Summer camp for youth with disabilities

2970977_research_mini_lab_assignment_1 2970977_goodwin-d.-l.-staples-k.-2005.-the-meaning-of-summer-camp-experiences-to-youths-with-disabilities_2 2970977_summer_camp_research_2_3

Please see below: Occupational Therapy Assistant Program Innovative Theory & Practice Spring 2013 RESEARCH MINI-LAB ASSIGNMENT PURPOSE: To write and submit an abbreviated literature review of TWO research articles from peer-reviewed, professional sources (journals) that provide supporting evidence for your New Program Development Project. You must adhere to the following guidelines below. GENERAL GUIDELINES: 1. Submit your typed review (3-4 pages of content after cover sheet, 1” margins, double-spaced, 12 pt. Times New Roman font) in either MS Word or PDF. No other formats will be accepted. 2. Include a cover page (exempt from the total page count) with the following information, double-spaced and centered on the page: Name, Course Name, Term and Instructor Name 3. Use the three headings below for organizing each section of your paper. 4. Follow APA format for citations and reference page (refer to any Online Writing Lab – OWL – website for help with APA format). CONTENT REQUIREMENTS: I. INTRODUCTION Write a brief paragraph identifying the following: • The general topic or issue addressed in the articles and how these articles relate to your New Program Development project • The authors purpose behind the articles (state the problem) and then briefly compare/contrast the two articles II. DISCUSSION In the discussion section of your paper: • Identify the type of research conducted (single case study, experimental design, etc.) • Identify the participants and sample size • Identify the methodology of the data collected (qualitative or quantitative) and comment on any statistically significant findings • Summarize the results III. CONCLUSION In the conclusion state the following: • Conclusion of the authors in both studies, including the need for further research if indicated • Determine if an OTA could further contribute to the implementation of either study or whether that role would be appropriate, including o Which steps of the methodology an OTA could administer o What specific training would you as an OTA want to establish service competency for inter-rater reliability • Finally, describe how these studies support your New Program Development project or how you might use this evidence for educational purposes

LBCC Occupational Therapy Assistant Program

OTA 230 Innovative Theory & Practice

Spring 20

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3

RESEARCH MINI-LAB ASSIGNMENT

DUE DATE: Submit to Dropbox later than 11:59pm on Sunday, 6/9/13

PURPOSE:
To write and submit an abbreviated literature review of TWO research articles from peer-reviewed, professional sources (journals) that provide supporting evidence for your New Program Development Project. You must adhere to the following guidelines below.

GENERAL GUIDELINES:

1. Submit your typed review (3-4 pages of content after cover sheet, 1” margins, double-spaced, 12 pt. Times New Roman font) in either MS Word or PDF. No other formats will be accepted.

2. Include a cover page (exempt from the total page count) with the following information, double-spaced and centered on the page: Name, Course Name, Term and Instructor Name

3. Use the three headings below for organizing each section of your paper.

4. Follow APA format for citations and reference page (refer to any Online Writing Lab – OWL – website for help with APA format).

CONTENT REQUIREMENTS:

I. INTRODUCTION

Write a brief paragraph identifying the following:

· The general topic or issue addressed in the articles and how these articles relate to your New Program Development project

· The authors purpose behind the articles (state the problem) and then briefly compare/contrast the two articles

II. DISCUSSION

In the discussion section of your paper:

· Identify the type of research conducted (single case study, experimental design, etc.)

· Identify the participants and sample size

· Identify the methodology of the data collected (qualitative or quantitative) and comment on any statistically significant findings

· Summarize the results

III. CONCLUSION

In the conclusion state the following:

· Conclusion of the authors in both studies, including the need for further research if indicated

· Determine if an OTA could further contribute to the implementation of either study or whether that role would be appropriate, including

· Which steps of the methodology an OTA could administer

· What specific training would you as an OTA want to establish service competency for inter-rater reliability

· Finally, describe how these studies support your New Program Development project or how you might use this evidence for educational purposes

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ADAPTED PHYSICAL ACTIVITY QUARTERLY, 2005, 22, 159-158
© 2005 Human Kinetics Publishers, Inc.

Donna L. Goodwin is with the College of Kinesiology at the University of Saskatchewan,
Saskatoon, SK CANADA S7N 5B2. E-mail: donna.goodwin@usask.ca. Kerri Staples is with \bb\ at
McGill University \bb\..

The Meaning of Summer Camp
Experiences to Youths With Disabilities

Donna L. Goodwin
University of Saskatchewan

Kerri Staples
McGill University

The purpose of the study was to capture the meaning of segregated summer
camp experiences to youths with disabilities. The experiences of nine youths
with physical, sensory, or behavioral disabilities between the ages of 14 and
19 were captured using the phenomenological methods of semistructured
interviews, document review, and field notes. Mothers’ perceptions were
also gathered. The thematic analysis revealed three themes: not alone,
independence, and a chance to discover. Camp experiences provided a reprieve
from perceptions of disability isolation often felt in their home communities.
The campers experienced increased self-reliance, independence, and new
understandings of their physical potential. The findings are discussed within
the context of identity development and therapeutic landscapes.

Summer camp programs for youth with disabilities in North America
represent three broad categories. There are camps that are (a) inclusive in nature,
bringing together youth with and without disabilities to enjoy recreational
experiences (Bedini, 1990); (b) segregated in nature, providing recreational
programs specifically designed for campers with disabilities within barrier free
environments (Thurber & Malinowski, 1999); and (c) designed to provide the
medical and social supports necessary for campers who might otherwise be excluded
from recreational camp settings (e.g., campers with kidney disease, cancer, sickle
cell disease, asthma; Klee, Greenleaf, & Watkins, 1997; Martiniuk, 2003; Powars
& Brown, 1990; Punnett & Thurber, 1993).

