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Monday, August 14, 2000
By Cindi Lash, Post-Gazette Staff Writer
Plopped on the sturdy lap of a matron in a Russian orphanage, the baby girl stares straight ahead while a cereal-filled spoon is shoved into her mouth.
The baby swallows. The matron swipes a napkin over the baby's mouth, then spoons in another dollop of cereal without ever smiling or speaking to the child.
Something so simple as facing that baby, or as ordinary as talking to her while she eats, could have a crucial effect on the way she develops.
This month, University of Pittsburgh researchers will launch a project aimed at teaching workers in Russian orphanages that they must provide more than perfunctory, impersonal care for their young charges.
The project will be conducted in three St. Petersburg homes for children up to 4 years old. It is intended to reduce or eliminate attachment disorder, a psychological problem that often occurs in children who, as babies, didn't receive the care they needed to form attachments to others.
The disorder is particularly acute in children who've grown up in orphanages or institutions that provided few opportunities for them to interact with adults. The disorder can make it difficult, even impossible, for a child who's later adopted to form bonds or develop affection for his new family.
"Attachment, and what facilitates or enhances it, is the driving force," said Christina J. Groark, co-director of the project planned by Pitt's Office of Child Development. "We want to help [orphanage workers] understand more about child development and what's necessary and age-appropriate for kids as they grow."
During previous trips to Russia, Pitt researchers noted that the St. Petersburg baby homes were clean and adequately supplied. But matrons and other workers seldom talked to the children and did not coo, sing or play with infants while they changed their diapers or dressed them.
Older children walked silently in straight lines and were fed and bathed in groups, without individual attention. Researchers estimated that the workers spent, on average, 2.3 minutes with each child in a three-hour period.
"There's no talking, no eye contact, no responsiveness to the child. It's kind of assembly-line," said Robert B. McCall, the project's other co-director. "We want to increase [the workers'] social responsiveness."
That's because most matrons who work in Russia's baby homes have received little or no training in how to care for children, McCall said. Frequent turnover among part-time matrons means children become accustomed to seeing between 60 and 100 matrons come and go in their first two years, and they don't learn to become fond of the people who care for them, he said.
Also, many workers admit that they deliberately spend little one-on-one time with children because they're loath to get too close to sick babies who might die or healthier children who are likely to be adopted.
Pitt researchers will work in St. Petersburg with baby home director Natalia Nikoforova, St. Petersburg State University psychology professor Rifkat Muhamedrahimov and special education teacher Oleg Palmov.
They will seek to train baby home workers how to interact with children in a way that stimulates the children's development. They will encourage baby homes to hire more full-time workers and to structure work schedules so children will see the same faces each day, "almost like a mom or dad," Groark said.
Workers also will be given grief counseling aimed at helping them handle their emotions when children die or leave for adoptive homes.
Workers at one home will be trained in child development and will get counseling aimed at reducing their grief and boosting their job satisfaction. Workers at a second home will receive only training; the third home will operate as it always has.
Researchers will compare developments at the three homes to determine whether improved training and counseling results in children who become more social and adjusted as they grow. Children from homes where the researchers intervened also will be compared with children who left those homes before the project began and with other groups of children who've been raised in the United States.
The project could be expanded to more orphanages in Russia and other countries. It also could provide helpful guidance for U.S. day-care programs, particularly small home-based operations, McCall said.
The project is being funded with a $2.8 million grant from the National Institute of Child Health and Human Development, as well as grants from the Howard Heinz Endowment and the International Assistance Group, an Aspinwall adoption agency that specializes in placing Russian-born children.