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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The nutritional status of children living within institutionalized care: A systematic review

Emily DeLacey, Cally Tann, Nora Groce, Maria Kett, Michael Quiring, Ethan Bergman, Caryl Garcia and Marko Kerac - PeerJ, 06 Feb 2020

This review from PeerJ aimed to evaluate currently available data on the nutrition status of children living within institutionalized care.

Created to Heal: A brief window into the changing brain

Christian Alliance for Orphans (CAFO) , 20 Jan 2020

This 'companion primer' from the Christian Alliance for Orphans (CAFO) provides an overview of the ways in which adversity impacts brain development and how the use of appropriate interventions based on relationships can help reshape children's brains, leading to greater wellbeing and better outcomes for kids from hard places.

Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment

Nuria K. Mackes, Dennis Golm, Sagari Sarkar, Robert Kumsta, Michael Rutter, Graeme Fairchild, Mitul A. Mehta, Edmund J. S. Sonuga-Barke - PNAS, 07 Jan 2020

To investigate the impact of childhood deprivation on the adult brain and the extent to which structural changes underpin these effects, the authors of this study from PNAS utilized MRI data collected from young adults who were exposed to severe deprivation in early childhood in the Romanian orphanages of the Ceaușescu era and then, subsequently adopted by UK families.

Aggression and Internalizing Behavioural Problems Among the Orphan and Non-Orphan Children of Kashmir: A Comparative Study

Nisar Ahmad Rather & Dr Manish Kumar Verma - Our Heritage, 2020

The present study aimed to study the aggression and internalizing behavioural problems among orphan and non-orphan children in Kashmir.

The Relationship between Dance and Multiple Intelligences of Institutionalised Children: A Theoretical Framework for Applied Research

Monica Stănescu and Gabriela Tomescu - Broad Research in Artificial Intelligence and Neuroscience, 2020

The paper aims to make a systematic analysis of the literature that addresses the relationship between dance and multiple intelligences in order to identify the main theoretical aspects that underpin the design and implementation of educational interventions for institutionalised children to learn dance.

Evaluation of institutionally reared children and adolescents in terms of mental health in Ankara

Ahmet Ozaslan and Nuran Demir - The Archives of the International Association for Child and Adolescent Psychiatry and Allied Professions, 2020

This study examines the mental health symptoms of children in institutional care in Ankara, Turkey and possible factors that may cause these symptoms.

Familial Attendance at Indian Residential School and Subsequent Involvement in the Child Welfare System Among Indigenous Adults Born During the Sixties Scoop Era

Amy Bombay, Robyn J. McQuaid, Janelle Young, Vandna Sinha, Vanessa Currie, Hymie Anisman, and Kim Matheson - First Peoples Child & Family Review, 2020

Through an online study, the authors of this paper explored the links between familial (parents/grandparents) Indian Residential School (IRS) attendance and subsequent involvement in the child welfare system (CWS) in a non-representative sample of Indigenous adults in Canada born during the Sixties Scoop era.

Case Study on Family-Based Care. ACE Zambia, Lusaka, Zambia

Simon Kanyemob, Shoshon Tama, Gabriel Walder - Alliance for Children Everywhere (ACE), 2020

The goal of this case study is to demonstrate a working model of family-based care in Zambia which can produce a replicable framework that can be modified for other regions and circumstances.

Maltreatment in residential child protection care: A review of the literature

Fotine Konstantopoulou & Ioanna Mantziou - Dialogues in Clinical Neuroscience & Mental Health, 2020

The current literature review provides a conceptual and empirical framework for understanding child institutional maltreatment.

Tools for Working with Children in Institutional Care

Kshipra Marathe - Counsel to Secure Justice, 2020

This knowledge resource discusses and provides examples of practice tools and calming techniques (in English and Hindi) which counsellors and adults can use while working with children who are in institutional care. The paper reviews evidence on the impact of institutionalisation on children as well as evidence-based interventions that can help mitigate this impact.