The ideology of inclusion has resulted in increased opportunities for youth
with disabilities to attend typical summer camps, while segregated recreational
camp programs for otherwise healthy youth with disabilities have become fewer
in number (Bullock, Mahon, & Welch, 1992). Programs that have provided
exemplary summer camp services solely for youth and adults with disabilities for
over 25 years are moving toward models of inclusion, resulting in the closure of
segregated camps. Easter Seals of North Carolina, for example, made a radical

160 Goodwin and Staples 161 Camp Experiences for Youth

departure from its traditional segregated camping programs by providing a range of
recreational options including Mainstream, Modified Mainstream, and Segregated
options (Bullock et al., 1992). In the Modified Mainstream Option the Easter Seals
program provided trained staff and counselors to accompany Easter Seal campers to
mainstream regional camps. The full Mainstream Option consisted of Easter Seals
staff conducting on-site staff training and consultation to mainstream camps that
accepted campers with diverse needs. An evaluation of this progressive mainstream
model recommended segregated options remain an option to families, albeit a less
desirable and unnecessary option for most campers.

The decline in segregated programs has been due, in part, to perceptions of
inequality in service provision involving overprotection, restricted activities, and
thwarted opportunities for social development (Bedini, 1990). Moreover, many of
the segregated camp experiences available to youth with disabilities fall under the
auspices of charities that have been further criticized for fund raising tactics that
capitalize on the sentiments of pity, thereby reinforcing the dependency stereotype
(Gill, 1997). It has been further suggested that moving away from inclusion in
service delivery may be a step backward in terms of equity of access and social
justice (DePauw & Doll-Tepper, 2000).

In light of the closing of segregated camp experiences, the availability of
inclusive summer camp programs to campers with disabilities remains a concern.
In Ontario, Canada, for example, approximately 20% of 200 accredited camp
administrators indicated they would like to have their camp name appear on an
“Integrated Camp List” (Bogle, 1996). Reasons for not being on the list were
inaccessible facilities and lack of trained staff. It would appear that opportunities
for youth to come together with peers with disabilities in summer recreational
settings are precarious for reasons of public acceptability, financial support, and
even legal standing (Kearns & Collins, 2000). In the USA, according to Section
302 of the Americans with Disabilities Act (P.L. 101-336) providing separate, albeit
equal services and programs as a public service is considered to be a discriminatory
practice (Germ & Schleien, 1997).

By supporting ideologically, financially, and emotionally, the inclusion
of persons with disabilities in programs originally designed for persons without
disabilities, issues of isolation, loneliness, and disempowerment have begun to
surface (Mulderij, 1997; Taub & Greer, 2000). The importance of segregated
or disability-only physical activity and recreational experiences as therapeutic
landscapes (Gesler, 1992) for individual biography and identity development may
have been overlooked (Groff & Kleiber, 2001). Those with disabilities remind
us, “Many of us growing up with disabilities have few peers with disabilities. We
do not have playmates, friends, or confidants who share our unique identities and
perspectives” (French Gilson, Tusler, & Gill, 1997, p. 8).

Youth with disabilities can internalize the stigmatization they experience
in inclusionary settings and may feel uncomfortable associating with others with
disabilities, perhaps in part because their social models are ambiguous or their
relevance to personal identity development is unclear (Cote & Levine, 2002; Gill,
1997). Hutzler, Fliess, Chacham, & Van den Auweele (2002) reported that all of
the 10 students between the ages of 9 and 15 years they interviewed about their
inclusive physical education experiences tried to identify themselves with their able-
bodied peers. One of the young women went so far as to say she was ashamed to be

160 Goodwin and Staples 161 Camp Experiences for Youth

seen with other children with disabilities. She did not want the stigma associated
with disability to be generalized to her. These authors suggested the avoidance of
disability peer models may be later linked to anxiety and maladaptive behaviors
as the gap between the socially constructed ideal image and the real self-image
becomes evident. The social identity of these youth with the larger social structure
of mainstream society reflects the pressure they encounter to fit in and sustain a
social role or membership reflective of the mainstream group (Cote & Levine,
2002; Leary, 2002).

Whereas numerous groups feel the sting of stigmatization (ethnic minorities,
homosexuals, women), parents with children with disabilities are seldom members
of the disability community themselves (French Gilson et al., 1997; Gill, 1997).
Parents of children with disabilities may not be as well prepared as other minority
parents to pass on “survival” techniques learned through their own identity with the
minority culture in question. The process of forming an adult identity by assuming
or fitting into the culturally prescribed roles of their parents and grandparents is
not as straight forward a process for young people with disabilities as it may be for
those without (Cote & Levine, 2002). Children and youth can be placed in situations
of having to negotiate their disability identity on their own while integrating it
with their nondisability identity within the mainstream social context (Gill, 1997;
Low, 1996).

The avoidance of persons with disabilities by those with disabilities is not an
uncommon response. Gill (1997) provides several explanations for such avoidance.
She contends (a) contact with other persons with disabilities can evoke disturbing
memories of rehabilitation hospitals or other sites of disability segregation, (b)
an assertion of the right to inclusion in all instances, (c) internalization of the
public’s devaluation of disability thereby rejecting those with disabilities as valued
companions, and (d) a fear of stigma contagion by association. Alternatively,
persons with disabilities who have been isolated from others with disabilities
due to transportation, environmental, geographical, or mobility reasons often find
unexpected joy in the company of others “who have been there.” Gill refers to a
shared identity with others with disabilities as “coming home” or integrating with
the disability community (p. 42).

Pensgaard and Sorensen (2002) highlighted the importance of contexts that
bring persons with disabilities together, “An empowered group or organization is
characterized by a high degree of participation of individuals in decision-making
processes, identification with other group members, social support, and sharing of
information, knowledge, and collective resources” (p. 57). Through the process of
self-categorization that accompanies feelings of belonging to a socially relevant
group comes differential treatment to those they identify with the group (Leary,
2002). The more a person identifies with another, the easier it becomes to empathize
with other members of the same group. Furthermore, personal identity with disability
denotes an individual’s ability to find a fit between their social identity (i.e., position
within a social structure) and the uniqueness and idiosyncrasies of their life history
(i.e., biological dispositions and personal agency; Cote &Levine, 2002).

