Loopholes

Following the collapse of the Soviet Union, former Soviet countries inherited a widely developed network of residential social care institutions intended for persons who have intellectual disabilities. Monitoring inspections carried out by disability and human rights organizations in these regions reveal fundamental human rights violations at the institutions concerned. The aim of this article is to analyze one of the most severe and under-reported human rights violations experienced by women who have intellectual disabilities, while residing in social care institutions: the violation of their sexual and reproductive rights. Authors of this article employ Foucault’s viewpoint with regard to disciplinary society and understanding of control of sexuality as an expression of power. The institutional culture that prevails in residential care institutions and allows room for hiding serious human rights violations is also discussed in this article. Restrictions imposed on sexuality in care institutions are not merely limited to a number of individual cases, but they are connected with broader systematic issues. Above all others, the system of residential care institutions itself allows for violations of most of its residents’ rights to occur, including violations of sexual and reproductive rights. None of these rights can be safeguarded and promoted sporadically or partially; therefore, systematic changes are needed, as well as shifts in public mentality and amendments in mental health policy.

ObjectivesThe primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the...

Young People's Experiences of Support, Belonging, and Freedom Before and After Leaving Residential Care Institutions in Kenya.

BackgroundGovernments have an ethical imperative to safeguard children in residential care institutions at all times, including in the aftermath of an emergency. Yet, a lack of accurate data about how the magnitude and characteristics of this population may change due to an emergency impedes leaders’ ability to formulate responsive policies and services, mobilize resources and foster accountability. The purpose of this study was therefore to determine the feasibility of evaluating movement of children into residential care following an emergency.MethodsThe pilot study took place in Les Cayes commune in the Sud Department of Haiti in April 2017. Six months prior to the pilot, the area was severely affected by Hurricane Matthew, with widespread devastation to property, livestock and livelihoods. Using a two-stage process, the team created a comprehensive list of residential care institutions in Les Cayes. At each facility, the data collectors attempted to administer four separate tools: a group count tool, a record review tool, interviews with staff, and interviews with children 10 years of age and older.ResultsOut of 27 known institutions in Les Cayes, 22 institutions consented to participate in the research. Within these 22 institutions, the prevalence of new arrivals to residential care since Hurricane Matthew varied significantly across the four tools, ranging from 0.69% according to the aggregated child interviews to 20.96% according to the aggregated staff interviews. Record availability and quality was very poor and child participation was difficult to arrange due to travel and scheduling constraints.InterpretationRobust measurement of new arrivals to residential care institutions was not feasible in Haiti following Hurricane Matthew. Moreover, many of the challenges encountered are likely to be encountered in humanitarian emergencies in other settings. Therefore, the research team does not recommend scale-up of these methods in most humanitarian settings. Alternative approaches that incorporate household survey methods to ascertain movement into residential care based on reports from caregivers may be more realistic in places with poor pre-existing governance systems and weak registries and records for residential care institutions.

Social images of residential care: How children, youth and residential care institutions are portrayed?

Repression in residential youth care institutions threatens youth’s positive development. When youth experience arbitrary use of power, structure, or coercion, this may cause demotivation, reactance or aggression, and diminished chances of rehabilitation in youth. Because institutional repression may be hard to recognize, a valid and reliable measurement instrument is necessary to signal repression in residential institutions. This article outlines the conceptualization, development and validation of the Institutional Repression Questionnaire in a sample of 180 youth (aged 12–24, 32% female) staying in open, secure, and forensic residential youth care institutions. The Institutional Repression Questionnaire is a self-report questionnaire, designed to measure five dimensions of repression: abuse of power, injustice, lack of autonomy, lack of meaning, and dehumanization. The multicomponent structure was confirmed in a confirmatory factor analysis, resulting in 24 items in five subscales: Abuse of Power, Justice, Lack of Autonomy, Meaning, and Humanization. One open-ended question is part of the questionnaire to invite youth to disclose more extreme cases of repression. Convergent validity was established via correlations between the Institutional Repression Questionnaire and the Prison Group Climate Inventory—as a measure of living group climate in residential institutions—and the Basic Psychological Need Satisfaction and Frustration Scale-Intellectual Disability—as a measure of self-determination. The five Institutional Repression Questionnaire subscales demonstrated good internal consistency. The study provides preliminary evidence to support validity and reliability of an adolescent self-report questionnaire of perceived institutional repression as a multidimensional construct. Residential youth care institutions can use outcomes of the Institutional Repression Questionnaire to improve their living group climate.

