**L8 - Institutional Care

Question 1

what is INSTITUTIONAL CARE?

Answer 1

INSTITUTIONAL CARE is when a child’s LIVING ARRANGEMENTS are OUTSIDE OF THE FAMILY.

Some children are RAISED IN INSTITUTIONS, such as CHILDREN’s HOMES, HOSTELS, HOSPITALS etc.

Children raised in institutions can ADOPT THE RULES AND NORMS OF THE INSTITUTION, which COULD IMPAIR FUNCTIONING and lead to a LOSS OF PERSONAL IDENTITY (DEINDIVIDUATION)

Question 2

who conducted a study into the EFFECTS OF INSTIUTIONALISATION on ROMANIAN ORPHANS?

Answer 2

RUTTER ET AL

Question 3

what was the PROCEDURE OF RUTTER ET AL’S STUDY?

Answer 3

This study involved 165 ROMANIAN CHILDREN who spent their EARLY LIVES in ROMANIAN ORPHANAGES BEFORE BEING ADOPTED, and thus SUFFERED from the EFFECTS OF INSTITUTIONALISATION.

The ADOPTEES were TESTED at REGULAR INTERVALS (ages 4,6,11 and 15) to ASSESS their PHYSICAL, COGNITIVE and SOCIAL DEVELOPMENT.

Their PROGRESS was COMPARED TO A CONTROL GROUP of 52 BRITISH CHILDREN ADOPTED in the UK BEFORE THE AGE OF 6 MONTHS

Question 4

what were the FINDINGS OF RUTTER ET AL’S STUDY?

Answer 4

At the TIME OF ADOPTION, the ROMANIAN ORPHANS LAGGED BEHIND their BRITISH COUNTERPARTS on ALL MEASURES of PHYSICAL, COGNITIVE and SOCIAL DEVELOPMENT.

BY THE AGE OF FOUR the ROMANIAN CHILDREN ADOPTED BEFORE THE AGE OF 6 MONTHS had CAUGHT UP with their BRITISH COUNTERPARTS.

However, a SIGNIFICANT NUMBER of individuals adopted AFTER THE AGE OF 6 MONTHS STILL had SIGNIFICANT DEFICITS AT AGE 4.

Question 5

what CONCLUSIONS were drawn from RUTTER ET AL’S STUDY?

Answer 5

This study SUGGESTS that the LONG TERM CONSEQUENCES of INSTITUTIONALISATION may be LESS SEVERE than was once thought IF CHILDREN ADOPTED BEFORE 6 MONTHS and RECEIVE SENSITIVE PARENTING.

However, if children are NOT ADOPTED BY SIX MONTHS then the CONSEQUENCES OF INSTITUTIONALISATION ARE LIKELY TO BE SEVERE

Question 6

HOW MANY EFFECTS of INSTITUTIONALISATION are there and WHAT ARE THEY? (QLEDDD)

Answer 6

There are 6 EFFECTS OF INSTITUTIONALISATION: (QLEDDD)

1) (Q) QUASI-AUTISM
2) (L) LACK OF INTERNAL WORKING MODEL
3) (E) EMOTIONAL DEVELOPMENT
4) (D) DELAYED INTELLECTUAL DEVELOPMENT
5) (D) DELAYED PHYSICAL DEVELOPMENT
6) (D) DISINHIBITED ATTACHMENT

Question 7

what ACRONYM can be used to help remember the EFFECTS OF INSTITUTIONALISATION?

Answer 7

Q L E D D D (remember there’s 6 EFFECTS and each letter stands for a different effect)

Question 8

what is (Q) in QLEDDD?

Answer 8

CHILDREN RAISED IN INSTITUTIONS may suffer from QUASI-AUTISM because they STRUGGLE TO UNDERSTAND the MEANING of SOCIAL CONTEXTS and can have OBSESSIONAL BEHAVIOURS.

They can have LOWER FREQUENCY of PRETEND PLAY and REDUCED EMPATHY

Question 9

what is (L) in QLEDDD?

Answer 9

another EFFECT OF INSTITUTIONALISATION is a LACK OF INTERNAL WORKING MODEL. CHILDREN RAISED IN INSTITUTIONS may have DIFFICULTY INTERACTING WITH PEERS and FORMING CLOSER RELATIONSHIPS.

As adults they will have IMPAIRED ADULT RELATIONSHIPS and can STRUGGLE TO PARENT THEIR OWN CHILDREN.

Question 10

what is the (E) in QLEDDD?

