Rifkat J. Muhamedrahimov

Background. Studies of children raised in institutions have shown that they are at substantial risk in various domains of functioning, but these studies have not examined the children’s developmental change at the very early period of institutionalization. 

Objective. The main aim of this study was to examine the behavioral development of institutionalized infants between three and nine months of life as a function of their birth circumstances and the nature of their institutional care. 

Design. General behavioral development was studied in 58 (34 males) infants from two St. Petersburg (Russian Federation) institutions (Baby Homes, BH). The infants were divided into four groups according to 1) their gestational age—full-term children (FCh) of 37-41 weeks gestational age, or preterm children (PCh) of 30-36 weeks gestational age; and 2) the type of institutional care environment—either the typical socio-emotionally depriving, non-intervention Baby Home (NoI BH), or an institution that had undergone a program of training plus structural changes intervention (T+SC BH). All the children were assessed at approximately three and nine months of age with the Battelle Development Inventory (BDI; LINK Associates, 1988). 

Results. Both the FCh and PCh children from the NoI BH displayed significant declines in their BDI Total scores between three and nine months, whereas only the FCh children in T+SC BH improved over this period of time. In general, the FCh group had higher mean BDI Total developmental quotients (DQs) than the PCh group, and children from the T+SCh BH displayed higher scores than children from the NoI institution. 

Conclusion. Thus, the current study showed that the impact of spending their early months in an institution on infants’ development depends on the gestational age of children and the type of institutional care environment.

The research literature suggests that institutions for children left without parental care do not provide environments that adequately promote children’s development, and that characteristics of orphanages should be considered as an environmental factor influencing developmental difficulties in children living in institutions and later in post-institutional families. This study aimed to analyze the structural characteristics of the caregiving environment in two St. Petersburg (RF) orphanages—baby homes for children from birth to 4–5 years of age (BH A and BH B), and the maintenance of the structural interventions that were implemented in BH A during 2000-05 (The St. Petersburg–USA Orphanage Research Team, 2008). Both institutions belong to the Ministry of Health and are managed under the same medical regulations, providing about the same quality of medical care and nutrition. The results of the study show that the number of children living in each ward (4 to 6 in BH A and 5 to 8 in BH B), and the child–caregiver ratio (2 to 3 for BH A and 2.5 to 4 for BH B) in the two baby homes are about the same, while BH A have fewer staff members who are assigned to the ward (6–8 vs. 9–14 in BH B). The ward assistant teachers in BH A are assigned as the primary caregivers, working 5 days a week (39 hrs) vs. about 25 hrs a week for assistant teachers in BH B. While living in the baby home, children in BH A are integrated by age and disability (vs. segregation by age and partial disability integration in BH B), and are assigned to one ward (meaning the same caregivers, peers, rooms, etc.), while in BH B the children change their ward when they reach a certain age or developmental milestone (number of wards children experienced M(SD) = 1.1 (0.2) in BH A and 2.7 (1.1) in BH B). Our results support the hypothesis that the structural characteristics of institutional environment in the two baby homes are different, and that in comparison with BH B, the structural characteristics of BH A show more caregiving stability and consistency. The results also show that the interventions implemented in BH A within the St. Petersburg–USA Orphanage Research Project were maintained for many years after the project was finished. The specific features of an institutional caregiving environment should be taken into consideration in studies of the mental health and bio-behavioral development of children in institutions and postinstitutional families.