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Nikolaeva EI, Dydenkova EA, Mayorova LA, Portnova GV. The impact of daily affective touch on cortisol levels in institutionalized & fostered children. Physiol Behav 2024; 277:114479. [PMID: 38309608 DOI: 10.1016/j.physbeh.2024.114479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/08/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
Institutionalized children are often deprived of affective touch. Such tactile deprivation often leads to constant stress, as measured by the levels of salivary cortisol. We report here the impact of an affective touch program, optimized to activate a specific population of unmyelinated mechanosensitive nerves in the skin called c-tactile afferents (CT) on stress resistance. Two populations of children (age 4-10) were recruited: (i) a cohort living in an orphanage and (ii) a fostered cohort. Both groups received the affective touch program daily for 10-15 min for 5-6 weeks. A cohort of age-matched children living in a family environment acted as a control group and did not receive any instructions for tactile stimulation. Salivary cortisol was collected at the beginning (T1) and at the end (T2) of the study in all three groups. For institutionalized and fostered children there was a significant improvement in the level of cortisol (p < 0.0001) between T1 and T2, which is manifested in the balancing cortisol levels: a decrease where it was elevated and an increase, where the critically low level testified to the distress of the child. Balancing cortisol levels is a process of recovery to normal values, which indicates the restoration of neurohumoral mechanisms of stress regulation. The effect of balancing cortisol levels was more pronounced in the group of fostered children compared to the group of orphanage children (p = 0.0326). The children in the control group had no significant differences.
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Affiliation(s)
- Elena I Nikolaeva
- Herzen State pedagogical University, Saint-Petersburg, Russian Federation; Pushkin State Russian Language Institute, Moscow, Russian Federation
| | - Eva A Dydenkova
- Minin University, Nizhny Novgorod, Russian Federation; Pushkin State Russian Language Institute, Moscow, Russian Federation.
| | - Larisa A Mayorova
- Pushkin State Russian Language Institute, Moscow, Russian Federation; Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Science, Moscow, Russian Federation
| | - Galina V Portnova
- Pushkin State Russian Language Institute, Moscow, Russian Federation; Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Science, Moscow, Russian Federation
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Sato Y, Kamei A, Endo F, Matsuyama S, Toda H, Kasai T. Vitamin D Supplementation at a Dose of 10 µg/Day in Institutionalized Children with Severe Motor and Intellectual Disabilities. Nutrients 2023; 16:122. [PMID: 38201951 PMCID: PMC10780696 DOI: 10.3390/nu16010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/13/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Vitamin D (VD) deficiency can lead to health-related consequences. This study determined the effects of VD administration in VD-deficient children with severe motor and intellectual disabilities (SMID). Twenty-eight subjects were included. Among them, 25 subjects with parental consent for VD administration were given 10 µg/day (400 IU/day) of VD in April 2021. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured at least 30 days after the start of VD administration. The total VD intake, serum 25(OH)D levels, and ultraviolet (UV) exposure before the blood tests were investigated. The results showed that the median serum 25(OH)D levels were 8.7 ng/mL (4.3-17.2) and 24.0 ng/mL (7.8-39 ng/mL) from March to May in 2020 and 2021, respectively. Among the 25 subjects, 22 with UV exposure had >20 ng/mL serum 25(OH)D level, and 2 without UV exposure had <20 ng/mL serum 25(OH)D level. Three subjects who did not receive VD supplementation had <20 ng/mL serum 25(OH)D level. Taken together, VD supplementation (10 µg/day) is effective in children with SMID in institutional care. Moreover, it may be sufficient for children with UV exposure, but not for those without.
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Affiliation(s)
- Yota Sato
- Nutrition Support Team, Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, Iwate 028-3603, Japan
- Department of Pediatrics, Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, Iwate 028-3603, Japan
| | - Atsushi Kamei
- Department of Developmental Disability Medicine, School of Medicine, Iwate Medical University, Morioka 028-3694, Japan
| | - Fumie Endo
- Nutrition Support Team, Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, Iwate 028-3603, Japan
| | - Sakura Matsuyama
- Nutrition Support Team, Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, Iwate 028-3603, Japan
| | - Hiroyuki Toda
- Department of Pediatrics, Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, Iwate 028-3603, Japan
| | - Takeo Kasai
- Department of Pediatrics, Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, Iwate 028-3603, Japan
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Njoku MO, Iloh KK, Okike CO, Njoku GC, Iloh ON, Ojinnaka NC. Intestinal Helminthiasis: Risk factors and relationship with Nutritional status and Anaemia among Institutionalised Children in three States of South-East Nigeria. West Afr J Med 2023; 40:1262-1273. [PMID: 38099563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Intestinal helminthiasis occurs in sub-optimal living conditions with poor hygiene practices and is more prevalent in rural, suburban and institutionalized centres. Heavy helminthic burden negatively affects the nutritional status and the severity of anaemia among children living in orphanages. AIM To determine the risk factors and relationship of intestinal helminthiasis with nutritional status and anaemia among institutionalized children in three states of South-East Nigeria. METHODS A cross-sectional study was conducted over seven months involving 198 children recruited from orphanages in Anambra, Ebonyi and Enugu states. Their stool samples were analyzed using the Kato-Katz and Ether concentration techniques, and packed cell volume and anthropometric indices were documented. Data were analyzed. RESULTS Of the 198 children, 109 (55.1%) were females with a median age of 2.5 years and interquartile range (3 months - 17 years). The prevalence of intestinal helminthiasis was 2.5%. Among the children that had intestinal helminthiasis, 4 (80%) had mono-parasitism with Ascaris lumbricoides, while 1 (20%) had mixed infestation of Ascaris lumbricoides and Trichuris trichiura. There was a significant association (p=0.01) between being infested with intestinal helminthiasis and caregiver handwashing practices. The anthropometric indices demonstrated that 5.6%, 6.6% and 13.1% of the children were underweight, wasted and stunted respectively. No helminth-infested child had malnutrition and only 1 (20%) infested child had moderate anaemia. CONCLUSION Caregivers' good handwashing practice was associated with reduced prevalence of intestinal infestations and should be encouraged. There was no relationship found between the presence of helminthic infestations and nutritional status or anaemia among the institutionalised children.
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Affiliation(s)
- M O Njoku
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi, State, Nigeria
| | - K K Iloh
- Department of Paediatrics, University of Nigeria Teaching Hospital/University of Nigeria, Enugu, Enugu State, Nigeria. ; +23408038813454
| | - C O Okike
- Department of Paediatrics, Federal Medical Centre Asaba, Delta State, Nigeria
| | - G C Njoku
- Laboratory Scientist, Grace Gate Hospital and Maternity Ndufu Echara Ikwo, Ebonyi State, Nigeria
| | - O N Iloh
- Department of Paediatrics, University of Nigeria Teaching Hospital/University of Nigeria, Enugu, Enugu State, Nigeria. ; +23408038813454
| | - N C Ojinnaka
- Department of Paediatrics, University of Nigeria Teaching Hospital/University of Nigeria, Enugu, Enugu State, Nigeria. ; +23408038813454
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Matias AR, Santos GD, Almeida N. Equine-Assisted Therapeutic Intervention in Institutionalized Children: Case Studies. Int J Environ Res Public Health 2023; 20:2846. [PMID: 36833542 PMCID: PMC9956268 DOI: 10.3390/ijerph20042846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
A significant number of institutionalized children have behavior problems. Socio-emotional skills are fundamental for their adaptation and success throughout life and are usually weakened in this population. Equine-assisted services (EAS) are a form of therapeutic mediation that facilitates and requires the practitioner's participation, contributing to the promotion of various psychomotor and socio-emotional dimensions. This study was developed during 17 sessions of EAS with a psychomotor intervention, which took place individually and weekly and lasted approximately 45 min, with three institutionalized children. A quantitative and qualitative assessment was carried out before and after the intervention to study the effects of an EAS intervention on socio-emotional competencies in the three institutionalized children. There was an improvement in skills, with an impact on intrapersonal skills and marked improvement in self-regulation and self-control, in addition to an improvement in the intentionality of movement and adequacy of gesture to the context. This type of intervention underlies a renewed educational and therapeutic approach, contributing to mental health promotion in this population.
