Thursday, September 3, 2020

You can't cherry-pick your scientific data

Institutionalized children as depicted in "The science of
early adversity
" (The Lancet) quoted in this post
A recent promotional piece ["Joint Educational Activity with Southern Israel Rehabilitation Centers" | August 31, 2020] on the ALEH website describes how its Negev/Ofakim rehabilitation center
was proud to host a forum of health-related professionals from Ashdod’s Barzilai Medical Center, Ber Sheva’s Soroka Medical Center and Macabbi HMO’s Bayit B’Lev... A joint initiative of the various department directors, the forum aims to hold bi-monthly meetings, provide academic activity and ensure that professionals in health-related fields receive ongoing updates regarding advancements and breakthroughs in matters concerning rehabilitation... Discussion moved on to the current COVID-19 crisis and complications stemming from the more serious incidents of illness. Apart from the immediate need to save lives after exposure to the virus, the group discussed and reviewed the authentic need for rehabilitation after initial recuperation...
In their Hebrew Facebook version of this article (which I am translating now to English) but not in the English version quoted above, they then say
"The forum serves to strengthen the link and cooperation between the departments in the hope that they will progress to joint research. Likewise, core subjects of  rehabilitation are being dealt with, challenging clinical cases are presented along with brainstorming sessions to reach solutions".
For an enterprise that prides itself on partnering with "scientific experts", Aleh does a studious job of ignoring the reams of scientific data, relating to the deficiencies of institutionalization - Aleh's primary activity.

Cherry-picking the scientific data is simply not on. Deleting scientific findings to suit your goal of entrenching and expanding your large, closed institutions is deplorable.

Here are just a few of the reputable articles that Aleh.has chosen to disregard.

Ending institutionalisation of children | The Lancet (Editorial) | Published:July 25, 2015
"Childhood is a time when the seeds of a person's future health and wellbeing are sown. Ideally, it happens within a family setting that provides individualised care in a loving, safe, enriching, and happy environment. Sadly, more than 8 million vulnerable children worldwide do not have access to such care and grow up in large institutions or orphanages. Such environments share conditions that can be detrimental to children..."
Institutionalisation and deinstitutionalisation of children | Niall Boyce, Jane Godsland, Edmund Sonuga-Barke | The Lancet Child & Adolescent Health | Published: June 23, 2020 (Archived)
"...This Lancet Group Commission advocates global reform of the care of separated children through the progressive replacement of institutional provision with safe and nurturing family-based care."
The science of early adversity: is there a role for large institutions in the care of vulnerable children? | The Lancet | Anne E Berens, MSc, Prof Charles A Nelson, PhD | Published:January 28, 2015
"It has been more than 80 years since researchers in child psychiatry first documented developmental delays among children separated from family environments and placed in orphanages or other institutions. Informed by such findings, global conventions, including the 1989 UN Convention on the Rights of the Child, assert a child's right to care within a family-like environment that offers individualised support. Nevertheless, an estimated 8 million children are presently growing up in congregate care institutions..."
Children in Institutional Care: Delayed Development and Resilience | Monographs of the Society for Research in Child Development | Marinus H. van IJzendoorn and others | Published December 21, 2011
"...Children exposed to institutional care often suffer from “structural neglect” which may include minimum physical resources, unfavorable and unstable staffing patterns, and socially emotionally inadequate caregiver‐child interactions."
One very early such report appeared over 100 years ago on January 2, 1915 under the title "Are Institutions for Infants Necessary?", by Henry Dwight Chapin MD [online here]:
In considering the best conditions for the relief of acutely sick infants and for foundlings or abandoned babies, two important factors must always be kept in mind: (1) the unusual susceptibility of the infant to its immediate environment, and (2) its great need of individual care. The best conditions for the infant thus require a home and a mother. The further we get away from these vital necessities of beginning life, the greater will be our failure to get adequate results in trying to help the needy infant. Strange to say, these important conditions have often been overlooked, or, at least, not sufficiently emphasized, by those who are working in this field.
Writing about that century-old article, Berens and Nelson, referred to above, wrote in their January 2015 "The science of early adversity" piece that:
Following the publication of this [1915] article nearly a century ago, scientific studies began to document stunted cognitive, social, and physical development among children placed in institutions during key developmental years. In 1989, the UN Convention on the Rights of the Child (endorsed by nearly all countries, although not in the USA) drew upon scientific findings to generate international normative standards, asserting that “the child, for the full and harmonious development of his other personality, should grow up in a family environment, in an atmosphere of happiness, love, and understanding”.
Why don’t we hear ALEH making statements like these?

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