The Stress of Institutionalised Children

While doing research for a book I am currently writing, I have gradually gotten a more and more in-depth understanding of the effects of institutionalisation on children. I have long been aware of the results, but I now have more detailed insight into the underlying mechanisms that lead to those results. It is interesting and useful to gain this increase in theoretical knowledge. However, it did not quite prepare me for the impact of seeing the proof in real life, when I did a little experiment while I was in India recently. I would like to share this with you.

First some of the theory, to get an understanding of what is going on in institutionalised children: A baby is unable to calm himself down, he is not able to turn off his stress response by himself, and in an institution usually there is no one to help him do it. This means that for children who enter institutions as small babies, the stress response is simply left turned on. And because there is no one the help the child calm down, the child does not get the opportunity to learn to calm himself down, as usually happens in a family. The child does not experience stress in small, manageable doses, with help to calm down again, he is simply left in a state of stress, or high arousal, all the time. When this is the case for a prolonged time, it gets very hard for anyone at all to still find the ‘off button’ to the child’s stress response system. When the stress response system is activated almost all the time, due to lack of care and physical contact, the body does not get the information needed to let it know that it is safe to grow, and so growth stunting happens.

Living in a situation where your essential basic needs are not met is a stressful situation for anyone. This means that even for children who enter an institution at a somewhat later age, it is very likely that they have encountered stressful situations at such frequent intervals, making the stress response system activate entirely appropriately, that the stress response system has become sensitised and prone to overreacting. The child’s stress response system has become so used to having to react to so many things throughout the day, that it has gotten in the habit of reacting to almost anything.

When the stress response is activated, stress hormones are sent throughout the body to help prepare it for fight or flight. These hormones cause an increased heart rate and higher blood pressure to get more blood to the muscles so that they are able to respond fast and effectively. This is very useful in an emergency situation where a physical response is needed, it may save your life. However, when stress levels are high all the time, they become damaging to the body and the brain.

Also, just, imagine for a moment: when you get a really big scare, the way you feel for about ten minutes after that… have you captured that feeling? This is essentially what an institutionalised child feels like pretty much all the time. That is a really hard way to live.

Anyway, that is a small sliver of the theory, when I visited an institution while I was in India, I decided to see for myself if I could find evidence of this. As mentioned, with the stress response system activated, the heart rate tends to go up. So I brought my handheld oximeter, which registers heart rate and oxygen concentration in the blood. I sat down somewhere where the children could see me and started playing with it.

Pretty soon I was surrounded by a group of boys who were fascinated and wanted to try themselves. Between this group and a group of girls later, I put the oximeter sensor on the fingers of about 30-40 children aged 6 to 17 years old (most of them teenagers). A normal resting heart rate (meaning taken when someone has not done something tiring, they are just sitting down or standing relaxed) at this age is between 70 and 100 beats per minute, though if it is always above 80, this can raise some concerns.

What I found among these children was about 4 children with a heart rate in the 80s, so pretty normal, maybe another 3 between 90 and 100. All the rest of them had a heart rate above 100, which is very fast. and about 5 (all teenagers) had a heart rate in the 120s, extremely fast, while they were standing there, just hanging about.

As I said, seeing the theory proven in real life, with children I am familiar with, came as a bit of a shock. It also made me quite sad. And in turn even more determined – if that is possible – to do what I can to change things for them.

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