Structural Neglect in Orphanages: Physical Growth, Cognition, and Daily Life of Young Institutionalized Children in India

In this chapter we present our study in an orphanage in India. We examined physical growth and cognitive development in 37 young children (1–6 years; mean age 35 months) and conducted time use observations in a subsample of 20 toddlers (mean age 25 months). In the time use procedure, spot observations focused on toddlers’ daily life experiences. Each child was observed on 1 day during 5 h, once every 10 min, resulting in 31 observations per child. Our findings show that more than a third to half of the children had severe growth delays (underweight, stunted growth, or microcephaly). Their mean developmental quotient (DQ) was 68, with 61% of the children showing a severe delay in cognitive development (DQ < 70). Follow-up assessments revealed that there was no catch-up in physical and cognitive development after more than a year of institutionalization. The time use observations showed that the toddlers did not interact with caregivers or peers most of the time (80%). Based on our findings and convergent evidence from comparable studies, we conclude that children’s daily life experiences in orphanages should be qualified as structural neglect, resulting in profound developmental delays. Placement in (foster or adoptive) family care is necessary to break the cycle of sustained traumatization and to enable the children to recover from their developmental delays.

Keywords

Institutional care Orphanage India Physical growth Cognitive development Time use Developmental delays

(…) the more the social environment in which a human child is reared deviates from the environment of evolutionary adaptedness (which is probably father, mother, and siblings in a social environment comprising grandparents and a limited number of other known families) the greater will be the risk of his developing maladaptive patterns of social behavior.

Bowlby (1982, p. 166).

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