The lives of some of the UK’s most vulnerable children are being devastated by a string of missed opportunities to provide them with timely and adequate support, a new report reveals today.

The Adoption Barometer, published by charity Adoption UK, also describes the dramatic impact the right support can have. Now in its second year, the Barometer is based on the biggest ever survey of adopters. This year, almost 5,000 people responded to the survey.

One of the main themes to emerge is the failure in diagnosing and treating brain damage caused by children being exposed to alcohol in the womb. The report reveals that one-in-four adopted children are either diagnosed with, or suspected to have, Fetal Alcohol Spectrum Disorder (FASD). 55% of families polled had waited two years or longer for a diagnosis, and 78% felt healthcare professionals lacked even basic knowledge about the condition, even though FASD is more common in the general population than autism.

Adoptive mother Gemma said: “When Isabelle came to us at eight months old she was described as a perfect baby. At two and a half she started headbutting, kicking and biting. Then she became obsessed with sharp knives. She told me she wanted to ‘cut me open and see me bleed’. We went to countless GPs, health visitors and social workers but we got nowhere. We finally got a diagnosis of FASD when she was four years old. It has made a huge difference to the support we’ve been able to access.”

Around three-quarters of adopted children experienced violence, abuse or neglect while living with their birth families, often with life-long impacts on their relationships, their health and their ability to learn.

Despite the considerable challenges, the report shows that adopters remain positive and resilient – 73% would encourage others to consider adoption. But failures in policy and practice and missed opportunities to intervene mean that problems often build into a crisis.

Almost half (48%) of families with older children report severe challenges, such as being drawn into criminally exploitative behaviour, including child sexual exploitation and county lines activities. The vast majority (70%) of respondents with secondary aged children anticipate they will leave school with few or no qualifications because they lacked the right support.

Author of the report Becky Brooks said: “It is morally and economically imperative that adoptive families are given the right support from day one. Yet 68% of new adoptive families who responded to the survey had no support plan in place. The cost to the child, the wider family and society when an adoptive family falls apart, is unacceptable.”

The Adoption Barometer also assesses the government policies that regulate adoption. Welsh policies scored best, with three areas of policy scoring ‘good’. However, all nations score poorly in at least one area of policy. Policy relating to finding families for children scores best across the board. Policy relating to FASD scores worst, with all nations assessed as ‘poor’, and adopter experiences also ‘poor’ in all nations.

There has been some progress since last year’s Barometer, including the extension of the English Adoption Support Fund (ASF) and the first experimental data collection on school exclusions in England, both of which were recommendations from last year’s report. In Wales there has been a £2.3m investment in adoption services.

The Adoption Barometer calls on the governments in all four nations of the UK to provide detailed therapeutic assessments for every child before they arrive in their new family, with up to date support plans to be maintained into early adulthood.