1. Aspects of Cognitive Development for Orphanage Children Laura Florescu MD, PhD Laura Florescu MD, PhD

2. The lack of family environment, in particular the lack of maternal care, unbalances the entire process of development. The lack of family environment, in particular the lack of maternal care, unbalances the entire process of development. Frustration appears, with biological and psychological consequences. Frustration appears, with biological and psychological consequences.

3. Method: We used a database containing data on 100 children protected in the Placement Center Iasi, between 2001 – 2003. We used a database containing data on 100 children protected in the Placement Center Iasi, between 2001 – 2003. Age: from 1 through 24 months at the time of admission Age: from 1 through 24 months at the time of admission Period of protection (time in residence at the Center): from 4 months through 3 years (on an average, 18 months) Period of protection (time in residence at the Center): from 4 months through 3 years (on an average, 18 months) Children with abnormalities or congenital problems were not included. Children with abnormalities or congenital problems were not included.

5. Evaluation was done at the time of admission and every 3 months thereafter, using Denver Developmental Screening Test (DDST). Evaluation was done at the time of admission and every 3 months thereafter, using Denver Developmental Screening Test (DDST). The DDST is designed to detect developmental delays in: The DDST is designed to detect developmental delays in: personal – social fine motor – adaptive language gross motor dimensions The DDST is only a measure of developmental attainment and not a measure of intelligence. The DDST is only a measure of developmental attainment and not a measure of intelligence.

6. Results: Distribution of the sample by age of admission to the orphanage and where they came from

7. The cognitive behavior evolution based on age of admission

8. The evaluation of cognitive behavior based on the length of residence in the orphanage

9. Conclusions: The results show the lack of stimulation after separation and the regression of cognitive behavior. The results show the lack of stimulation after separation and the regression of cognitive behavior. The negative effects are more evident when separation occurs in infancy. The negative effects are more evident when separation occurs in infancy. The longer the period outside the family environment, the harder it is to improve cognitive behavior. The longer the period outside the family environment, the harder it is to improve cognitive behavior.

10. Reducing children’s cognitive behavior problems means focusing on strategies to improve parenting. Reducing children’s cognitive behavior problems means focusing on strategies to improve parenting. Interaction techniques explained by Vygotsky and illustrated in resources such as LearningGames can support parenting. Interaction techniques explained by Vygotsky and illustrated in resources such as LearningGames can support parenting. Parents are the major agent of health promotion in children. Parents are the major agent of health promotion in children. If we are to achieve a healthier world, we must emphasize health promotion during childhood.

11. 2 Experimental Studies used LearningGames as an intervention Conducted by: Joseph Sparling, Ph.D., USA, Cristiana Dragomir, M.D., Romania, Laura Florescu, M.D., Ph.D., Romania, Sharon L. Ramey, Ph.D., USA Conducted by: Joseph Sparling, Ph.D., USA, Cristiana Dragomir, M.D., Romania, Laura Florescu, M.D., Ph.D., Romania, Sharon L. Ramey, Ph.D., USA Iasi, Romania Iasi, Romania 169 children 169 children

13. Overall Intervention Program Formal staff training, active supervision Formal staff training, active supervision Clear curriculum, daily documentation Clear curriculum, daily documentation 1:4 child:caregiver ratio, group size = 4 1:4 child:caregiver ratio, group size = 4 6+ hours per day, 5 days per week 6+ hours per day, 5 days per week Stable groups and staffing Stable groups and staffing Duration: Duration: Study 1 = 13 mos.; Study 2 = 14 mos. Study 1 = 13 mos.; Study 2 = 14 mos.

17. Key Elements of Educational Program Enriched caregiving Enriched caregiving Conversational book reading Conversational book reading Invatin Impreuna curriculum (translation of LearningGames, Sparling & Lewis, 1985) Invatin Impreuna curriculum (translation of LearningGames, Sparling & Lewis, 1985)

20. Sample Item from Invatin Impreuna Curriculum

21. Language (Study 1)

22. Denver Developmental Gains, Study 2

23. Duration of Two Types of Adult Talk in Videotaped Adult-Child Sessions, Study 1

24. “When I approach a child, he inspires in me two sentiments: tenderness for what he is, and respect for what he may become.” Louis Pasteur