In this excerpt,
a well known pediatrician made the case against orphanages and for
family foster care. Henry
Dwight Chapin began with statistical findings about infant mortality,
but also suggested that institutional child care was damaging even
for those children lucky enough to survive it. At risk, according
to Chapin, was the long-term mental and emotional development of
children in orphanages or asylums. Especially interesting is his
emphasis on infants’ need for affection, which anticipated
later research on attachment and loss, such as Harry
Harlow’s monkey love experiments.
According to my experience, the earlier the age the greater the
undesirability of handling children in mass. While it is often difficult
to get exact figures, there is a heavy mortality and morbidity in
most institutions caring for babies. It is of comparatively recent
date that any really intelligent investigation of this problem has
been attempted.
Mortality in Institutions
The information given in the reports of infants’ institutions
is usually meager and unsatisfactory. In 1914 the then American
Association for Study and Prevention of Infant Mortality attempted
a study of this question. In their review the New York State Department
of Charities is quoted as presenting the statistics from 1909 to
1913 of eleven institutions in the State in which the death rate
for babies under two years, during this period, based on the total
number of children cared for, varied in the different institutions
from 183 to 576 per 1,000, with an average mortality rate for the
eleven of 422.5 per 1,000. During these same years the death rate
for children under two years, based on the estimated population
for the state at that age, was 87.4 per 1,000 or about one-fifth
of that in institutions. . . .
Very little accurate study has been made as to what effect the
institution has upon the mental development of children. Three years
ago the Bureau of Jewish Social Research undertook a careful and
exhaustive study of this subject. It was made in connection with
the children of the Hebrew Home for Infants, the Hebrew Orphan Asylum,
and the Hebrew Sheltering Guardian Society, the first an institution
for infants, the two latter for older children. In a study of mental
development as determined by school grade among 311 children that
had been done at one time or another under the care of the Hebrew
Home for Infants it was found that about 20 per cent were retarded
three terms or more in school. Against this, it was found that among
the children of the Hebrew Orphan Asylum and the Hebrew Sheltering
Guardian Society who had not previously been under the care of the
Hebrew Home for Infants only about 12 per cent were retarded three
terms or more. . . .
While the numbers concerned in this investigation are limited,
they certainly show a distinct trend. There has never been as careful
and exhaustive a study, as this of the Bureau of Jewish Social Research.
As far as its findings go, they show that a longer residence in
an asylum for infants may have an effect on the later mental life. . . .
It may also be noted that the very young infant craves and responds
to affection, which seems to have a stimulating effect, particularly
when there is drooping and lack of vitality. That close human observer
Jane Addams, with sympathetic vision, puts it thus,
We are told that the will to live is aroused in each baby by
his mother’s irresistible desire to play with him, the physiological
value of joy that a child is born, and that the high death rate
in institutions is increased by the discontented babies whom no
one persuades into living.
Such persuasion to life runs all through nature. This is one of
the reasons why the young thrive best under individual care and
attention. We have here a biological law: all animals respond to
affection. . . .
Most workers in this field. . .have found that carefully
regulated boarding out is the best method of handling abandoned
babies. In 1902 the writer started the Speedwell Society, the method
of which consists in boarding out babies in carefully supervised
units. . . .
There are few studies that statistically show the comparative results
of institutional care and boarding out, especially with babies of
the atrophic type. One of the most illuminating comparisons is found
in a report of studies made ten years ago by the Sage Foundation
and Dr. Josephine Baker of the New York Department of Health. A
number of babies were taken from the marasmus [malnutrition] ward
of the New York Foundling Hospital. This ward receives only the
chronic cases of extreme atrophy that in spite of the best care
have always ended in death. In boarding out a number of these babies,
an extra bonus was given to selected women and a doctor and a nurse
furnished for every ten babies. As a result there was an eventual
mortality of 46 per cent. Thus nearly half of the babies were saved
in the home who in spite of the greatest care were bound to die
in the institution. This is the method employed by the Speedwell
Society. . . .
The magnitude and importance of the problems raised by abandoned
children have not been sufficiently realized. In New York state
alone over 30,000 dependent children are being housed and trained
in institutions. Are these little lives being warped by unnatural
surroundings? . . .
Children are brought into the world singly and not in droves and
their physical, mental and moral health should be conserved in the
family unit. . . . The institution as a stop gap
represents a failure along the normal lines that development should
take place in child life. This truth must be spread abroad in the
hope that wealthy and well-meaning people will lose the common obsession
of endowing asylums.
Is the family or the institution best suited to conserve the child
as a valuable asset? To ask such a question is to answer it in favor
of the family. In the past much unselfish work has been done in
institutions and there is no reason for trying summarily to close
them all. But their future work should lie in the direction of clearing
houses or centers where the dependent child may be studied and classified
as to the direction of future effort. In the future let the family
and home be stressed while institutions take a secondary and retiring
place. |