This field study describes changes in caregiving and young children's physical and behavioral/cognitive development as a consequence of a pilot intervention using typical staff in 2 Central American orphanages for children with severe and multiple disabilities. The intervention trained staff in sensitive, responsive, child-directed, caregiver–child interactions; provided on-the-ward coaching; and changed staff employment practices to promote greater stability of caregivers in children's lives. In addition, trainers of caregivers received 5 hours of instruction on positioning, handling, and other aspects of working with children with severe disabilities. Caregivers improved their appropriate positioning and handling of children and sensitive and responsive caregiving, and children improved in physical and behavioral/cognitive development. This pilot study shows that typical orphanage staff can improve the development of infants and young children with severe disabilities by increasing their sensitive, responsive caregiving with minimal specialized professional services.
University of Pittsburgh Office of Child Development (Drs Groark, McCall, Salaway, and Palmer and Mss McCarthy, Eichner, and Warner), Pittsburgh, Pennsylvania; and Whole Child International (Ms Lopez), Los Angeles, California.
Correspondence: Robert B. McCall, PhD, University of Pittsburgh Office of Child Development, 400 N. Lexington St. Pittsburgh, PA 15208. (firstname.lastname@example.org).
This project was funded by Whole Child International under Technical Cooperation ATN/KP12327-NI, in partnership with the Korean Poverty Reduction Fund and the Inter-American Development Bank. Whole Child International is a nonprofit organization devoted to improving the quality of care in institutions for infants and young children. Author Megan Lopez is an employee of Whole Child International.
The authors declare no conflict of interest.