Early institutionalization
One of the most vulnerable young children populations is that of infants under state custody. Due to terrible circumstances such as death or absence of their mothers, fathers, or other legal custodians, these boys and girls live in institutions or residential centers, where the environment is usually not adequate for their development and for their emotional ties. This pioneering project examines and compares the effect of two improved childrearing services interventions on the socio-emotional, cognitive, and mind development of 0-2-year olds under state custody in Sao Paulo, Brazil. Aiming to provide them quality services, one of the interventions supports foster homes and another one supports institutional care. This innovation, based on the influential Bucharest early intervention project, seeks to provide fresh scientific evidence within the Brazilian context of the best childrearing strategies for children under state care.
Problematic
An estimated 250,000 children in Latin America and the Caribbean live under state care, with many more living in unregistered institutions. In Brazil there are 40,000 institutionalized children, and their number keeps growing fast. There is evidence from other countries of the negative effects of growing up in these institutions on children’s physical, social, cognitive, and emotional development. On the other hand, studies provide evidence of the advantages of foster homes over institutions, particularly when dealing with very young children. Infants under state care with satisfactory environments have better chances to recover from the effects of deprivation of adequate affection and stimulation. However, there is not enough evidence and governments have expressed concerns about the high costs of alternative care based on foster families, an issue that makes their implementation difficult in areas of low and medium income.
Solution
The project seeks to generate a positive atmosphere for children under these difficult conditions, striving to provide personalized attention to their needs and mitigate the physical and emotional damage caused by their distancing from their original families. To this end, it will work alongside the State of Sao Paulo Family Court to identify children under 24 months old who are under state care. The foster parents and the institutional caregivers will receive the same video feedback intervention to promote positive childrearing. While this intervention has been tested before and proved successful, this will be its first implementation in Brazil. Trainers will meet with caregivers for 10 weeks to discuss videos of the children and the caregivers and seek to strengthen positive interactions.
The project will promote new forms of care with the expectation that they will be incorporated into public approaches of childhood protection and be made scalable. Its aim is to contribute to implement policies to protected abandoned young children and teenagers, improving assistance alternatives, and conducting networking and differentiated tasks to ensure that the judicial and executive powers as well as other institutions involved work in an articulate manner. In addition, the project will provide the first cost-benefit analysis of the different types of care, closing a major evidence gap in this field at global level.
Evaluation and Impact
An experimental evaluation will be conducted to determine and provide scientific evidence on which of the two childhood-assistance interventions is the most cost-effective and beneficial. Twenty-four months and again 36 months after the intervention, children and their caregivers will participate in follow-up socio-emotional, brain-size, IQ, and mental health evaluations. Also, children’s environment and their use of language will be evaluated, using interviews and questionnaires. This project will have multiple impacts on a number of actors: boys, girls, families, and institutions, and will provide evidence for the world’s main decision-makers on this area.