I think it is important to bring forward the unseen side of the development of children who reside in institutions. While growing up, orphan children tend to lack social and emotional support. This often results in both mental and physical issues. Amongst the mental health issues, it can be enumerated: atypical behavior, difficulties in cognitive development, and unhealthy attachment style (which leads to later problems of creating a long-term bond with other people). Physically, due to environmental deficiency and growth hormones, in times of stress the children tend to grow less compared to their non-orphan peers. Several interventions, such as psychological therapy and community-based support, already exist. If you would like to know more about this subject, I invite you to read the following article.

This article will cover:

1. Who are orphans?
2. Mental health obstacles
3. Physical obstacles
4. Confounding factors
5. Interventions

Who are orphans?

Orphans are children who have lost both of their parents, their parents are unknown or the parents have abandoned them. According to UNICEF, there are approximately 153 million orphan children across the globe.[5] Adverse circumstances such as poverty, diseases, or conflict zones that threaten the well-being of the family can lead some parents to abandon their children in institutions. Children who are born in such families are at high risk of being exploited, malnourished, or abused, thus placing them in orphanages might be the solution for a safer life. The number one reason for child abandonment is poverty. By contributing to programs that aim to strengthen families in financial difficulties might be one of the solutions for abandonment.

Mental health obstacles

Children who are living in orphanages display atypical behaviors and development delays. As compared to non-adopted children, children who are later adopted show extreme behaviors. A significant  difference in depression and self-esteem was observed between orphans and non- orphans. [2]

Amongst the causes that lead to this behavior, we can enumerate the prenatal causes such as exposure to smoke, drugs, and alcohol, difficult birth circumstances, but also postnatal care   that was given in the orphanage such as poor medical care, neglect, lack of emotional connection and even abuse.

Bandura [3], Bowlby [4] and Freud [7] all emphasize the importance of social and emotional interaction from early childhood for healthy development. Maternal emotional support and responsiveness facilitated a higher cognitive development according to a study by Landry, Smith, Swank [11]. Without this support, children who reside in institutions present poorer logical and sequential reasoning and general rigidity in thinking. A meta analysis of 75 studies that included 3 888 individuals has shown that children who live in orphanages present a lower IQ (with 20 IQ points) than their peers who live in foster homes. [13] This period is also critical in forming a healthy attachment style. If the infant is receiving care, warmth, attention, and social-emotional responses, it is more likely that he will develop a secure attachment style. That will allow him to explore the social and physical world with a sense of worth, self-esteem and it will permit the development of trustworthy long-term social relations.

However, in the absence of these elements, the infant is more likely to develop an insecure attachment style. When the social and emotional needs are persistently not covered while the child is growing up, the chances that they will present mental health issues will increase. The disorganized style (part of the insecure attachment style) is related to mental health and behavior problems such as behavior control and, in extreme cases, crime.

In terms of atypical behavior, the children in orphanages showed to be easily distracted and overactive. They display stereotyped self-stimulation and a shift from early passivity to later aggression. These children are less likely to form genuine relations, as they are unable to distinguish friendliness. It is theorized that this behavior can be the result of inconsistent caregivers. It is important to note that these behaviors can be displayed by children who lived in deficient orphanages but also children who lived in good orphanages but who lacked social and emotional support.

Physical obstacles

Aside from mental development, it is important to bring into the discussion physical development.[12]. Children who live in deficient orphanages tend to be shorter, smaller in weight, head, and chest circumference. A hypothesis named “psycho-social short stature” posits that because of the absence of emotional and social care, the children present hyperactivity of the corticotropin (a hormone that regulates responses to a variety of stressors). This leads to an increase of somatostatin, also known as the growth-inhibiting hormone, but also the increase of cortisol, the stress hormone which inhibits the growth-supporting factors too.

However, despite this hypothesis, it is difficult to conclude that solely emotional and social neglect are the causing factors because all the aspects of these institutions’ environments present deficiencies. For example, because of malnutrition, children present a “failure to thrive”. Malnutrition constitutes as well as one of the most important factors that lead to height and weight issues. Following this, the children grow to be depressed, show to be shy, display bizarre behaviors and even present speech impediments. [10]

Confounding factors

The development of these children is also dependent on factors such as time spent in the orphanage, the nature of this orphanage, the people who cared for the children and the social-economic status of the country they live.

The circumstances under which the children lose the parents rather than the actual losing of the parents contributes to their mental health issues.[6]

Orphan children may present temporary problems, such as slow cognitive development, physical issues, stereotypical self-stimulation, refusal to eat, or eating too much. However, these temporary issues might disappear after they are adopted. Following the adoption, children often show dramatic changes in terms of mental performance. This depends a lot on the time spent in the orphanage. If the children are adopted before 6 months, it is likely that they wil23345l be healthy. Even if the time spent in the institution constitutes a major factor in child development, the quality of the institution must be taken into consideration as well. In a good orphanage, the time spent there is not directly proportional to poor development. Contrary, in deficient orphanages, the first 6-12 months are a period in which problems can originate.