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Affiliation(s)
- Ana Rita Matias
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000 Évora, Portugal
| | - Graça Duarte Santos
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000 Évora, Portugal
| | - Nicole Almeida
- Psychomotor Therapist at T-Terapias, 2500 Caldas da Rainha, Portugal
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Wade M, McLaughlin KA, Buzzell GA, Fox NA, Zeanah CH, Nelson CA. Family-based care buffers the stress sensitizing effect of early deprivation on executive functioning difficulties in adolescence. Child Dev 2023; 94:e43-e56. [PMID: 36254858 PMCID: PMC9828738 DOI: 10.1111/cdev.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We examined whether family care following early-life deprivation buffered the association between stressful life events (SLEs) and executive functioning (EF) in adolescence. In early childhood, 136 institutionally reared children were randomly assigned to foster care or care-as-usual; 72 never-institutionalized children served as a comparison group. At age 16 years, adolescents (n = 143; 54% female; 67.1% Romanian) self-reported recent SLEs, completed a battery of memory and EF tasks, and completed a go/nogo task in which mediofrontal theta power (MFTP) was measured using electroencephalogram. More independent SLEs predicted lower EF and more dependent SLEs predicted lower MFTP, but only among adolescents with prolonged early deprivation. Findings provide preliminary evidence that family care following early deprivation may facilitate resilience against stress during adolescence on EF.
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Affiliation(s)
- Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto
| | | | | | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | - Charles H. Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine
| | - Charles A. Nelson
- Boston Children’s Hospital of Harvard Medical School
- Harvard Graduate School of Education
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Reid BM, Zhong D, Donzella B, Howland M, Moua B, Gunnar MR. Does rapid rebound height growth come at a neurocognitive cost for previously institutionalized youth? J Child Psychol Psychiatry 2022; 63:1434-1444. [PMID: 35253222 DOI: 10.1111/jcpp.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Height growth faltering is associated with less optimal behavioral outcomes and educational achievement. Although catch-up growth after growth delay may result in developmental gains, it may also present as a double-edged sword, with consequences for neurocognitive functioning such as symptoms of inattention and hyperactivity. As previously institutionalized (PI) children experience height delays at adoption and catch-up growth after adoption, they provide a cohort to test associations between catch-up growth and attention deficit hyperactivity disorder (ADHD) symptoms. METHODS This study used latent growth curve modeling to examine how catch-up in height-for-age growth is related to attention problems in a population of PI youth followed from adoption in infancy through kindergarten. Participants were assessed within three months of arrival into their families (age at entry: 18-36 months). Anthropometrics were measured four times, approximately 7 months apart. Two visits measured behavioral outcomes with parent and teacher reports of ADHD, internalizing, and externalizing symptoms at age 5 and kindergarten. RESULTS The slope of growth in height z-scores, but not the intercept, was positively associated with parent- and teacher-reported ADHD symptoms in children. A one standard deviation increase in the slope of height z-scores across four assessments was associated with a 0.252 standard deviation increase in ADHD symptoms after controlling for internalizing and externalizing problems, iron status, duration of institutional care, sex, and age. The slope of growth was also associated with internalizing but not externalizing symptoms. CONCLUSIONS This study demonstrates that PI children exhibit individual trajectories of height growth postadoption. Higher rates of change in height-for-age growth were associated with increased ADHD symptoms. These results suggest that catch-up growth comes 'at the cost' of poor attention regulation and hyperactive behavior.
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Affiliation(s)
- Brie M Reid
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Danruo Zhong
- Institute of Child Development, University of Minnesota Twin-Cities, Minneapolis, MN, USA
| | - Bonny Donzella
- Institute of Child Development, University of Minnesota Twin-Cities, Minneapolis, MN, USA
| | - Mariann Howland
- Institute of Child Development, University of Minnesota Twin-Cities, Minneapolis, MN, USA
| | - Bao Moua
- Institute of Child Development, University of Minnesota Twin-Cities, Minneapolis, MN, USA
| | - Megan R Gunnar
- Institute of Child Development, University of Minnesota Twin-Cities, Minneapolis, MN, USA
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Al-Awadi AAH, Abdul-Ghani R, Al-Mekhlafi AM. Toxoplasma gondii Infection Among Institutionalized Children with Down syndrome in Sana'a city, Yemen: Implications of Low IgG Seroprevalence. Acta Parasitol 2022; 67:530-534. [PMID: 34623612 PMCID: PMC8499612 DOI: 10.1007/s11686-021-00473-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
Purpose To assess the IgG seroprevalence of Toxoplasma gondii as an indicator of past exposure and immunity against infection among children with Down syndrome (DS) in Sana’a city, Yemen. This preliminary study is justified by the primary immunodeficiency of children with DS and the opportunistic nature of the parasite, considering the vague situation of anti-Toxoplasma IgG seroprevalence among children with DS because of neglecting its study on local and global scales. Methods This descriptive, facility-based, cross-sectional study was conducted among 107 children with DS hosted in six randomly selected rehabilitation centers for children with special needs in Sana’a city. Demographics of children and their mothers’ knowledge of toxoplasmosis were collected using a pre-designed, structured questionnaire. Anti-Toxoplasma IgG antibodies were measured in the sera of children using electrochemiluminescence assay. Results Of 107 children with DS, 3 (2.8%) were seropositive for anti-Toxoplasma IgG. Approximately two-thirds (71/106) of the mothers of children with DS were aware of toxoplasmosis. Of whom, 83.1% (59/71) were aware of its congenital complications. Conclusion The majority of children with DS in Sana’a city are seronegative for anti-Toxoplasma IgG, where the seropositivity rate is lower than 3.0%. Therefore, children with DS are non-immune and susceptible to the acquisition of primary infections during their life. Further analytical studies are recommended to determine whether the defective immune response of children with DS is associated with false seronegativity, to assess the role of their mothers’ knowledge in reducing their exposure to infection if they were confirmed truly seronegative and to identify the predictors of infection among them.
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Affiliation(s)
- Asmaa A H Al-Awadi
- Department of Medical Laboratories, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen
| | - Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
- Tropical Disease Research Center, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen.
| | - Abdulsalam M Al-Mekhlafi
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
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Berkvens JJL, Mergler S, Beerhorst K, Verschuure P, Tan IY, Majoie HJM, van den Bergh JPW. Bone mineral density and fractures in institutionalised children with epilepsy and intellectual disability. J Intellect Disabil Res 2021; 65:962-970. [PMID: 34472148 DOI: 10.1111/jir.12880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Long-term use of antiseizure drugs is associated with a low bone mineral density (BMD) and an increased fracture risk. The literature regarding institutionalised children on chronic antiseizure drugs is limited. Therefore, the aim of this cross-sectional study is to evaluate the prevalence of low BMD and the history of fractures in institutionalised children with epilepsy and intellectual disability (ID). METHODS A dual-energy X-ray absorptiometry of lumbar spine (L1-L4) and hip was performed in 24 children, residing in a long-stay care facility in the Netherlands. Additionally, serum concentrations of albumin, calcium and 25-hydroxyvitamin D were determined. Data on fractures were retrospectively extracted from the medical files. RESULTS Ages of the children (14 male and 10 female) ranged from 5 to 17 years with a mean age of 13.0 (±3.2). The criteria of the International Society for Clinical Densitometry (ISCD) were used for classification of bone mineral disorders. Eight (33.3%) children had a normal BMD (Z-score > - 2.0). Of the 16 children with a low BMD (Z-score ≤ - 2.0), three were diagnosed as osteoporotic, based on their fracture history. Ten children (41.7%) were reported to have at least one fracture in their medical history. Serum concentrations of albumin-corrected calcium (2.28-2.50 mmol/L) and (supplemented) vitamin D (16-137 nmol/L) were within the normal range. CONCLUSIONS This study demonstrated that 67% of institutionalised children with epilepsy and ID had low BMD and 42% had a history of at least one fracture, despite supplementation of calcium and vitamin D in accordance with the Dutch guidelines.
