Social Adaptation and Resilience of Children in Care Institutions: A Systematic Review of Effective Strategies and Practices

Introduction

There will always be children who are left without parental care for a variety of reasons in every nation and civilisation. These children’s upbringing and education are handled by the state and society. A child who is orphaned lives in a world that is extremely terrible. One of the child’s greatest wants is to have a family, a mother and a father. Children under the age of 18 who have been placed in residential facilities for a variety of reasons, such as abandonment, orphanhood or removal from their families due to abuse, neglect or other unfavourable circumstances, are known as institutionalised children, or those living in care institutions (Browne, 2009). Care institutions, often referred to as residential care facilities, children’s homes, or orphanages, are organisations created to offer vulnerable kids assistance, care and safety (Dozier et al., 2014). More than 140 million people are orphans worldwide, according to UNICEF (2019). The plight of children who are institutionalised is a serious issue in India. The Ministry of Women and Child Development’s report from 2022 states that more than 370,000 children are housed in over 7,000 registered child-care facilities throughout the nation. Social adaptation refers to the process by which individuals develop the necessary skills and behaviours to function effectively within their social environment. For institutionalised children, this process is particularly complex, as they must adapt to a new living situation, often with limited familial support and potentially traumatic experiences (Salmorbekova & Karimova, 2020). Resilience, on the other hand, is the ability to cope with and overcome adversity, enabling individuals to bounce back from difficult circumstances and thrive. Effective strategies and practices aimed at fostering social adaptation and resilience are crucial for ensuring the wellbeing and successful integration of institutionalised children into society.

Our main research question is: What are the effective strategies and practices that enhance the social adaptation and resilience of institutionalised children in care institutions? We aim to answer this question by reviewing the existing literature on the topic, and conducting a narrative synthesis of the findings. We focus on the following aspects of social adaptation and resilience: social skills, intra-personal and interpersonal intelligence, socio-emotional behaviour, family values, adjustment and coping with adversities. We also examine the role of various activities, programmes and caregiver–child relationships in the orphanage as potential sources of support and influence for institutionalised children. This systematic review aims to provide best practices and recommendations for the social adaptation and resilience of institutionalised children in care institutions. The existing literature on this topic is insufficient and inconclusive. There is also a shortage of reliable and comprehensive research on the outcomes and durability of the interventions that target these aspects. Additionally, there is a need for more comparative and contextualised studies that reflect the diversity and specificity of the institutionalised children and their circumstances.

Social Adaptation and Resilience: A Conceptual Framework

Social adaptation is a complex and multidimensional concept that refers to the process of adjusting to changing social environments and conditions (Terziev, 2015, 2019). It involves both individual and collective aspects, such as norms, values, behaviours, skills and attitudes, which enable people to cope with and benefit from social changes (Boulton et al., 2015). Social adaptation is relevant for various fields and contexts, such as education, health, migration, development and climate change, where it can enhance the wellbeing, resilience and sustainability of individuals and communities (Boulton et al., 2015; Terziev, 2015). However, social adaptation is not a static or linear process, but rather a dynamic and iterative one, that depends on multiple factors and interactions, such as motivations, capacities, opportunities, barriers and feedbacks (Boulton et al., 2015; Terziev, 2019). Therefore, social adaptation requires a comprehensive and systemic approach that considers the diversity, complexity and uncertainty of social systems and their responses to change (Boulton et al., 2015; Terziev, 2019). Institutionalised children face many challenges and risks in their socialisation process, such as the lack of parental care, the experience of trauma, the stigma and discrimination, and the transition to independent living. As a result, it is critical to recognise and put into action efficient plans and techniques that can support their social adaptation and resilience—described as the capacity to overcome obstacles and attain favourable life outcomes. The quality of caregiver–child relationships, involvement in a variety of activities and programmes, peer and mentor support and adulthood preparation are some of the factors that have been found to improve the social adaptation and resilience of institutionalised children. However, there is a need for more rigorous and comprehensive research to examine the mechanisms and outcomes of these interventions, and to tailor them to the specific needs and contexts of different populations of institutionalised children, such as the institutionalised children, who are the focus of this systematic review.

