From 1991 to 1994, a group of Romanian and American colleagues undertook an experimental and humanitarian effort to try to improve the quality of life, mental health, and developmental progress of young children in a Romanian orphanage. In the context of institutional care, we experimentally introduced stable adult–child relationships, small group size, and a protocol of enriched caregiving and educational activities. These procedures were adapted from an intervention in childcare centers in the United States that had been proven effective in reducing intellectual decline in at-risk children. Developmental scores for orphanage children were derived from the Denver II (a revision of the Denver Developmental Screening Test; Frankenburg & Dodds, 1990), which was translated into Romanian and administered as a pre- and post-test to the experimental subjects and comparison groups in the same institution. Mixed models combining both within- and between-subject heterogeneous variance-covariance structures were utilized to analyze the impacts of time, intervention/control group assignment, child sex, child age, and interaction of Group × Time on the developmental scores. For the developmental outcome variables, the effects of group assignment (experimental vs. comparison) were highly significant. There also was a Group × Time interaction effect. We conclude that an educational intervention which includes the addition of resources and training can be initiated and sustained in an orphanage for young children as a way of improving institutional care.
Infant Mental Health Journal