Scenario

A 33-year-old single man approaches the local adoption service with an interest in adopting a child. He asks whether people on the adoption panel will see him as a worse candidate than a couple and whether there is any evidence on children’s outcomes when adopted by a single person.

Structured clinical question

In a child placed for adoption (patient) does placement with a single person (intervention) in comparison with placement with a couple (control) give better long-term outcome, in terms of physical/mental health, success of placement and general well-being (outcome)

Search

Secondary sources – Cochrane reviews. None found.

Primary literature search terms: (single OR lone) AND (parent* OR adopter) AND (adoption* OR adoptive). This search was performed using the Healthcare Databases Advanced Search platform (HDAS), on 3 July 2020, selecting AMED, BNI, CINAHL, Embase, EMCARE, HMIC, Medline, PsycINFO and PubMed databases. There were 905 results (not unique results). The dominant databases were Psycinfo (271 unique results), Embase (259 unique results) and Medline (154 unique results).

Only English language abstracts were considered. Studies were excluded if they included less than 10 participants. Forty-six abstracts were reviewed and 38 were excluded, leaving eight included papers, covering six different studies.1–8

Eleven further reports were examined after identification from reference lists and two further papers were included, covering one further study.9 10 One further Department for Education Research Report was included after manuscript review.11 table 1 summarises the findings of these studies.

Commentary

In the UK, single adults have always been legally allowed to adopt children, since legislation was first introduced in 1926.12 In England, 12% of children were adopted by single people in 2018/2019 and in Wales, 7%.13 UK single adopters …