The purpose of typical summer camps is primarily to provide a pleasant
recreationally-based experience with other youth (Thurber & Malinowski, 1999).
Secondary goals can include the development of activity related skills, the
encouragement of self-reliance, enhanced self-esteem, and opportunities for peer

162 Goodwin and Staples 163 Camp Experiences for Youth

relationships (Kiernan & MacLachlan, 2002). An additional reported outcome of
the disability camps is the mutual self-help that occurs as children share their
fears, anger, frustration, loneliness or guilt, and come to realize that they are
not alone in their feelings (Maher, 1995; Mulderij, 1996, 1997). Consequently,
recreational settings provide a landscape within which youth with disabilities have
the opportunity to explore identity alternatives (Groff & Kleiber, 2001; Henderson,
Bedini, & Hecht, 1994; Sherrill, 1997; Williams, 1994).

Conceptual Framework

Gesler (1992) presents therapeutic landscapes as those that have restorative qualities
for environmental, individual, and societal reasons. He drew on cultural geography
to expand the traditional definition of geography beyond the interaction of physical
and human processes to include the social structures within those settings. The
strong sense of place that emanates from the notion of cultural geography is said
to be attributed to the physical surroundings, historical context, and release from
the routines and demands of daily life they offer (Gesler, 1992). The importance of
these pluralist qualities is linked to their symbolic meanings to both physical and
psychological health (Kearns & Collins, 2000). “Social scientists who study health
would agree that environment and culture play extremely complicated, interacting
roles in health” (Gesler, 1992, p. 737).

The sense of place associated with cultural geography refers to the meaning,
intention, and significance individuals or groups give to places, be they hospitals,
schools, or recreational settings (Kearns & Collins, 2000). Much of the meaning
attributed to therapeutic landscapes can be associated with and culturally coded
through the symbols associated with the landscapes. For example, the white coats
of physicians emphasize the biological component of disability (medical landscape),
the parallel bars of the therapy setting emphasize restoration to previous levels
of function (rehabilitation landscape), and the lake front of a summer get-away
emphasize the regenerative qualities of self-reflection (recreation landscape).

For the purposes of this paper, the term therapeutic landscape will be used
to describe the restorative qualities of recreational settings. Therapeutic recreation
by definition contributes to an individual’s morale, the return of function, teaches
skills related to creative use of leisure, and reinforces abilities associated with living
independently in the community (Kraue & Shank, 1992). While camp experiences
solely for persons with disabilities continue to survive, little information is available
on their therapeutic value in individual and group identity development. The
interactive and restorative qualities of the environment, the individual, and social
context of segregated summer camps provided a meaningful and yet parsimonious
conceptual framework from which to interpret segregated summer camp experiences
as therapeutic landscapes.

The purpose of this study was to capture the meaning of summer camp
experiences solely for youth with disabilities. More specifically, the research
questions were the following: (a) What meaning does participation in segregated
recreational programs hold for youth with disabilities; (b) What within the segregated
camps experience is of relevance to identify development; and (c) Do parents share
their children’s meaningfulness of the segregated recreational experience?

162 Goodwin and Staples 163 Camp Experiences for Youth

Method

A phenomenological study was undertaken as it provided the sensitive and
sophisticated perspective needed to understand and describe the essence
of day-to-day experiences of youth with disabilities as they negotiated the
environmental, individual, and social contexts of a camp experience (van Manen,
1997). Phenomenology offers a descriptive, reflective, interpretive, and engaged
mode of inquiry that seeks to understand and describe the essence of experiences
and enables underlying structures (themes) and commonalties in meanings to be
understood (Moustakas, 1994). Phenomenology is inherently hermeneutic in nature
in that although the participants and mothers spoke for themselves, to understand
the commonality of meaning behind the experiences requires interpretation on the
part of the researcher and reader (Allen & Jensen, 1990; van Manen, 1997).

Participants

An opportunistic sampling strategy was undertaken, meaning that all of the
participants were drawn from the pool of participants who attended the same
national summer camp program (Cresswell, 1998). In addition, only those campers
who could complete in-depth telephone interviews were invited to participant (no
significant cognitive impairment). A letter of invitation was sent by mail to 41 of the
55 families. Nine campers (8 with congenital disabilities and one with an acquired
hearing impairment) and their mothers volunteered to participate (see Table 1).
Pseudonyms have been used to protect the participants’ identities. As parents are
active decision makers in the choices of organized activities in which their children
partake (Prochaska, Rogers, & Sallis, 2002), the mothers’ expectations for and
perceptions of their children’s experiences were also of interest.

The campers, 4 young women and 5 young men, ranged in age from 14
to 19 years (average age 16 years). The participants were from 6 provinces and

Table 1 Summary of Participants

Age in Home
Camper Sex years Disability locale Mother

Megan F 14 CP – ambulatory City in PEI Diane
Teran F 16 CP – ambulatory City in BC Anne
Mandy F 19 HI – FM system user City in AB Jane
Cassie F 15 Asthma, VI, and MI Town in NB Janice
Ben M 14 CP – wheelchair for distance Town in SK Debra
Ryan M 17 CP – wheelchair user Town in NB Jodie
Paul M 17 VI – tunnel vision Town in NT Karen
Phil M 16 CP – wheelchair for distance City in BC Joyce
Nathan M 16 Autism spectrum disorder City in ON Heather

Note: CP = cerebral palsy, VI – visual impairment, MI – mobility impairment

164 Goodwin and Staples 165 Camp Experiences for Youth

one territory representing all major regions of Canada (see Table 1). They came
from small towns and large urban centers. The disability representation included
cerebral palsy, sensory impairments, multiple disabilities, and autism. Demographic
information on the mothers of the participants was not collected and is a weakness
of the study.

Data Collection

To gain a broad view of the setting, information in the form of one-on-one
semistructured telephone interviews, artifacts (photographs and written documents),
and field notes were gathered over a six-month period following the camp (Janesick,
1994). The primary sources of data were the in-depth interviews with the campers
and their parents. To provide supporting evidence to the transcripts (Kuzel & Engel,
2001; Meadows & Morse, 2001), the campers also were invited to share photographs
of their experiences (Emmison & Smith, 2000). The letters of application written
by the campers were also reviewed.

Interviews. Due to the vast geographic areas represented, telephone
interviews were completed. Although telephone interviews are cost effective, can
reduce interviewer effects, and bring standardization to the questions and their
delivery, we acknowledge they cannot capture the nuances of body language, facial
gestures, or the intimacy of a face-to-face interview (Shuy, 2002). The campers
completed telephone interviews of approximately 45 to 60 min in length. The
mothers’ perspectives were captured in telephone interviews of approximately
the same length. The semistructured interviews were audio-taped and transcribed
verbatim. At the request of the youth with a hearing impairment, the interview
guide with additional probe questions was e-mailed to her and she provided her
interview responses via e-mail.