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Affiliation(s)
- J J L Berkvens
- Department of Residential Care, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands
| | - S Mergler
- Medical Department, ASVZ, Care and Service Centre for People with Intellectual Disabilities, Sliedrecht, The Netherlands
- Department of General Practice and Intellectual Disability Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - K Beerhorst
- Department of Neurology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - P Verschuure
- Laboratory for Clinical Chemistry and Pharmacology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands
| | - I Y Tan
- Department of Residential Care, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands
| | - H J M Majoie
- Department of Neurology, Academic Centre for Epileptology Kempenhaeghe, Maastricht University Medical Centre, Heeze, The Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - J P W van den Bergh
- Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
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Brubacher SP, van Doore KE, Powell M. Responding to orphanage trafficking from an information gathering perspective. Child Abuse Negl 2021; 120:105222. [PMID: 34364174 DOI: 10.1016/j.chiabu.2021.105222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/17/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
Estimates suggest that close to 3 million institutionalized children internationally have some family to whom they could go home. A proportion of these children is recruited from their communities under false pretenses and has false documentation that describes them as legal orphans. The orphanages where they live exploit them on the basis of their orphanhood. These children are known as paper orphans. The aim of the current article is to provide a profile of their origins and networks based on current available evidence, from an investigative interviewing perspective. Increased discussion and research of this problem will assist in supporting efforts towards reunification of children with families, investigations by law enforcement into orphanages, and successful prosecution of orphanage trafficking. The article provides an overview of the orphanage trafficking context, followed by a comparison of orphanage trafficking victims with other child trafficking victims from the perspective of investigative needs. Investigative needs are outlined with respect to two primary groups who would interview paper orphans and other involved parties (e.g., birth parents, orphanage staff)-law enforcement and reunification officers. In the final section of the article, we encourage further research on orphanage trafficking and provide initial guidance for interviewing in this unique context. This paper serves as a step to raise further awareness of paper orphans, orphanage trafficking, and the specific characteristics of their cases that affect research and planning into how to identify and interview them and others involved.
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Affiliation(s)
- Sonja P Brubacher
- Centre for Investigative Interviewing, Griffith Criminology Institute, Griffith University, QLD, Australia.
| | | | - Martine Powell
- Centre for Investigative Interviewing, Griffith Criminology Institute, Griffith University, QLD, Australia
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Howland MA, Donzella B, Miller BS, Gunnar MR. Pubertal recalibration of cortisol-DHEA coupling in previously-institutionalized children. Horm Behav 2020; 125:104816. [PMID: 32649929 PMCID: PMC7543053 DOI: 10.1016/j.yhbeh.2020.104816] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 12/16/2022]
Abstract
As a period of heightened plasticity, puberty may provide a window of opportunity for recalibration of the hypothalamic-pituitary-adrenal (HPA) axis to current conditions. Our group has recently documented evidence for pubertal recalibration of HPA axis reactivity among children internationally adopted as infants from institutions into supportive, well-resourced homes. As a first step at examining potential mechanisms by which puberty may facilitate recalibration of the HPA axis, the current study assessed whether previously-institutionalized (PI) children differed from non-adopted (NA) comparison children in levels of the adrenal steroid hormone dehydroepiandrosterone (DHEA) and in its intra-individual covariation (coupling) with cortisol by adrenal pubertal stage. In an accelerated longitudinal design, 7- to 15-year-olds completed up to 3 annual assessments, which included nurse-conducted pubertal staging and the Modified Trier Social Stress Test for Children (TSST-M). Adrenal (pubic hair) rather than gonadal pubertal stage scores were used in the analysis. Paired salivary cortisol-DHEA samples were available at 60-80 min post-TSST-M. NA and PI children did not differ in DHEA levels, which were higher among children at more advanced pubertal stages (averaged across the sessions) for both groups. For NA children, post-stressor cortisol and DHEA were positively coupled across sessions at all average adrenal pubertal stages. For PI children who were, on average, at earlier adrenal pubertal stages, post-stressor cortisol and DHEA were not coupled, but PI children who were at later pubertal stages demonstrated positive cortisol-DHEA coupling similar to that of the NA children. We suggest that these findings provide insights into processes which may underlie pubertal recalibration of the HPA axis.
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Affiliation(s)
- Mariann A Howland
- Institute of Child Development, University of Minnesota - Twin Cities, United States of America.
| | - Bonny Donzella
- Institute of Child Development, University of Minnesota - Twin Cities, United States of America
| | - Bradley S Miller
- Department of Pediatrics, University of Minnesota - Twin Cities, United States of America
| | - Megan R Gunnar
- Institute of Child Development, University of Minnesota - Twin Cities, United States of America
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11
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Longfield A. Children in institutional settings. Lancet Child Adolesc Health 2020; 4:563-565. [PMID: 32589870 DOI: 10.1016/s2352-4642(20)30185-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Anne Longfield
- Children's Commissioner for England, London, UK, SW1P 3BT.
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12
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Boyce N, Godsland J, Sonuga-Barke E. Institutionalisation and deinstitutionalisation of children: the Executive Summary from a Lancet Group Commission. Lancet Child Adolesc Health 2020; 4:562-563. [PMID: 32589874 DOI: 10.1016/s2352-4642(20)30089-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London SE5 8AB, UK.
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Sheridan G, Carr A. Survivors' lived experiences of posttraumatic growth after institutional childhood abuse: An interpretative phenomenological analysis. Child Abuse Negl 2020; 103:104430. [PMID: 32143090 DOI: 10.1016/j.chiabu.2020.104430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 12/10/2019] [Accepted: 02/18/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Institutional childhood abuse (ICA) represents a chronic and severe form of childhood maltreatment and is associated with a host of adverse outcomes. However, there is some evidence to suggest that survivors can also experience positive psychological change after institutional childhood abuse and neglect. OBJECTIVE To examine the lived experiences of posttraumatic growth (PTG) in adult survivors of institutional childhood abuse. PARTICIPANTS AND SETTING Nine survivors of historical institutional abuse in Ireland ranging in age from 41 to 75 years (M = 60.5). METHOD Semi-structured interviews were conducted to explore survivors' experiences of positive change after institutional upbringing. Data were analysed in the tradition of interpretative phenomenological analysis (IPA). RESULTS The analysis yielded two superordinate themes. The first major theme, 'Survivor Identity' described participant's subjective understanding of their survivorship through five subthemes. The second major theme, 'Engendering Growth' comprised seven subthemes which collectively identified key factors and processes related to positive change and posttraumatic growth after significant early-life maltreatment. CONCLUSIONS Findings underscore the importance of supporting survivors to construct a comprehensive self-narrative that identifies their personal strengths and growthful experiences, whilst also acknowledging the continued distress associated with their unique survivorship trajectory.
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Affiliation(s)
- Grace Sheridan
- School of Psychology, University College Dublin, Ireland.
| | - Alan Carr
- School of Psychology, University College Dublin, Ireland
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Muros JJ, Cabrera-Vique C, Briones M, Seiquer I. Assessing the dietary intake of calcium, magnesium, iron, zinc and copper in institutionalised children and adolescents from Guatemala. Contribution of nutritional supplements. J Trace Elem Med Biol 2019; 53:91-97. [PMID: 30910214 DOI: 10.1016/j.jtemb.2019.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/23/2022]
Abstract
In childhood and adolescence an adequate mineral intake is essential for normal growth and immune function, and to prevent chronic diseases in adulthood. The aim of this study was to analyse the dietary intake of Ca, Mg, Fe, Zn and Cu in children and adolescents from an orphanage-school in Guatemala and to assess the mineral contribution of nutritional supplements used by this population. Mineral content was analysed in nutritional supplements, bioaccesible fractions obtained after an in vitro gastrointestinal method, and diets sampled by a 7-day duplicate diet study. The average mineral content in the duplicate diets, including supplements, was (mg/d): Ca 452, Mg 230, Fe 25, Zn 8 and Cu 0.22. Especially Ca and Cu values were below recommended daily intakes. The content of these minerals in the nutritional supplements (mg/serving) was 49-112 for Ca, 1.2-3.8 for Fe, 24-47 for Mg, 0.7-4.16 for Zn and 0.08-0.23 for Cu. A great proportion of dietary minerals was provided by supplements, the contribution of which was: Ca 53.1%, Mg 58.4%, Fe 27.6%. Zn 82.2% and Cu 98.5%. Mineral bioaccessibility in supplements was particularly low for Ca and, to a lesser extent, for Fe and Zn. In spite of the high supplement consumption (up to 4 servings/d) important mineral deficiencies were detected in the diet of institutionalised children. Findings suggest that formulation and nutritional values of supplements used in Latin America should be carefully reviewed, in order to be a useful tool in the prevention and treatment of hidden hunger.
