Methods: We use data on 211 children living in 5 childcare institutions from the Community – Family Intergration Team (C-FIT) project carried out in cooperation with government and community-based organizations. We conducted a systematic assessment of the developmental needs of institutionalized children with a battery of standardized instruments collecting both caregiver and child reports of depressive/anxious symptoms, attachment security, sensitivity to the prospect of rejection in relationships, goodness-of-fit with caregivers and behavioral outcomes.
Results: Overall, 69% of children were found to have current depressive symptoms in the clinical range, with over two-thirds reporting feeling hopeless about their future. In keeping with the developmental literature, this hopelessness was found to be a potent risk for self-harming and risk-taking behavior. Nearly two-thirds of children were found to have insecure attachment, and this relational context was associated with the children's perceived hopelessness and depression. Insecurely attached children were significantly more likely to feel that their life has been a failure with rates of over 85% compared to only 20% of children who were securely attached. Insecurely attached children were also significantly less likely to have caregivers who reported a good relational fit with them, which presents a worrisome situation as poor caregiver reported goodness-of-fit was predictive of how far they hoped the child would go in school, how much time staff spent talking to them about their interests, and peer exclusion.
Conclusions and Implications: The current Jordanian analysis adds to a growing international body of research highlighting the developmental risks associated with the use of Institutional models of care. It also highlights the important connection between the relational caregiving context and child health and wellbeing, such that children who are more sensitive to the prospect of rejection in relationships and who are insecurely attached also tend to elicit less optimal care and feel more hopeless about their future. This may create a particularly potent context for risk-taking behaviors for these children as they transition into adolescence and adulthood. The problematic developmental status of the institutionalized children underscores the importance of the larger C-FIT project initiative to develop evidence-based community care alternatives for children in keeping with the Jordanian National Action Plan for Children.