Although separate guides were needed to reflect the perspectives of the
campers and their mothers, the topics for the questions were similar. Questions
were phrased in two broad areas, the meaning of the camp experiences to the youths
that attended and the experiences of being in a recreational setting with other youths
with disabilities. Sample questions asked of the campers included these: (a) What
did you learn about yourself and others while at camp? (b) What experiences were
most meaningful to you? (c) What memories or feelings did you take home with
you? (d) What it was like to meet youths with disabilities from across Canada in
a camp setting? (e) What stories did you share with your parents or friends upon
returning home?

Documentation. Seven of the nine campers shared photographs they took
during their time at camp. The photographs provided another way for the campers to
symbolically express their thoughts and feelings about their camp experiences and
express information that may not have been articulated during the interview (Graue
& Walsh, 1998; Johnson & Weller, 2002). The significance of the photographs
was provided in writing at the time the campers submitted the photographs. These
descriptions, as well as the letters of applications written by the campers outlining
why they should be selected to attend the camp, became part of the textual record
(Pink, 2001; Jewitt & Oyama, 2001).

Field Notes. At the end of each interview, reflections on what was said and
preliminary thoughts about emerging themes were recorded. These notes were used
to conceptually return the researchers to the interview setting during the analysis
of the data (Bogdan & Biklen, 2003).

164 Goodwin and Staples 165 Camp Experiences for Youth

Trustworthiness

Multiple strategies were incorporated into the study thereby bringing plausibility to
the essences of the captured experiences, congruence between the research question
and the information presented, and authenticity to the findings (Denzin, 1994).
Confirmability was sought through the use of multiple data sources. Campers and
mothers were purposively and systematically included in the study (Flick, 1998). In
addition, the number of participants included in the study resulted in data saturation
whereby repetition of the information and confirmation of previously collected data
across participants was sought (Morse, 1994). Methodological triangulation was
undertaken as interviews, document review, and field notes were used to capture
the experiences of the participants and bring a sense of relational knowing to
the information. To reduce researcher bias beyond the confirmability strategies
described, investigator triangulation also occurred (Cresswell, 1998). The authors
possess an adapted physical activity background as well as expertise in qualitative
inquiry, interview techniques, and knowledge of physical activity and children
with disabilities.

To bring dependability or consistency to the interpretation of the data, two
data-coders completed interpretive code checks. An audit trail also was kept
documenting methodological decisions, contextual notes, and personal analytic
comments so as to acknowledge the complexity of the information (Meadows
& Morse, 2001). The interview guide was developed with the support of the
second author who also was one of the camp leaders. This brought credibility to
the relevance of the interview questions asked and their relevancy to the research
question. Interpretive code checking between the two authors during the analysis
phase of the study added to the credibility of the interpretation of the findings.
Member checks were not completed with all participants, although two families
were asked if they saw themselves in the interpretation of the findings. Both
families indicated they felt the themes captured the essences of their experiences.
The transferability or fittingness of the findings beyond the study to other contexts
and settings rests with recognizable congruence of summer segregated program
activities, sites, age, and abilities of the campers (Schofield, 1990).

Description of the Camp

The Active Living Alliance for Canadians with a Disability in partnership with
YMCA Youth Exchanges Canada sponsored a national summer camp experience
to provide an opportunity for youths from each province and territory to share their
experiences, come to understand and value an active lifestyle, and learn more about
other regions of Canada. The goals of the camp were to (a) create an enjoyable
experience for all attending, (b) foster friendships, (c) build self-worth and self-
confidence, (d) provide a wide range of physical activity pursuits, (e) experience
campus life, and (f) develop an appreciation for the diverse cultures of Canada.

The campers were required to submit an application for acceptance at the
camp explaining why they would be good candidates for the camp. In addition to
the application, two letters of support were required, one from a member of the
home community and one from their school. No camper was turned away due
to financial concerns because substantial funding was available to this national
initiative. As the campers traveled substantial distances by air, they could bring
a peer buddy with them to camp if they so chose. Four of the campers brought

166 Goodwin and Staples 167 Camp Experiences for Youth

friends with them while five elected to attend alone. The practice of inviting
friends to camp was discontinued following the evaluation of this inaugural
year. Travel support and in-camp support of friends was not deemed necessary
by the camp organizers.

Scheduled activities included tennis, sailing, swimming, horseback riding,
dancing, fencing, Jiu Jitsu, fitness activities, rock climbing, and high ropes. Hang-
out time also was scheduled into the program whereby campers spent time getting
to know more about each other and their respective home communities.

Whereas many summer camps are located in natural surroundings away from
urban settings and familiar surroundings, this camp was situated at a university
campus. The campers resided in the university residences, ate in the student
cafeteria, and took advantage of the university sport and recreation facilities
and cultural activities in the surrounding area (dinner theater, tours of local
attractions).

Data Analysis

To identify common threads that extended throughout the data, an inductive analytic
thematic analysis was conducted (van Manen, 1997). To isolate the emerging
thematic statements, a line-by-line analysis was conducted. This entailed reading
the transcripts and field notes numerous times. Particularly revealing phrases
were highlighted and coded with meaningful labels. The data analysis continued
by constantly comparing phrases to determine whether they should be classified
separately or whether they belonged to an existing code (Wolcott, 1994). To
enhance confirmability of the emergent themes, the letters of application and the
descriptions of the significance of the photographs provided by the campers also
underwent a line-by line thematic analysis. The essential or invariant themes, those
that gave fundamental meaning to the phenomenon as identified by their pattern
regularities, were then determined (van Manen, 1997; Wolcott, 1994, 2001).
Although the photographs themselves were not analyzed for their content (what
was in the photograph) or their referent (what the photograph was of) (Emmison
& Smith, 2000), many examples of social interactions (sailing) and well as novel
individual efforts (high ropes course) were evident.

