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Paper

Developmental adjustment in adolescents growing up in childcare institutions in Romania

abstract

Background. Over the last fifty years, studies have highlighted the high rates of emotional and behavioural disturbance shown by many children reared in institutions. For example, Hodges and Tizard (1989) found that attention-seeking behaviour, restlessness and disciplinary problems were the most frequently reported difficulties children who had spent their early years in institutional care. Vorria et al. (1998) found that a group of children in long-term residential care in Greece displayed more emotional difficulties, conduct problems and hyperactivity than children reared in their families. The negative findings were followed, in many countries, by a marked reduction in the use of children's residential care institutions and alternative care options (foster placement or adoption) were encouraged. Nevertheless, the practice of 'institutional child rearing' has continued to exist in many countries throughout the world.

In the early 1990s, reference to Romania became almost synonymous with mention of 'orphan children' due to media exposure of large scale use of institutional care for children. Interest in the topic of 'institutional deprivation and child rearing' was revived in the 1990s via the opportunities to study children who grew up in impoverished institutions in Romania and who were subsequently adopted by foreign couples after the fall of the Communist regime. Studies conducted in the main receiving countries (the UK, the USA, Canada) brought new insights regarding the causes of the higher rate of psychological disturbance in institutionally-raised children.

Purpose. This paper describes the findings of a study comparing one hundred Romanian adolescents (aged between 12 and 16) who had lived for several years in residential childcare with one hundred adolescents who have always lived with their two-parent families. The effect of type of rearing (in institution/with parental family) on adolescents' developmental adjustment was explored in respect of a number of outcome variables: emotional and behavioural strengths and difficulties (assessed using the Strengths and Difficulties Questionnaire, SDQ - Goodman, 1997), intellectual development (assessed by the Standard Progressive Matrices, SPM - Raven et al., 1988), and school performance (assessed from school reports supplemented by accounts from teachers).

Variations in adolescents' behaviour, cognitive development and school performance within the institutional care group were considered in relation to a series of variables that reflect different types of possible mediating, risk and protective factors, such as: age at admission into institutional care and length of institutional placement; family experience prior to admission; and amount of contact with parents/families during institutional placement and the presence/absence of a sibling within same the residential unit.

Key findings and implications. The behaviour patterns that emerged from the present data as being strongly associated with institutional rearing (by their prevalence in the borderline/clinical rage) were higher levels of conduct problems (Chi-squared=20.09, df=2, p<.001) and less pro-social behaviour (Chi-squared=10.049, df=2, p=.004), as well as more self-reported peer problems Chi-squared=30.85, df=2, p<.001). Teenagers living in care had average levels of intellectual development and average school performances, but they exhibited more school difficulties and problematic school behaviour.

The pattern of dysfunction associated with institutional upbringing that emerge from the present data is different from that revealed by the recent reports of 'institutional privation patterns', based on the longitudinal study of Romanian children adopted in the UK. For example, in the present study the incidence of hyperactivity scores in the borderline and clinical range for adolescents living in institutions did not differ from that of clinical rates of hyperactivity in the comparison group (Chi-squared=3.19, df=2, p=.2). This is counter to the findings of ERA (Kreppner et al., 2001; Rutter et al., 2001), which support the conclusion that inattention/overactivity is a factor associated with duration of institutionalisation. Moreover, in the present samples, the prevalence of conduct problems in the clinical borderline range among teenagers in institutional care was significantly higher than for teenagers living with their families (see above). Conduct problems were not found to belong to the 'institutional privation patterns' described by Rutter et al. (2001).

The three behavioural patterns which emerged as strongly associated with institutional rearing in the present study seem to be mediated by different factors. Informant-reported conduct problems seem to be particularly increased in teenagers who had infrequent and inconsistent contact with their families (F=4.47, p=.01). The relatively short duration of institutionalisation seems to play a protective role regarding teenagers' pro-social behaviour (F=3.56, p=.03), whereas coming from a disrupted/conflictual familial background represents a risk in terms of teenagers' pro-social behaviour (F=3.14, p=.04). The level of self-reported peer problems was reduced for teenagers who had a sibling living with them (F=4.98, p=.02). Teenagers' levels of intellectual development and school performance do not seem to be mediated by their experiences before or after admission into care.

This research is particularly important because no systematic studies have previously been conducted with children living in state care institutions in Romania. It enables comparison with studies of Romanian 'orphans' adopted internationally in the early 1990s. The findings reflect a configuration of adjustment difficulties which differs from that reported by these studies, suggesting that assumptions of 'institutional deprivation' should be reconsidered.

Key references

Hodges, J., & Tizard, B. (1989). IQ and behavioral-adjustment of ex-institutional adolescents. Journal of Child Psychology and Psychiatry and Allied Disciplines, 30(1), 53-75.

Kreppner, J. M., O'Connor, T. G., Rutter, M., Beckett, C., Castle, J., Croft, C., Dunn, J. & Groothues, C. (2001). Can inattention/overactivity be an institutional deprivation syndrome? Journal of Abnormal Child Psychology, 29(6), 513-528.

Rutter, M., Kreppner, J. M. & O'Connor, T. G. (2001). Specificity and heterogeneity in children's responses to profound institutional privation. British Journal of Psychiatry, 179(Aug.), 97-103.

Vorria, P., Rutter, M., Pickles, A., Wolkind, S. & Hobsbaum, A. (1998). A comparative study of Greek children in long-term residential group care and in two-parent families: I: Social, emotional, and behavioural differences. Journal of Child Psychology and Psychiatry and Allied Disciplines, 39(2), 225-236.

Contacts: Gabriela Misca, Lecturer, Keele University, Keele University, School of Criminology, Education, Sociology and Social Work, Keele, Staffordshire, ST5 5BG England, E-mail: g.m.misca@keele.ac.uk, Phone +44 1782584290.

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