Answer 10

another effect of INSTITUTIONALISATION is POOR EMOTIONAL DEVELOPMENT.

Children raised in institutions can have DIFFICULTY MANAGING THEIR ANGER (tantrums)

Question 11

what is the first (D) in QLEDDD?

Answer 11

Children raised in institutions also suffer from DELAYED INTELLECTUAL DEVELOPMENT - they may have LOW IQ and CONCENTRATION PROBLEMS.

This means they may STRUGGLE AT SCHOOL because they CANNOT LEARN NEW BEHAVIOURS and CONCEPTS AS QUICKLY.

They can also have DELAYED LANGUAGE DEVELOPMENT

Question 12

what is the second (D) in QLEDDD?

Answer 12

another effect is DISINHIBITED ATTACHMENT - children raised in institutions MAY NOT KNOW what APPROPRIATE BEHAVIOUR TOWARDS STRANGERS IS.

They can be OVERLY AFFECTIONATE and ATTENTION SEEKING

Question 13

what is the third (D) in QLEDDD?

Answer 13

these children can also suffer from DELAYED PHYSICAL DEVELOPMENT.

Children raised in INSTITUTIONS are usually PHYSICALLY SMALL.

Research has shown that a LACK OF EMOTIONAL CARE rather than POOR NOURISHMENT is the CAUSE of what has been called DEPRIVATION DWARFISM

Question 14

+ NEGATIVE CONSEQUENCES (EVALUATING THE EFFECTS OF INSTITUTIONALISATION)

Answer 14

+ studies that have shown the EFFECTS OF INSTITUTIONALISATION have ENHANCED OUR UNDERSTANDING of the POTENTIAL NEGATIVE CONSEQUENCES of INSTITUTIONAL CARE and has led to the ESTABLISHMENT OF KEY WORKERS in INSTITUTIONS to PROVIDE EMOTIONAL CARE for children

Question 15

+ ADOPTION PROCESS (EVALUATING THE EFFECTS OF INSTITUTIONALISATION)

Answer 15

+ studies that have INVESTIGATED the EFFECTS OF INSTITUTIONALISATION have also LED TO CHANGES in the ADOPTION PROCESS.

In the past, MOTHERS were ENCOURAGED to NURSE THEIR CHILDREN for AS LONG AS POSSIBLE BEFORE GIVING THEM UP FOR ADOPTION.

Today, MOST BABIES are ADOPTED WITHIN THEIR FIRST WEEK OF LIFE (certainly before 6 months)

Question 16

• GENERALISATION ISSUES (EVALUATING THE EFFECTS OF INSTITUTIONALISATION)

Answer 16

• There are PROBLEMS WHEN GENERALISING FINDINGS of STUDIES OF ROMANIAN ORPHANS as STANDARDS OF CARE were PARTICULARLY POOR in these orphanages.

The ROMANIAN ORPHANS were faced with MUCH MORE THAN EMOTIONAL DEPRIVATION.

The PHYSICAL CONDITIONS WERE APPALLING, and there was a LACK OF COGNITIVE STIMULATION. Its likely that LONG TERM DAMAGE FROM institutional care only occurs when there are MULTIPLE RISK FACTORS

Question 17

• LE MARE and AUDET (EVALUATING THE EFFECTS OF INSTITUTIONALISATION)

Answer 17

• Its possible that the NEGATIVE EFFECTS OF INSTITUTIONALISATION can be REDUCED with SENSITIVE PARENTING.

Le MARE and AUDET conducted a LONGITUDINAL STUDY of 36 ROMANIAN ORPHANS ADOPTED TO FAMILIES IN CANADA.

The adopted orphans were PHYSICALLY SMALLER than a MATCHED CONTROL GROUP at AGE FOUR but this difference had DISAPPEARED BY TEN. The same was true for PSYCHOLOGICAL HEALTH

Question 18

• PP VARIABLES (EVALUATING THE EFFECTS OF INSTITUTIONALISATION)

Answer 18

• ADOPTION and CONTROL GROUPS were NOT RANDOMLY ALLOCATED to conditions in STUDIES OF ROMANIAN ORPHANS.

This means that PARTICIPANT VARIABLES BETWEEN THE CHILDREN could INFLUENCE THE FINDINGS in UNANTICIPATED WAYS.

The ADOPTED CHILDREN might have been adopted BECAUSE OF PERSONAL CHARACTERISTICS such as RESILIENCE or BEING MORE SOCIABLE.

These characteristics might explain why they were LESS AFFECTED by INSTITUTIONAL CARE, which LOWERS THE VALIDITY of the research.