In addition, the support of the people who took care of the children is a factor that influences the way they bond later with the new family, with their friends and create social interactions at school.

Research has shown that orphans who live in low and middle-income countries are more vulnerable and more prone to be exposed to traumatic events because they lack protection from adults.[1]

Interventions

Currently, there is a number of community-based support for children who are residing in orphanages. Educational support plays a crucial role in helping children to recover from the psychological impact their lives have burdened them with and helps them thrive further. Basic knowledge in reading, writing and arithmetic can nudge them to study further and have better lives. Schools should not be seen just as a resource for education but also as centers where these children can receive emotional support, supervision, guidance and an opportunity to create a network.

Psychological support and research-based interventions are offered for children whose parents have died of AIDS in order to improve their resilience.[8].

Interventions for PTSD for children who experience violence in orphanages have a significant effect on their mental health. A new instructional system for the caregivers that entails positive parenting strategies, means to deal with grief, stages of development, attachment and bonding helped the caregivers empathize and understand the children better.

Unfortunately, these interventions are often limited to orphanages in well developed countries since the orphanages in low and middle-income countries are more focused on meeting the basic needs of children such as food and shelter.[9]

Conclusion

The present article focuses on the mental and physical development of orphan children. It emphasizes the factors that influence and lead to a deficient development such as lack of socio-emotional support from the caregiver, the time spent in the orphanage and circumstances under which their parents have died. Moreover, it brings into discussion the physical problems the children may face, such as weight and height problems due to a hormonal imbalance and lack of necessary nutrients.

To overcome these issues, there are several interventions in place that are school based but also orphanage based. Children receive guidance and emotional support in schools. In terms of orphanages, the caregivers receive training on how to understand and offer better care.

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What do you think about this subject and how can we contribute to better solutions?

Additional Sources:

https://resourcecentre.savethechildren.net/keywords/orphaned-children/

References:

1. Ahmad, A., Qahar, J., Siddiq, A., Majeed, A., Rasheed, J., Jabar, F., & Von Knorring, A. L. (2005). A 2‐year follow‐up of orphans’ competence, socioemotional problems and post‐traumatic stress symptoms in traditional foster care and orphanages in Iraqi Kurdistan. Child: Care, Health and Development, 31(2), 203-215.

2. Asif, A. (2017). Self-esteem and depression among orphan and non-orphan children. MedCrave Group LLC.
3. Bandura, A., & Walters, R. H. (1977). Social learning theory (Vol. 1). Prentice Hall: Englewood cliffs

4. Bowlby, J. (1958). The nature of the child's tie to his mother. International journal of psycho-analysis, 39, 350-373

5. Children's Statistics. (2022). Retrieved 7 January 2022, from https://www.sos-usa.org/our-impact/focus-areas/advocacy-movement-building/childrens-statistics

6. Escueta, M., Whetten, K., Ostermann, J., & O’Donnell, K. (2014). Adverse childhood experiences, psychosocial well-being and cognitive development among orphans and abandoned children in five low income countries. BMC international health and human rights, 14(1), 1-13.

7. Freud, S. (1989). An outline of psycho-analysis. WW Norton & Company.

8. Heath, M. A., Donald, D. R., Theron, L. C., & Lyon, R. C. (2014). AIDS in South Africa: Therapeutic interventions to strengthen resilience among orphans and vulnerable children. School Psychology International, 35(3), 309-337.

9. Hermenau, K., Hecker, T., Ruf, M., Schauer, E., Elbert, T., & Schauer, M. (2011). Childhood adversity, mental ill-health and aggressive behavior in an African orphanage: Changes in response to trauma-focused therapy and the implementation of a new instructional system. Child and Adolescent Psychiatry and Mental Health, 5(1), 1-9.

10. Johnson, D. E., & Gunnar, M. R. (2011). IV. Growth failure in institutionalized children. Monographs of the Society for research in child development, 76(4), 92-126.

11. Landry, S. H., Smith, K. E., & Swank, P. R. (2006). Responsive parenting: establishing early foundations for social, communication, and independent problem-solving skills. Developmental psychology, 42(4), 627.

12. Lien, N. M., Meyer, K. K., & Winick, M. (1977). Early malnutrition and “late” adoption: a study of their effects on the development of Korean orphans adopted into American families. The American Journal of Clinical Nutrition, 30(10), 1734-1739

13. Van Ijzendoorn, M. H., Luijk, M. P., & Juffer, F. (2008). IQ of children growing up in children's homes: A meta-analysis on IQ delays in orphanages. Merrill-Palmer Quarterly (1982-), 341-366.