Since my last posting, I was guided by a colleague to The Better Care Network, and to The Better Care Network Working Paper (Williamson and Greenberg, 2010).  This paper describes the deleterious effects of institutional care on children, referencing important studies of institutionalized children, particularly in Rumania, Russia, and African countries. Although it includes a section addressing the Latin American countries, the section is short and reflects the relative lack of literature on residential care of children in this part of the world. The paper attempts to address the general problem of abandoned or neglected children throughout the world. It is a valuable document, but does not attempt to deal with the many specific and unique situations included in this important issue.  As the authors acknowledge, “… in some countries and in some specific cases, it (residential care) may be acceptable” (pp. 3-4). The paper offers an example of adolescents living on the street and unable to return to their families of origin, who may use a substitute family or even residential care as “the best currently available alternative to an abusive family situation”, “a short-term measure until the child can be placed with a family” (pp. 3-4). 

What the authors do not consider in the paper is the powerful effect of “breaking the cycle” that can occur when young children are removed from depriving and abusive environments and placed in a nurturing and protective “home”. This is what the directors of the children’s homes refer to when they call themselves “cycle breakers”.  It is important to note that living in a children’s home does not mean that children must lose the connection with their biological families. It simply means that there are many potential creative solutions to the problem of families who cannot care for their children, and a residential home – at least during the week – may be one of them.  

The use of Attachment Theory to support the position against residential care often involves an internal contradiction in that abusive and neglectful “attachment figures” have been shown to be at the root of “attachment disorders” (Lyons-Ruth K, “Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies”. In J. Cassidy & P. Shaver, Eds., Handbook of Attachment Theory and Research, NY: Guilford Press, 1998).  While true that “it is poverty that pushes most children into institutions”, the fact that poverty is often the result of war and other traumatic events cannot be overlooked. Addressing the roots of poverty often takes generations; children returned to traumatized communities cannot wait for the healing to take place. The “targeted, community-based alternatives to children in need” recommended to replace institutional care are an excellent goal but too often remain a fantasy in the minds of planners or politicians (p. 11).

This well-intentioned and intelligent working paper should not be used to justify the hasty and often ill-advised process of “reunification” of children with families that are not prepared to care for them. Children are growing fast; in many cases they cannot wait for community supports to be put in place.