‘We have similar sad stories’: A life history analysis of left-behind children in Cambodian residential care

This article offers a novel approach to understand the phenomenon of running away from residential care institutions, challenging prevailing views that pathologize these incidents as individual deviance. Drawing on insights from the sociology of escape and Deleuze and Guattari’s concepts of rhizome and lines of escape, we examine spatial, temporal, and relational dimensions of institutions, revealing the porous nature of institutional boundaries and non-linear characteristics of runaways. By reframing runaways as integral to institutional life rather than isolated events, we argue against reducing them to individual traits. Running away serves as pivotal moments that disrupt and shape institutional norms, highlighting inherent limitations in care. Conceptualizing running away as running-around within the institutional assemblage, we challenge binary inside/outside distinctions and argue that they oversimplify institutional complexity. Our analysis underscores how institutions exert totalizing control through surveillance, while being transformed through acts of running away. Examining the employees’ experiences though five focus group interviews, we critique the conventional perception of institutions as places of care, emphasizing their unbounded and multifaceted social configurations. We discuss how institutional powers shape semiotic systems that govern young people’s behaviour, advocating for a nuanced understanding of residential institutions as rhizomatic formations, where individual actions continually reshape institutional practices and perceptions.

10% of children worldwide live in households without a biological parent, and 5.4 million children live in residential care institutions. This study describes a participatory, child-informed process of developing a multidimensional measure of child subjective well-being tailored towards the priorities of children who have lived in residential care. Eight focus groups were held with n = 49 adolescents reunified with family after living in residential care in Kenya and Guatemala and six focus groups were held with n = 29 young adults who had lived in residential care during childhood. After analysis of the focus groups, and using the Orphans and Vulnerable Children Wellbeing Tool as a foundation, the resulting tool contained 43 survey questions. Member checking, translation, and cognitive interviewing were conducted. The survey was administered to N = 180 young people in Kenya and Guatemala who were reunified with family after living in residential care or at risk of entering residential care. Exploratory factor analysis indicated that the measure had three salient factors with good convergent validity and internal consistency: care and safety (12 items), basic needs (13 items), and leisure and freedom (7 items). This study contributes a new, psychometrically validated survey measure that can be used to assess the well-being of children connected to residential care, as well as a replicable model for creating contextualized quantitative measures via child participation that can inform policymaking on children’s care in low- and middle-income countries.

Young people in residential care settings hold distinct preferences regarding their relationships with key adults, including caseworkers and caregivers. However, their perspectives are not consistently assessed or effectively integrated into case planning. Evaluating this integration is essential for fostering positive adjustment and placement stability. Given that residential care represents the predominant child welfare intervention in Portugal, this study adapts and validates an existing instrument for use with youth in residential care institutions, providing evidence of its validity and reliability. Self-report questionnaires—the Positive Residential Care Integration (PRCI) scale (an adapted Positive Home Integration scale) and Strengths and Difficulties Questionnaire—were administered to 511 youth (279 girls and 232 boys), aged 12 to 24 years, across 46 Portuguese residential care institutions. The study examined the face validity, discriminant validity, and reliability of the PRCI scale. Confirmatory factor analysis indicated good model fit, supporting a unidimensional six-item structure. Correlation analyses demonstrated associations with psychological adjustment and sociodemographic variables. The PRCI scale showed satisfactory psychometric properties, confirming its reliability for assessing youth integration in residential care. Cross-gender measurement invariance was also confirmed. These findings underscore the instrument’s relevance and validity for evaluating integration within residential settings and provide valuable guidance for caregivers, professionals, and caseworkers in child welfare services.

Residential child care institutions around the globe play a significant role in protecting children in need of care and protection. While these facilities facilitate hope and rehabilitation, the displacement of children from their families introduces a variety of psychosocial stressors. This qualitative study aims to elucidate children’s vulnerabilities and coping mechanisms in residential child care institutions in Kerala, India. We conducted in-depth interviews with 21 children aged 8-16 living in institutional care within Ernakulam District, Kerala, India, registered under the Juvenile Justice (JJ) (Care and Protection of Children) Act 2015. Semi-structured interviews covered various domains, including demographics, emotional well-being, social interactions, behavioral issues, academics, and coping mechanisms. Attride-Stirling’s thematic network analysis was used in the data analysis to identify significant themes. The themes identified include (a) emotional well-being and self-perception, (b) behavioral problems, (c) social networking and interaction patterns, (d) educational and career aspirations, and (e) strengths and coping mechanisms. Our study presents the multifaceted challenges encountered by children in Kerala’s residential child care institutions, highlighting the need to create a nurturing environment that fosters child-centric practices that are essential to ensure their well-being and better prospects for their future.

