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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Effects of early institutionalization on emotion processing in 12-year-old youth

Johanna Bick, Rhiannon Luyster, Nathan A. Fox, Charles H. Zeanah, Charles A. Nelson - Development and Psychopathology, 22 Nov 2017

This study examined facial emotion recognition in 12-year-olds in a longitudinally followed sample of children with and without exposure to early life psychosocial deprivation (institutional care).

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Peer Problems Among Postinstitutionalized, Internationally Adopted Children: Relations to Hypocortisolism, Parenting Quality, and ADHD Symptoms

Clio E. Pitula, Carrie E. DePasquale, Shanna B. Mliner, Megan R. Gunnar - Child Development, 08 Nov 2017

Seventy-eight postinstitutionalized (PI) children adopted at ages 17–36 months were assessed 2, 8, 16, and 24 months postadoption on measures of cortisol and parenting quality, and compared to same-aged children adopted from foster care (FC, n = 45) and nonadopted children (NA, n = 45).

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The Children Behind the Wall

Lumos, 07 Nov 2017

This publication from Lumos describes the institutionalization of children the world over and its impacts, calling for an end to institutions and highlighting some of the particular groups of children who are most deprived of liberty.

Implementation of deinstitutionalization of child care institutions in post-soviet countries: The case of Azerbaijan

Aytakin Huseynli - Child Abuse & Neglect, 04 Nov 2017

This study examined the status of the State Program on Deinstitutionalization and Alternative Care (SPDAC), a public policy aimed at transforming 55 institutions covering 14,500 children during 2006–2016 in Azerbaijan.

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Suicide behaviour among Guyanese orphans: Identification of suicide risk and protective factors in a low- to middle- income country

Ellen-ge D. Denton, George J. Musa & Christina Hoven - Journal of Child and Adolescent Mental Health, 02 Nov 2017

Guided by an ideation-to-action theoretical framework for suicide prevention, the goal of the proposed research study is to describe and identify risk and protective factor correlates of youth suicidal behaviour among those at highest risk for suicide – orphans who reside in a low- and middle-income country (LMIC) institutional setting.

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Finding Families - The State of Residential Care for Children and Implications for Human Development: A Research Review

Catholic Relief Services, Changing the Way We Care, 01 Nov 2017

This review is a summary of the literature, from multiple disciplines, on residential child care and its deleterious effects on children.

Children’s Perceptions of the Relational and Educational Practices at Shelter Institutions

Eliane Lima Piske, Angela Adriane Schmidt Bersch, Maria Angela Mattar Yunes - Vulnerable Children and Youth in Brazil, 24 Oct 2017

This chapter aims to present a research grounded in the bioecology of human development that analyzed shelter institutions through the perceptions of children aged from 7 to 12 years in Brazil.

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Tubarerere mu Muryango (TMM) - Reintegrating children from institutions into families

UNICEF Rwanda, 16 Oct 2017

This video from UNICEF Rwanda shows some of the moving stories of children and their new families who have been brought together through the TMM initiative, which reintegrates children who have been living in institutions into families and the community.

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Workshop on Depression in Children and Young Persons Living in Alternative Care: Challenges and Possibilities

Udayan Care, 01 Oct 2017

This document provides a full report of the workshop on “Depression in Children and Young Persons living in Alternative Care: Challenges and Possibilities.”

Memory and Executive Functioning in 12-Year-Old Children With a History of Institutional Rearing

Johanna Bick, Charles H. Zeanah, Nathan A. Fox, Charles A. Nelson - Child Development, 17 Sep 2017

This study examined visual recognition memory and executive functioning (spatial working memory, spatial planning, rule learning, and attention shifting) in 12-year-olds who participated in the Bucharest Early Intervention Project, a randomized controlled trial of foster care for institutionally reared children.

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