Category: Caregiving Situations and Living Environments

Article Title: Characteristics of children, caregivers, and orphanages for young children in St. Petersburg, Russian Federation

Authors: Rifkat J. Muhamedrahimov; Natalia V. Nikoforova; Oleg I. Palmov; Christina J. Groark; Robert B. McCall; Larry Fish

Abstract: This report provides baseline information on conditions in orphanages in the Russian Federation. This information addresses three major limitations in the literature on the development of children residing in substandard orphanages and those adopted from such environments. First, although there is an assumption that early exposure to substandard orphanages is associated with a variety of developmental delays during and after residency, there are essentially no comprehensive, empirical descriptions of what these early environments are like. This paper provides such information on the orphanage system in the Russian Federation and on a sample of children from 0–4 years of age residing in three orphanages in St. Petersburg. Second, because the orphanage environment is typically globally deficient, it is difficult to discern causal variables in developmental delays. In this report we attempt to show that the most salient deficiencies are in the social–emotional environment. Third, there are few empirical descriptions in the literature of the birth circumstances and characteristics of children residing in orphanages which make it difficult to untangle the relative contributions of poor perinatal circumstances and the orphanage environment in accounting for developmental delays. The results of this study show that a larger than expected number of orphanage children have poor perinatal circumstances, and most fall far below the average local Russian norms on physical, cognitive and psychosocial development.

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Study Title: Structure, caregiver–child interactions, and children’s general physical and behavioral development in three central American institutions

Authors: Groark, Christina J.; McCall, Robert B.; McCarthy, Stephanie K.; Eichner, Joan C.; Gee, Amy D.

Abstract: This article describes structural characteristics and caregiver–child interactions (N = 34) in three Central American institutions for infants and young children (N = 79) and relates differences in these characteristics to differences in children’s physical, behavioral, and cognitive development. Generally, the institution with the smallest group size, fewest children per caregiver, and a few consistent caregivers had children with the best physical, behavioral, and cognitive development; this institution also had many temporary volunteers who played with the children. Differences in the quality of caregiver–child interactions were not directly related to children’s development, but the potential benefit of high-quality interactions may have been minimized by a high children:caregiver ratio in one institution, and the presence of volunteers to play with children may have compensated for and/or minimized the display of higher-quality interactions by staff caregivers in another institution. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

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Study Title: A new model of foster care for young children: The Bucharest Early Intervention Project

Authors: Smyke, A.T., Zeanah, C.H., Fox, N.A., & Nelson, C.A.

Abstract: The Bucharest Early Intervention Project is a randomized controlled trial of foster care as an intervention for young children who have spent most of their lives in institutions in Bucharest, Romania. The authors implemented an attachment-based model of child-centered foster care there, and a team of three Romanian social workers trained and supported foster parents in managing the complex challenges of caring for postinstitutionalized infants and toddlers. They received regular weekly consultation from US-based clinicians designed to guide their work with foster parents and children. From language development to toilet training to encouraging the development of the young child’s ability to trust, foster parents received ongoing support to help these young children transition to family life. Developmental outcomes so far indicate significantly better outcomes for young children in this foster care program than children who remained in institutions. For some domains of development, earlier placement was associated with better outcomes but for others, timing of placement did not appear to matter.

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Study Title: Ethical considerations in international research collaboration: The Bucharest Early Intervention Project

Authors: Zeanah, C.H., Koga, S.F.M., Simion, B., Stanescu, A., Tabacaru, C., Fox, N.A., Nelson, C.A., & the BEIP Core Group

Abstract: The Bucharest Early Intervention Project (BEIP) is the first ever randomized controlled trial of foster care as an alternative to institutional care for young children. It involved a collaboration between American investigators and Romanian health and child protection professionals. We present a brief description of the Romanian context and the project itself before discussing a number of ethical issues raised by the project. Organized around a discussion of exploitation, risk/benefit ratio, and cultural sensitivity, we evaluate a number of ethical issues involved in the BEIP using the Ethical Clinical Research Framework and the Fair Benefits Framework. Based on this review, we conclude that notwithstanding challenging ethical dilemmas, the benefits of the project outweighed its risks. Throughout the planning and implementation of the project, ethical issues were a central focus of discussion among the investigators and in the collaboration between Americans and Romanians. Thoughtful discussions from multiple perspectives are necessary to conduct research that is ethically sound and scientifically meaningful.