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Affiliation(s)
- José Joaquín Muros
- Department of Nutrition and Food Science. Faculty of Pharmacy, University of Granada, Spain.
| | - Carmen Cabrera-Vique
- Department of Nutrition and Food Science. Faculty of Pharmacy, University of Granada, Spain
| | - Mercedes Briones
- Department of Nutrition and Food Science. Faculty of Pharmacy, University of Granada, Spain
| | - Isabel Seiquer
- Department of Physiology and Biochemistry of Animal Nutrition, Estación Experimental del Zaidín (CSIC), Granada, Spain
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Naumova OY, Rychkov SY, Kornilov SA, Odintsova VV, Anikina VО, Solodunova MY, Arintcina IA, Zhukova MA, Ovchinnikova IV, Burenkova OV, Zhukova OV, Muhamedrahimov RJ, Grigorenko EL. Effects of early social deprivation on epigenetic statuses and adaptive behavior of young children: A study based on a cohort of institutionalized infants and toddlers. PLoS One 2019; 14:e0214285. [PMID: 30913238 PMCID: PMC6435191 DOI: 10.1371/journal.pone.0214285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/11/2019] [Indexed: 12/15/2022] Open
Abstract
Early social deprivation (i.e., an insufficiency or lack of parental care) has been identified as a significant adverse early experience that may affect multiple facets of child development and cause long-term outcomes in physical and mental health, cognition and behavior. Current research provides growing evidence that epigenetic reprogramming may be a mechanism modulating these effects of early adversities. This work aimed to investigate the impact of early institutionalization—the immersion in an extreme socially depriving environment in humans—on the epigenome and adaptive behavior of young children up to 4 years of age. We conducted a cross-sectional study involving two comparison groups: 29 children raised in orphanages and 29 children raised in biological families. Genome-wide DNA methylation profiles of blood cells were obtained using the Illumina MethylationEPIC array; the level of child adaptive functioning was assessed using the Vineland Adaptive Behavior Scales-II. In comparison to children raised in families, children residing in orphanages had both statistically significant deficits in multiple adaptive behavior domains and statistically significant differences in DNA methylation states. Moreover, some of these methylation states may directly modulate the behavioral deficits; according to preliminary estimates, about 7–14% of the deviation of adaptive behavior between groups of children may be determined by their difference in DNA methylation profiles. The duration of institutionalization had a significant impact on both the adaptive level and DNA methylation status of institutionalized children.
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Affiliation(s)
- Oxana Yu. Naumova
- Human Genetics Laboratory, Vavilov Institute of General Genetics RAS, Moscow, Russian Federation
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
- Department of Psychology, University of Houston, Houston, Texas, United States of America
- * E-mail: (EG); (OYN)
| | - Sergey Yu. Rychkov
- Human Genetics Laboratory, Vavilov Institute of General Genetics RAS, Moscow, Russian Federation
| | - Sergey A. Kornilov
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
- Department of Psychology, University of Houston, Houston, Texas, United States of America
| | - Veronika V. Odintsova
- Department of Biological Psychology, VU University, Amsterdam, Netherlands
- National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
- Federal Research Institute for Health Organization and Informatics, Moscow, Russia
| | - Varvara О. Anikina
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | - Maria Yu. Solodunova
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | - Irina A. Arintcina
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | - Marina A. Zhukova
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | - Irina V. Ovchinnikova
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | - Olga V. Burenkova
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
- Department of Psychology, University of Houston, Houston, Texas, United States of America
| | - Olga V. Zhukova
- Human Genetics Laboratory, Vavilov Institute of General Genetics RAS, Moscow, Russian Federation
| | - Rifkat J. Muhamedrahimov
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | - Elena L. Grigorenko
- Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
- Department of Psychology, University of Houston, Houston, Texas, United States of America
- Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail: (EG); (OYN)
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16
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Kopetz C, Woerner JI, MacPherson L, Lejuez CW, Nelson CA, Zeanah CH, Fox NA. Early psychosocial deprivation and adolescent risk-taking: The role of motivation and executive control. J Exp Psychol Gen 2019; 148:388-399. [PMID: 30221961 PMCID: PMC7181402 DOI: 10.1037/xge0000486] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Risk-taking in adolescence has been often associated with early life adversities. However, the impact of such macrolevel factors on risk behavior has been rarely studied in humans. To address these gaps we recruited a sample of young adolescents who were part of a randomized control trial of foster care. Children institutionalized at or soon after birth were randomly assigned either to be removed from institutions and placed into a family or foster care intervention or to remain in institutions receiving care as usual. These children were subsequently followed up through 12 years of age and compared with a sample of children who had never been institutionalized. Using this sample, we examined the impact of early childhood deprivation on risk-taking behavior and explored the role of motivation (i.e., sensation seeking) and executive control (i.e., planning). Early psychosocial deprivation decreased engagement in risk-taking among young adolescents by reducing sensation seeking, a motivation often associated with risk-taking in adolescence. The impact of early psychosocial deprivation on sensation seeking and consequently on engagement in risk-taking was further reduced by its deleterious effects on executive control. These findings challenge the traditional view according to which risk behavior is a maladaptive response to adversities and suggest that it may represent adolescents' attempts to fulfill important motivations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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17
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Johnson DE, Tang A, Almas AN, Degnan KA, McLaughlin KA, Nelson CA, Fox NA, Zeanah CH, Drury SS. Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial. J Pediatr 2018; 203:345-353.e3. [PMID: 30172435 PMCID: PMC6271564 DOI: 10.1016/j.jpeds.2018.07.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence. STUDY DESIGN This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5-31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development. RESULTS Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions. CONCLUSIONS For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental. TRIAL REGISTRATION clinicaltrials.gov: NCT00747396.
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Affiliation(s)
- Dana E Johnson
- Division of Neonatology and Global Pediatrics, Department of Pediatrics, University of Minnesota Medical School, Minnesota, MN.
| | - Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Alisa N Almas
- The Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia
| | - Kathryn A Degnan
- Department of Psychology, Catholic University of America, Washington, DC
| | | | - Charles A Nelson
- Harvard Graduate School of Education, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Cambridge, MA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Charles H Zeanah
- Department of Psychiatry, Tulane University Health Science Center, New Orleans, LA
| | - Stacy S Drury
- Department of Psychiatry, Tulane University Health Science Center, New Orleans, LA
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18
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Tang A, Slopen N, Nelson CA, Zeanah CH, Georgieff MK, Fox NA. Catch-up growth, metabolic, and cardiovascular risk in post-institutionalized Romanian adolescents. Pediatr Res 2018; 84:842-848. [PMID: 30323348 PMCID: PMC6330119 DOI: 10.1038/s41390-018-0196-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reduced prenatal growth followed by rapid postnatal weight gain are risk factors for developing metabolic and cardiovascular disease. Children reared in institutions experience a similar pattern of growth restriction followed by catch-up growth after removal. We explored whether patterns of catch-up growth affect metabolic and cardiovascular outcomes in previously institutionalized adolescents. METHOD A longitudinal study of institutionalized infants randomized to care as usual (n = 68) or foster care intervention (n = 68), and never institutionalized controls (n = 127). Body mass index (BMI) was measured at baseline (20 months), 30, 42 months, and ages 8, 12, 16. At age 16, metabolic and pro-inflammatory markers were derived from blood samples. RESULTS Four BMI trajectories were derived (i.e., average-stable, low-stable, elevated, and accelerated). The accelerated trajectory was comprised predominately of children randomized to foster care, who also exhibited higher levels of glycosylated hemoglobin and C-reactive protein than the other three trajectories. Also, children placed in foster care at younger ages were more likely to be on the accelerated rather than the average-stable trajectory. CONCLUSIONS Although catch-up growth is viewed as a positive improvement among post-institutionalized children, rapid/continuous increases in body size pose a health concern. Attention should be given to monitoring weight gain, diet, and physical activity.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Natalie Slopen
- Shool of Public Health, University of Maryland, College Park, MD, USA
| | - Charles A Nelson
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Michael K Georgieff
- Department of Pediatrics, Institute of Child Development, and Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN, USA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA.
