Sheri R. Parris

Severe punishment of children by staff in Romanian placement centers for school-aged children: Effects of child and institutional characteristics

The objective of this study was to determine whether childrens characteristics and/or institutional characteristics were predictors of severe punishments (including beatings) and/or frequency of punishments that children received from staff in Romanian institutions. The data was hierarchical with institutionalized children (N=1391) nested within 44 institutions, and the measurement of punishments by the staff and frequency of punishments had a binary distribution. Thus, multilevel logistic regression models were used to examine the effects of individual and institutional level variables on reported punishments and to account for the clustering of the children within institutions. Two general patterns of results emerged. First, regarding individual level variables, it was found that: (1) amount of time spent by children in their current institutions had a significant effect on the probability of being punished by staff and the frequency of this punishment; (2) the probability of being punished was higher for boys than for girls; and (3) having no siblings in the institution increased the odds of being punished several times. Second, regarding institutional level variables: (4) being in placement centers for school-aged children with a traditional type of institutional organization increased the odds of severe punishment compared to a familial/mixed type. The results of the present study highlight the importance of understanding the consequences of institutionalization in a broader way, where children not only experienced early severe psychosocial deprivation as documented in other studies, but also high levels of severe punishments administered by institutional staff.

Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma

Children and youth who have experienced foster care or orphanage-rearing have often experienced complex developmental trauma, demonstrating an interactive set of psychological and behavioral issues. Trust-Based Relational Intervention (TBRI) is a therapeutic model that trains caregivers to provide effective support and treatment for at-risk children. TBRI has been applied in orphanages, courts, residential treatment facilities, group homes, foster and adoptive homes, churches, and schools. It has been used effectively with children and youth of all ages and all risk levels. This article provides the research base for TBRI and examples of how it is applied.

Decrease in Behavioral Problems and Trauma Symptoms Among At-Risk Adopted Children Following Web-Based Trauma-Informed Parent Training Intervention

Children who have experienced early adversities are at risk for behavioral problems and trauma symptoms. Using a two-group, pre–post intervention design, the authors evaluated the effectiveness of an online parent training for Trust-Based Relational Intervention, a trauma-informed, attachment-based intervention, in reducing behavioral problems and trauma symptoms in at-risk adopted children. Children of parents in the treatment group (n = 48) demonstrated significant decreases in behavioral problems and trauma symptoms after intervention. Scores for children in a matched-sample control group did not change. Findings suggest this intervention can effectively reduce behavioral problems and trauma symptoms in children with histories of adversities.

An Introduction to Maltreatment of Institutionalized Children

This chapter serves as an introduction to the concept of maltreatment of children and provides a very brief overview of published research that has been pivotal in the development of defining and describing this concept. First, we provide an understanding of how maltreatment has been defined historically and how definitions have changed over time, leading to current definitions used by researchers and child welfare organizations. Maltreatment is also described within the context of trauma and sociocultural issues that are associated with it. We also provide a brief review of the consequences of various types of childhood maltreatment on biological, psychological, academic, and social functioning. Then, using mainly the World Health Organization definitions of maltreatment (i.e., neglect and negligent behavior; emotional, physical, and sexual abuse; as well as witnessing violence), we discuss forms of child victimization within the context of institutionalization, including types and factors that increase the risk of maltreatment in long-term residential institutions, and consequences on well-being.

Academic Achievement of Romanian Institutionalized Children: A Social–Ecological Approach

The aim of this study was to investigate the relationship between the self-reported academic performance of Romanian institutionalized children placed in long-term residential centers in 1999 and multiple child- and institution-related variables considered to have an impact on children’s development and their everyday functioning.

Child Maltreatment in Residential Centers: Summing Up

Readers of this summary chapter of the book will find that while there are many reasons that children are placed in institutions, with each institution having its own unique qualities and experiences, there are nevertheless many similarities among children’s experiences across institutions. This chapter identifies many of these similarities, as well as some differences, among institutional experiences across the globe, as gleaned from the information presented in the chapters of this book. In particular, we focus on maltreatment in institutions, including its consequences, prevention, intervention strategies, and alternative care settings. Among the many improvements to institutional care recommended by the authors in this book, most have generally agreed that institutional settings should abide by quality care standards tied to accreditation and accountability structures and that institutional settings should resemble family-type environments that provide children with stable, nurturing relationships with staff. In particular, themes discussed in this chapter are living conditions in institutions; outcomes from institutional rearing; standards, accreditation, and licensing; recommendations for interventions in institutions; the role of organizations and communities; institutional settings and environment; and suggestions for future research.

