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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How Early Experience Shapes Human Development: The Case of Psychosocial Deprivation

Charles A. Nelson III, Charles H. Zeanah, and Nathan A. Fox - Neural Plasticity, 15 Jan 2019

The question addressed in this paper from the Neural Plasticity journal is what happens to brain and behavior when a young child is deprived of key experiences during critical periods of brain development.

Effects of early adversity on the brain: Larger-volume anterior cingulate cortex in AIDS orphans

Peiying Zuo , Yinan Wang , Jia Liu, Siyuan Hu, Guoxiang Zhao, Lijie Huang, Danhua Lin - PLoS One, 14 Jan 2019

This study used magnetic resonance imaging to compare adolescent AIDS orphans reared in institutions with a sex- and age-matched group of healthy adolescents reared in families in China using a voxel-based morphometry analysis.

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Long-term effects of institutional rearing, foster care, and brain activity on memory and executive functioning

Mark Wade, Nathan A. Fox, Charles H. Zeanah, and Charles A. Nelson III - PNAS, 14 Jan 2019

The current study examined longitudinal trajectories of memory and executive functioning (EF) from childhood to adolescence in the Bucharest Early Intervention Project, a randomized controlled trial of foster care for institutionally reared children in Romania.

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The neglect–enrichment continuum: Characterizing variation in early caregiving environments

Lucy S. King, Kathryn L. Humphreys, Ian H. Gotlib - Developmental Review, 09 Jan 2019

In this paper, the authors advance a framework for examining the nature and consequences of neglect, which they posit can be represented as variations along a continuum from severe psychosocial neglect to environmental enrichment.

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Early Deprivation Revisited: Contemporary Studies of the Impact on Young Children of Institutional Care

Megan R. Gunnar and Brie M. Reid - Annual Review of Developmental Psychology, 2019

This article reviews the modern literature on the impact of institutional care from animal models to longitudinal studies in humans.

Transforming Care Systems Through EU External Action

Lumos, 2019

This report from Lumos sets out the evidence about the harm that institutions can cause and presents the case for prioritising family and community-based alternatives to institutional care.

Eating Patterns, Dietary Diversity and the Nutritional Status of Children Residing in Orphanages in Southwestern Nigeria

Adeomi AA, Aliyu MS, and Sabageh AO - Journal of Nutrition and Health Sciences, 2019

This study aimed to assess the eating patterns, dietary diversity and the nutritional status of children residing in orphanages in southwestern Nigeria.

Learning from Lived Experience in Government Care: Sharing Gains in Knowledge and Practice in Youth Participation with Key Care Stakeholders

Jade Purtell, Luke Westwick, Brittany Witnish, Jarrad Butcher, Annie [Withheld], Ralph Salera, Jenna Bollinger, 2019

This paper presents three care experienced perspectives on the benefits and challenges of capturing the voices of young people to inform policy and organisational decision-making in youth services.

World Without Orphans Roadmap: Foundations for Active Engagement

World Without Orphans, 2019

World Without Orphans Roadmap: Foundations for Active Engagement is a result of broadscale collaboration
among global, regional, and national leaders across many faith communities. It is informed by experts
from global organizations that lead the way in identifying best practices for caring for vulnerable families
and children.

Exploring the "Orphan Myth" in Thailand (Thai language): An Analysis of Unregistered, Private Children's Homes in Sangkhlaburi District

Convention on the Rights of the Child Coalition for Thailand Alternative Care Working Group, 2019

This summary report presents key findings and recommendations from an analysis of unregistered, private children's homes in Thailand's Sangkhlaburi District.