Effects of Institutional Care

Institutionalising children has been shown to cause a wide range of problems for their development, well-being and longer-term outcomes. Institutional care does not adequately provide the level of positive individual attention from consistent caregivers which is essential for the successful emotional, physical, mental, and social development of children. This is profoundly relevant for children under 3 years of age for whom institutional care has been shown to be especially damaging.

Common issues for children in institutional care are a significantly increased risk of sexual and physical abuse, a lack of stimulation, and harsh discipline. Children in institutions are less likely to attend school, and are frequently isolated from their traditional communities. Long periods in an institution make it harder for a child to assimilate back into a family and community, and deny them access to the life-long attachments and community support systems that family relationships and communities can provide. For funders and implementing bodies, care in the community is a significantly more effective and sustainable use of resources since it avoids the high maintenance costs of institutions, and prevents many of the problems posed by institutional care.

It is widely accepted that institutions should be used as a last resort only. Countries which have traditionally relied on institutional care are now transforming their institutions into small family style group homes and actively pursuing preferences for community-based care options based around small family style units. This policy shift is urgently required in HIV/AIDS affected countries which are taking a backward step in resorting to the use of institutions to care for children orphaned or affected by the disease.

The body of literature contained in this section provides in-depth explanations of the damaging effects of institutionalisation on children and provides recommendations for alterative community care options.

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Kristen Cheney 'Combatting the Orphan Industrial Complex'

Kristen Cheney | HagueTalks, 25 Nov 2018

In this video, Dr. Kristen Cheney discusses how her work led her to study the growth of the Orphan Industrial Complex and its adverse effects on children, families, communities, and child protection systems.

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Signs of attachment disorders and social functioning among early adolescents with a history of institutional care

Katherine L. Guyon-Harris, Kathryn L. Humphreys, Nathan A. Fox, Charles A. Nelson, Charles H. Zeanah - Child Abuse & Neglect, 20 Nov 2018

The aim of this study is to examine associations between signs of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) and social functioning in children with a history of institutional rearing in early adolescence.

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Uncertain Living: Challenges of Orphans in the Philippines

John Mark Vergara, Ladee Abigail Angeles, Ashley Angel Pagkalinawan, Maurice Villafranca - JPAIR Multidisciplinary Research, 13 Nov 2018

This phenomenological study focused on the experiences, aspirations, and fears of orphaned children living in and outside the orphanage in the Philippines.

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Relation between Mindfulness and Depression among Adolescent Orphans

Shambhu, Dayal Sharma; Rajesh, Sasidharan K.; Subramanya, P. - Journal of Clinical & Diagnostic Research, 01 Nov 2018

The aim of this study was to examine associations between mindfulness and psychological factors (i.e., depression, cognitive function, positive emotion, and negative emotion) among adolescent orphans in children's care homes in India.

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Prevalence of Depression and Its Associated Factors among Orphan Children in Orphanages in Ilu Abba Bor Zone, South West Ethiopia

Gemechu Shiferaw, Lemi Bacha, and Dereje Tsegaye - Hindawi Psychiatry Journal, 15 Oct 2018

The aim of this study was to assess the prevalence of depression and its associated factors among orphans in Ilu Abba Bor Zone orphanages, 2016.

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Quality Of Life Among Children Deprived From Family Care In Residential Institutions In El-Beheira Governorate- Egypt

Eman Ahmed Rashad El-Sakka; Prof. Dr. Mahassen Ahmed Abd El-Wahed; Dr. Doaa Abd-Elsalam Amin; Dr. Fathia Khamis Kassem; Dr. Houaida Helal - , 13 Oct 2018

This study was conducted to identify the quality of life among children deprived of family care in residential institutions in El-Beheira governorate.

Handbook of Infant Mental Health: Fourth Edition

Charles H. Zeanah, Jr., 09 Oct 2018

This volume examines typical and atypical development from birth to the preschool years and identifies what works in helping children and families at risk.

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The Impact of Caregiving Disruptions of Previously Institutionalized Children on Multiple Outcomes in Late Childhood

Alisa N. Almas, Leanna J. Papp, Margaret R. Woodbury, Charles A. Nelson, Charles H. Zeanah, Nathan A. Fox - Child Development, 08 Oct 2018

This study examined disruptions in caregiving, as well as the association of these disruptions, with cognitive, behavioral, and social outcomes at age 12 in a sample of 136 Romanian children who were abandoned to institutions as infants and who experienced a range of subsequent types of care.

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Catch-up growth, metabolic, and cardiovascular risk in post-institutionalized Romanian adolescents

Alva Tang, Natalie Slopen, Charles A. Nelson, Charles H. Zeanah, Michael K. Georgieff & Nathan A. Fox - Pediatric Research , 01 Oct 2018

This study explored whether patterns of catch-up growth affect metabolic and cardiovascular outcomes in previously institutionalized adolescents in Romania.

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Effect of Foster Care Intervention on Trajectories of General and Specific Psychopathology Among Children With Histories of Institutional Rearing

Mark Wade, Nathan A. Fox, Charles H. Zeanah, Charles A. Nelson - JAMA Psychiatry, 26 Sep 2018

The aim of this study was to examine trajectories of latent psychopathology factors—general (P), internalizing (INT), and externalizing (EXT)—among children reared in institutions and to evaluate whether randomization to foster care is associated with reductions in psychopathology from middle childhood through adolescence.

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