Punishment, Peer Exploitation, and Sexual Abuse in Long-Term Romanian Residential Centers: Findings from a Nationally Representative Sample of Institutionalized Children

In this study, we investigated the prevalence of abuse (i.e., punishments, exploitation, and sexual abuse) experienced or witnessed by Romanian children placed in long-term residential centers in 1999. Data based on a nationally representative sample of 1511 (802 boys and 709 girls) children with ages between 7 and 19 years (M = 12.67; SD = 2.84) and living in 53 long-term residential centers was analyzed to identify the prevalence of abuse awareness and victimization.

Institutional Neglect in Romania’s Long-Term Residential Centers in the 1990s from the Perspective of Children’s Rights

In 1990, Romania signed the United Nations (UN) Convention on the rights of children. This created the conditions for the adoption of some measures that lead to the improvement of children’s lives by protecting them against neglect and abuse. This study is the result of a secondary analysis of study data collected in 1999 that focused on neglect and abuse existing in the long-term residential centers of Romania. Our goal was to reconstruct the living conditions of institutionalized children at the end of the 1990s, based on the requirements formulated in the Convention articles. This reconstruction has more than a historical value. It may contribute to our understanding of institutional neglect whose victims were thousands of children who were cared by an inadequate protective system. This analysis included a national representative sample of 3164 (1701 boys and 1463 girls) children residing in 80 different long-term residential centers (i.e., nurseries, centers for preschool and school aged, and institutions for disabled) between 0 and 19 years of age (M = 9.45; SD = 5.39) whose quality of life was measured following the UN Convention vision on the rights of children. The results show that respect of children’s fundamental rights varied within each type of institution. Thus, 9 years after signing the Convention and after 2 years of intense structural reforms, the respect given to the basic human rights of Romanian children placed in long-term residential centers still had many weak points, but included some accomplishments as well.

Congregate Care Settings in the United States

Currently, congregate or group care is seen in the United States as being a less desirable form of taking care of children and adolescents who have experienced maltreatment in their biological families or who live in struggling families. Among many other reasons, congregate care, especially long-term living arrangements, often deprives children of having the opportunity to develop a nurturing relationship with an attachment figure and experience parental control and authority in the context of the intrinsic need for autonomy. Furthermore, congregate care is not seen as a substitute for a home environment, and it could cause physical and psychological harm or increase the likelihood of problem behaviors. However, congregate care arrangements have been part of the childcare landscape prior to the 1800s. Currently, congregate care includes approved group homes that provide 24 h care in small group settings of 7–12 children or approved institutions which provide 24 h care and/or treatment typically for 12 or more children. Throughout the history of congregate care in the United States, basic needs such as food, clothing, and shelter have not always been met adequately in these settings, and emotional and psychological needs have been met to a lesser degree.

The Prevalence of Stunting Among the Romanian Institutionalized Children Placed in Long-Term Institutional Settings in the 1990s

Children exposed to institutional care have been shown to suffer from a variety of disruptions of their physical, hormonal, cognitive, and emotional development, with the most affected being children institutionalized from a very early age. Growth deficiency is one of the most severe consequences of this experience. Research on the magnitude and factors that are associated with growth deficiency is valuable because it helps practitioners to design the best policies and actions needed to protect children experiencing maltreatment. The present study investigated the growth disturbances of Romanian institutionalized children in the1990s, including relating this phenomenon to a very complex historical and sociopolitical context. Specifically, we assessed the prevalence of children’s growth stunting and compared its magnitude across four institutional settings which were organized according to children’s age and health status. This study is a secondary analysis of data collected in 1999 by the Survey on Child Abuse in Residential Care Institutions in Romania (SCARCIR). From this original survey (N = 3164), we selected 1178 (651 boys and 527 girls) children with ages between 0 and 19 years (M = 6.61; SD = 5.17; Mdn = 5.0) and living at the time in 57 long-term residential centers (i.e., nurseries, centers for pre-, school-aged, and disabled children). For our current study, we selected only participants whose height data was recorded in 1999. Overall, the descriptive analyses revealed that stunting was very prevalent, averaging 46.4% among Romanian institutionalized children. Most affected were children in centers for disabled (80.6%) and nurseries (52.7%), followed by children placed in centers for preschool-aged (46.9%) and school aged (30.3%). The results of the study highlight the need to implement adequate policies and treatment models for the stunting of institutionalized children that take into account their need for an emotionally secure environment, especially for those placed in long-term residential institutions from a young age.