During the same period, the Progressive movement swept the United States with a critical goal of ending the prevailing orphanage system. The culmination of such efforts came with the First White House Conference on the Care of Dependent Children called by President Theodore Roosevelt in 1909, where it was declared that the nuclear family represented "the highest and finest product of civilization" and was best able to serve as primary caretaker for the abandoned and orphaned. Anti-institutional forces gathered momentum. As late as 1923, only two percent of children without parental care were in adoptive homes, with the balance in foster arrangements and orphanages. Less than forty years later, nearly one-third were in an adoptive home.
In some countries, such as the United States, "Homecoming Day" is the day when an adoptee is officially united with their new adoptive family. In some adoptive families, this day marks an especially important event and is celebrated annually from thereafter. The term Gotcha Day is also used to refer to this day. Many adopted people and birth parents find this term to be offensive.
Adopting older children presents other parenting issues. Some children from foster care have histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, and are at risk of developing psychiatric problems. Such children are at risk of developing a disorganized attachment. Studies by Cicchetti et al. (1990, 1995) found that 80% of abused and maltreated infants in their sample exhibited disorganized attachment styles. Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms, as well as depressive, anxiety, and acting-out symptoms. "Attachment is an active process- it can be secure or insecure, maladaptive or productive." In the UK some adoptions fail because the adoptive parents do not get sufficient support to deal with difficult, traumatized children. This is a false economy as local authority care for these children is extremely expensive.
The biological relationship between a parent and child is important, and the separation of the two has led to concerns about adoption. The traditional view of adoptive parenting received empirical support from a Princeton University study of 6,000 adoptive, step, and foster families in the United States and South Africa from 1968 to 1985; the study indicated that food expenditures in households with mothers of non-biological children (when controlled for income, household size, hours worked, age, etc.) were significantly less for adoptees; step-children, and foster children, causing the researchers to speculate that, instinctively, people are less interested in sustaining the genetic lines of others. This theory is supported in another more qualitative study where in adoptive relationships marked by sameness in likes, personality, and appearance, both adult adoptees and adoptive parents report being happier with the adoption.
In many jurisdictions the adopted person's full original birth certificate is cancelled and replaced with a fabricated post-adoption birth certificate which states that the child was born to the adoptive parents. This deception, when carried out, may continue with the adopted person for life and can be the cause for many well documented traumas experienced by the adopted person, including loss of identity, family history, culture, biological family (including not only biological parents but also siblings and extended family), family medical history and records, and increased risk of suicide, homelessness, incarceration, PTSD, depression, and anxiety.
Externally focused theories, in contrast, suggest that reunion is a way for adoptees to overcome social stigma. First proposed by Goffman, the theory has four parts: 1) adoptees perceive the absence of biological ties as distinguishing their adoptive family from others, 2) this understanding is strengthened by experiences where non-adoptees suggest adoptive ties are weaker than blood ties, 3) together, these factors engender, in some adoptees, a sense of social exclusion, and 4) these adoptees react by searching for a blood tie that reinforces their membership in the community. The externally focused rationale for reunion suggests adoptees may be well adjusted and happy within their adoptive families, but will search as an attempt to resolve experiences of social stigma.