As the idea of institutional care gained acceptance, formal rules appeared about how to place children into families: boys could become apprenticed to an artisan and girls might be married off under the institution's authority. Institutions informally adopted out children as well, a mechanism treated as a way to obtain cheap labor, demonstrated by the fact that when the adopted died, their bodies were returned by the family to the institution for burial.
Attitudes and laws regarding adoption vary greatly. Whereas all cultures make arrangements whereby children whose birth parents are unavailable to rear them can be brought up by others, not all cultures have the concept of adoption, that is treating unrelated children as equivalent to biological children of the adoptive parents. Under Islamic Law, for example, adopted children must keep their original surname to be identified with blood relations, and, traditionally, women wear a hijab in the presence of males in their adoptive households. In Egypt, these cultural distinctions have led to making adoption illegal.
Europe's cultural makeover marked a period of significant innovation for adoption. Without support from the nobility, the practice gradually shifted toward abandoned children. Abandonment levels rose with the fall of the empire and many of the foundlings were left on the doorstep of the Church. Initially, the clergy reacted by drafting rules to govern the exposing, selling, and rearing of abandoned children. The Church's innovation, however, was the practice of oblation, whereby children were dedicated to lay life within monastic institutions and reared within a monastery. This created the first system in European history in which abandoned children did not have legal, social, or moral disadvantages. As a result, many of Europe's abandoned and orphaned children became alumni of the Church, which in turn took the role of adopter. Oblation marks the beginning of a shift toward institutionalization, eventually bringing about the establishment of the foundling hospital and orphanage.
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.
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Adoption is the legal process through which a child joins a family different from his or her birth parents. Adoption is a permanent, lifelong commitment to a child. In CPS cases, adoption becomes an option if CPS and the child's birth parents cannot resolve issues that made it unsafe for the child to live at home. Then, CPS may ask the court to end the parents' rights to the child and place the child with another family permanently. A child can also become legally free for adoption if both birth parents agree to give up their parental rights.
In the 1970s, as adoption search and support organizations developed, there were challenges to the language in common use at the time. As books like Adoption Triangle by Sorosky, Pannor and Baran were published, and support groups formed like CUB (Concerned United Birthparents), a major shift from "natural parent" to "birthparent" occurred. Along with the change in times and social attitudes came additional examination of the language used in adoption.