This video features a segment of a talk on the effects of care environments on children, hosted by the Christian Alliance for Orphans. The key speakers featured include Dr. Kathryn Whetten & Dr. Charles Nelson, who discuss the Positive Outcomes for Orphans study (POFO) and the Bucharest Early Intervention Project (BEIP), respectively.
Dr. Nelson speaks about the institutionalization of children and its impact on the brain development of institutionalized children. Many children in institutions, says Dr. Nelson, experience isolation, a lack of response to distress, a lack of psychological care from caregivers, and other factors that contribute to negative outcomes for children including higher risk for social and behavioral problems and growth-stunting. Nelson explains why early experiences are so important to brain development. Genes, he says, provide the building blocks for development but the “circuitry of the brain relies on experience to customize the connections to serve the needs of the individual.” Early experiences, therefore, are especially important to brain development – these are known as “critical periods” or “sensitive periods.”
If children do not receive the stimulation, or “inputs,” and positive relational and other experiences necessary for strong brain development – as is often the case with institutional rearing - it will result in compromised brain growth, a weaker foundation for future learning and growth, and more negative developmental outcomes. Normative inputs have been found to be lacking among children living in institutions and therefore, says Nelson, we should expect errors in brain development. “This is an old problem that needs new solutions,” says Dr. Nelson.
In this video, Dr. Kathryn Whetten next discusses her multi-country longitudinal study - conducted in Kenya, Tanzania, Cambodia, India, Ethiopia - which is following over 3,000 children ages six and up for an extended period of time. The goal of the study was to examine what is happening for children who are orphaned or separated from their parents in developing or low-income countries and to find caregiving characteristics that lead to better outcomes for children, particularly those that can be found across care structures (including residential care). Half of the participants in the study, therefore were living in institutions (broadly defined). Whetten notes that there is not one common definition for “institution,” nor is there one definition for “orphan.” In her study, Whetten and her team found that, in fact, institutions vary greatly in their structure and how they look. Most institutions that they studied, she says, were small group homes, run by people who lived there full-time, which looked more like family settings.
The researchers were looking to study outcomes for children by measuring: cognition, behavior, emotional difficulties over time, health status, civic engagement, educational attainment, high-risk sexual behaviors, substance use, marital formation, and more. The researchers found that some children in institutions were not doing well in institutions or group homes, while others were experiencing positive outcomes, and she warned against shutting down institutions where some children are thriving and sending them out into the community. Whetten acknowledges that abuse does happen in institutions but that children can also experience abuse, violence, and insecurity in their communities as well.
Group home placement, Whetten says, may be beneficial for those children who have experienced maltreatment in the family or community, at least until the proper supports have been implemented for careful family reintegration to ensure that the child does not continue to experience maltreatment in the home. Whetten believes there is a place for group homes for the short-term and calls for reforms that will build up families, support foster care, and eventually eliminate the need for institutional placement to begin with. She warns against a one-size-fits-all policy for alternative care and urges decision-makers to consider the voices and perspectives of the child when deciding on alternative placement.
The video concludes with both Dr. Whetten and Dr. Nelson answering questions from the audience. They speak about the limitations of their studies, the impacts of foster care on children and the continuum of care settings, the need for community-based care that supports the whole family, extended family care, measuring caregiving quality, and the necessary variable to keep in mind in making policy decisions.