Contributions

• Demonstrates that there are numerous adjustment outcomes possible within institutional care settings.

• Provides evidence that children raised in institutional care settings are capable of functioning at a level similar to children raised in families.

• Advanced the current literature by integrating the cultural values, beliefs, and perspectives of key informants into the interpretation of quantitative results.

Dissertation Study

This study sought to:

• Determine if there were variations in functioning among Children in Institutional Care, and if so, what those patterns were.

• Identify factors present in children’s lives that differentiated patterns of functioning.

• Investigate how the patterns of functioning shown in

  Children in Institutional Care compared to those for Children in Family Care.

• Provide culturally-informed interpretations of quantitative findings, while illuminating additional areas of adjustment, risk and resilience to include in future studies.

Summary

• Four unique patterns functioning for CIC

• Three patterns of functioning for CIF

• When the CIC clusters were compared to CIF functioning means, three groups met the definition of resilience in at least one area of functioning

• For the CIC, problem-solving coping significantly varied between clusters with the “High Internalizers” using significantly more problem-solving coping

• For the CIF sample, the “Best Functioning” cluster reported significantly higher levels of both the self-efficacy and adaptability and persistence

• Nearly half of the sample showed resilient functioning in all measured domains

• The only group of CIC who did not demonstrate resilience in two or more areas of adjustment were the CIC Worst Functioning group

  • Fortunately, only 14% of the sample was in the CIC Worst Functioning group

• Surprisingly, many of the protective factors included in the study did not significantly differentiate patterns of functioning for either the CIC or CIF sample

• Problem-solving coping differentiated children raised in institutionalized care: High Internalizers used this strategy significantly more than the Best Functioning group 

• The Best Functioning CIF had significantly more self-efficacy and adaptability/persistence than the worst functioning group, suggesting that these factors may be protective for CIF

• Results for the two samples differed in terms of number of clusters identified, although the three patterns for the CIF sample were fairly similar to some of the CIC patterns

• The CIF Best Functioning group was smaller than the CIC Best Functioning group (N = 23 vs. N = 47)

• If we include the CIF School Strugglers with the CIF Best Functioning group, we see that an overall 67% of the CIF sample are doing well, which is greater than the 47% of the CIC sample

• The CIC Worst Functioning group was smaller than the CIF Worst Functioning group, but was doing worse in terms of anxious symptoms, quality of life, and academic progress

Qualitative Interpretations of Quantitative Results

• Most participants agreed that children can show varying levels of adjustment in different domains

• Caregivers tended to report that the children they worked with were doing very well

  • When they discussed the ways in which children struggle, they commonly perceived disability or developmental delays as the primary area of poor adjustment

• Teachers deferred to talking about academics and provided more elaborate responses when questioned about academics versus other areas of functioning

Intervention Implications

• Previous international intervention efforts within institutional care have targeted a range of biopsychosocial-system levels 

  • Interventions within Ghanaian institutional settings should focus on the micro or macrosystem levels

  • Ghanaians hold a collectivist perspective

• Stability of home environment and having all basic needs met are the most important factors

  • Interventions must address basic needs first

  • Good quality of life is necessary before growth  can happen

Summary

• Caregiver and teacher perceptions were fairly consistent with each other, and supported the findings of Study 1

• Most participants felt that children may struggle in one or more areas, but that they will have personal strengths in certain other areas

• Having all basic needs met, a stable home environment, and a high level of parental involvement or adult support were the most common factors believed to contribute to positive functioning 

• No consistent explanations for Study 1 differentiating factor findings, with the exception of problem-solving coping