Implementing Changes in Institutions to Improve Young Children's Development

An estimated 8 million children, mostly birth to approximately 6-8 years of age, live in institutions worldwide. While institutional environments vary, certain characteristics are common, including relatively large groups; high children:caregiver ratios; many and frequently changing caregivers; homogeneous grouping by age and disability status; periodic graduations to new groups of peers and caregivers; and an "institutional style of caregiving" that minimizes talking, provides rather dispassionate perfunctory care, and offers little warm, sensitive, contingently-responsive caregiver-child interactions. The development of children in residence is usually delayed, sometimes extremely so, in every physical and behavioral domain. Although efforts are being made in many countries to care for children without permanent parents in family environments (e.g., domestic adoption, foster and kinship care, reunification with biological parents), it is not likely that transitions to family alternatives will be completed in all countries in the near future; thus, institutions are likely to exist for many years if not decades. But institutions need not operate in the current manner; they can be modified to be substantially more family-like in structure and in the behavior of caregivers. Research indicates that when such changes are made the development of children, both typically developing and those with special needs, is improved substantially. Based on the available literature and the authors' experience, this paper describes steps that can be taken to implement such changes in residential institutions for infants and young children.     

Making Sense in and of the Asexual Community: Navigating Relationships and Identities in a Context of Resistance

Despite some increased visibility in recent years, the asexual community and asexuality generally remain largely unknown. Aiming to demystify asexuality, this paper discusses the context of anti‐asexual animosity in which the (largely American) asexual community is situated. Specifically, the asexual community constructed itself in response to hostility, including explicit anti‐asexual discrimination, homophobia against asexual people perceived to be lesbian or gay, and the negative impact of (implicit) pathologising low sexual desire. This theoretical paper outlines some of the unique challenges asexual people face negotiating identities and relationships; the collective sense‐making strategies they use (generating language and discourse) to do so; and why these things are central to understanding asexual people's experiences. This is accomplished through a purposeful review of literature and a case study of the Asexual Visibility and Education Network as an asexual community space. Understanding the challenges asexual people face and the resources they invoke to overcome them helps applied psychologists develop the cultural competence they need to work effectively with the asexual people they will encounter. Copyright © 2014 John Wiley & Sons, Ltd.     

Clamped Corticosterone (B) Reveals the Effect of Endogenous B on Both Facilitated Responsivity to Acute Restraint and Metabolic Responses to Chronic Stress

To determine the effects of both corticosterone (B) and chronic stressors on acute ACTH responses to restraint, young male rats were exposed to streptozotocin-induced diabetes, cold (5-7 degreesC) or intracerebroventricular (icv) neuropeptide Y (NPY) for 5 d and then exposed to restraint within 2 h after lights on. Two groups of rats were studied: intact and adrenalectomized replaced with B pellets that maintained plasma B in the normal mean 24-h range of intact rats. In addition to ACTH and B responses to restraint on d 5, body weight, food intake, fat depots, glucose and other hormones were measured to determine the role of stress-induced elevations in B on energy balance. ACTH responses to restraint were normal in intact rats subjected to diabetes or cold. By contrast, there was no ACTH or B response to restraint in NPY-infused intact rats. All 3 groups of chronically stimulated adrenalectomized rats with clamped B had facilitated ACTH responses to restraint compared to their treatment controls. Overall food intake increased in all groups of stressed rats; however, augmented intake occurred only during the light in intact rats and equally in the light and dark in B-clamped rats. White adipose depot weights were decreased by both diabetes and cold and increased by NPY in intact rats; the decreases with cold and increases with NPY were both blunted and changes in fat stores were not significant in adrenalectomized, B-clamped rats. We conclude that: 1. diabetes- and cold-induced facilitation of restraint-induced afferent input to hypothalamic control of the hypothalamo-pituitary-adrenal (HPA) axis is opposed in intact rats by the elevated feedback signal of B secretion; 2. NPY does not induce facilitation of afferent stress pathways; 3. chronic stimulation of the HPA axis induces acute hyperresponsiveness of hypothalamic neurons to restraint provided that the afferent input of this acute stimulus is not prevented by B feedback; 4. stimulus-induced elevations in B secretion result in day-time feeding; 5. insensitivity of both caloric efficiency and white fat stores to chronic stress in adrenalectomized, B-clamped rats results from loss of normally variable B levels.     

