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Adverse Impacts on Children Living in Orphanage Institutions

Dr. Victor Groza explains risk factors and impacts in children institutionalized in orphanages for long periods of time.

Interview by Allison Martin

Children who are institutionalized at an early age often demonstrate delays in emotional, social, and physical development. Institutionalization places children at great risk for certain diseases. Institutional care may affect a child's ability to make smooth transitions from one developmental stage to another throughout his/her life. Children brought up in institutions may suffer from severe behavior and emotional problems, such as aggressive or antisocial behavior, have less knowledge and understanding of the world, and become adults with psychiatric impairments. Finally, children raised in institutions are at risk for learning problems-such as poor reading ability and have more difficulty with critical thinking, establishing vause-and-effect, and impulsivity.

However, the effects of institutionalization are not uniform and are dependent on other factors. The extent of suffering is not the same for every child who is institutionalized. The differential effects are due to child characteristics (genetic predisposition, basic personality, attractiveness, prenatal risk factors), caregiver characteristics (training, motivation & attitude), institutional characteristics (child-to-caregiver ratio, quality and degree of programming), and the child's history (the age of the child when he/she entered the institution and the length of time in the institution.

Not all children are treated equally in the same institution. Some children are prenatally exposed to risk factors. Prenatal medical care, nutrition, stress, exposure to toxic substances or environments, and genetics influence the developing neonate. Some children are born with a predisposition to be cranky, sickly, or colicky. Some children are immediately responsive to any stimulus or person, while others are more lethargic or less responsive. Some children are physically more attractive than other children. These factors influence how caregivers respond to these children.

Children who are cranky, sickly, or colicky are challenging; they are usually ignored by staff or subjected to harsh treatment if they demand more time than caregivers can give. At the same time, if a child responds easily when spoken to or touched, and the caregiver gets some satisfaction from the response, the child receives more attention and responds even more positively. On the other hand, if the child does not respond easily to caregivers, he/she receives less attention. The cycle of stimulus-response-stimulus affects the child either positively or negatively. Finally, children who are physically attractive receive more attention than their less attractive counterparts. Also, children with obvious physical handicaps may receive less attention if they are placed with children who have no apparent handicaps.

The institution itself places children at-risk. The regimentation and ritualization of institutional life do not provide children with the quality of life, or the experiences they need to be healthy, happy, fully functioning adults. In group care, the child's needs are secondary to the requirements of the group's routine. Relationships between adults and children are usually superficial and brief, with little continuous warmth and affection. Institutional staff do not connect emotionally or physically with children in quite the same way that families connect with children. Finally, the age at placement and the length of institutionalization have an effect on children. The younger the child when placed and the longer he/she remains in the institution, the more negative the effects on cognitive, emotional, social, and physical development.


Dr. Victor Groza is an Associate Professor and the Interim Associate Dean for Reseach and Training at Case Western Reserve University in Ohio. He is a prolific author and editor in the field of adoption studies; four books and over 40 professional articles are in publication, including A Peacock Or A Crow.


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