Compared to a nurturing family environment, studies 1 from varying country and cultural contexts show that growing up in institutional care is not supportive of children’s development. Institutional care has been shown to produce long-term and sometimes permanent effects on children’s brains and their physical, intellectual, and social-emotional development. 2
Chronic neglect within institutions can weaken and disrupt the developing brain structure resulting in problems related to mental health and physical disease. Neglect, in this case, is defined by as “conditions with many children, few caregivers, and no individualized adult-child relationships that are reliably responsive and where basic survival needs may be met, but lack of individualized adult responsiveness can lead to severe impairments in cognitive, physical, and psychosocial development.” 3 The negative effects are more severe the longer that a child remains in residential care, and are most critical in younger children.4
The first three years of life are a “sensitive period” 5 6 when a child must receive intimate emotional and physical contact. If this is not present then there is a high risk that the child’s development will be significantly impaired.
“A rule of thumb is that for every three months that a young child resides in an institution, they lose one month of development. A 2004 study based on survey results from 32 European countries and in-depth studies in nine of the countries, which considered the ‘risk of harm in terms of attachment disorder, developmental delay and neural atrophy in the developing brain reached the conclusion that… NO child under three years should be placed in a residential care institution without a parent/primary caregiver.” 7
Nurturing family environments are associated with positive outcomes for children’s development. 8 9 Children raised in biological, foster and adoptive families 10 demonstrate better physical, intellectual and developmental outcomes compared to children living within poor quality residential care. 11
 The Development and Care of Institutionally Reared Children. The Leiden Conference on the Development and Care of Children Without Permanent Parents, Child Development Perspective, 2012. Growth Failure in Institutionalized Children. Dana Johnson and Megan Gunnar, Monographs of the Society for Research in Child Development, 2011. The Science of Neglect: The Persistent Absence of Responsive Care Disrupts the Developing Brain: Working Paper 12. National Scientific Council on the Developing Child, 2012.
 The Risk of Harm to Young Children in Institutional Care. Browne, K., Save the Children and Better Care Network, 2009.
 The Development and Care of Institutionally Reared Children. The Leiden Conference on the Development and Care of Children Without Permanent Parents, Child Development Perspective, 2012.
 Families, Not Orphanages. John Williamson, Aaron Greenberg, Better Care Network Working Paper Series, 2010.
 Where the Heart Is: Meeting the Psychosocial Needs of Young Children in the Context of HIV/AIDS. Linda Richter, Geoff Foster, and Lorraine Sherr, The Hague, Netherlands, Bernard Van Leer Publications, 2006.
 Plasticity of Growth in Height, Weight, and Head Circumference: Meta-analytic Evidence of Massive Catch-Up of Children’s Physical Growth After Adoption. Journal of Developmental and Behavioral Pediatrics, 2007.
To learn more about the impact of institutional care on children, see these Resources.