Posted by: rhoban | June 29, 2010

What’s best for kids in need?

How do you solve a problem like orphans?

International orphans have been in the news a lot lately – a group of Idahoans take 30 Haitian children across the border after the earthquake; a mother in Tennessee puts her adopted child on a plane alone back to Russia; fewer countries are offering children for adoption by western parents as stories of baby-selling and coercion reach the ears of officials both here and in ‘sending countries.’

Images of destitute orphans endure throughout literature.

But the world holds many children who desire a place to call home. To be ‘orphaned’ in many countries means losing one parent. In a 2004 study, UNICEF put the number of orphaned children anywhere up to 143 million worldwide. Many of those are ‘double-orphaned’, meaning they’ve lost both parents. Although many of those children have been orphaned by AIDS, even without AIDS, the numbers of orphaned children would be staggering.

Duke’s Dr. Kate Whetten has a personal connection to what happens to kids orphaned in other countries. She was a Peace Corps volunteer in the Democratic Republic of Congo in the 80s where she saw kids orphaned by malaria and other easily treatable diseases. Later, her work took her to many countries where she met more kids orphaned by AIDS.  So, when it came time, she chose to adopt from abroad. She has three children.

When Whetten published her paper last year in the online journal PLoS, she expected it to add to the literature about what happens to all those kids in other countries – she never expected the results to have an impact here in the U S.

You can listen to today’s story about her research here:

Whetten says that when she first wrote her proposal what she was most interested in was examining which caregiving characteristics make sense for the kids in terms of promoting good outcomes over time – she really didn’t go looking to enter the debate over institutions vs families. Ironically, she originally included in her study 550 orphaned and abandoned kids in North Carolina, Texas, New York and Chicago. But the committee that reviewed her study proposal said it wasn’t necessary to study kids in the U S – the attitude was that ‘we know what we’re doing.’

But Whetten was amazed when she got the first phone call from a residential care provider in this country after her paper was published. In the U S, it turns out there’s a whole world of opinions and ideas about what’s ‘best’ for kids. There’s little agreement on the answers and no one is dispassionate about their opinions.

For example:

CORE – the Coalition for Residential Education represents programs which house kids congregately. They believe kids can do just fine in high-quality residential programs, even living away from family. CORE asked Whetten to speak about her research at their annual meeting earlier this year. Many of the residential care providers volunteered to be one of Whetten’s study sites when she does another round of research.

Many researchers at Chapin Hall  at the University of Chicago tend towards favoring foster care over institutional care. In recent years, ‘kinship’ care, where kids are placed with someone with a connection to the family – whether it be blood relative or a close friends – has become the favored placement for kids. But there’s room for debate. And – importantly, as Fred Wulczyn said (in an hour-long interview), resources are limited, kids’ are wired to live with stable caregivers and there’s a need to maximize the benefit to the child. He argued that family care does this better than institutional care. He also said the quality of the care makes a big difference – we just don’t always know what that is.

Observers such as UC Irvine economist Richard McKenzie argue that kids who’ve grown up in well-run residences do better over the long run economically. He also found ‘graduates’ of these orphanages had more stable relationships. McKenzie does have a bias, however… he grew up in such a residence, and he’s studied self-selected ‘alumni’ of several programs.

The kids are alright.

The view of North Carolina's mountains near Crossnore

Drive through the North Carolina mountains, through the trees, past the trailers and abandoned stores and then past the new-ish condominium communities for retirees and vacationers.

A sign appears on the side of the road a the green street sign that reads, “Crossnore School – Miracle in the Mountains”. Turn there.

Suddenly the bracken and the forest gives way to manicured lawns, stone retaining walls and tidy buildings. Two teenaged boys with weed whackers, earphones and hats are working on the side of the road . One wears a red shirt proclaiming saying, “sober.” He gives me a nod, as if to say welcome.

You’re at Crossnore.

Dr Phyllis Crain leads the place. As she tells it, she was on the career ladder as teacher, then principal, then superintendent of the Avery County schools. She planned to stay there a few years, then move onto a larger, urban district. “I really think I envisioned being the head of the public schools in North Carolina at some point,” she says.

But the Crossnore opportunity opened up, and she took a visit. She says she’d been looking for ‘purity of purpose’ in her life and found it in this job.

Crain is a woman on fire. During her tenure, she’s presided over the building of a beautiful, light-filled school building, that has therapy spaces integrated into the facility. As she walked me through the school’s library, she said, “When we opened the place up, one of the kids who was here came up to me and grabbed my hand and asked me, ‘isn’t it too good for us?’”

The light-filled library at Crossnore.

Crain says that comment has stayed with her – that many of these kids believe that something good would be ‘too good’ for them. She says that’s driven her to seek out quality in the buildings and staff.

By all appearances, she’s accomplished creating a quality program. The day I visited, I met more than a dozen kids who looked happy and healthy. What was even more remarkable was that all these kids – even the teenagers – stood straight and looked me in the eye as they spoke. They talked. They expressed themselves – sometimes hesitatingly, but nonetheless they expressed themselves. As each of the kids walked away, Crain would quickly sketch for me a history – sexual abuse, neglect, drugs, alcohol, prison. Each story was filled with sadness – but you’d never know it to talk to these kids.

For example, Amy,14, calmly talks about her two stints at Crossnore. “I was here for about two years and then I went with my grandma. Then, I came back here after she OD’d.”

She talks about calling the ambulance to take her grandma away and ending up at Crossnore that same evening. I have to keep myself from visibly starting. Did I hear that right? Her grandmother overdosed…?

I heard her correctly. Her mom lives in Charlotte, she’s not allowed to have contact with her and she didn’t mention a father. She did say she hopes residential advisor (house father), Mr. Todd, walks her down the aisle when she marries someday.

She hopes to be adopted. “I want someone who loves me and cares about me and supports me and doesn’t put me down, and believes what I believe in,” Amy says.

What constitutes quality?

Crossnore director Dr Phyllis Crain talks with one of the boys and a residential counselor

I asked Crain about scandals, such as sexual abuse and neglect that have taken place at some of these facilities. She admitted that it’s an issue. “We have to screen our people very carefully and I’m always holding my breath, wondering, ‘did we miss something?’” She’s asked people to leave. But Crain also talks about how kids are abused in foster homes all the time, and they’re simply moved from the foster home. She argues, institutions like hers receive more public scrutiny, so a single scandal at a residential care facility can end up tainting all other such enterprises, even when there are no problems.

However, she makes the point that there’s considerable regulation on residential care facilities, and so problems get reported and addressed vigorously. And there are more ‘adults’ around to notice things. But she says it’s often harder for child welfare officials to know what happens in foster homes.

The one commonality I noticed through all the interviews and visits was one word – ‘quality.’ There seems to be common ground that ‘quality’ programs, and ‘quality’ care, are key for kids’ success. The question is, what is quality, and are we, as a society, willing to pay for it?

Questions? Comments? Contact us at



%d bloggers like this: