A socioemotional intervention in a Latin American orphanage

Abstract

A pilot intervention that emphasized training and technical assistance to promote warm, sensitive, and responsive one-on-one caregiver-child interactions primarily during feeding and bathing/changing was implemented using regular staff in a depressed orphanage for children birth to approximately 8 years of age in Latin America. Despite a variety of unanticipated irregularities in the implementation of the intervention, many beyond the researchers' control, ward environments improved; caregivers displayed more warm, sensitive, and responsive interactions with children; and children improved an average of 13.5 developmental quotient (DQ) points after 4+ months' exposure to the completed intervention. Furthermore, 82% of the children had DQs greater than 70 before the intervention, but only 27.8% did so afterward. Although the training for all caregivers was aimed at children birth to 3 years, the number of different caregivers was reduced, and technical assistance was provided only to caregivers serving children less than 3 years, younger and older children (3-8 years) improved approximately the same amount. However, children who were transitioned from a younger to an older ward during the intervention improved less than did children who remained in either a younger or an older ward, the first evidence suggesting that the common orphanage practice of periodically graduating children from one homogeneous age group to another may impede their development. The study is consistent with others that have shown that orphanages can be changed, and increases primarily in warm, sensitive, responsive caregiver-child interactions can produce improvements in children's development.

The Effects of a Social–Emotional Intervention on Caregivers and Children With Disabilities in Two Central American Institutions

“…Whole Child International (WCI), a nonprofit organization devoted to improving or-phanages worldwide, first conducted an intervention in a Central American orphanage for children without severe disabilities that emphasized training typical staff caregivers to be more sensitive, contingently responsive, and child-directed as well as attempting to have fewer and more stable caregivers in the lives of young children (McCall, Groark, Fish, Harkins, Serrano, & Gordon, 2010). This intervention improved caregiver-child interactions, raised the general behavioral and cognitive development of children an average of 13.5 DQ points, and reduced the number of children scoring below DQ = 70 to 27.8% compared with 82% before the intervention.…”

Implementing changes in institutions to improve young children's development

“…Similarly, the quality of care in orphanages also matters. The published literature (Bakermans-Kranenburg, van IJzendoorn, & Juffer, 2008; Rosas & McCall, 2010) shows very substantial variations in the general behavioral development of children residing in orphanages, and comprehensive intervention programs designed to improve the caregiving environment in orphanages using existing staff have been successful at improving children's development (McCall, Groark, Fish, Harkins, Serrano, & Gordon, in press; The St. Petersburg-USA Orphanage Research Team, 2008). …”

“…Given the lack of research on implementation, case studies will need to suffice until more systematic and experimental evidence is available. Consequently, what follows is a description of the authors' experience accumulated in the USA (Groark & McCall, 2008), Russian Federation (The St. Petersburg-USA Orphanage Research Team, 2008), Central America (McCall et al, in press), and more recently China on how to implement such changes. These procedures fit parts of the more comprehensive scheme offered by Wandersman, Duffy, Flaspholer, Noonan, Lubell, Stillman et al (2008), and will need to be modified to fit the particular residential institution, culture, resources, and other factors that may be idiosyncratic to the particular situation and discovering these factors and working with them is part of the implementation process.…”

Selective Prevention for Anxiety and Resilience Promotion: Outcomes of an Anxiety Prevention and Resilience Program with Girls at Risk

“…It is very likely that the program will be more effective and gains will be more likely to be maintained over time if it also focuses on building capabilities in significant adults. Parents and caregivers, especially those living in the orphanage with the children, have the capacity to meet critical social and emotional needs (Groark et al, 2005;McCall et al, 2010).…”

“…There are some studies that have implemented programs, which aim is to improve the physical conditions and the social and emotional development of children and youth living in orphanages (Ssewamala, Neilands, Waldfogel, & Ismayilova, 2012;McCall et al, 2010;Schnek, 2009;Groark, Muhamedrahimov, Palmov, Nikiforova, & McCall, 2005), but most of them were delivered to the caregivers, not to children. There are two studies that have implemented programs with the children.…”