Burghardt on Sufian, 'Familial Fitness: Disability, Adoption, and Family in Modern America'

Sandra M. Sufian
Madeline Burghardt

Sandra M. Sufian. Familial Fitness: Disability, Adoption, and Family in Modern America. Chicago: University of Chicago Press, 2022. Illustrations. 360 pp. $35.00 (paper), ISBN 978-0-226-80870-3; $210.00 (cloth), ISBN 978-0-226-80853-6.

Reviewed by Madeline Burghardt (University of Western Ontario) Published on H-Disability (October, 2022) Commissioned by Iain C. Hutchison (University of Glasgow)

Printable Version: https://www.h-net.org/reviews/showpdf.php?id=57706

Familial Fitness, by Sandra M. Sufian, is a detailed twentieth-century history of the adoption of children labeled "disabled" in the United States. The text traces adoption policy and practices from the Progressive Era at the turn of the twentieth century through what the author describes as the era of partial inclusion at the beginning of the twenty-first.

The text is presented chronologically, yet key ideas emerge throughout, which bind it thematically. Most prominent of these is the idea of "disability risk," in reference to the historical presumption that disability poses a threat to "successful" adoption placement, an idea that has consistently underscored adoption policy and surrounding discourse for as long as adoption has been formalized. In addition, and especially with regard to the increase in foster care in the later decades of the twentieth century, Sufian astutely notes that the idea of risk can also be inverted to describe the less discussed, but no less important, process of children becoming disabled due to the bureaucracies of an inept and complicated system, in the way of conditions stemming from unaddressed trauma, lengthy family displacement, and lack of needed supports.

Another theme that emerges concerns the degree to which adoption processes are dependent on ever-fluctuating discourses around disability within both professional and public spheres. Sufian notes that regardless of the nature of the disability with which a child is living, the way the disability is framed and understood has had greater influence on whether or not the child is adopted and how much support—financial and otherwise—the adoptive family receives than the condition itself. This theme therefore connects the text to other seminal work in disability studies that has consistently pointed out that the lived realities of disability are less about body/mind differences than they are about how non-disabled people and decision-makers perceive them. This theme of malleable identities, Sufian points out, is also relevant with regard to the changing ways adoptive parents have been described and understood—including heroes or "up for the challenge"—framings that have, at times, been used as tools to encourage adoption.

The author uses what she describes as a disability-focused framework, with the goal of foregrounding the situation of disabled children over time. Yet in the introduction, Sufian acknowledges that the text is missing a key set of voices—those of the children who populate the adoption and fostering systems—noting the methodological difficulties inherent to locating children’s accounts due to privacy regulations and other policies. While this is certainly a loss, it lays bare the central paradox of the adoption process, at least of children considered disabled: that while children needing adoption are the reason for the system’s existence (and have concurrently been used to shore up some professions, such as social work), for most of its history they have been silent. This gives the reader the impression that adoptive children have often been pawns, fulfilling the needs of various players, subjected to the fluctuating discourses that describe them, yet remaining vulnerable and voiceless throughout. Perhaps because of this vacancy, the text is as much an account of the social and political phenomena surrounding adoption as it is of the experience itself. For example, the text provides a thorough history of social work’s prominent influence in adoption practices in twentieth-century America, a depiction that is far from flattering in many instances, and of US legal and policy developments that have both supported and hindered adoption practices. In addition, and again perhaps due to the lack of first-person accounts from the perspective of adoptees, the list of personal narratives of adoption near the end of the text, primarily by parents, is a welcome inclusion, and points toward a much-needed broadening of accounts of the adoption experience by disabled people.

This is a comprehensive and meticulous text focused on the United States. At times, the text feels heavy with detail. For those seeking details regarding how American policies have frustrated the adoption of disabled children, such as bizarre rules that leave adoptive parents with less funding than those who foster and the significant impact of the lack of universal health care, then this book will serve as a valuable resource. Some analysis regarding the extent to which the adoption of disabled children in the United States aligns or contradicts practices in other countries would be a welcome addition. Sufian hits a stronger analytical stride in the last two chapters, in which she highlights more general themes, provides insightful analyses, and notes the importance of historical research in the development of current and future policy. As a reader interested in how important ideas can be applied to the situations of marginalized people more generally, I would have liked to have seen more of this kind of writing throughout the text, as opposed to, or in addition to, the detailed discussion of policy documents and legislation.

At book’s end, the reader is left with a recurring and ultimately frustrating sense of the reality of adoption policy and the ways it has affected the lives of disabled children—a feeling of two steps forward, one step back—that regardless of positive gains in policy or discourse, there will inevitably be pushback or policy reversals. Sufian has made a valuable contribution by articulating this reality and makes clear that ongoing activism and advocacy is needed to ensure that every child can live in the confidence that they will be welcomed into a secure and loving home.

Citation: Madeline Burghardt. Review of Sufian, Sandra M., Familial Fitness: Disability, Adoption, and Family in Modern America. H-Disability, H-Net Reviews. October, 2022. URL: https://www.h-net.org/reviews/showrev.php?id=57706

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.