THE HARM OF INSTITUTIONS 2

High child to caregiver ratios also limit the physical experiences of children who may be restricted to a room for extensive periods of time, may spend very little time in interaction with any caring adult and are unlikely to have treatment for any physical special need they have.

Nutritional deprivation or contamination of food or water with toxins such as lead or mercury can also impact development and health. Children WILL experience sexual or physical abuse and infectious diseases and parasites are easily transmitted in the collective living conditions of an institution. Children who have spent an extended period of time in institutions are often developmental delayed and retarded in growth due to physical and emotional deprivation.

Children will often have three different "ages," a chronological age, a developmental age and an emotional age, which may vary widely from one another. In many institutions, babies were left lying on their backs for extended periods of time and preschool aged children were restricted to a cot or room for most of the day and therefore had poor gross motor skills. Even older children were likely to have had limited opportunities for physical or fine motor activities and thus, will and do compare poorly to children in families.

However, children often experience enormous catch up growth developmentally and physically if their circumstances change for the better, and can benefit from the assistance of physical therapy and early intervention services.

It is also worth considering that although there is often rapid improvement if circumstances change for the better, some children will have permanent damage as a result of their early experiences. Children's emotional age will be related to the quality of relationships the child has had in the institution. If the child has not had sensitive care from a primary caregiver their emotional growth will be severely retarded. Many suggest that the emotional age of the child is linked to the length of time they have been in a family.

# Institutionalised children are denied the opportunity to form a consistent relationship with a caregiver in their early years and are at serious risk for developmental problems and long-term personality disorders.

# Many insecurely attached, institutionalised children lack empathy, seek behavior in negative ways, exhibit poor self-confidence, show indiscriminate affection toward adults, are prone to noncompliance, and are more aggressive than their non-institutionalised counterparts.

# Insecurely attached children rebound from adversity far less effectively than securely attached children.