could not be located within the period required by state law and the birth mother did not reverse her decision within six months of her relinquishment.

Mawhinney commented that the "California law is sufficiently vague that more specific guidelines are needed." He noted that the American Academy of Child and Adolescent Psychiatry supports APA's position.

Thomas Lowe, M.D., chair of APA's work group on infant adoption issues, told Psychiatric News, "We were motivated to develop the position statement because the courts made several custody decisions involving newborn adoptions without fully considering the infants' psychological and emotional development."

He credited the California Academy of Child and Adolescent Psychiatry with drafting the original statement a few years ago. Lowe's work group revised the document with input from its parent council, the Council on Children, Adolescents, and Their Families, and the Council on Psychiatry and Law. The final version was approved by both councils in September.

"This statement is an excellent example of two councils collaborating to develop the best APA position possible," said Renee Binder, M.D., chair of the Work Group on Child Custody Issues, which also reviewed and modified the statement. Binder is a member of the Council on Psychiatry and Law, which oversees the work group.

She acknowledged that some work group and council members disagreed with specifying a four-month limit on finalizing newborn adoptions. However, they agreed to it after being persuaded that the courts might not act in a timely manner on adoption cases if given a less definitive time frame, observed Binder.

"The question for us was, Were everyone's rights taken into account? We decided yes and support the position statement."

She continued, "It is possible to pay attention to the needs of the infant, the adoptive parents, and the biological parents. The most important thing is to get the infant into a stable home as soon as possible." (Psychiatric News, February 7, 1997)