Although institutional care jeopardizes children’s development, some studies suggest that well-functioning child-care institutions may offer children a better environment than their own... Show moreAlthough institutional care jeopardizes children’s development, some studies suggest that well-functioning child-care institutions may offer children a better environment than their own dysfunctional families. For the growing number of HIV-infected children who often live in underprivileged families or institutions, comparative studies on their care arrangements are crucial. In her dissertation Natasha Dobrova-Krol examined the impact of institutional care and HIV-infection on several developmental domains of more than 60 Ukrainian preschoolers. Physical growth, stress regulation, cognitive and social development, as well as organization of attachment and children’s indiscriminately friendly behavior were addressed in this study. Developmental outcomes of HIV-infected children reared in disadvantaged families were compared with the outcomes of children reared in institutions providing adequate medical and physical care. In search for possible risk and protective factors in the development of the children individual characteristics and various aspects of the rearing environment were explored. The findings of this study demonstrated that institutional rearing impeded the development of children in all domains. Both for children with and without HIV family care, even of compromised quality, was better than institutional care, even of good quality. HIV-infection was found to be associated with less favorable outcomes in physical growth and cognitive development. The negative impact of institutional care, however, was larger than the presence of HIV. In three out of six developmental domains that were examined, HIV-infected children reared in disadvantaged families showed significantly better results than both HIV-infected and uninfected children reared in institutions, and no difference was found in the other domains. The quality of the child-caregiver relationship had a larger impact on children’s physical growth and cognitive performance than either HIV-infection or the quality of the physical environment and thus represents an important intervention target. The study has important implications for intervention efforts in child-care institutions. Show less