Results

Three themes emerged from the data (a) not alone, (b) independence, and (c) a chance
to discover. Although the campers were of different ages, sexes, and disabilities,
the researchers heard these common themes run through their camp experiences.
The development of a strong sense of community and social belonging was evident
in the participants’ portrayals of their camp experiences thereby reinforcing the
notion of recreational camps as therapeutic landscapes. Their close social contact
and shared life experiences provided a reprieve from the disability isolation they
felt in their home communities giving social and cultural meaning to the segregated
camp context. In the letters of application, the anticipation the youths felt in meeting
other youths with disabilities was very evident. Of particular note was the degree
to which the mothers of the campers echoed the themes in their reflections of their
children’s experiences.

166 Goodwin and Staples 167 Camp Experiences for Youth

Not Alone

Although throughout the year the youths had contact with young people without
disabilities on a daily basis through school and other social activities in their
communities, they had little opportunity to interact with youths with disabilities.
The impact of this disability isolation was apparent in the participants’ comments
about discomfort with having a disability and how rewarding it was to discuss
issues with others who had “been there.” Five of the 9 participants indicated in their
letters of application to the camp that they looked forward to meeting other youths
with disabilities. The benefit of the segregated camp environment was evident in
Ryan’s application letter:

I want a chance to share. I have never met with a group of young people
with disabilities, always youth without disabilities. It would be interesting
to share how others with disabilities experience their communities and how
they are looking to their future.

Teran also was interested in meeting other youths with disabilities similar
to hers to learn more about who she was. “I think the youth exchange would be a
great way for me to meet other teens from across Canada with similar disabilities
as mine . . . to learn more about my disability as well as other disabilities too.”
Megan’s desire to meet other youths with disabilities was motivated by her desire
to learn more about what their interests were. “I don’t have much of a chance to
talk with other disabled teens and find out what they do for fun and stay active
because there aren’t many of them or any programs for them.”

The campers welcomed the opportunity to talk to others about their disability
and learn more about disabilities. The social significance of the segregated camp
environment for individual biography development cannot be overlooked,
particularly in light of Cassie’s experiences. At age 15, Cassie met for the very first
time another person with a visual impairment. The segregated camp environment
provided an opportunity for youths to come together and share common life
experiences while also learning about themselves. There was a comfort level being
in a social environment where disability was the norm and not the exception. Megan
recalled, “[Camp] was fun. You talked about what it was like being disabled, your
experiences. You didn’t have to act. I was more at ease with them.”

Several of the campers reflected upon the uncertainty around their own
disability identity and the desire they felt to talk to others with disabilities about
their uncertainty. Ben’s sense of isolation, due in part to his rural location, was
further accentuated because he was home schooled. Even though he excelled in
his studies and was working on a Bachelor of Arts degree at age 14, he longed to
be among a group of young people. “It would be really neat to go somewhere and
learn something with a group of young people. Sometimes I feel uncomfortable with
looking disabled and I would like to talk to other teenagers with disabilities.”

The evaluation, stereotyping, and taunting that contributed to feelings
of isolation at school were not evident during their camp experiences. Cassie
recalled,

There was nobody there that laughed or was making fun of other people.
There was no stereotyping. There was nobody looking down on me. I get
that all the time at school and at different things that I do.

168 Goodwin and Staples 169 Camp Experiences for Youth

A sense of belonging was reflected in the participants’ stories of camp. Ben’s
opportunity to be among a group of youths with disabilities gave him a sense of
coming home. Being a member of a larger community resonated loudly in his
short but powerful statement: “I learned that I was not alone with being disabled.”
One of the photos that Paul selected to help express the significance of his camp
experiences depicted three people facing the camera with enormous grins. Paul
was in the center with his arms around two of his fellow campers. In describing his
photograph, Paul recollected, “Meeting and making friends from across Canada
gave me a sense of belonging. I have stayed in touch with some of the people I
met and will continue these friendships.” The participants expressed feelings of
acceptance, understanding, and a sincere connection to the other campers. Teran
recalled, “It was an experience I will never forget because we connected so well.
Everyone understood and you didn’t have to worry about people judging you.”
Megan concurred:

It was fun. You talk about what it was like being disabled. You didn’t have
to act. I was maybe more at ease with them. When you are with a friend who
is nondisabled, you can’t really forget that you’re disabled.

The mothers also wanted to see their sons and daughters connect with other
youths with disabilities. The mothers were aware of the isolation they experienced
as youth with disabilities in their home communities. The mothers recognized the
life experiences associated with disability could only be truly understood by another
who shared in those experiences. Karen (Paul’s mother) recalled,

He is pretty much a loner. I thought it would be a chance for him to develop
friendships and meet other people who are in similar situations. It’s very
difficult being in such a small and remote community. He doesn’t really have
many friends here . . . he does feel alone, that he’s an oddity. He doesn’t
really participate an awful lot with kids of his own age.

As much as mothers love, nurture, and prepare their children for adulthood,
they cannot take away the impact that disability has on self-identity and how they
are perceived by others. Debra’s pleasure in her son (Ben) interacting with his true
peer group was clearly apparent.

I have never seen him feel so much that he was in a group of peers. . . . It helped
give him perspective. I think it made him feel way more normal. . . . The
experience of spending several days with a huge group of peers and feeling
perfectly normal was just wonderful, incredible and it certainly did something
to him as a person. His social maturity just started taking off there. To put a
kid with a disability in with a bunch of other kids his age in a classroom or
wherever and say it’s inclusion that isn’t. They still are not peers.

Summer camp is often perceived to be an opportunity to enjoy recreational
activities in a socially rewarding context. The experiences of the campers of
this study suggest that the social landscape of segregated summer camps can
be much deeper than was previously recognized. Connecting with other youth
with disabilities provided a landscape to explore individual biographies, identify

168 Goodwin and Staples 169 Camp Experiences for Youth

with a group of common mindedness and experience, and share in the collective
experiences and interests of others with disabilities.

Independence

The youths spoke of feeling more independent during and after their camp
experiences than prior to attending the camp. The period of time and distance
they were from their families required them to be self-reliant. Although many of
the campers had been away from their parents previously and even traveled on
airplanes, they realized the safety net that was often present in more locally based
experiences was absent in this context. The youths spoke of being more confident
and determined to do things independently. Ryan recalled,

When I first heard of it I was nervous of the thought of going away and being
with other people. But at the same time I was very excited, so I thought this is
my opportunity to be away from mom and dad and most of my friends. I knew
mom wasn’t going to come running; she can’t just drive up. It was neat.

