Many people consider institutionalisation of children not ideal, but still preferable to the alternatives. This is very unfortunate, and ultimately dangerous. Because it is one of the things that leads to institutionalisation. The reason why many people think institutionalisation is not so bad, is because they think that children’s basic needs are covered when they are put in an institution: they get food, clothes, shelter, they can wash themselves and most of the time they will get education too. The problem is that this covers only half of the basic needs. It covers what I tend to call the child’s practical needs, but not all of their physical and practically none of their psychological needs, which are just as urgent.
What I call a child’s basic essential needs, include the practical needs mentioned above, as well as the need for attention, stimulation, affectionate physical contact and the opportunity to form attachments. Many people, even those who are highly educated, are not aware of the devastating effects of not having these needs met. We are all aware that children like getting attention and like to be held, but these things are often seen as a luxury. They really are no such thing.
Children who chronically do not get enough affectionate physical contact, will not just be less happy, there will be a physiological reaction: they will produce less growth hormone and their immune system will become less active. This means that the children will get sick more often than children in families and that illnesses are more likely to become very serious. And their growth will be stunted. When you walk into an ‘orphanage’ you will always be struck by how much smaller these children are than children of the same age in the community in the same area. Plus, lack of growth hormone can delay puberty and proper development of the body. Worst of all, for babies the physiological effect is even stronger, their immune system can shut down completely. Babies who do not get held, will die.
Attention and stimulation are essential for proper brain development. A baby is born with a certain number of neural pathways and connections and is primed to create more, based on the experiences she has. If she spends her days lying in bed, without any stimulation and very little human interaction, the brain does not get signals to create new neural pathways. And the brain, being very efficient, will even destroy existing pathways if they are not used, to make room for other, more useful ones. Pathways that are not so beneficial may be made in the brain of a child whose needs are not met, a child who learns that no one will come when you cry, that your hunger and discomfort are ignored, will experience toxic stress, which has a strong, negative effect on brain development.
At age ten the foundation of our brain is laid, after that, you build on that, but you cannot improve the foundation further. So if pathways have not been build or have been destroyed, then you will just have to do without them. This way you can end up with a foundation with serious holes in it, meaning that whatever you end up building on that foundation cannot stand strong. Research has shown that children who have grown up in an institution from a young age, have a brain capacity 20-30% smaller than that of children in families in the same area. This is brain-matter that is simply not there.
And then there is the need for attachment. When a baby is born in a family, she learns how to bond with people and form attachments, simply by making her needs known and having them met most of the time. By spending time interacting with her parents and wider family. By learning that she can depend on certain people being there to take care of her and to help her when she is in trouble or discomfort. Throughout this process neural pathways grow in her brain, which allow her to form attachments and relationships, of all kinds, later in life. Without even realising that she had to learn how to do this, early on.
In institutions, there is usually little or no opportunity for forming attachments and learning how to go about that. There are few caregivers and many children. The turn-over of caregivers tends to be high and children are moved around, so children learn they cannot depend on individuals being there for them. And because of this lack of opportunity to bond, the child does not develop the parts of the brain that help her form attachments as she grows older. This can leave her unable to form any kind of relationship in later life: working relationship, friendship, romantic relationship or even a bond with her own children if she has them. It leads to a variety of attachment disorders, such as indiscriminate attachment disorder, disorganised attachment, or reactive attachment disorder. All of which can involve seriously challenging behaviour.
Attachment is also essential in things like learning to regulate your own emotions and behaviour and in learning about empathy. A child needs a trusted adult, whom she has bonded with, to gradually make her aware of how to deal with her own emotions and outbursts, and of the fact that other people also have feelings and that these feelings are affected by her behaviour. Without attachment, it becomes much harder to learn this. And if you have not been able to learn about this, you could end up becoming a danger to your environment.
Apart from this basic, fundamental brain development, there is another layer to what institutionalisation does to children. Children living in institutions tend to live large cut off from the outside world. They just live inside the institution. This means that they do not have the opportunity, like children in family, to observe the way regular, everyday life works for adults in the community. Children in a family see their parents interacting with neighbours, with family members, with shop keepers, with religious leaders and through these observations, and through being taken along to the market and to someone else’s house, they learn how the world works, what is expected from men and from women and from people with your position in society. This allows the child to gradually absorb what she needs to know, over the course of 15-20 years, to prepare her for independent adult life.
Children who grow up in institutions do not have that opportunity. When they are shown the gates once they turn 18 years old, they have no idea how the world works, where you should go to buy things affordably, how to find a place to live and a job, how to interact correctly with people of different background. This is why research has shown that children who grew up in institutions are more likely to end up living in the street. They are 10x more likely than children from families to end up in prostitution, 40x more likely to end up with a criminal record and 500x more likely to commit suicide.
This is not because when they leave the institution they think ‘I’m going to become a prostitute’ or because they think ‘I’m going to steal a car’. When they leave the institution, they think ‘now life begins!’, ‘now I have freedom’. Only to find out very soon that they are unable to cope with life on their own out in the community. They are vulnerable to people taking advantage of them and they have no other options. The combination of the improper brain development and the lack of preparation for what it means to live out in the community leaves them unable to keep standing.
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