Wittgenstein's New Way of Talking to Himself

A lack of consensus persists as to whom exactly the dialogues of Wittgenstein's Philosophical Investigations are between: Wittgenstein and an interlocutor? Or perhaps a variety of interlocutors, none of whom can be identified with Wittgenstein himself? I argue here that this lack of consensus is possibly due to an ambiguity in the ordinary concept of “talking to oneself,” and that a new concept of “talking to oneself” appropriate to Wittgenstein's dialogues is needed to properly understand them. Wittgenstein is talking to himself—but he is doing so in the way we talk to other people.     

A socioemotional intervention in a Latin American orphanage

A pilot intervention that emphasized training and technical assistance to promote warm, sensitive, and responsive one‐on‐one caregiver–child interactions primarily during feeding and bathing/changing was implemented using regular staff in a depressed orphanage for children birth to approximately 8 years of age in Latin America. Despite a variety of unanticipated irregularities in the implementation of the intervention, many beyond the researchers' control, ward environments improved; caregivers displayed more warm, sensitive, and responsive interactions with children; and children improved an average of 13.5 developmental quotient (DQ) points after 4+ months' exposure to the completed intervention. Furthermore, 82% of the children had DQs greater than 70 before the intervention, but only 27.8% did so afterward. Although the training for all caregivers was aimed at children birth to 3 years, the number of different caregivers was reduced, and technical assistance was provided only to caregivers serving children less than 3 years, younger and older children (3–8 years) improved approximately the same amount. However, children who were transitioned from a younger to an older ward during the intervention improved less than did children who remained in either a younger or an older ward, the first evidence suggesting that the common orphanage practice of periodically graduating children from one homogeneous age group to another may impede their development. The study is consistent with others that have shown that orphanages can be changed, and increases primarily in warm, sensitive, responsive caregiver–child interactions can produce improvements in children's development.     

The role of transitions to new age groups in the development of institutionalized children

Children in two institutions in St. Petersburg (Russian Federation) experienced ward transitions, one in which caregivers were trained to provide sensitive, responsive caregiving and one that conducted business as usual. A third institution eliminated transitions, received the same training, and implemented a variety of structural and employment changes designed to promote improved caregiver–child interactions and relationships. While the no‐transition comprehensive intervention group of children steadily improved in Battelle Developmental Inventory (LINC Associates, 1988 ) scores across all age intervals, the children in the institution who encouraged some positive caregiver–child interactions improved before and after, but not during, an age period that involved a transition. In contrast, the no‐treatment group displayed no developmental changes across any age period with or without a transition. These results suggest that the common institutional practice of ward transitions to new peers and caregivers is potentially disruptive to infants' and toddlers' general development, but primarily in a context in which some degree of caregiver–child sensitive and responsive interactions are encouraged.     

CAREGIVER–CHILD INTERACTION,CAREGIVER TRANSITIONS,AND GROUP SIZE AS MEDIATORS BETWEEN INTERVENTION CONDITION AND ATTACHMENT AND PHYSICAL GROWTH OUTCOMES IN INSTITUTIONALIZED CHILDREN

This report describes a secondary analysis of data from a comprehensive intervention project which included training and structural changes in three Baby Homes in St. Petersburg, Russian Federation. Multiple mediator models were tested according to the R.M. Baron and D.A. Kenny ( 1986 ) causal‐steps approach to examine whether caregiver–child interaction quality, number of caregiver transitions, and group size mediated the effects of the intervention on children's attachment behaviors and physical growth. The study utilized a subsample of 163 children from the original Russian Baby Home project, who were between 11 and 19 months at the time of assessment. Results from comparisons of the training and structural changes versus no intervention conditions are presented. Caregiver–child interaction quality and number of caregiver transitions fully mediated the association between intervention condition and attachment behavior. No other mediation was found. Results suggest that the quality of interaction between caregivers and children in institutional care is of primary importance to children's development, but relationship context may play a less direct mediational role, supporting caregiver–child interactions.