Phil also spoke of the how the camp environment provided him with an
opportunity to exercise independence and test his ability to take care of daily
tasks without parental supervision or support. The self-assurance he experienced
was also echoed in his thinking forward to leaving home and attending university.
The impact of children with disabilities thinking about leaving home and leading
independent lives must be of immense importance to parents. The segregated camp
experience within this university based experience provided an environment for the
achievement of outcomes far beyond the traditionally perceived recreation activity
and socialization benefits. Phil recalled,

Each time I tried a different activity, I got a different perspective. I learned
how to be more self-confident and independent, being that far away for an
extended period of time. I think I handled it pretty well. I set up my own wake
up call . . . I liked the whole staying away from your parents. Then you get to
see for your future. . . . You get to see what its like to stay in residence, and
study at an actual university. It’s like it raises your independence level more
so that you get ready for when you’re an adult and you move away.

Being among youths with disabilities in a physical activity context highlighted
the self-determination, strength of character, and will of the other campers. The
group experience appeared to contribute to the youths’ need to prove to themselves,
their fellow campers, and the camp leaders that they had what it took to overcome
apprehensions, try new activities, and make new friends. Ben also disclosed how
his opinion of himself and what persons with disabilities could do changed as a
result of his camp experiences.

I was learning to become independent at the exchange. I am able to do a bit
more stuff around the house than I was before I went. The confidence I gained
was tremendous. That’s what I am trying to go for. The confidence helped
me. . . . I think that persons with disabilities are able to do anything if they
want to, if they are able to set their minds to it. Before I wasn’t so sure.

170 Goodwin and Staples 171 Camp Experiences for Youth

The mothers also spoke of the impact that being with their new friends and
older children had on their children’s desire to succeed and demonstrate that they
could be self-reliant. Debra commented on the positive peer pressure that the camp
environment provided. The self-checking and withdrawing from activities that
may have occurred in other environments was overcome. The camp provided an
environment to explore who they were and wanted to be. Debra recalled,

I think being in a university environment and being with the older youth and
stuff sort of encouraged him to move toward that young adult that he can be
instead of being a kid. I think it helped him to take that step forward. He tried
things because his peers were there that he would not have done otherwise.
And he told me that there was no way that he would not have gone. “Mom
all my friends were standing there.” Positive peer pressure.

Situating the camp at a university and housing the youths in a university
residence setting resulted in some of the campers thinking about their futures and
the eventuality of moving away from home. They negotiated an unfamiliar and
adult oriented environment, including the campus residence, cafeteria, physical
activity complex, and student union facilities. The mothers also shared a need
for their children to begin distancing themselves from them, emotionally and
physically. The camp provided a mechanism for both the mothers and children to
explore their mutual independence. Anne spoke of her daughter’s experience of
being away on her own:

It was the first time that she had traveled completely on her own. We were
concerned about whether or not they can manage things on their own,
especially as they get older and older, more toward living on their own. So
it was good for her to be able to have this chance.

Joyce, on the other hand spoke of her emotion around putting her son on
an airplane to be so far from home for an extended period. It was a time for him
to build confidence, but also for her to begin the process of letting go. “I was so
proud, and of course a little bit nervous, certainly choked up as well. I am still
feeling a bit choked up.”

The therapeutic nature of the physical landscape of the camp was cause
for the campers to learn new skills (e.g., physically negotiate the complexities of
a university campus), optimize existing skills (e.g., management of daily living
skills and time), and challenge their physical abilities (e.g., explore new physical
limits). The environment provided subtle pressure to excel to the best of one’s
ability, validated by standards reflected in the accomplishment of fellow campers
with disabilities. The university residences, for example, were symbolic of newly
affirmed independence thereby reaffirming the cultural significance of this landscape
to self-discovery.

A Chance To Discover

Being among other youths with disabilities afforded the campers the opportunity
to discover more about physical activity and recreation opportunities available to
them. The campers were by nature very confident and capable young people. Even

170 Goodwin and Staples 171 Camp Experiences for Youth

so, they expressed doubt in their own abilities. Paul, who had a visual impairment,
not only doubted his own ability to participant in some activities but was surprised
at the abilities of his fellow campers.

I learned that there were many opportunities open to people with disabilities
. . . all the things that I could do that I kind of doubted at first. Actually, what
I experienced widened my eyes to different types of activities that disabled
people can achieve, like the fencing.

The camp setting provided the opportunity for the campers to face doubts they
may have held about their ability and in some instances “put them to the test.” For
example, Phil indicated that his ability to function within the limits of his disability
were higher than he had previously believed. “I learned that my limitations are
pretty high. I can do almost pretty much anything. I also learned that it’s different
for everyone. No matter what your ability is, you can still participate in different
activities.” Cassie similarly indicated that the camp provided a context within which
to explore her limits. Whereas, she previously, either consciously or unconsciously,
restricted her willingness to become involved, the camp environment encouraged
her explore new activities. “I really changed in some ways because I had a broader
outlook on things. And I wasn’t trying to restrict myself, like I was willing to try
more things.” Megan discovered also that she was more capable than she previously
thought. “I learned that I can actually do a lot more activities than I thought I could
do, like the high ropes challenge.”

The mutual respect that developed among the participants was unmistakable.
The camp environment brought together youths with diverse backgrounds, abilities,
and aspirations. The respect and admiration for the accomplishment of others was
clear. The campers shared their increased understanding of themselves, those
with whom they interacted throughout the week, and the potential they possessed
individually and as a group. Teran expressed a strong sense of community when
she said,

I learned that anything is possible for youth with disabilities. It opened my
eyes to see that there are all different kinds of people and how diverse we
really are, like different disabilities and how we can all come together despite
these disabilities. It was inspirational. I saw other youth that have worse
disabilities than me and I saw how they did the activities.

