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Is the global child protection community prioritising family care?


Is the global child protection community prioritising family care?

Lumos, the international children’s charity founded by J.K. Rowling, has welcomed the publication of an authoritative international survey of scientific evidence proving that life in institutional care causes ‘often devastating’ harm to the development of children.

A study in medical journal The Lancet warns that the “prevalence of child institutionalisation worldwide is alarming in view of scientific evidence for the developmental risks of institutional care.”

Babies and young children raised in institutions and so-called orphanages suffer most harm, because they are deprived - at the most sensitive stages of development - of the one-to-one adult parental engagement which strengthens the connections in the growing brain.

Evidence from studies over nearly a century, and particularly in recent decades, “imparts urgency to achieve deinstitutionalisation in global child protection”, the authors say. Deinstitutionalisation (DI) is the process of closing institutions and so-called orphanages and replacing them with systems to support children in families, in their communities.

Written by Harvard academics Anne Berens and Charles Nelson, the article - The science of early adversity: is there a role for large institutions in the care of vulnerable children? - gathers scientific evidence from more than 90 sources.

For well over 80 years “scientific studies have documented stunted cognitive, social, and physical development among children placed in institutions during key developmental years.”

“We have analysed,” the authors say, “robust evidence about the often devastating developmental consequences of institutionalisation in early childhood.

“We present evidence from a vast body of child development research suggesting that there is no appropriate place in contemporary child protection systems for the large, impersonal child-care institutions documented in many studies, at least for young children.”

The authors report that there are an estimated eight million children worldwide in institutions and so-called orphanages – so-called because the majority of children are NOT orphans – and the practice is growing in some parts of the world.

They find grounds for hope, though, in the scientific literature. Children can ‘catch up’ developmentally if they are taken out of institutional care - into a loving, attentive family environment – at an early age. Under the age of three, a crucial stage of development, their brains are most vulnerable to damage. The article explains that adult engagement strengthens regularly-used neurological connections in the child’s brain. There is also, however a process of ‘pruning’ of unused connections. The effect of the lack of engagement and stimulation in institutional care is that connections which would normally be strengthened are under-stimulated and at risk of pruning.

The article acknowledges that deinstitutionalisation is a complex challenge. Efforts to reform health, educational and social services for children can meet resistance, particularly from those employed in institution-based systems. However, it summarises evidence showing that running institutions not only harms children but is the most expensive form of care for vulnerable children. Early intervention and work to prevent children entering institutions in the first place are more cost-effective.

“Studies also offer hope, showing that children placed into family care, including forms of care deliverable in settings of poverty and economic transition, can experience developmental recovery.”

The authors urge a reform of services to target intervention and removal of children from institutions at the key developmental ages. “When it comes to removing children from harmful institutions, time is of the essence.”

Georgette Mulheir, Lumos CEO, said: “Those of us working to achieve global deinstitutionalisation and a better future for eight million children will welcome this authoritative and compelling summary of the science around child brain development.

“If anyone has ever doubted that children are harmed – in their physical, cognitive, emotional, and social development - by the lack of love, care and consistent adult engagement in institutions, they should read this article.

“And any politicians or child care professionals asking whether they can or should replace their institutions for children with family-based care alternatives, the evidence summarised in The Lancet will make clear that it is possible and, for the most vulnerable children, it is vitally important.”