BackgroundEvaluating youth welfare services is vital, both because of the considerable influence they have on the development of children and adolescents, as well as owing to the extensive financial costs involved, especially for child residential care. In this naturalistic study we have undertaken to evaluate changes in various behaviors of young people who are in youth welfare institutions, not only by using standardized questionnaires, but also specifically modified goal attainment scales (GAS). These scales were meant to represent the pedagogical objectives of youth welfare professionals as well as the individual goals of the young people in care.MethodsGoal attainment scales were used to ascertain behavioral changes in 433 children and adolescents (age 6 to 18 years) in 25 youth welfare institutions (day care and residential care) in Germany. Social and individual goals were rated by young people and caregivers together on at least two occasions. In addition, to examine potential problems of children and adolescents, quality of life as well as mental health and behavior problems were identified by the caregiver and also by the youth using a self-report inventory.ResultsMany of the children and adolescents had experienced critical life events, problems in school, impaired quality of life, along with mental health and behavior problems (range: 41-87%). During their stay in day care or residential care institutions, children and adolescents showed some improvement in social goals (Cohen’s d = 0.14-0.44), especially those young people with deficits at the beginning, and with regard to mental health and problem behavior (d = 0.10-0.31). For individual goals, progress was even more pronounced (d = 0.75). Improvements to social goals were more pronounced if mental health and behavior problems decreased. This link to changes in behavioral and emotional problems was only ascertained to a limited extent for individual goals.ConclusionsYoung people residing in youth welfare institutions achieved individual and social goals and improved with regard to behavior problems. The applied goal attainment scales are well suited for measuring individual change in children and adolescents and constitute a relevant addition to established instruments. Furthermore, their advantages include cooperative goal setting, the assessment of goals by caregivers and young people, and congruence with the pedagogical objectives of professionals.

Seizure-related complication rate in a residential population with epilepsy and intellectual disability (ECOMRAID-trial)

Young people at risk of social exclusion have complex lives and find the transition to working life complicated. This article aims to: a) analyze the life trajectories of young people leaving the protection of residential care institutions; b) examine how certain life experiences can influence the success or failure of their social and professional integration and independence. A multiple case study was conducted. Four young people participated in this study and which involved the tutors of the young people and the entrepreneurs who offered the young people work experience. The case selection took three criteria into account: a) have been in residential care institutions; b) have been in a job placement program for at least 6 months and c) are 16-18 years of age. The study data were collected using qualitative and quantitative techniques and instruments: questionnaires, interviews, insertion plans, worksheets, field notes, control records; this allowed the triangulation of the information and gave the results credibility. The results of the study show that a) the life experiences of young people who leave the residential care cause multiple deficiencies; b) these deficiencies limit their opportunities for personal development, their duration in the job and, therefore, their autonomy. It’s necessary to design career development programmes to encourage the labour transition of these young people.

Acute health and social services for children and adolescents often struggle with youth aggression and violence. Early identification of violence risk during institutional stay can help prevent violent incidents. As such, this study assessed the predictive accuracy of the Violence Risk Assessment Checklist for Youth (V-RISK-Y) aged 12-18 in two different juvenile settings providing 24-hour services for youth. Institutions were included from child and adolescent inpatient psychiatry and residential youth care under child protective services. A prospective, naturalistic observational study design was employed. V-RISK-Y was administered for youth admitted to four acute inpatient psychiatric units and four acute residential youth care institutions. Incidents of violence and threats during the youth's stay were registered by institutional staff. In total, 517 youth were included in analyses, 59 of whom were registered with at least one incident of violence or threats during their stay. Area under curve (AUC) and logistic regression analyses were used to assess predictive accuracy and validity of V-RISK-Y. For the overall sample, V-RISK-Y had good predictive accuracy, and the sum score of V-RISK-Y significantly predicted registered violent incidents. Stratified analyses indicated good predictive accuracy of V-RISK-Y for the inpatient units, but not for the residential youth care institutions. Findings imply that V-RISK-Y is accurate in identifying violence risk for youth admitted to inpatient psychiatric units but has limited predictive accuracy in residential youth care institutions. Future research should explore approaches to correctly identify violence risk in residential care settings.