What does the literature tell us about how many children worldwide are in institutions/orphanages; how likely they are to be exploited and in which ways; and what interventions are most effective in preventing this?
The most common adverse effects that children who grow up in residential care experience include: developmental delays; behavioural problems; attachment disorders; lack of life skills; institutionalisation; and difficulty forming and maintaining healthy relationships. The literature is extremely clear that residential care should be a last resort for children separated from their parents, following family support, community support, and fostering. As such, the literature strongly supports deinstitutionalisation and reintegration of families whenever possible and provision of extra support to families as the best intervention. Evidence shows that many children can recover from problems experienced in residential care when placed in family care environments, although they have incomplete catch-up compared to their never-institutionalised peers.
This paper does not review deinstitutionalisation, but instead provides a few examples of interventions which have improved the quality of care in residential homes, as an immediate response or precursor to deinstitutionalisation.
An ‘institution’ for children is defined as “as a group living arrangement for more than ten children, without parents or surrogate parents, in which care is provided by a much smaller number of paid adult carers. Residential care implies an organised, routine and impersonal structure to the living arrangements for children (e.g., all children sleep, eat and toilet at the same time) and a professional relationship, rather than parental relationship, between the adults and children.” (Browne, 2009:1). This definition may include children in boarding school, summer camps, prison and asylum detention centres. This report focuses mainly on residential homes in