Research evidence increasingly suggests that young children in residential care without parents are at risk of harm in terms of attachment disorder, developmental delay and normal brain development. This damage caused by early privation of parenting has been shown to have long-term consequences. Kevin Browne and colleagues* report on a survey of 33 European countries that was conducted to identify the number and characteristics of children aged less than three years placed in residential care without their parents for more than three months during the year ending 31 December 2003. Ministries of Health in Europe were asked for official data. For the 31 countries who responded it was estimated that 23,099 children (11.2 per 10,000) aged less than three years were living in institutions. There was great variation between countries for the proportion of young children in institutions and family foster care. Although residential care was shown to cost on average three times as much as foster care, 33 per cent of countries had more young children in institutions than fostered. Those countries with lower GDP and health expenditure had larger proportions of young children in institutions associated mainly with abandonment, disability and medical problems. Only four per cent of children were biological orphans with deceased parents. It is recommended that no child less than three years should be placed in residential care without a parent. Even when high-quality institutions are used as an emergency measure, research has suggested that a child should be moved into family foster care as soon as possible.
Changes in Attachment Disorder symptoms in children internationally adopted and in residential care
