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. 

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Aisha K Yousafzai - The Lancet Child & Adolescent Health,

In this commentary piece, Aisha K Yousafzai - of the Department of Global Health and Population at the Harvard TH Chan School of Public Health and the  and Department of Paediatrics and Child Health at Aga Khan University - notes that "the evidence presented [in the Lancet Group Commission on the institutionalisation and deinstitutionalisation of children] and their call to action to ensure abandoned children can thrive in family-based care environments rather than in institutions matters now more than ever as the global community addresses unprecedented challenges to ensure a generation of children are not left behind with respect to their survival, health, development, learning, and safety."

Niall Boyce, Jane Godsland, Edmund Sonuga-Barke - The Lancet,

This Executive Summary provides an overview of the Lancet Group Commission, which advocates global reform of the care of separated children through the progressive replacement of institutional provision with safe and nurturing family-based care.

Marinus H van IJzendoorn, Marian J Bakermans-Kranenburg, Robbie Duschinsky, Nathan A Fox, Philip S Goldman, Megan R Gunnar, Dana E Johnson, Charles A Nelson, Sophie Reijman, Guy C M Skinner, Charles H Zeanah, Edmund J S Sonuga-Barke -The Lancet Psychiatry,

This paper reviews the literature on child institutionalisation and deinstitutionalisation from a global perspective. This review included a survey of historical and cultural trends and estimates of current numbers of children in institutional care, a systematic review and meta­-analysis of developmental sequelae, and a largely qualitative review of factors found to predict individual variations in such outcomes.

Joan Kaufman - The Lancet,

In this commentary piece for The Lancet Psychiatry, Joan Kaufman highlights some key findings and recommendations from the Lancet Group Commission on the institutionalisation and deinstitutionalisation of children.

Philip S Goldman, Marian J Bakermans-Kranenburg, Beth Bradford, Alex Christopoulos, et al - The Lancet Child & Adolescent Health,

In this second part of the Lancet Group Commission on institutionalisation and deinstitutionalisation of children, international experts in reforming care for children identify evidence-based policy recommendations to promote family-based alternatives to institutionalisation.

Anne Longfield - The Lancet Child & Adolescent Health,

In this commentary piece, Anne Longfield, Children’s Commissioner for England, explores the use of children's care homes in England and the need for improved supports to prevent placement in children's home and to provide for the needs of children and young people who are placed in these homes.

Lumos Foundation, King’s College London, and Maestral - The Lancet Child & Adolescent Health and The Lancet Psychiatry,

This Lancet Group Commission, published between The Lancet Child & Adolescent Health and The Lancet Psychiatry, advocates global reform of the care of separated children through the progressive replacement of institutional provision with safe and nurturing family-based care.

Paraskevi Tatsiopoulou, Christina Chatzidimitriou, Eugenie Georgaca, Grigori Abatzoglou - Children and Youth Services Review,

The aim of the present study was to provide understanding into the past and present experiences of individuals who had resided in a child-care institution during their childhood and/or adolescence and to contribute to the study of the long-term impact of institutional care on adult life.

Dennis Golm, Sagari Sarkar, Nuria Mackes, Graeme Fairchild, Mitul Mehta, Michael Rutter, Edmund Sonuga-Barke - Psychological Medicine,

Using 20-year follow-up data from a unique natural experiment – the large scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s – the authors of this paper examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Mark Wade, Charles H. Zeanah, Nathan A. Fox, Charles A. Nelson - The Journal of Child Psychology and Psychiatry,

In this study, the authors examined (a) whether institutional rearing is associated with continued social communication (SC) deficits into adolescence; (b) whether early placement into foster care mitigates risk for SC problems; and (c) associations between SC and psychopathology from middle childhood (age 8) to adolescence (age 16).