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"Youth Deinstitutionalization."
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Supporting adult care-leavers : international good practice
Featuring detailed case studies and examples of good practice, this is an excellent international source book for practitioners and policy makers in social work and social care.
Book
Leaving Care
How can social workers best support young people as they make the transition from care to independent living? This authoritative study investigates the successes and failures of care services for young people, identifying factors that hinder effective transition from care and the types of support that help to promote positive life choices.
eBook
For a Sociology of Expertise: The Social Origins of the Autism Epidemic
This article endeavors to replace the sociology of professions with the more comprehensive and timely sociology of expertise. It suggests that we need to distinguish between experts and expertise as requiring two distinct modes of analysis that are not reducible to one another. It analyzes expertise as a network linking together agents, devices, concepts, and institutional and spatial arrangements. It also suggests rethinking how abstraction and power were analyzed in the sociology of professions. The utility of this approach is demonstrated by using it to explain the recent precipitous rise in autism diagnoses. This article shows that autism remained a rare disorder until the deinstitutionalization of mental retardation created a new institutional matrix within which a new set of actors-the parents of children with autism in alliance with psychologists and therapists-were able to forge an alternative network of expertise. Adapted from the source document.
Journal Article
The science of early adversity: is there a role for large institutions in the care of vulnerable children?
It has been more than 80 years since researchers in child psychiatry first documented developmental delays among children separated from family environments and placed in orphanages or other institutions. Informed by such findings, global conventions, including the 1989 UN Convention on the Rights of the Child, assert a child's right to care within a family-like environment that offers individualised support. Nevertheless, an estimated 8 million children are presently growing up in congregate care institutions. Common reasons for institutionalisation include orphaning, abandonment due to poverty, abuse in families of origin, disability, and mental illness. Although the practice remains widespread, a robust body of scientific work suggests that institutionalisation in early childhood can incur developmental damage across diverse domains. Specific deficits have been documented in areas including physical growth, cognitive function, neurodevelopment, and social-psychological health. Effects seem most pronounced when children have least access to individualised caregiving, and when deprivation coincides with early developmental sensitive periods. Offering hope, early interventions that place institutionalised children into families have afforded substantial recovery. The strength of scientific evidence imparts urgency to efforts to achieve deinstitutionalisation in global child protection sectors, and to intervene early for individual children experiencing deprivation.
Journal Article
The All4Children project to assess the initial implementation of the Integrated Model of Family Foster Care in Portugal: A description of the study protocol
The All4Children project addresses the urgent need to transition from institutionalization to family-based care for out-of-home children in Portugal. Despite evidence highlighting the detrimental effects of institutionalization, only a small percentage of children (less than 4%) are currently placed in family foster care in the country. In response to European directives for deinstitutionalization, Portuguese legislation now prioritizes non-kinship family foster care as the preferred alternative for young children in need of care. To facilitate this transition, the Integrated Model of Family Foster Care (MIAF) was developed, offering a comprehensive framework covering the entire spectrum of family foster care.
This research aims to investigate the initial implementation stage of the MIAF to promote high-quality family foster care in Portugal.
The study will conduct a mixed-method and longitudinal research project in family foster care agencies across different regions of Portugal, focusing on evaluating the implementation and outcomes of the MIAF model using a multi-informant and multi-method approach. The participants will include caseworkers, children aged 0-9 years entering foster care, and their respective foster families enrolled in the MIAF program. Process evaluation will assess fidelity, feasibility, appropriateness, and acceptability of MIAF modules, while outcome evaluation will examine child safety, stability, well-being, as well as foster family well-being and quality of relational care.
The insights gained from this research initiative will serve as a foundation for the ongoing enhancement of MIAF. Consequently, this project has the capacity to advance evidence-based child welfare practices by refining processes and strategies to better serve vulnerable children and youth.
Facilitated by a multidisciplinary team, this project will contribute to advancing research in the field, enhancing practice, and informing policy during a pivotal stage of deinstitutionalization in Portugal.
