Most of us feel that all infants and toddlers need warm, sensitive, responsive care from a few consistent adults to reach their potential. But what happens if they don't experience that kind of early care?
This is the case for infants and toddlers reared in many institutions around the world. They are reared in a regimented fashion with many other children by many different and changing caregivers who provide the basics in a business-like fashion and very little else — no response to crying, no conversation, no play, no hugs.
These children are usually substantially behind in their physical and mental development, but most catch up to typical levels if they are adopted or placed into families early enough. Otherwise, if they remain in the institution longer, the rates of longer-term problems are higher than for non-institutionalized children.
Recent research suggests that these outcomes are specifically a result of a lack of nurturing early caregiver-child interactions and the nature of institutional environments that typically do not support good caregiver-child interactions and relationships.
To test this idea, McCall and colleagues (2016) (PDF, 89KB)opens in new window conducted a study in an institution in St. Petersburg, Russian Federation. Caregivers in the institution were encouraged to behave in a more typical "parent-like" manner with the children; that is, to be warm, caring, sensitive, and responsive to the children — the same as they would do with their own children at home.
In addition, the institution was restructured to be more "family-like." This consisted of reducing the number of children in a group from 12 to 6, cutting the number of different caregivers the children experienced (otherwise between 60–100 in the first two years), having at least one of two specific caregivers consistently present every day, integrating children of different ages and abilities within each group, and stopping the common practice of periodically moving children to new groups.
Importantly, no changes were made to the children's diet or medical care.
Children living in this institution improved substantially in their physical, mental, attachment, and social development compared to children in an unimproved, care-as-usual institution. But would these early benefits of nurturance be associated with better outcomes after the children left the institution for life in a family?
Recently, children from these institutions were transitioned to Russian families, and their parents rated their children's development after they had lived with them for an average of 33.5 months and were between 1.5 and 10.8 years of age.
First, children benefited substantially from living in a family, even those from the unimproved institution. On average, they were not very different from Russian parent-reared children, consistent with the often reported finding of substantial "catch up" growth after family placement.
Second, children who resided longer in the institutions were more likely to have internalizing and externalizing problems in childhood, also consistent with other studies.
Third, children from the improved parent/family-like institution displayed some persistent developmental advantages. Specifically, parents rated them as being less indiscriminately friendly with strangers and less aggressive/defiant than children from the unimproved institution, especially those who spent a longer time in the institution.
This research shows that the characteristics of typical family life are important contributors to the development of infants and toddlers, even when implemented in an institution. The quality and consistency of early caregiver-child interactions appears to be the most important element, probably regardless of whether the children live in an institution or a family.
Most infants and toddlers exposed to severely neglectful early environments can benefit substantially from being subsequently placed into families, but prolonged institutionalization is associated with higher rates of longer-term problems.
Infants should be transitioned out of institutions as early as possible, and it would be best if children were placed into families from the beginning, but institutions for those children who must be there can be improved.
Citation:
- McCall, R. B., Muhamedrahimov, R. J., Groark, C. J., Palmov, O. I., Nikiforova, N. V., Salaway, J. L., & Julian, M. M. (2016). The development of children placed into different types of Russian families following an institutional intervention. International Perspectives in Psychology: Research, Practice, Consultation, 5(4), 255-270. https://dx.doi.org/10.1037/ipp0000060
Note: This article is in the Developmental Psychology topic area. View more articles in the Developmental Psychology topic area.