Social workers and other professionals in the field of adoption began changing terms of use to reflect what was being expressed by the parties involved. In 1979, Marietta Spencer wrote "The Terminology of Adoption" for The Child Welfare League of America (CWLA),[184] which was the basis for her later work "Constructive Adoption Terminology".[185] This influenced Pat Johnston's "Positive Adoption Language" (PAL) and "Respectful Adoption Language" (RAL).[186] The terms contained in "Positive Adoption Language" include the terms "birth mother" (to replace the terms "natural mother" and "real mother"), and "placing" (to replace the term "surrender"). These kinds of recommendations encouraged people to be more aware of their use of adoption terminology.
The research says that the dysfunction, untruths and evasiveness that can be present in adoptive families not only makes identity formation impossible, but also directly works against it. What effect on identity formation is present if the adoptee knows they are adopted but has no information about their biological parents? Silverstein and Kaplan's research states that adoptees lacking medical, genetic, religious, and historical information are plagued by questions such as "Who am I?" "Why was I born?" "What is my purpose?" This lack of identity may lead adoptees, particularly in adolescent years, to seek out ways to belong in a more extreme fashion than many of their non-adopted peers. Adolescent adoptees are overrepresented among those who join sub-cultures, run away, become pregnant, or totally reject their families.[133][134]
These differences in development appear to play out in the way young adoptees deal with major life events. In the case of parental divorce, adoptees have been found to respond differently from children who have not been adopted. While the general population experienced more behavioral problems, substance use, lower school achievement, and impaired social competence after parental divorce, the adoptee population appeared to be unaffected in terms of their outside relationships, specifically in their school or social abilities.[117]

Adoptions can occur either between related family members, or unrelated individuals. Historically, most adoptions occurred within a family. The most recent data from the U.S. indicates about half of adoptions are currently between related individuals.[78] A common example of this is a "stepparent adoption", where the new partner of a parent may legally adopt a child from the parent's previous relationship. Intra-family adoption can also occur through surrender, as a result of parental death, or when the child cannot otherwise be cared for and a family member agrees to take over.
Nevertheless, work on adult adoptees has found that the additional risks faced by adoptees are largely confined to adolescence. Young adult adoptees were shown to be alike with adults from biological families and scored better than adults raised in alternative family types including single parent and step-families.[137] Moreover, while adult adoptees showed more variability than their non-adopted peers on a range of psychosocial measures, adult adoptees exhibited more similarities than differences with adults who had not been adopted.[138] There have been many cases of remediation or the reversibility of early trauma. For example, in one of the earliest studies conducted, Professor Goldfarb in England concluded that some children adjust well socially and emotionally despite their negative experiences of institutional deprivation in early childhood.[139] Other researchers also found that prolonged institutionalization does not necessarily lead to emotional problems or character defects in all children. This suggests that there will always be some children who fare well, who are resilient, regardless of their experiences in early childhood.[140] Furthermore, much of the research on psychological outcomes for adoptees draws from clinical populations. This suggests that conclusions such that adoptees are more likely to have behavioral problems such as ODD and ADHD may be biased. Since the proportion of adoptees that seek mental health treatment is small, psychological outcomes for adoptees compared to those for the general population are more similar than some researchers propose.[141]

More recent research found that in a sample of mothers who had released their children for adoption four to 12 years prior, every participant had frequent thoughts of their lost child. For most, thoughts were both negative and positive in that they produced both feelings of sadness and joy. Those who experienced the greatest portion of positive thoughts were those who had open, rather than closed or time-limited mediated adoptions.[123]

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