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19
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Fareri DS, Gabard-Durnam L, Goff B, Flannery J, Gee DG, Lumian DS, Caldera C, Tottenham N. Altered ventral striatal-medial prefrontal cortex resting-state connectivity mediates adolescent social problems after early institutional care. Dev Psychopathol 2017; 29:1865-1876. [PMID: 29162189 PMCID: PMC5957481 DOI: 10.1017/s0954579417001456] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Early caregiving adversity is associated with increased risk for social difficulties. The ventral striatum and associated corticostriatal circuitry, which have demonstrated vulnerability to early exposures to adversity, are implicated in many aspects of social behavior, including social play, aggression, and valuation of social stimuli across development. Here, we used resting-state functional magnetic resonance imaging to assess the degree to which early caregiving adversity was associated with altered coritocostriatal resting connectivity in previously institutionalized youth (n = 41) relative to youth who were raised with their biological families from birth (n = 47), and the degree to which this connectivity was associated with parent-reported social problems. Using a seed-based approach, we observed increased positive coupling between the ventral striatum and anterior regions of medial prefrontal cortex (mPFC) in previously institutionalized youth. Stronger ventral striatum-mPFC coupling was associated with parent reports of social problems. A moderated-mediation analysis showed that ventral striatal-mPFC connectivity mediated group differences in social problems, and more so with increasing age. These findings show that early institutional care is associated with differences in resting-state connectivity between the ventral striatum and the mPFC, and this connectivity seems to play an increasingly important role in social behaviors as youth enter adolescence.
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Affiliation(s)
- Dominic S. Fareri
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY 11530
| | | | - Bonnie Goff
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA 90095
| | - Jessica Flannery
- Department of Psychology, University of Oregon, Eugene, OR 97403
| | - Dylan G. Gee
- Department of Psychology, Yale University, New Haven, CT 06511
| | - Daniel S. Lumian
- Department of Psychology, University of Denver, Denver, CO 80208
| | - Christina Caldera
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA 90095
| | - Nim Tottenham
- Department of Psychology, Columbia University, New York, NY 10027
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20
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Bentaleb D. [Placement, a therapeutic act]. Soins Pediatr Pueric 2017; 38:22-23. [PMID: 28499477 DOI: 10.1016/j.spp.2017.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Any proposed placement of a child is carried out with the aim of providing protection as well as care. The therapeutic aspect is not straightforward, as it comes up against the repetition of situations, the anxiety and the defences of all concerned. In these complex situations, it is essential to provide suitable care to the child and their parents.
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Affiliation(s)
- Djamila Bentaleb
- Pouponnière, Établissement public départemental Le Charmeyran, 9 chemin Duhamel, 38700 La Tronche, France.
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21
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Maldera D. [A scheme to support teenagers in care]. Soins Pediatr Pueric 2017; 38:38-40. [PMID: 28499482 DOI: 10.1016/j.spp.2017.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In some family situations, the placement of a teenager, even in the case of a court decision, proves ineffective. The accumulation of all kinds of difficulties requires a different type of support, based on responsiveness, attention and above all time to come together. A dedicated scheme helps to prevent situations of waywardness or marginalisation among these teenagers and to support the families.
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Affiliation(s)
- David Maldera
- Dispositif Sépia, Foyer de l'Enfance Sud Isère, 6 rue Voltaire, 38320 Eybens, France.
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22
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Bonnefoy C, Dreina J. [The place of the parents in an infant care home]. Soins Pediatr Pueric 2017; 38:30-34. [PMID: 28499480 DOI: 10.1016/j.spp.2017.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the infant unit of Chambéry children's home, the organisation of parental visits is the fruit of an institutional project. Practices have changed over the years. The reflection and the responsiveness of the professionals and their desire to create a secure environment for the children and the parents, have enabled them to establish a setting which favours the preservation of the parent-child bond.
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Affiliation(s)
- Christine Bonnefoy
- Foyer départemental de l'enfance, 152 rue Franz-Liszt, 73000 Chambéry, France.
| | - Jeannine Dreina
- Foyer départemental de l'enfance, 152 rue Franz-Liszt, 73000 Chambéry, France
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23
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Prat A. [Supporting the parental function in the case of child placement]. Soins Pediatr Pueric 2017; 38:35-37. [PMID: 28499481 DOI: 10.1016/j.spp.2017.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
When a child is placed in care, it is important that the parents' access visit can take place in an environment which helps to support the parental function. Time remains a major component which professionals must understand in order to support the children and their parents along this long pathway. This article presents the experience of the Diapason service, a meeting place for parents of children in care.
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Affiliation(s)
- Annie Prat
- Établissement public départemental Le Charmeyran, 9 chemin Duhamel, 38700 La Tronche, France.
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24
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Rapoport D. ["Opération pouponnières", yesterday and today: placement or a living environment?]. Soins Pediatr Pueric 2017; 38:19-21. [PMID: 28499476 DOI: 10.1016/j.spp.2017.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
For several decades, major progress has been made in changing and improving living conditions for children placed in an infant care home. From hospitalism to the emergence of the concept of compassionate care, professionals have constantly striven to support this evolution.
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Affiliation(s)
- Danielle Rapoport
- Association Bien-traitance, formation et recherches, 30 rue Erard, 75012 Paris, France.
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25
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Gaudin É, Guérault D. [The nurse and child health nurse at the heart of the care in an infant care home]. Soins Pediatr Pueric 2017; 38:24-26. [PMID: 28499478 DOI: 10.1016/j.spp.2017.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Infant care homes cater for children up to the age of 3. The work of the nurse and the child health nurse lies at the heart of the care project, helping the children to construct themselves and develop. The harmonisation of practices and continuity are essential notions.
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Affiliation(s)
- Élise Gaudin
- c/o Soins Pédiatrie-Puériculture, Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - Delphine Guérault
- c/o Soins Pédiatrie-Puériculture, Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France.
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26
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Castello C. [Different perspectives on caring for a child in an infant care home]. Soins Pediatr Pueric 2017; 38:27-29. [PMID: 28499479 DOI: 10.1016/j.spp.2017.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Caring for a child in an infant care home leads professionals to examine their practices. Perrine Hugel, manager of an infant care home, and Maud Léon, an auxiliary child health nurse in the same home, describes the nursing values which they implement on a daily basis to favour the wellbeing of the infant and support parenthood.
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Affiliation(s)
- Christine Castello
- Établissement public départemental Le Charmeyran, 9 chemin Duhamel, 38700 La Tronche, France.
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27
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28
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Spasennikov BA, Vorobeii SV, Cherkasov SN. [The maternity and childhood care in penal executive system of Russia]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2016; 24:141-144. [PMID: 29553225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Russian Federation pays particular attention to maternity and children care. During the last three years, slight decreasing of number of women held in detention together with children of tender age was marked. This tendency is related to policy of humanization of penalty determination and execution of punishment. At that, number of women with pregnancy at the moment of adjudgement of conviction of court increases. Annually, 3% of women residing in institutions of penal executive system are observed because of pregnancy that results with delivery in curative preventive institutions of the penal executive system in 35% and in medical institutions of municipal and state health care systems in 65% of cases. The newborns of women serving a sentence by way of deprivation of freedom enter Home of Child. The Federal penitentiary service of Russia comprise 13 Homes of Child in female correctional institutions where about 700 children are brought up. The article considers issues of development of organization of medical sanitary support of children of tender age in homes of Child of the penal executive system.
