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PubMedDate not supplied

The causes of children's institutionalization in Romania. The Children's Health Care Collaborative Study Group.

A country-wide, cross-sectional survey was conducted to determine the causes of institutionalization of Romanian children aged 0-3 years. A total of 628 children were sampled at random. Interview were conducted with directors of institutions and records of each sampled child were reviewed. Each sampled child was given a brief medical and developmental evaluation. The children in Romanian institutions have one or more chronic health conditions. Their families have multiple, complex social problems. The referral to institutions usually involved a paediatrician (76% of children). Fifty-four per cent of children were referred primarily from paediatric and maternity hospitals. The majority of children currently interned are likely to remain in institutional care. Implications for policy and re-organization of health and social services are discussed.

Child, Institutionalized↗
PubMed1989

[Prevention--a promising goal or illusory task for institutional child guidance, adolescent and family counseling?].

Beginning with some comments on prevention as a concept that is en vogue the meaning of the concept in scientific literature is described. Hereafter the field of prevention is differentiated. Primary and general forms of prevention as well as secondary and specific forms of prevention are specified. Preventive activities in the field of child-guidance, youth- and family-counselling are shown. As an example for these activities a small survey is reported followed by remarks about the critical approach of community health proponents towards the position of institutionalized child-guidance and youth- and family-counselling within the field of psycho-social services. Next the work with clients of lower-class background is characterized. Finally some primary preventive activities of social-political relevance basing on the practical experience of institutionalized child-guidance, youth- and family-counselling are given.

Adolescent↗
PubMed1977

A study of Cytomegalovirus, Epstein-Barr virus and Herpesvirus hominis (types 1 and 2) antibody in institutionalized and non-institutionalized children.

In an attempt to demonstrate differences in antibody prevalence between free-living and institutionalized children, antibodies to Cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Herpesvirus hominis (HVH), types 1 and 2, were assayed in 123 children. The children comprised three groups consisting of 41 institutionalized patients with Down's syndrome (all non-disjunctive trisomy-G karyotype and equal numbers of age-, sex-, and race-matched non-mongoloid institutionalized subjects and non-institutionalized normal controls. CMV antibody titer values were statistically similar in the three groups. However, fewer mongoloids (21.9%) were seropositive than other institutionalized retardates (39.0%) and normal control subjects (43.9%). Antibody titer values to EBV were also similar; however, in comparison to the other groups, significantly more mongoloids were seropositive at younger ages. More mongoloids were seropositive to HVH-1 and had higher antibody titers than the other two groups. Antibody to HVH-2 was more prevalent in institutionalized subjects, 85.4% in mongoloids and 65.8% in other institutionalized retardates, than in normal non-institutionalized children (26.8%).

Adolescent↗
PubMed1978

Suppression of repetitive self-injurious behavior by contingent inhalation of aromatic ammonia.

Two institutionalized children who exhibited high rates of severely self-injurious behaviors were punished with aromatic ammonia inhalation on a response-contingent basis. This contingency was applied throughout all aspects of each child's institutional program which focused on teaching of self-help skills. Suppression of the self-injurious responses was both rapid and general. The contingency was maintained for 2 months, although there was no responding after the first 5 days. Follow-up sessions, conducted 4 months after the punishment contingency was removed, revealed that suppression effects were highly durable. Aromatic ammonia inhalation appears to be an effective alternative for decelerating extremely maladaptive behaviors that do not yield to more conventional nonaversive forms of therapy. However, the procedure should be used with great caution, for it may involve risk to the subject.

Ammonia↗
PubMed2003

Designing research to study the effects of institutionalization on brain and behavioral development: the Bucharest Early Intervention Project.

