Adoption of Children with Special Needs

Choosing to adopt a child with special needs is a life-changing decision. If you’re considering adoption, there are many ways you can begin to prepare yourself and your home. By doing your research and preparing yourself ahead of time, you can make a more informed decision, easily navigate adoption process, and be ready to provide a stable, loving and supportive home for a child.

About Adoption of Children with Special Needs

There are over 100,000 children in foster care waiting to be adopted. Many of the children who wait the longest to become forever members of a new family have similar challenges--they often fit into one or more of the following groups:

  • Seven years of age or older
  • Part of a group of brothers and/or sisters that needs to be placed in a family together
  • A member of a minority group
  • Has disabilities which may involve mental, physical and/or behavioral challenges
  • Is at risk for having learning, emotional, behavioral or physical disabilities in the future
  • Was prenatally exposed to drugs or alcohol

Because children in foster care face change and doubt, and because many have suffered neglect or abuse, all children in the foster care system are thought to be at greater risk for life-long physical, developmental, behavioral, or emotional health issues. Many children in foster care need health care or other services beyond the type or amount needed by most children, and so they are called Children and Youth with Special Health Care Needs (CYSHCN), either by diagnosis or cause. Each state has its own definition of special needs to determine a child’s eligibility to have adoption assistance when adopted from the foster care system.

Getting Ready for Adoption

Adoption is a special process, and many adoptive parents say that finding and adopting their child was "meant to be." It is also a lot of work, and there are many considerations to be made when choosing to adopt a child with special needs:

  • Extra financial resources are often needed to care for a child with special needs.
    • Talk with the case worker before placement to get a sense of what care and support a child may need.
    • Check with your health plan to make sure there is coverage for the child's needs. Some plans may even offer adoption assistance.
  • Caring for children with special needs may be draining, both physically and emotionally for any parent.
    • Keep in mind that “caring for the caregiver” (yourself) is just as vital as caring for your child.
    • Your child’s health and well-being depend upon your health and ability to be there for them.
Talking with other parents of children with some of the same special needs as your own child can be helpful in knowing the essentials. Other parents can give you tips for the challenges, and they’ll also remind you of all the love and joy you’ll share with your child. Disability support groups and organizations can link parents with other parents and training sessions. Foster care and adoption agencies also offer training and support to parents before and after adoption; look to them for help finding support and training for your family.

If your child needs special accommodations, such as a wheelchair accessible home or car for accessibility, see these pages of the Medical Home Portal:

Being as ready as you can be will make your adoption go smoother, letting you focus on the “welcome home” for your child as you form a new family union.

Choosing an Adoption Agency

Adult couple standing in a field with woman holding a small child
Each adoption is one of a kind, and different circumstances will affect needs, costs, and even relationships between adopted children and their birth parents:
  • In a “closed” adoption, the birth parents and adoptive parents do not know each other, either before or after the adoption.
  • In an open adoption, the birth parents and adoptive parents will trade contact information, and may even arrange to meet with each other as the child grows, or they may simply keep contact by phone or email.

There are also different types of agencies. You can choose the type of adoption and the agency that is right for you:

Public Agency Adoption or "Foster to Adopt"

A public agency is supervised by a state or local Department of Health and Human Services and often has children with special needs who are looking for forever families.
  • A public agency may have more open requirements for adoptive parents.
    • Single parents, older parents, and parents with low incomes, who may find it hard to adopt in other types of agencies will more often meet the rules of public agencies.
  • Placement of a child can happen in as little as a few months, after a home study and approval.
  • Because many foster parents adopt children that have been placed in their care, you may be approved as a licensed foster parent as well as a possible adoptive parent at the same time.
  • Adopting a child through the foster care system is often very low cost, or even free.
    • Some states will give subsidies to help you with the cost of adopting a child.

Private agency adoption

A private agency is not run with state or federal funds. They often work with infants from the local area or nearby states, but sometimes they also work with children with special needs.
  • A private agency may have more set rules (than a public agency) about who can adopt.
    • They may have eligibility requirements based on race, religion, or age.
  • Placement through a private agency can take longer, often up to a few years after a home study and approval.
  • As stated by the website, private agency adoptions can range from $5,000 to $40,000, based on many things, such as services, travel costs, birth mother needs, and rules in the state.

Independent Adoption

An independent adoption is most often arranged through a lawyer, doctor, friend, or adoption case worker.
  • Each state may have its own rules.

International adoption

This is often more involved than domestic adoption.
  • It often calls for extra paperwork, waiting lists, health concerns, travel, and the laws of the child’s birth country.
  • International adoptions also differ greatly based on the child’s birth country.
  • The website states that the cost of international adoption can range from $7,000 to $30,000.

Outline of the Adoption Process

While your adoption will be as unique as your child, there are common steps you must take to welcome a child with special needs into your family:

  • Learn the adoption process and laws
  • Search for and select an agency
  • FIll out an adoption application
  • Start the home study process.
    • This is a full evaluation of you, your family, and your home. It is a required step in approving you as an adoptive parent.
  • Receive approval for a placement
  • Search for a child
  • Meet and have pre-placement visits with the child
  • Set up your home for your child's arrival
  • Begin building your own medical and support network
  • Welcome your child into your family
  • Finalize your adoption


Information & Support

For Parents and Patients

National Foster Care & Adoption Directory Search
A database of adoption and post-adoption resources that is searchable by state and region.

North American Council on Adoptable Children
Provides information about adoption, tax credits, assistance, and other support for adoptive parents.

Intercountry Adoption
Has accurate information and resources on international adoptions; U.S. Department of State.

Dave Thomas Foundation for Adoption
Features the Wendy’s Wonderful Kids adoption program and has a resource library for parents.

Services for Patients & Families Nationwide (NW)

For services not listed above, browse our Services categories or search our database.

* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.

Authors & Reviewers

Initial publication: February 2013; last update/revision: November 2018
Current Authors and Reviewers:
Author: Tina Persels