In addition, social adaptation of institutionalised children can be influenced by the type and duration of alternative care they receive, such as institutional care, foster care or adoption (Browne et al., 2009). The most prevalent alternative care option in many nations is institutional care, which has been linked to detrimental effects on the social, emotional, cognitive and physical development of institutionalised children, particularly when those children are subjected to high staff turnover, overcrowding and poor quality care (Browne et al., 2009). Foster care and adoption are regarded as better alternatives to institutionalised care because they can offer more individualised attention, a family-like setting and stable attachments, all of which can help institutionalised children become more resilient and socially adaptive (Browne et al., 2009). Foster care and adoption, however, also present risks and challenges for institutionalised children, including the potential for repeated placements, the loss of cultural identity, acclimating to new expectations and norms, and social stigma and discrimination (Browne et al., 2009). Foster care and adoption must thus be properly regulated, overseen and supported. Additionally, institutionalised children must get sufficient preparation, knowledge and counselling both prior to and during their placement (Browne et al., 2009). Additionally, the requirements and features of the institutionalised children themselves, such their age, gender, ethnicity, health and educational attainment, may have an impact on their social adaption (Browne et al., 2009). Institutionalised children may have different experiences and outcomes of social adaptation depending on their developmental stage, biological factors, cultural background, physical and mental conditions and academic performance (Browne et al., 2009). For instance, younger institutionalised children may have more difficulties in forming secure attachments and trusting relationships with others, while older institutionalised children may have more challenges in developing self-reliance and independence skills (Browne et al., 2009). Institutionalised children may also face different types and levels of discrimination and marginalisation based on their gender, ethnicity or health status, which can hinder their social integration and participation (Browne et al., 2009). Moreover, institutionalised children may have different opportunities and aspirations for education and employment, which can affect their social mobility and economic security (Browne et al., 2009). Therefore, it is important to recognise and address the diversity and complexity of the institutionalised children’s situations and needs, and to provide them with appropriate and individualised support and services that can enhance their social adaptation and resilience (Browne et al., 2009).

Resilience is the ability to adapt positively to adversity, stress or trauma (Herrman et al., 2011). Resilience is not a fixed trait that some people have and others do not, but rather a dynamic process that can be influenced by various personal, social and environmental factors (Herrman et al., 2011). Resilience can be enhanced by interventions that target different domains of life, such as emotional, cognitive, behavioural and relational skills (Herrman et al., 2011). Resilience can also be fostered by supportive relationships and networks that provide emotional, informational and instrumental resources (Cross et al., 2021). Resilience is especially important for vulnerable populations, such as institutionalised children, who face multiple challenges and risks in their lives (Herrman et al., 2011). Resilience can help them overcome the negative effects of institutionalisation, attachment disruption and social stigma, and improve their wellbeing and functioning in society (Herrman et al., 2011). Resilience can also enable them to cope with the transition from institutional care to independent living, which often entails new difficulties and uncertainties (Herrman et al., 2011). Therefore, resilience is a key concept and outcome for research and practice in the field of institutionalised children. A conceptual framework for social adaptation and resilience helped us to identify and analyse the key elements, processes and outcomes of social adaptation and resilience, as well as the challenges and opportunities for enhancing it in different settings and populations (Boulton et al., 2015; Terziev, 2019). Such a framework can also guide the design, implementation and evaluation of effective interventions and policies that foster social adaptation and resilience in the face of social change (Boulton et al., 2015; Terziev, 2019).

Methodology

The aim of this systematic review is to examine the effective strategies and practices that enhance the social adaptation and resilience of institutionalised children. The specific objectives are to:

Identify and appraise the relevant studies on the topic, using predefined inclusion and exclusion criteria, and following the PRISMA guidelines for reporting.

To conduct this review, we searched and selected 16 studies that met the following criteria: they were published in English or Russian between 2000 and 2023; they focused on institutionalised children, aged 6–18 years; they used quantitative or qualitative methods to measure or explore their social adjustment and resilience and they reported on the outcomes or impacts of specific activities, programmes or caregiver–child relationships that aimed to improve these aspects. We searched the following databases: Web of Science, Scopus, Google Scholar and eLibrary.ru. We also used snowballing and hand-searching techniques to identify additional sources. The search terms included: Institutionalised children, orphan, institutional care, orphanage, boarding school, social adaptation, social adjustment, resilience, coping and wellbeing. We appraised the quality and rigour of the studies using the Mixed Methods Appraisal Tool (MMAT), and extracted the data using a standardised form. We then performed a narrative synthesis of the data, using thematic analysis.

Findings

The search of databases provided a total of 3,204 articles. After duplicate removals 1,802 articles remained. Of these, 1,786 were removed after title and abstract screening, as they did not meet the eligibility criteria. The research question guiding this review was: What are the effective strategies and practices for improving the social adaptation and resilience of institutionalised children? To answer this question, the selected articles were analysed using a thematic synthesis approach, which involved extracting, coding and synthesising the data from each article and identifying the main themes and subthemes that emerged from the literature. The analysis revealed three main themes: Enrichment activities, Orphanage programmes and practices and care-giving relationships. These themes represent the different types of strategies and practices that have been implemented or investigated in relation to the social adaptation and resilience of institutionalised children. The following sections will present the findings of each theme and discuss how they answer the research question.

Conclusion

In this troubled nation, the setting of the care facility can be quite important in helping institutionalised children develop social adaptability and resilience. The review analysed three main aspects of the environment: Enrichment activities, programmes and practices, and care-giving relationships. The review showed that these aspects can improve the children’s social and emotional skills, identity, life skills, communication, cooperation, culture, diversity, coping, mental toughness, resilience, adjustment, inclusion, empowerment, family values, bonds, attachment, trust, security, self-esteem, regulation, support, quality of care and outcomes. The review also emphasised the significance of the caregivers’ mental health, wellbeing, training and education.