This paper provides an overview of the largest longitudinal investigation of institutionalized children less than 2 years old ever conducted. The Bucharest Early Intervention Project is an ongoing randomized controlled trial of foster placement as an alternative to institutionalization in abandoned infants and toddlers being conducted in Bucharest, Romania. In addition to describing the contexts in which this study is imbedded, we also provide an overview of the sample, the measures, and the intervention. We hope that the natural experiment of institutionalization will allow us to examine directly the effects of intervention on early deprivation. We hope it will provide answers to many of the critical questions that developmentalists have asked about the effects of early experience, the timing of deprivation, and the ameliorating effects of early intervention and provide clues to which underlying neurobiological processes are compromised by, and resilient to, dramatic changes in early experience.

Brain↗
PubMed1976

Experimental preadmission program to encourgage home care for severely and profoundly retarded children.

An experimental treatment program was designed to reduce institutionalization of severely and profoundly retarded children under 6 years of age. Subjects were randomly assigned to experimental and control groups. Results showed that counseling with the mother alone tends to result in increased marital conflict as well as a decision to keep the child at home, particularly for parents who are uncertain about their plans and hopes for the child. Since this conflict could defeat the real purpose of fostering the welfare of the child, family counseling should be used and consensus within the family should be sought. Instructing the mother in child-training procedures tends to reduce the number of instances of objectionable child behavior, as well as to induce a decision to keep the child at home, particularly for parents who are uncertain about their hopes and plans for the child.

Attitude↗
PubMed1975

Distribution of serotypes of hepatitis B surface antigen in an institution for the mentally retarded.

The serotypes of hepatitis B surface antigen present in patients at the Lynchburg Training School and Hospital were determined by counterelectrophoresis. Hepatitis B surface antigen was detected by counterelectrophoresis in 72 of 82 samples that were positive by complement fixation or passive hemagglutination techniques. Of the isolates that were serotyped, 51 (71 percent) were ad, and 21 (29 percent) were ay; thus the ad:ay ratio was about 2.4:1. The incidence of the ay serotype was significantly higher in females and in patients with Down's syndrome. The ay serotype was not randomly distributed in the institution but was clustered in two of seven female wards and four of 11 male wards, all of which contained younger patients who had been institutionalized at an early age.

Age Factors↗
PubMed1980

Inequality in the social services.

This article analyzes national data on the institutionalized population and shows the different patterns for white and nonwhite children and adults. It considers and refutes explanations based on differential problems and needs and explores organizational mechanisms. It also marshals evidence to show how such proxies as race and class are employed by organizations to induce a rationing of diagnostic categories and of services. The outcome is downward drift, the propelling of minority and poor persons into failure-reinforcing institutions. Directions for change are indicated.

Adolescent↗
PubMed1979

[Dental examinations in 4 and 5 year old children from nurseries and institutions].

The authors compared the dental findings (caries frequency and conspicuous malocclusions) in 201 institutionalized children and 399 kindergarten children aged between 4 to 5 years. It is true that the proportion of primary healthy teeth was greater in the institutionalized children than in the kindergarten children, but the dentitions of the institutionalized children were more frequently in need of care. Furthermore, in institutionalized children malocclusion associated with finger-sucking was four times as frequent as in kindergarten children, which is attributed to the living conditions in the homes.

Child, Institutionalized↗
PubMed1975

A 21-year psycho-social follow-up of 524 unselected cases of down's syndrome and their families.

The death rate was followed, and a life table has been constructed. Three crucial events were examined: 1. the period of diagnosis, 2. the problem of institutionalization versus homecare, 3. the ageing and death of the parents and its consequences for the person with D.S. Several other medical problems, psychological implications and social consequences for the person with D.S., for his parents and siblings are highlighted. The worst problem for parents with the child at home was social isolation; for the parents with the child at an institution it was the very existence of the child. To both groups the most encouraging fact was that their child was happy, friendly and in good spirits. Finally, emphasis is laid upon the medical and paramedical problems which must be discussed and solved to make a harmonious and social life for the person with D.S., for his normal siblings, and for the parents.

Adolescent↗