Cómo son los niños que atendemos y que residen en un centro de infancia? Conocer para ayudar / Foster care children in treatment: what are they like? Understanding in order to help / Com són els nens que atenem i que resideixen en un centre d’infància?

En este trabajo se comparan, dentro de una población clínica, las características sociales, demográficas y clínicas de dos subgrupos, uno de menores en acogimiento residencial (grupo caso) y otro que reside en un entorno familiar (grupo control). Encontramos un perfil de mayor gravedad clínica en el grupo caso. Los trastornos neuróticos y reacciones de estrés, diagnosticados en un tercio de los pacientes, son los que alcanzan la mayor prevalencia en ambos grupos. El trastorno de la vinculación, también muy presente en el grupo caso, pero prácticamente inexistente en el de control, es el que provoca la discrepancia de mayor significación entre ambos grupos

This study features a comparison of the the social, demographic and clinical characteristics of two subgroups within a clinical population: one group of children in residential care (case group) versus another group of children living in a family environment (control group). We observed a more severe clinical profile in the case group. Anxiety and adjustment disorders were the most prevalent diagnosis in both groups, and were present in a third of all patients. Attachment disorder was highly prevalent in the case group, while virtually non-existent in the control group. This was the most significant difference between the two groups

Conèixer-los per ajudar-los. En aquest treball es comparen, dins d’una població clínica, les característiques socials, demogràfiques i clíniques de dos subgrups, un de menors en acolliment residencial (grup cas) i un altre que resideix en un entorn familiar (grup control). Trobem un perfil de més gravetat clínica en el grup cas. Els trastorns neuròtics i reaccions d’estrès, diagnosticats en un terç dels pacients, són els de més prevalença en tots dos grups. El trastorn de la vinculació, també molt present en el grup cas, però pràcticament inexistent en el de control, és el que provoca la discrepància més significativa entre els dos grups

¿Qué pasa en La Inclusa? The role of press scandals, doctors and public authorities in the evolution of La Inclusa de Madrid, 1890-1935

Traditionally, infants abandoned at foundling hospitals were identified as «bastards» and «children of vice» whose health, to all intents and purposes, reflected the moral sins of their parents and thus, led to unavoidable mortality. By late 19th century, several changes challenged that consideration: a growing emphasis on the importance of fighting infant mortality, the appearance of a new, medicalized, ideal of motherhood, the spread of new medical theories, the appearance of disciplines like Child Health, the construction of pediatric wards, and maternity hospitals. The consequences of these changes had their greatest impact at La Inclusa due to its location in the capital city, close to the decision-making centres and as focus of the interest of the national media. This article examines the role of the press and the medical profession in successively denouncing La Inclusa’s excess mortality during the period 1890-1935. By looking at daily press and medical publications, it sheds light on the uneven consequences of the press scandals denouncing foundlings’ extreme mortality in the period. The first scandal (1899-1900) faded without acknowledging any excess foundling mortality; the second (1918) was initiated by the doctors in charge but only produced some changes. The third scandal (1927) was instrumental in bringing about the changes that would turn a century-old institution in a state-of-the art medicalized centre and the change from debris of society to healthy children of foundlings. The effects of the press coverage were not restricted locally to foundlings in Madrid, and had a wider impact: by making the public aware of the dire situation of foundlings, they contributed to the development of legislation related to the fight against infant mortality and the control of mercenary breastfeeding (AU)

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From maid to mother: transforming facilities, staff training, and caregiver dignity in an institutional facility for young children in Nepal.

This article provides a case study of a project to improve the health, safety, and development of children birth to 6 years old in a large orphanage in Nepal. Two interventions were conducted: improvement of physical infrastructure and training, mentoring, and support for caregiving staff. As a result of these interventions, positive outcomes in terms of children's health and development have been observed, including reduction of communicable diseases and increased social interactions with caregivers. As part of the new training initiative, the caregivers began to meet regularly to share their ideas and experiences, and came to realize their vital role in the holistic development of the children in their care. One important change was a greater sense of dignity for the caregivers. The caregivers were formerly called Maids (Aaya), but asked to be called Mothers (Aama). The project also faced challenges, including communication barriers related to organizational structure.

Developmental relationships as the active ingredient: a unifying working hypothesis of "what works" across intervention settings.

Developmental relationships are characterized by reciprocal human interactions that embody an enduring emotional attachment, progressively more complex patterns of joint activity, and a balance of power that gradually shifts from the developed person in favor of the developing person. The working hypothesis of this article is that developmental relationships constitute the active ingredient of effective interventions serving at-risk children and youth across settings. In the absence of developmental relationships, other intervention elements yield diminished or minimal returns. Scaled-up programs and policies serving children and youth often fall short of their potential impact when their designs or implementation drift toward manipulating other "inactive" ingredients (e.g., incentive, accountability, curricula) instead of directly promoting developmental relationships. Using empirical studies as case examples, this study demonstrates that the presence or absence of developmental relationships distinguishes effective and ineffective interventions for diverse populations across developmental settings. The conclusion is that developmental relationships are the foundational metric with which to judge the quality and forecast the impact of interventions for at-risk children and youth. It is both critical and possible to give foremost considerations to whether program, practice, and policy decisions promote or hinder developmental relationships among those who are served and those who serve.

Against the odds: psychomotor development of children under 2 years in a Sudanese orphanage.

Providing abandoned children the necessary medical and psychological care as possible after their institutionalization may minimize developmental delays. We describe psychomotor development in infants admitted to an orphanage in Khartoum, Sudan, assessed at admission and over an 18-month follow-up. Psychological state and psychomotor quotients were determined using a simplified Neonatal Behavior Assessment Scale (NBAS), the Brunet-Lezine and Alarm distress baby (ADBB) scale. From May-September 2005, 151 children were evaluated 2, 4, 9, 12 and 18 months after inclusion. At admission, ~15% of children ≤1 month had a regulation impairment according to the NBAS, and 33.8% presented a distress state (ADBB score >5). More than 85% (129/151) recovered normal psychomotor development. The results of the program reinforce the importance of early detection of psychological disorders followed by rapid implementation of psychological case management to improve the development of young children in similar institutions and circumstances.