Journal Article
A Comparative Analysis of Residential Care: A Five-Country Multiple Case-Design Study
BackgroundDespite a global policy push toward the advancement of family- and community-based care, residential care for children and youth remains a relevant and highly utilized out-of-home care option in many countries, fulfilling functions of care and accommodation as well as education and treatment.ObjectiveAs part of a larger project involving five European countries (Finland, Germany, Italy, Lithuania, and Spain), the objective was “to map” the context and content of residential care in each country, thereby building a foundation for meaningful comparisons and deepened understanding of each system’s inherent logic. Within the context of global deinstitutionalization efforts, the study also aimed to understand factors that hinder or enhance the transformation of residential care.MethodUsing an embedded multiple-case design, data was gathered by each country on its residential care macro context as well as salient variables related to three units of analysis–residential care system/program features, residential care training and personnel, characteristics of youth. Cross-case synthesis was used to summarize and compare cases across relevant dimensions.ResultsThe analysis highlighted areas of overlap and singularity, particularly with regard to utilization rates, concepts and methods, workforce professionalization, and characteristics of youth.ConclusionsFindings provide a more nuanced understanding of how residential care continues to be viewed and utilized in some countries, challenging the ‘residential-care-as-a-last-resort-only’ rhetoric that is currently dominating the discourse on residential care. It further provides an understanding of historical and sociocultural factors that need to be considered when trying to transform services for children, youth, and their families.
Journal Article
Trauma of separation: the social and emotional impact of institutionalization on children in a post-soviet country
Background
In the former Soviet Union (fSU) region, which has the highest rate of institutional care worldwide, ‘
social orphans’
—indigent children who have one or both parents living—are placed in publicly run residential institutions to receive education, food, and shelter. Few studies have focused on understanding the emotional effects of separation and life in an institutional environment on children who grow up with their families.
Methods
Semi-structured qualitative interviews (
N
= 47) were conducted with 8- to 16-year-old children with a history of institutional care placement and their parents in Azerbaijan. Semi-structured qualitative interviews were conducted with 8- to 16-year-old children (
n
= 21) involved in the institutional care system in Azerbaijan and their caregivers (
n
= 26). Trained interviewers collected narratives about children’s experiences prior to being separated from their families while living in an institution, as well as the impact of institutional placement on their emotional well-being. We applied thematic analysis with inductive coding.
Results
Most of the children entered institutions around the school entry age. Prior to entering institutions, children had already experienced disruptions within their family environments and multiple traumatic events, including witnessing domestic violence, parental divorce, and parental substance abuse. Once institutionalized, these children may have had their mental health further impaired by a sense of abandonment, a strictly regimented life, and insufficiencies of freedom, privacy, developmentally stimulating experiences, and, at times, safety.
Conclusion
This study illustrates the emotional and behavioral consequences of institutional placement and the need to address accumulated chronic and complex traumatic experiences that occurred before and during institutional placement, which may affect emotion regulation and the familial and social relationships of children who lived in institutions in a post-Soviet country. The study identified mental health issues that could be addressed during the deinstitutionalization and family reintegration process to improve emotional well-being and restore family relationships.
Journal Article
Diverging Patterns of Union Transition Among Cohabitors by Race/Ethnicity and Education: Trends and Marital Intentions in the United States
The rise of cohabitation in family process among American young adults and declining rates of marriage among cohabitors are considered by some scholars as evidence for the importance of society-wide ideational shifts propelling recent changes in family. With data on two cohabiting cohorts from the NSFG 1995 and 2006–2010, the current study finds that marriage rates among cohabitors have declined steeply among those with no college degree, resulting in growing educational disparities over time. Moreover, there are no differences in marital intentions by education (or race/ethnicity) among recent cohabitors. We discuss how findings of this study speak to the changes in the dynamics of social stratification system in the United States and suggest that institutional and material constraints are at least as important as ideational accounts in understanding family change and family behavior of contemporary young adults.
