Improving Institutions
Improving Institutions: Can We? Should We? How?

by Christina J. Groark and Robert B. McCall

Throughout human history the family has been regarded as the best environment in which to rear children and promote their development. This is partly because the family typically has only a few children, mixed ages, and few relatively stable caregivers who provide consistent, frequent one-on-one interactions that are predominately warm, sensitive, contingently responsive, and child-directed. Unfortunately, an estimated 2-8 million children live in institutions worldwide that usually represent nearly the opposite environment, and resident children tend to be developmentally delayed in every domain. While rearing children without permanent parents is ideally conducted in an adoptive or foster family, it is unlikely that all low-resource countries worldwide will achieve this goal soon for all children. Fortunately, for those children who must remain in transitional or even long-term institutional care, the institutions do not have to operate in the way most do; a few stable caregivers within these institutions could provide more sensitive, responsive care in a more family-like environment. When this is accomplished, research shows children’s physical, mental, behavioral, social, and emotional development can improve, sometimes very substantially.

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