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29
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Tibu F, Sheridan MA, McLaughlin KA, Nelson CA, Fox NA, Zeanah CH. Disruptions of working memory and inhibition mediate the association between exposure to institutionalization and symptoms of attention deficit hyperactivity disorder. Psychol Med 2016; 46:529-541. [PMID: 26470598 PMCID: PMC4739820 DOI: 10.1017/s0033291715002020] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Young children raised in institutions are exposed to extreme psychosocial deprivation that is associated with elevated risk for psychopathology and other adverse developmental outcomes. The prevalence of attention deficit hyperactivity disorder (ADHD) is particularly high in previously institutionalized children, yet the mechanisms underlying this association are poorly understood. We investigated whether deficits in executive functioning (EF) explain the link between institutionalization and ADHD. METHOD A sample of 136 children (aged 6-30 months) was recruited from institutions in Bucharest, Romania, and 72 never institutionalized community children matched for age and gender were recruited through general practitioners' offices. At 8 years of age, children's performance on a number of EF components (working memory, response inhibition and planning) was evaluated. Teachers completed the Health and Behavior Questionnaire, which assesses two core features of ADHD, inattention and impulsivity. RESULTS Children with history of institutionalization had higher inattention and impulsivity than community controls, and exhibited worse performance on working memory, response inhibition and planning tasks. Lower performances on working memory and response inhibition, but not planning, partially mediated the association between early institutionalization and inattention and impulsivity symptom scales at age 8 years. CONCLUSIONS Institutionalization was associated with decreased EF performance and increased ADHD symptoms. Deficits in working memory and response inhibition were specific mechanisms leading to ADHD in previously institutionalized children. These findings suggest that interventions that foster the development of EF might reduce risk for psychiatric problems in children exposed to early deprivation.
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Affiliation(s)
- F. Tibu
- Institute of Child Development, Bucharest, Romania
| | | | | | - C. A. Nelson
- Harvard University, Boston, USA
- Boston Children’s Hospital, Boston, USA
| | - N. A. Fox
- University of Maryland, College Park, USA
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Jahan MU, Karim MR, Rahman A, Akhter S. Cognitive Functions and Health Related Quality of Life of Institutional Autism Spectrum Disorder Children in Dhaka city. Bangladesh Med Res Counc Bull 2015; 41:151-159. [PMID: 29870171 DOI: 10.3329/bmrcb.v41i3.29973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In Bangladesh, nearly 10.5 hundred thousand individuals may have autism. Recent figures released by the CDC (2012) show that autism spectrum disorders (ASDs) now affect 1 in 88 children. Cognitive impairment, limited adaptive skills, and severe social impairment as seen in Autism Spectrum Disorders (ASD) thought to be associated with poorer health related quality of life (HRQoL). The objective of the study was to measure HRQoL and cognitive functioning in a group of autism Spectrum Disorder (ASD) children and to relate HRQoL with their socio demographic characteristics and cognitive functioning from parents' perception. This cross sectional study was conducted amongl49 purposively selected parents who have institutionalized autistic children (2 to 18 years old) from January to June 2013. HRQoL was assessed by Pediatric Quality of Life Inventory 4.0 (Vemil998) and cognitive functioning was assessed with The PedsQL TM Cognitive Functioning Scale. Three fourth of the children were male (n=-115, 77.2%) and the mean (SD) age of the children was 7.8(3.06) years. Symptoms of autism appeared at about their 2rd birthday 2.1 (.70) while the average (SD) age of diagnosis was around three years 2.9 (.98). The children were reported to go to school at an early age of 3(1.75) years. Out of 149 respondents, ten percent parents (n=14) had the history of consanguineous marriage. The sample data provides significant difference between the scores by the ability of verbal communication (p<.05), presence of autistic siblings (p<.05) and mother's occupation (p<.05). There found negative correlation between HRQoL and age of symptom appearance and cognitive functioning with age of diagnosis (r = - 0.18; p=.03). Cognitive functioning was strongly correlated with total PedsQL score and its domains (r = 0.73; p=.00). i.e. Higher cognitive function leads to good health related quality of life. Linear regression was performed to study the relationship between HRQoL and independent variables found significant in univariate analysis. The results of the regression indicated the predictors in the model explained 57 % of the variance (R2=.57, F=23.05, p<.001). It was found that fathers who were doctors and engineers by profession (t=2.34, p= .02), child's ability to communicate with words (t= 2.73, p= .007), age of symptom appearance (t= -2.71, p=.008), and cognitive functioning (t =12.28, p <0.001) significantly predicted HRQol of ASD children. Father's occupational status child's ability to communicate by word, age of symptom appearance, and Cognitive functioning of ASD children were found related to their quality of life.
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Nussbaum S. Inside institutionalization. Author-activist discusses lives of the disabled. Mod Healthc 2013; 43:16. [PMID: 23947099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Fluke JD, Goldman PS, Shriberg J, Hillis SD, Yun K, Allison S, Light E. Systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care. Child Abuse Negl 2012; 36:722-731. [PMID: 23102720 DOI: 10.1016/j.chiabu.2012.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 05/27/2023]
Abstract
OBJECTIVES This article reviews the available evidence regarding the efficacy, effectiveness, ethics, and sustainability of approaches to strengthen systems to care for and protect children living outside family care in low- and middle-income countries. METHOD For trafficked children, children of and on the street, children of conflict/disaster, and institutionalized children, a systems framework approach was used to organize the topic of sustainable approaches in low- and middle-income countries and addresses the following: legislation, policies, and regulations; system structures and functions (formal and informal); and continuum of care and services. The article draws on the findings of a focal group convened by the U.S. Government Evidence Summit: Protecting Children Outside of Family Care (December 12-13, 2011, Washington, DC), tasked with reviewing the literature on systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care in low- and middle-income country contexts. The specific methodology for the review is described in the commentary paper (Higgs, Zlidar, & Balster, 2012) that accompanies these papers. RESULTS For the most part, the evidence base in support of sustainable long-term care for the populations of interest is relatively weak, with some stronger but unreplicated studies. Some populations have been studied more thoroughly than others, and there are many gaps. Most of the existing studies identify population characteristics, needs, and consequences of a lack of systemic services to promote family-like care. There is some evidence of the effectiveness of laws and policies, as well as some evidence of service effectiveness, in improving outcomes for children outside of family care. CONCLUSIONS Despite the weaknesses and gaps of the existing research, there is a foundation of research for going forward, which should focus on developing and implementing systems for these most vulnerable children. The evidence reviewed indicates that child protection systems should aim for appropriate, permanent family care (including reunification, adoption, kinship care, or kafalah) for children in order to secure the best environment for a child's developmental prospects. Evidence also suggests that the quality and duration of care, including both permanent family care and alternative care, are important regardless of setting. The diversity of political, socioeconomic, historical, regional, community, and cultural contexts in which child protection systems operate need to be taken into account during programming and research design.
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Affiliation(s)
- John D Fluke
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA
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Drury SS, Theall K, Gleason MM, Smyke AT, De Vivo I, Wong JYY, Fox NA, Zeanah CH, Nelson CA. Telomere length and early severe social deprivation: linking early adversity and cellular aging. Mol Psychiatry 2012; 17:719-27. [PMID: 21577215 PMCID: PMC3518061 DOI: 10.1038/mp.2011.53] [Citation(s) in RCA: 244] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/22/2011] [Accepted: 03/28/2011] [Indexed: 12/25/2022]
Abstract
Accelerated telomere length attrition has been associated with psychological stress and early adversity in adults; however, no studies have examined whether telomere length in childhood is associated with early experiences. The Bucharest Early Intervention Project is a unique randomized controlled trial of foster care placement compared with continued care in institutions. As a result of the study design, participants were exposed to a quantified range of time in institutional care, and represented an ideal population in which to examine the association between a specific early adversity, institutional care and telomere length. We examined the association between average relative telomere length, telomere repeat copy number to single gene copy number (T/S) ratio and exposure to institutional care quantified as the percent of time at baseline (mean age 22 months) and at 54 months of age that each child lived in the institution. A significant negative correlation between T/S ratio and percentage of time was observed. Children with greater exposure to institutional care had significantly shorter relative telomere length in middle childhood. Gender modified this main effect. The percentage of time in institutional care at baseline significantly predicted telomere length in females, whereas the percentage of institutional care at 54 months was strongly predictive of telomere length in males. This is the first study to demonstrate an association between telomere length and institutionalization, the first study to find an association between adversity and telomere length in children, and contributes to the growing literature linking telomere length and early adversity.
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Affiliation(s)
- S S Drury
- Department of Psychiatry, Tulane University, New Orleans, LA, USA.