Paul indicated that his own assumptions about the abilities of those with
disabilities were dispelled. In describing the significance of a photo depicting a
fellow camper who was a wheelchair user on the high ropes course, Paul, who
does not use a wheelchair, expressed how impressed he was that people who used
wheelchairs would embrace this activity. Paul transferred the apprehension and
sense of satisfaction he felt upon completing the course to his fellow camper who
he perceived to have less functional mobility than himself.

Doing this activity gave me a feeling of accomplishment. I was apprehensive
at first, but felt satisfaction upon completion. Seeing that people in wheelchairs
could experience the feeling was as eye opener and made me realize that we
all have opportunities for challenge.

172 Goodwin and Staples 173 Camp Experiences for Youth

Whereas Megan described how much she enjoyed various activities such as
fencing and sailing, she mentioned with some sadness that there is not a great deal
of program support for youths with disabilities in her home community.

Wheelchair fencing was one of the new sports I tried. I liked it a lot. I
would have liked to have tried wheelchair fencing when I got home, but
unfortunately, we have no sports organizations or teams for physically
disabled kids. Too bad.

The experiences of the campers also were reflected in the comments of the
mothers. It was important to the mothers to see their children not only come to an
understanding of their own capabilities, but also see how other youth functioned
and interacted within their environments. Karen felt that the camp provided an
opportunity for her daughter to reflect upon her strengths. “I think it helped with
the perspective thing, because she will run around moaning about being disabled.
It is good to have the perspective that you are not that disabled.”

Although the mothers were very supportive of the experience, in some cases
they felt they did not have the personal or community resources or tools to build
on the experiences their children gained at the camp. The campers spent one week
learning, exploring, sharing, and growing together. Upon returning home, however,
the realities of poor facilities, lack of opportunities, and physical distance from
programs were once again apparent. Karen put it very well when she indicated the
positive camp experience only reinforced further how limited her son’s previous
experiences had been:

I think it’s good for anyone to experience these things. It opened his eyes to
try different things; to see what is available out there. But at the same time,
when he came back . . . I think in some ways it was an awakening to what
we don’t have here, rather than what we do.

Debra suggested there is a need for follow-up to such intense experiences.
She and her son had learned so much and yet she felt at a loss as to how to pursue
physical activity and recreational activities in her home community. Debra suggested
the services of a family recreational counselor that families could call upon to inform
and support families in recreational planning would have been of benefit to her.

I am thinking about someone like a school counselor to talk you through how
we might find ways for him to live out or develop new interests. He came
back from camp and all of a sudden realized that maybe he can do things that
he didn’t think he could. You could brainstorm with them. I am not thinking
that they would necessarily provide the program, but they’d enable you to
apply whatever you had brainstormed about.

Discussion

Therapeutic landscapes are those with restorative qualities for individual,
environmental, and societal reasons. The camp experience provided a personal,
physical, and social landscape from which to learn more about their own capabilities,
the capabilities of others, and their physical potential. The opportunity to express
their independence and learn to be self-reliant while away from family was

172 Goodwin and Staples 173 Camp Experiences for Youth

welcomed. The camp was an environment where personal independence and
management of time were expected. The subtle peer pressure they experienced
to do it on their own provided further motivation to be independent and take on
challenges they might not have sought previously. The campers came away with
new perspectives about who they were and where their futures may be taking them.
The interaction of the environment of a residential camp, the individual demands
in meeting the camp schedule, and the segregated social context had provided a
therapeutic or restorative landscape for personal and group identity formation.

The experiences of the youth of this study suggest they have few opportunities
to come together to explore their individuality, their social connectedness to others
with disabilities, and the change in perspective that a recreational environment
can provide. While the participants of this study enjoyed many benefits typical
of summer recreational programs, including fun, enjoyment, friendship, and
participation in activities not often encountered the remainder of the year, the
camp also was a valuable therapeutic context for it provided a setting for identity
exploration and self-definition. The inner conflicts expressed around their own
disabilities and the disabilities of others were reflected in their descriptions of
personal choice and agency through the milieu of physical activity.

All young people struggle with individual identity and individuation from
the values of their parents. Youth with disabilities have the additional struggle of
negotiating two identities and asserting links to both their disability identity and
the disability community, while seeking acceptance in the social mainstream (Gill,
1997). Whereas the individuation time for young adults can be tumultuous for
“typical” families, this may not be the case for all families. The parents of this study
were very excited and pleased to see their teens take steps toward independence.
The assumption of independence that is desired and even inevitable for most young
adults may not be one that is easily recognized and shared by youth with disabilities
and their families. The options for such “fledging” may also appear fewer and
hence seem less achievable.

Groff and Kleiber (2001) point out that “Identify formation is based on
the notion of choice and freedom to explore identity alternatives” (p. 319). The
therapeutic significance of segregated summer recreational landscape in identity
development has received very little consideration. The day to day interaction to
which those of us without disabilities are exposed results in the internalization of
social norms and values that are influential to identity formation (Cote & Levine,
2002). The youths of this study indicated exposure to the social norms and values
relevant to disability identity formation are not available to them on a day to day
basis.

The results of this study are similar to those reported by Groff and Kleiber
(2001). The participants indicated that feeling connecting to others with disabilities
helped them understand themselves better. The camp context allowed them to feel
comfortable as youths with disabilities, a context that was not readily available
to them in school or other community events. Connecting with other youths with
disabilities dissolved, even if for a short period of time, the feeling of disability
isolation and created a social landscape of companionship, a sense of belonging,
and acceptance. The participants appeared to be articulating their identity as youth
with disabilities and connecting with a larger disability community. Carol Gill
(1997) refers to this psychological wholeness of coming home as the celebration
of a common history, humor, customs, and worldviews.

174 Goodwin and Staples 175 Camp Experiences for Youth

Consideration needs to be given to the benefits of residential disability—only
recreation programs on individual disability biography development, particularly in
light of such circumstances such as rural geography, home schooling, or the inability
to take advantage of other physical activity opportunities due to transportation,
awareness, environmental, staff availability, programming, or financial constraints
that might otherwise bring youth with disabilities together (Bedini, 2000; French &
Hainsworth, 2001; Gill, 1997). The goodness or badness of recreational and physical
activity programs that bring youth with physical disabilities together may need to
be judged on several levels: the level of the participant, the family, the disability
community, the service provision level, and the ideological level.