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Study Title: Care arrangements of AIDS orphans and their relationship with children’s psychosocial well-being in rural China

Authors: Hong Y, Li X, Fang X, Zhao G, Zhao J, Zhao Q, Lin X, Zhang L, Stanton B

Abstract: There is an estimated 100,000 children orphaned by AIDS in China, but data on the care arrangement of these orphans are limited. In this study, we examine the relationship between AIDS orphans’ care arrangement and their psychosocial well-being among a sample of AIDS orphans in rural China. A total of 296 children who lost both parents to AIDS participated in the study, including 176 in orphanages, 90 in kinship care and 30 in community-based group homes. All participants completed a cross-sectional survey assessing their traumatic symptoms, physical health and schooling. Data reveal that the AIDS orphans in group homes reported the best outcomes in three domains of psychosocial well-being, followed by those in the orphanages and then the kinship care. The differences in psychosocial well-being among the three groups of children persist after controlling for key demographic characteristics. The findings suggest that the appropriate care arrangement for AIDS orphans should be evaluated within the specific social and cultural context where the orphans live. In resource-poor regions or areas stricken hardest by the AIDS epidemic, kinship care may not sufficiently serve the needs of AIDS orphans. Community-based care models, with appropriate government and community support preserving the family style and low child-to-caregiver ratio may constitute an effective and sustainable care model for the best interest of the AIDS orphans in developing countries.

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Study Title: Parent-Reported Executive Functioning in Postinstitutionalized Children: A Follow-Up Study

Authors: Emily Merz, Robert McCall, Victor Groza

Abstract: This study compared parent-rated executive functioning (EF) in 6- to 18-year-old children adopted from psychosocially depriving institutions to that in children adopted from severely or “globally” depriving institutions. Individual continuity in EF over 2 years was examined in children adopted from psychosocially depriving institutions. There were 471 children adopted from psychosocially depriving Russian institutions that provided adequate physical resources but failed to provide a consistent set of responsive caregivers. There were 111 children adopted in the early 1990s from globally depriving Romanian institutions that were characterized by physical deprivation as well as profound psychosocial neglect. Adoptive parents completed a background questionnaire and the Behavior Rating Inventory of Executive Function (BRIEF). Children adopted from globally depriving institutions had significantly higher levels of EF difficulties than children adopted from psychosocially depriving institutions. For both groups, adoption after 18 months of age was associated with higher levels of EF difficulties. Children adopted from globally depriving institutions had higher levels of EF difficulties than the BRIEF standardization sample at younger ages at adoption. There was moderate to strong continuity in EF difficulties over 2 years in children adopted from psychosocially depriving institutions. These findings suggest that more severe early deprivation may lead to a higher risk of later EF difficulties, which may persist over time.

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Study Title: Maltreatment experiences and associated factors prior to admission to residential care: A sample of institutionalized children and youth in western Kenya

Authors: Gillian Morantz, Donald Cole, Samuel Ayaya, David Ayuku, Paula Braitstein

Abstract: This study aims to determine the prevalence of maltreatment experienced by institutionalized children prior to their admission to Charitable Children’s Institutions (orphanages) in western Kenya, and to describe their socio-demographic characteristics, reasons for admission, and the factors associated with prior experiences of maltreatment.

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Study Title: Psychological impact of cerebral palsy on families: The African perspective

Authors: Olawale, O. A., Deih, A. N., & Yaadar, R. K.

Abstract: Psychological stress associated with cerebral palsy (CP) is known to be one of the most depressing conditions of families. In the traditional African society, some peculiar factors may contribute to the stress.  This paper highlights the high levels of stress experienced by many families in dealing with a child born with a disability. The focus of the paper is specifically on the impact of children with cerebral palsy on families in Accra, Ghana. Factors associated with the impact of cerebral palsy on parenting stress include increased care-giving demands, low maternal education and ethnic background.

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Study Title: Income disparities in preschool outcomes and the role of family, child, and parenting factors

Authors: Kohen, D., & Guèvremont, A.

Abstract: Numerous studies have shown that children from more affluent families achieve higher scores on a range of preschool developmental and achievement tests; further, these benefits extend far into the life course with implications on later school achievement, employment and earnings. The early skills, such as proficiency in reading and mathematics, have also been found to be predictive of a range of social and health problems, including the likelihood of teenage pregnancy, engagement in criminal activities and increased substance abuse. In this paper, the authors attempt to go beyond illustrating differences in test scores between children living in low income families compared with higher income families, to include an investigation of whether the differences in outcome can be partly attributed to factors other than income.

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Study Title: Perception and determination of child maltreatment: Exploratory comparisons across three countries

Authors: Fakunmoju, S., Bammeke, F., Boaiakoh, T., Asante, R., Wooten, N., Hill, A. & Karpman, H.

Abstract: Little is known about perception and determination of child maltreatment across countries. Although differences in perception and determination of maltreatment across regions of a single country are well documented, comparative knowledge across countries remains sparse. This paper examines the results of an internet survey that investigates the perception of abusive behaviors and factors considered important in determining maltreatment in three countries (i.e., the United States, Ghana, and Nigeria).

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