Monday, February 10, 2014
Foster Care, Institutions, and International Adoption: Re-focusing on Developmentally Appropriate Practice
Eton, Harrow, Marlborough, Roedean; Lawrenceville, Andover, Hill, Hotchkiss, Miss Porter’s, Sacred Heart… these are all boarding schools, institutions if you will, to which affluent British and American parents have been sending their children for over a hundred and fifty years now, for the purposes of education and socialization into the culture of their class. Some people have had horrible experiences there (cf. George Orwell), but great national leaders have also emerged from such schools (cf. FDR and Winston Churchill).
Can knowing these facts help us decide whether all institutions that do congregate care for children of any age are either acceptable or unacceptable? I’m afraid not, because not only are such institutions different from each other, children of different ages and different backgrounds are also different in their needs and abilities.
However, the facts about the great independent schools do tell us that it is quite possible for an institution’s care to create excellent outcomes for some children. Similarly, Richard McKenzie’s recent piece, “Foster Care versus Modern Orphanages” (http://www.ncpa.org/pub/ib136) tells us about the successes of the Crossnore School in North Carolina-- an institution whose graduates have done well in spite of challenges rarely known to the students of Harrow or Hotchkiss.
Of course, none of this tells us that institutional care, even for adolescents, is uniformly good. To be aware of this, we need only look at the track record of the World Wide Association of Specialty Programs and Schools, quite a number of whose members have been charged with serious maltreatment of children in their care. Or we might have a glance at the Miracle Meadows School in West Virginia (www.miraclemeadows.org), where on line complaints suggest that at least some outcomes have been less than successful, in spite of-- or perhaps because of-- the school’s claim to have a policy not to expel any child, perhaps meaning that the school will act as a private prison at parents’ wishes until the child ages out. A document describing a state investigation of events at the school mentions isolation of a child in a small space and beating of another child with a board (www.caselaw.findlaw.com/wv-supreme-court-of-appeals/1042637.html). Parents who had sent children to the school evidently did not want an investigation to proceed. (Incidentally, I know of my own knowledge of a Russian girl who was placed at this school as an investigation into abuse by her adoptive parents in another state was about to begin-- this being her second set of adopters, the first having decided that they did not like her and that she was not being changed by holding therapy. I see on the school website the presence of other Russian and of Ethiopian children, who were presumably adopted, or at least I can’t picture Russian and Ethiopian parents planning their children’s education in West Virginia.)
Similar stories of excellent and of abysmal conditions and outcomes can easily be told for both foster families and international adoptions. Institutions, foster care, and adoption are equal in their capacities to facilitate or to discourage good development. The care method is not the important thing; the details of how children are treated are the essential factors, and those details have not been transparently reported in materials published about the Bucharest Early Intervention Project (BEIP), the “scientific foundation” for many current claims about care for parentless children. Neither are they made very clear in the epidemiological study by Kathryn Whetten and her colleagues, published in 2009, and concluding that health and well-being of children aged 6 to 12 are not negatively affected by institutional living (www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0008169). Whetten noted the need for clarity about these details, pointing out the need to “understand which characteristics of care promote child wellbeing”, and adding, “Such characteristics may transcend the structural definitions of institutions or family homes.”
What details of care should we look for in studies about care of parentless children? Beyond simple issues like appropriate food and medical care, this depends on the ages of the children being considered. And, I should point out, this fact makes “apples and oranges” of any attempt to set the BEIP study in direct contradiction to the Whetten report. The BEIP study dealt with an intervention that began when the children were toddlers; Whetten’s work focused on children who were already “school age” when studied.
Much is already known about the different developmental needs of children at different ages. Designing environments that satisfy these needs and foster good development is known as developmentally appropriate practice (DAP). DAP concepts have been used primarily in discussion of children in early childhood (including infancy and the toddler period), and they focus on the importance for good development of having a small number of sensitive, responsive adults as caregivers for a small group of children, with consistent rules and practices guiding children’s social development, and a stable but interesting physical environment. Although caregivers often resist this idea, it has been suggested many times that caregivers should remain with their group of children as they move “up” to more advanced classrooms and activities (this is actually practiced, I believe, in the Waldorf Schools).
Although less has been said about this point, “school age” children also have their DAP concerns, and different ones than were the case in early childhood. Familiar caregivers are preferred, but by this age children much more easily engage with new adults who are friendly and interesting. These children still benefit from the presence of familiar people at bedtime or when sick or frightened, but they can explore new activities and people without needing the frequent “emotional refueling” of their younger days. They are strongly interested and involved in their peers and benefit from having a stable group of friends. This is a period of learning to negotiate and compromise with others and of developing skills in making social and moral decisions in a safe environment where helpful adults can buffer the effects of mistakes. Schooling and learning some adult-like tasks are another focus during this age period.
DAP with adolescents is somewhat different, as teenagers are in the process of moving toward adult status. They still appreciate and benefit from adults who respond warmly and helpfully when they are sought, but they need to be working toward independent judgment and decision-making. The advent of sexuality and increased aggressive impulses means that help is needed with insight into emotions as well as with self-control. Adolescents are also preparing for adult lives in the sense of working toward further education and refining their ability to do adult tasks, in anticipation of independent living.
Care for parentless children thus needs to be different for each of these age groups, and it also needs to be fine-tuned with respect to the child’s age when entering the care placement. Good outcomes cannot result from “warehousing” at any of these stages, and it’s possible to see how either a good job or a poor one could be done at any stage by an institution, a foster home, or adoption.
As Richard McKenzie pointed out, a “full menu” of care options for parentless children is needed world-wide. Glorification of a single option probably has real political benefits for those who do this, but it entirely avoids consideration of the real needs of orphaned and abandoned children. We need to re-focus on a variety of needs and a variety of developmentally appropriate solutions.