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Abstract
AIM This study sought to examine the effect of environmental enrichment on the motor skills of children adopted from orphanage settings. We investigated balance and bilateral coordination skills in 33 internationally adopted postinstitutionalized children (16 males, 17 females; age range 8 y 5 mo-15 y 10 mo; mean age 10 y 9 mo; SD 2 y 2 mo) and compared them with 34 non-institutionalized children (21 males, 13 females; age range 8 y 3 mo-14 y 10 mo; mean age 11 y 2 mo; SD 2 y 1 mo) being raised in their birth families. METHOD The children were individually administered the balance and bilateral coordination subtests of the Bruininks-Oseretsky Test of Motor Proficiency in a research laboratory. Parents completed questionnaires about developmental history, family environment, and orphanage care. RESULTS Postinstitutionalized children showed motor system delays compared with the non-institutionalized comparison children (postinstitutionalized balance mean 9.44, SD 5.92, comparison children balance mean 14.12, SD 4.39; postinstitutionalized bilateral coordination mean 11.97, SD 5.43, comparison children mean 19.97, SD 3.97). The length of time that children remained institutionalized before adoption predicted balance delays (b=-1.57, t=-2.33, p=0.027) and the severity of caregiving deprivation the children experienced correlated with bilateral coordination (r=-0.44, p=0.013). INTERPRETATION These findings suggest that institutionalized settings do not provide the early life experiences needed for the development of age-level motor skills later in childhood and that simple environmental enrichment following adoption is not enough to remediate skills. Children who have experienced early institutional care may benefit from early identification and targeted intervention.
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Affiliation(s)
- Barbara J Roeber
- Waisman Center and Department of Psychology, University of Wisconsin-Madison, Madison, WI 53705, USA
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Abstract
PURPOSE In this study, the authors investigated sentence comprehension and spatial working memory abilities in a sample of internationally adopted, postinstitutionalized (PI) children. The authors compared the performance of these PI children with that of an age-matched group of children living with their birth families. They hypothesized that PI children would perform below clinical threshold on tasks of sentence comprehension and that poor sentence comprehension would be associated with poor performance in working memory. METHOD Twenty-three PI children and 36 comparison children were administered sentence comprehension and spatial memory tasks from standardized assessments. RESULTS Some oral sentence comprehension skills and the spatial working memory skills were weaker in the school-age PI children than in the age-matched comparison children. A mediational analysis demonstrated that poor spatial working memory performance partially explains the sentence comprehension differences between the 2 groups. CONCLUSION These findings provide valuable information to better plan early intervention and special education for PI children.
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Clay R, CdeBaca L, De Cock KM, Goosby E, Guttmacher A, Jacobs S, Pablos-Mendez A, Polaski S, Sheldon G, Steinberg D. A call for coordinated and evidence-based action to protect children outside of family care. Lancet 2012; 379:e6-8. [PMID: 22166902 DOI: 10.1016/s0140-6736(11)61821-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Robert Clay
- US Agency for International Development, Washington, DC 20005, USA.
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Ayaz M, Ayaz AB, Başgül SS, Karakaya I, Gülen Şişmanlar S, Yar A, Sentürk E, Dikmen S. Prevelance of mental disorders and associated factors in institutionalized 3-5 year old children. Turk Psikiyatri Derg 2012; 23:82-88. [PMID: 22648870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE In this study, we aimed to determine the prevelance and severity of mental disorders in institutionalized children between the ages of 3-5 years, investigate the factors associated with the mental disorders and compare these findings with the data of a community sample composed of children who were raised by their own families. METHOD Thirty-four children raised in three institutions in Kocaeli were compared with an age- and sex-matched community sample. Children were assessed according to DSM-IV diagnostic criteria. The Socio-demographic information form, and Early Childhood Inventory-4 (ECI-4) parent scale were used for data collection. RESULTS Children that were reared in institutions had evidence of higher rates of mental disorders. In institution-reared children, symptom severity of attention deficit hyperactivity disorder, reactive attachment disorder, oppositional deficient disorder, and pervasive developmental disorder were higher than the community subjects. Age, time spent with father, duration of institutionalization, number of siblings, number of hospital admissions because of physical symptoms and presence of abuse before institutional care were determined to be predictive factors for psychiatric symptoms. CONCLUSION These findings revealed that institutionalized children are at risk for mental disorders and protective measures are as important as instutional care for these children. Our results suggest that essential steps should be taken to protect the mental health of children in institutional care.
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Affiliation(s)
- Muhammed Ayaz
- Sakarya Training and Research Hospital, Child and Adolescent Psychiatry, Sakarya, Turkey.
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Abstract
INTRODUCTION This article reviews research results obtained using the Danish Longitudinal Survey of Children born in 1995 (DALSC), which is placed at SFI, the Danish National Centre for Social Research. DALSC aims to gain insight into children's growing-up conditions in contemporary society. DALSC consists of three subsamples: (1) children of Danish mothers; (2) children of ethnic minority mothers; and (3) children in out-of-home care. Four waves of data collections have been carried out since 1996. Being designed with the purpose of obtaining rich and detailed information about children's development and family life, register data was not connected to DALSC before 2006. RESEARCH TOPICS By using three categories of children as examples (ethnic minority children, vulnerable children, and children in out-of-home care), the article shows how register data gradually has gained ground in research upon children's health conditions. CONCLUSION We expect to see a more extensive use of administrative registers as basis for the analyses in future research.
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Affiliation(s)
- Mai Heide Ottosen
- SFI - The Danish National Centre for Social Research, DK- 1052 Copenhagen K, Denmark.
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Olivan-Gonzalvo G. [Frequency of fetal alcohol syndrome in institutionalized children of eastern European countries]. Rev Neurol 2011; 53:127-128. [PMID: 21720984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Sheridan M, Drury S, McLaughlin K, Almas A. Early institutionalization: neurobiological consequences and genetic modifiers. Neuropsychol Rev 2010; 20:414-29. [PMID: 21042937 PMCID: PMC3100174 DOI: 10.1007/s11065-010-9152-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/18/2010] [Indexed: 11/26/2022]
Abstract
Children raised in the profound deprivation associated with institutionalization are at elevated risk for negative outcomes across a host of social and cognitive domains. This risk appears to be mitigated by early foster care or adoption into a family setting. Although pervasive developmental problems have been noted in a substantial proportion of previously institutionalized children, marked variation exists in the nature and severity of these deficits. Increasing evidence suggests that institutional deprivation impacts the developing brain, potentially underlying the wide range of outcomes with which it is associated. In the current review we examine the neural consequences of institutionalization and genetic factors associated with differences in outcome in an effort to characterize the consequences of early deprivation at a neurobiological level. Although the effects of institutional deprivation have been studied for more than 50 years much remains unanswered regarding the pathways through which institutionalization impacts child development. Through a more complete and nuanced assessment of the neural correlates of exposure and recovery as well as a better understanding of the individual factors involved we will be better able to delineate the impact of early adversity in the setting of severe social deprivation.
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Johnson DE, Guthrie D, Smyke AT, Koga SF, Fox NA, Zeanah CH, Nelson CA. Growth and associations between auxology, caregiving environment, and cognition in socially deprived Romanian children randomized to foster vs ongoing institutional care. Arch Pediatr Adolesc Med 2010; 164:507-16. [PMID: 20368481 PMCID: PMC4126580 DOI: 10.1001/archpediatrics.2010.56] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To determine effects of improved nurturing compared with institutional care on physical growth and to investigate the association between growth and cognitive development. DESIGN A randomized controlled trial beginning in infants (mean age, 21.0 months; range, 5-32 months), with follow-up at 30, 42, and 54 months of age. SETTING Institutionalized and community children in Bucharest, Romania. PARTICIPANTS One hundred thirty-six healthy institutionalized children from 6 orphanages and 72 typically developing, never-institutionalized children. INTERVENTION Institutionalized children were randomly assigned to receive foster care or institutional care as usual. OUTCOME MEASURES Auxology and measures of intelligence over time. RESULTS Growth in institutionalized children was compromised, particularly in infants weighing less than 2500 g at birth. Mean height and weight, though not head size, increased to near normal within 12 months in foster care. Significant independent predictors for greater catch-up in height and weight included age younger than 12 months at randomization, lower baseline z scores, and higher caregiving quality, particularly caregiver sensitivity and positive regard. Baseline developmental quotient, birth weight, and height catch-up were significant independent predictors of cognitive abilities at follow-up. Each incremental increase of 1 in standardized height scores between baseline and 42 months was associated with a mean increase of 12.6 points (SD, 4.7 points) in verbal IQ (P < .05). CONCLUSIONS Foster care had a significant effect on growth, particularly with early placement and high-quality care. Growth and IQ in low-birth-weight children are particularly vulnerable to social deprivation. Catch-up growth in height under more nurturing conditions is a useful indicator of caregiving quality and cognitive improvement.