Journal Article
Behavior problems in postinstitutionalized internationally adopted children
Using the Child Behavior Checklist (CBCL), the rate and type of
behavior problems associated with being reared in an institution prior to
adoption were examined in 1,948, 4- through 18-year-old internationally
adopted children, 899 of whom had experienced prolonged institutional care
prior to adoption. The children's adoptions were decreed between 1990
and 1998 in Minnesota. Binomial logistic regression analyses revealed that
early institutional rearing was associated with increased rates of
attention and social problems, but not problems in either the
internalizing or externalizing domains. Independent of institutional
history, children who were adopted ≥24 months had higher rates of
behavior problems across many CBCL scales, including internalizing and
externalizing problems. In general, time in the adoptive home, which also
reflected age at testing, was positively associated with rates of problem
behavior. Thus, there was little evidence that the likelihood of behavior
problems wane with time postadoption. Finally, children adopted from
Russia/Eastern Europe appeared at greater risk of developing behavior
problems in several domains compared to children adopted from other areas
of the world.Members of the International
Adoption Project (IAP) Team, all of whom are from the University of
Minnesota, are H. Grotevant (Family Social Science); R. Lee (Psychology);
W. Hellerstedt (Epidemiology); N. Madsen and M. Bale (Institute of Child
Development); and D. Johnson, K. Dole, and S. Iverson (Pediatrics). This
research was supported by an NIMH grant (MH59848) and K05 award (MH66208)
to M. R. Gunnar. The authors thank the IAP parent board, the Minnesota
Adoption Unit and its director, Robert DeNardo, and the adoption agencies
that encouraged this work: Children's Home Society, Lutheran Social
Services, Crossroads, Hope International, Bethany International, Child
Link International, European Children Adoption Services, International
Adoption Services, Great Wall China Adoption, and New Horizons. Special
thanks are due to the many parents who completed the IAP
survey.
Journal Article
Global priority for the care of orphans and other vulnerable children: transcending problem definition challenges
Background
Tens of millions of children lack adequate care, many having been separated from or lost one or both parents. Despite the problem’s severity and its impact on a child’s lifelong health and wellbeing, the care of vulnerable children—which includes strengthening the care of children within families, preventing unnecessary family separation, and ensuring quality care alternatives when reunification with the biological parents is not possible or appropriate—is a low global priority. This analysis investigates factors shaping the inadequate global prioritization of the care of vulnerable children. Specifically, the analysis focuses on factors internal to the global policy community addressing children’s care, including how they understand, govern, and communicate the problem.
Methods
Drawing on agenda setting scholarship, we triangulated among several sources of data, including 32 interviews with experts, as well as documents including peer-reviewed literature and organizational reports. We undertook a thematic analysis of the data, using these to create a historical narrative on efforts to address children’s care, and specifically childcare reform.
Results
Divisive disagreements on the definition and legitimacy of deinstitutionalization—a care reform strategy that replaces institution-based care with family-based care—may be hindering priority for children’s care. Multiple factors have shaped these disagreements: a contradictory evidence base on the scope of the problem and solutions, divergent experiences between former Soviet bloc and other countries, socio-cultural and legal challenges in introducing formal alternative care arrangements, commercial interests that perpetuate support for residential facilities, as well as the sometimes conflicting views of impacted children, families, and the disability community. These disagreements have led to considerable governance and positioning difficulties, which have complicated efforts to coordinate initiatives, precluded the emergence of leadership that proponents universally trust, hampered the engagement of potential allies, and challenged efforts to secure funding and convince policymakers to act.
Conclusion
In order to potentially become a more potent force for advancing global priority, children’s care proponents within international organizations, donor agencies, and non-governmental agencies working across countries will need to better manage their disagreements around deinstitutionalization as a care reform strategy.
Journal Article