Institionalized Children v. Those Raised in Families

Babies are born helpless, knowing nothing of the world. Unable to regulate temperature or get food, they depend on consistent caregivers to protect, feed, and keep them warm. They know nothing about permanence, routines, or what to expect from the world to get their needs met. What they can do is grasp, suck, and cry. What can they learn from these experiences? If you cry, somebody picks you up and feeds you. If you suck, your tummy gets full and feels better. If you grab something, it stays stuck to your fingers until you let go. If you smile, somebody smiles back at you. Looking into somebody’s eyes is nice. If you make sounds, somebody makes sounds back at you, and you can carry on a little conversation. Babies soon realize that they have an effect on the world, an influence on their environment and people. They begin to recognize patterns of care. .

Between 6 and 9 months, babies begin to form selective attachments to consistent caregivers. These selective attachments affect emotional bonds, behavior and thought processes. Caregivers contribute to this by their responsiveness to the children. Through these attachments, children can learn about themselves, looking to the caregivers for safety and information about the world. If a child is feeling insecure and can seek proximity to the caregiver, they feel safer. Once they have a secure base, they can venture out in exploratory behavior. When they get worried or feel insecure, they can go back to the caregivers for a dose of security, then venture out again. They learn to use visual referencing, looking back to the caregivers for reactions and support. As they get older, they begin to use internal representations when they are not in sight of the caregivers; “What would she think if I do this?” These attachments teach children what to expect from future relationships. They help the children develop an identity, to know who they are, to have a sense of self.

Things are quite different in ‘ an institutional setting, especially if there are multiple caregivers, deprived conditions, and shortages of supplies and support personnel. If you cry, nothing happens. Bottles, diaper changes and baths happen on a schedule convenient to the staff. Crying doesn’t work, so the babies learn to shut down when distressed. Babies can prolong interactions by wiggling and grabbing; in this way they can get their needs for attention met. They do not have the opportunity to develop relationships with consistent caregivers; to have ‘conversations’ or to gaze in somebody’s eyes; to learn how to be held and cuddled. They become passive and shut down when distressed. They do not learn how to regulate their emotions or their interactions with others.

Parents of very young children adopted from institutions usually find that their child is quiet, unemotional, and less reactive than other children of the same age. They are relatively compliant and cooperative. But suddenly, at some point, they get wild. Some parents report that the problems do not begin until the child is 3 to 4 years old. Once given the chance to laugh, cry, make noise, throw toys, etc. they do! Frustration leads to tantrums and aggressive behavior, or withdrawal to an internal world. Nobody has taught them how to regulate their responses, how to take turns, how to ask for help or care. They may not know how to take cues from the responses of others to gauge how their behavior is being perceived. Everything smells different, sounds different, feels different. They have to make a total life adjustment.

Like tiny infants, they need to be taught how to regulate their emotions, how to use sounds and gestures as tools to get their needs met. The behavior that worked before in the institution doesn’t work for them now; the responses that were adaptive to institutional life are not adaptive to family life. The adjustment to family life will happen through multiple interactions between the parents and child. It isn’t a matter of fixing the child; everyone in the family needs to adjust. It is very much like learning music; sometimes you need to be alone to practice, other times you need the teacher there to help you. But you can’t just talk about the music you have to get in there and do it together. Learning new behavior happens through modeling; it is a collaborative effort. The children need to learn a new pattern of care; they need to learn to form and use selective attachments as a secure base from which to explore the world.