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Affiliation(s)
- Dana E Johnson
- Department of Pediatrics, Division of Neonatology, 420 Delaware St SE, Minneapolis, MN 55455, USA.
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Romanenkova NI, Bichurina MA, Rozaeva NR. [Characterization of vaccine polioviruses isolated in the closed pediatric collective bodies (children's homes)]. Vopr Virusol 2010; 55:42-45. [PMID: 20455472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Examination of 281 healthy vaccinees from 6 children's homes could isolate 37 vaccine polioviruses. The detection rate for polioviruses in the children's homes, in which there were children born to HIV-positive mothers, was significantly higher than that in other children's homes. These children's homes showed the longest poliovirus excretion after vaccination. The RFLP analysis showed that 40% of the strains being examined were intertypic recombinant strains. The sequence analysis demonstrated that about 30% of the strains under study had a small number of nucleotide substitutions in the VP3-VP1 genomic region. The study revealed a correlation between the dynamics of poliovirus excretion after oral vaccination and the kinetics of formation of recombinant poliovirus strains.
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Abstract
Pediatric bioethics raises unique issues because children are constantly growing, developing, and changing. The ethical issues that arise for newborns are different from those that arise for seven-year-olds or 17-year-olds. Furthermore, children do not develop cognitive capacities or moral reasoning skills at the same rate. Thus, it is difficult to generalize about what is appropriate or inappropriate for children in either the clinical or the research setting. This article responds to some of the issues raised by a new volume of essays about pediatric bioethics. It puts these issues into historical context by examining the implications of Saul Krugman's famous studies on the etiology and prevention of hepatitis at New York's Willowbrook State School.
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Affiliation(s)
- John D Lantos
- University of Missouri at Kansas City, Children's Mercy Bioethics Center, Children's Mercy Hospital, Kansas City, MO 64108, USA.
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Barrett DM, Steel-Duncan J, Christie CDC, Eldemire-Shearer D, Lindo JF. Absence of opportunistic parasitic infestations in children living with HIV/AIDS in children's homes in Jamaica: pilot investigations. W INDIAN MED J 2008; 57:253-256. [PMID: 19583124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Many children living with HIV/AIDS in developing countries are infected with intestinal parasites. These infections add unnecessary morbidity to children already suffering the clinical insult of living with HIV/AIDS. OBJECTIVE To determine the prevalence and potential risk factors for intestinal parasitic infections in HIV-infected children living in two institutions in Jamaica. METHODS A total of 82 faecal specimens were collected from 41 HIV-infected children (age range 2-14 years) who resided in two Children's Homes. A structured 42-item questionnaire was administered to caregivers to obtain clinical and demographic data on each child. Faecal specimens from each patient were examined using standard microbiological techniques and Cryptosporidium antigen detection was conducted using a commercially available enzyme immunoassay (EIA). RESULTS No opportunistic intestinal parasites were identified in this study. Non-opportunistic parasites diagnosed included Giardia lamblia (12.2%) and Ascaris lumbricoides (2.4%) while the commensals Endolimax nana and Entamoeba hartmanni were found in 4.9% and 2.4% of children, respectively. CONCLUSION Children living with HIV/AIDS in institutions in Jamaica that are closely supervised do not appear to be at substantial risk for intestinal parasites. This may be due to the strict clinical monitoring of the children and personal and environmental hygiene practices.
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Affiliation(s)
- D M Barrett
- Department of Community Health and Psychiatry, The University of the West Indies, Kingston 7, Jamaica
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Abstract
PURPOSE To provide the first detailed information about native language abilities of children who are or had been institutionalized. METHOD The language of ten 30-month-old children raised in Romanian orphanages was compared with that of 30 chronological-age-matched peers: 10 children who had moved recently from orphanages to foster care, 10 children in foster families for at least 1 year, and 10 children raised in their biological families. Ten language measures were obtained from communication during play and from parent/caregiver report. RESULTS Children who were institutionalized and children in foster care for a brief time showed substantial language delays, with some of these children not yet producing intelligible words. Children in foster care for at least 1 year approximated the expressive output and receptive language of children who had never been institutionalized; however, they showed lower expressive grammatical abilities. Within the group of children who were institutionalized, the presence of a preferred caregiver and a measure of development, greater height, were associated with greater language output. Although children in orphanages produced fewer complex forms than children in biological families, there were no systematic qualitative differences in language structure across groups. CONCLUSION Foster care facilitated language growth after substantial language delays associated with institutionalization.
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Affiliation(s)
- Jennifer Windsor
- Department of Speech-Language-Hearing Sciences, 115 Shevlin Hall, University of Minnesota, 164 Pillsbury Drive SE, Minneapolis, MN 55455, USA.
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Grossberg RI. Closing facilities for children: an unrealistic position. Arch Pediatr Adolesc Med 2007; 161:418-9; author reply 419-20. [PMID: 17404145 DOI: 10.1001/archpedi.161.4.418-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Abstract
The issue of how best to address current problems in the foster care system while at the same time considering past problems with the orphanage concept is a cause of national debate. Among the questions being examined are, is a return to orphanage care feasible and if so, would the re-creation of orphanages benefit the children who would be placed in them. The advanced practice nurse is perfectly situated to participate in this discussion and to advance a theory of harmony by addressing social, economic, and political factors within a patient's environment. Nurse practitioners can also fill an important gap in care for these children who often suffer the consequences of well-intentioned but flawed child care systems.
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Affiliation(s)
- Joanne O'sullivan
- Massachusetts General Hospital's Institute of Health Professions in Boston, MA
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Jackson R. The role of social pedagogy in the training of residential child care workers. J Intellect Disabil 2006; 10:61-73. [PMID: 16495325 DOI: 10.1177/1744629506062275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A requirement for most people working in residential child care in Denmark, Germany and the Netherlands is a qualification in social pedagogy. Social pedagogy is not narrowly concerned with a child's schooling but relates to the whole child - body, mind and spirit. This article describes the first social pedagogy course to be introduced and professionally recognized in the UK: the BA in Curative Education Programme. This 4-year programme blurs the line between 'classroom learning' and 'learning in practice'. A unique feature of the programme is that most students 'live the course' in residential care communities for children or adults with intellectual and developmental disabilities. The life-sharing aspect of the programme ensures that the principles of dignity, value and mutual respect can be meaningfully translated into practice. The social pedagogic model presents a timely challenge to current care philosophy and practice.
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Cataldo F, Accomando S, Porcari V. Internationally adopted children: a new challenge for pediatricians. Minerva Pediatr 2006; 58:55-62. [PMID: 16541007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Children adopted from abroad by Italian families have increased during the last years. Since 2001 to 2004 they have been more than 10,000, mainly from Eastern Europe, and all indications suggest that they will continue to increase. Most of the internationally adopted children reside in orphanage before adoption where they may experience malnutrition, exposure to infectious diseases, environmental deprivation, neglect. Moreover, their pre-adoptive records are scarcely reliable and their immunization status is not always adequate. The most common long-term problems of internationally adopted children concern developmental and scholastic delay especially if they come from a long and severely deprived institutional setting, precocious puberty and, during adolescence, depressive disorders as well as antisocial behaviours. Inter-country adopted children are at increased risk for health and social problems and have to be recognized as a group of subjects requiring special medical attentions. Specialized centres for internationally adopted children where they could receive medical evaluations upon arrival and a prolonged health follow-up should be set up.
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Affiliation(s)
- F Cataldo
- Maternal Infantile Department, University of Palermo, Palermo, Italy.
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