CAFO 2014 Video

Kate Whetten and team are at the 2015 Christian Alliance for Orphans conference in Nashville, Tennessee. Please check out this Q&A video from Kate Whetten and Charles Nelson’s presentation at the 2014 CAFO conference.


Emotional Wellbeing

OVCs & Long-term Consequences

Educational Impact


Project Hope’s Parenting Map


Project Hope’s Parenting Map innovative concepts and tools such as the Parenting Map, a low-literacy data collection tool intended to provide caregivers with a quick but comprehensive snapshot of each child’s “well-being” in the household. 

Parenting Map Resource Tools

Parenting Map Tool

Training Guide

Score Card

Action Plan

Practice Exercises

Answer Key to Practice Exercises

Ice Breaker

Sample Analysis




Article Title: AIDS knowledge and HIV stigma among children affected by HIV/AIDS in rural China

Authors: Zhao Q1, Li X, Zhao G, Zhao J, Fang X, Lin X, Stanton, B.

Abstract: The current study was designed to assess the level of AIDS knowledge and its relationship with personal stigma toward people living with HIV/AIDS (PLWHA) among children living in communities of high HIV prevalence in rural China. The data were collected in 2009 from 118 orphanage orphans (children who had lost both of their parents to HIV and living in AIDS orphanages), 299 family-cared orphans (children who had lost one or both of their parents to HIV and living with surviving parents or extended families), 326 vulnerable children (children who were living with HIV-infected alive parents), and 276 comparison children (children from the same community who did not experience HIV-related illness and death in their family). Children were asked to answer 20 questions of AIDS knowledge. A 10-item stigma scale was employed to assess children’s own attitude toward PLWHA. Both bivariate and multivariate tests were performed to answer our research questions. The data in the current study demonstrate a relatively low percent of correct AIDS knowledge (60%) among samples. The comparison children reported the best score of AIDS knowledge and orphanage orphans scored the lowest. The children with better AIDS knowledge have less personal stigma toward PLWHA. The findings in the current study suggest the need of appropriate education strategies to provide AIDS knowledge to children, particularly for HIV-affected children living in communities of high HIV prevalence in rural China.

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Article Title: Perceived social support and psychosocial distress among children affected by AIDS in China

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

Abstract: The psychosocial wellbeing of the children affected by Acquired Immune Deficiency Syndrome (AIDS) receives growing international attention. However, limited data in this area are available in China, which hosts an estimate of 100,000 AIDS-orphaned children. The study aims to examine the relationship between perceived social support (PSS) and psychosocial wellbeing among children affected by AIDS. A cross-sectional survey was administered to 1,625 children (aged 6-18 years) in Henan Province, an area with a large number of HIV cases due to unhygienic commercial blood/plasma collection. Our sample included 296 double orphans (i.e., children who lost both parents to AIDS), 459 single orphans (children who lost one parent to AIDS), 466 vulnerable children (children living with HIV-infected parents) and 404 comparison children (children who did not experience HIV-related illness and death in family). Data suggest that vulnerable children reported the lowest level of PSS compared to AIDS orphans and comparison children. Level of PSS was significantly and positively associated with psychosocial wellbeing even after controlling for potential confounders. The study underscores the importance of providing social support and mental health services for children affected by AIDS in China.



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Article Title: A Caregiver-Child Social/Emotional and Relationship Rating Scale (CCSERRS)

Authors: Robert B. McCall, Christina J. Groark, and Larry Fish


This paper reports the construction and pilot reliability, validity, and psychometric properties of a new caregiver-child rating scale that emphasizes caregiver-child social-emotional interactions and relationships. While the scale was developed and studied in the context of orphanages for young children, it potentially could be used in non-residential early care and education settings as well as for parent-child interactions in the home. The intent was to assess a few dimensions that comprehensively cover the range of caregiver-child social-emotional interactions and relationships but could be administered in a relatively short period of time in a variety of situations and would not require extensive coder training, manuals, or materials. Results showed that the scale can be reliably administered even using observation periods as short as five minutes, reliability was replicated over seven different coders working in three different orphanages, and ratings of caregivers were similar across different types of caregiving activities (i.e., feeding, dressing/bathing, free play) and for caregivers attending to children birth to 4 and 4 to 8 yrs. of age. In the orphanage context, factor analyses showed the scale primarily reflects caregiver-child mutual engagement and relationship with subordinate components of caregiver punitiveness and caregiver- vs. child-directed behaviors and intrusiveness.

Early social/emotional relationship experiences, especially warm, caring, sensitive, and responsive interactions between adults and their infants and young children, are crucial contributors to promoting attachment (e.g., DeWolff & van IJzendoorn, 1997van IJzendoorn & Sagi, 1999), which in turn is associated with longer-term positive child outcomes in social and mental development (e.g.,Aviezer, Sagi, Resnick, & Gini, 2002Landry, Smith, & Swank, 2006;Landry, Smith, Miller-Loncar, & Swank, 1997Landry, Smith, Swank, & Miller-Loncar, 2000Steelman, Assel, Swank, Smith, & Landry, 2002). Social/emotional relationship experiences have also been associated with the quality of early care and education environments, early childhood developmental gains, and longer-term educational success (e.g., Edwards & Raikes, 2002Kontos, Howes, Shinn, & Galinsky, 1995).

Conversely, insecure attachment, especially disorganized attachment, is related to increased later problem behaviors, including externalizing behaviors in males and other social, behavior control, crime, and mental health problems, more so in high-risk children and those who continue to experience insensitive parenting and/or child care (e.g., Carlson, 1998Fonagy et al., 1997;Greenberg, 1999Lyons-Ruth, Alpern, & Repacholi, 1993Rothbaum & Weisz, 1994Shaw, Owens, Vondra, Keenan, & Winslow, 1997).

More specifically, institutional rearing environments for young children tend to provide quite minimal social/emotional relationship experiences (e.g., St. Petersburg-USA Orphanage Research Team, 20052008Rosas & McCall, 2008), and perhaps as a partial consequence of this deprivation such children tend to be substantially underdeveloped and have higher rates of behavioral problems even after being adopted into advantaged families (Blizzard, 1990Gunnar, 2001Johnson, 2000MacLean, 2003St. Petersburg-USA Orphanage Research Team, 20052008). Further, interventions that emphasize improved early social/emotional relationship experiences in orphanages (St. Petersburg-USA Orphanage Research Team, 2008Zeanah, Smyke, & Koga, 2003), provide high-quality foster care instead of institutionalization (Nelson, Zeanah, Fox, Marshall, Smyke, & Guthrie, 2007), or promote responsiveness in parents towards their own infants (Landry et al., 2006) have produced improvements in children’s development in several domains.

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