Participants of this study helped to illustrate the value of the segregated
summer camp as a therapeutic landscape. Through their recreational time and
physical activity experiences, the campers gave new meaning to their understanding
of self and that which persons with disabilities were capable. The external influence
of time spent with others with disabilities appeared to impact the internal agency
of the participants and bring a new level of comprehension to their own self-
definition. They moved beyond physical activity limits previously achieved, in
part because of expectations set by their peers with disabilities. By observing
the successes of other youths with disabilities more significant than their own,
the youths accepted challenges beyond their own previously perceived limits.
Past experiences in inclusive contexts appeared to not provide the motivation or
opportunity to come to understand their full physical potential. The participants
acknowledged that the camp experiences afforded them the opportunity to explore
activities of their choosing and develop alternate perceptions of their own abilities
and that of others.

The precarious nature of summer camps solely for persons with disabilities
is due in part to the lack of information regarding their efficacy. The importance
of camp experiences in disability community awareness, disability identity
development, and the therapeutic benefits of the camp “landscape” have yet to be
fully captured. Recreational settings have been identified as one context within
which youth with disabilities have the opportunity to explore identity alternatives
(Groff & Kleiber, 2001; Sherrill, 1997; Williams, 1994); however, the potential
for recreational and physical activities to influence disability identity development
is irrelevant if the opportunities to interact with others with disabilities are absent
or far removed (Groff & Kleiber, 2001). Providing environments where youth
with disabilities can connect with other youth with disabilities may not be a step
backward in social justice and disability rights (DePauw & Doll-Tepper, 2000) but
rather providing a context for their disability identities to unfold at the individual
and group level (Gill, 1997). Youth with disabilities have the complex task of
integrating their connection with the disability community with the parent society
in which they are educated and will ultimately be employed (Gill, 1997).

Recreational and physical activity programming for persons with disabilities
must be understood within a framework that acknowledges stage of life, nature
of impairment, functional ability, and personal interests. It would appear that
the bandwagon discourse (DePauw & Doll-Tepper, 2000) that has surrounded
inclusive programming needs to be carefully articulated so as to represent the
multiple perspectives of adapted physical activity consumers and providers. What
may be viewed on one level as social injustice due to questions of equity of access
to inclusive recreational opportunities for one individual or context may be viewed

174 Goodwin and Staples 175 Camp Experiences for Youth

as a landscape for learning, sharing, exploring alternate identities, developing self-
reliance, and coming home for another.

There are several limitations of the study. A comprehensive member check
procedure was not implemented thereby weakening the dependability of the analysis
of the information. The use of telephone interviews and the time that transpired
between the camp experience and the interviews may have affected the depth of
the information collected. It is also important to note that although the camp was
designed for youth with disabilities, some youths did bring friends with them who
did not have disabilities. This may have influenced the richness of the disability-
only context of the campers’ experience. Future inquiry into the role of segregated
physical activity programs as psychologically therapeutic contexts for the discovery,
development, and/or affirmation of disability identity is recommended.

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Acknowledgments

The authors would like to thank Jane Arkell of the Active Living Alliance for
Canadians with a Disability for making this study possible. Funding for this study was
provided by Human Resources Development Canada.

38 ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007

The Hope Connection A therapeutic summer day
camp for adopted and at-risk children with special
socio-emotional needs

Large numbers of North American and Western
European families are adopting children with serious
socio-emotional needs. Other children experience
similar deficits as a result of neglect and abuse by
carers. Often these children are diagnosed with
psychopathology and receive drug treatments that
can be ineffective and even detrimental. Karyn B
Purvis, David R Cross, Ron Federici, Dana
Johnson and L Brooks McKenzie report on The
Hope Connection, a project designed to meet the
needs of these at-risk children and their families. The
core of this project is a theoretically integrated
summer day camp offering activities that are attach-
ment rich, sensory stimulating and behaviourally
structured. Pre-test and post-test data indicate that
summer camp had a significant impact on the
children’s behaviour (n = 19), as indicated by parent-
report measures of child behaviour problems and
attachment. These findings are discussed with
regard to possible future directions of programme
implementation and evaluation.

Introduction
The purpose of this article is to explore a
camp structure that was developed to
address the enduring effects of early
deprivation upon the development of
adopted and other at-risk children.
Originally, internationally adopted child-
ren with histories of severe deprivation
and commensurate behavioural diff icul-
ties were the target population for this
intervention. However, a small number of
domestically adopted children were
included due to the urgent needs of these
families and the background similarities
of deprivation (Purvis, Cross and
Sunshine, 2007).

Although most adopted children do
not present serious problems in these
areas, many children from deprived
backgrounds do, and there is an undeter-
mined number of families who need
support addressing them. As noted in two

recent meta-analyses by Juffer and van
IJzendoorn (2005) and Meese (2005),
there is a scarcity of research on interven-
tions in these areas.

Specifically, three areas of psycholo-
gical development are likely to be
affected when inadequate care is pro-
vided: attachment, pro-social behaviour
and sensory processing. By integrating
these three aspects of development into a
camp structure that presupposes a
dynamic interaction between them, the
authors attempted to address a much
broader spectrum of developmental
deficits with greater efficacy than was
achieved using narrowly focused inter-
ventions. Additionally, by addressing
these areas simultaneously, a synergistic
therapeutic effect was anticipated, as each
independent construct has been shown to
affect the others.

Children eligible for adoption often
present developmental impairment and
are especially likely to have experienced a
wide variety of risk factors (Meese, 2005;
Beckett et al, 2006). By definition,
adopted children have lost their biological
mother through death, abandonment or
separation, thus experiencing maternal
deprivation, def ined here as resulting
from a wide range of possibilities, includ-
ing maternal privation, being deprived of
maternal care from birth or separated
from the biological mother after some
period of maternal care (Ainsworth, 1962;
Gandelman, 1992).

In addition to maternal deprivation,
children eligible for adoption, especially
those with backgrounds of institutional
care, may have experienced environ-
mental deprivation (Gandelman, 1992;
Gunnar, 2001), postnatal environments
that do not include the normal range of
non-maternal stimulation, including
social and physical stimulation (eg sen-
sory stimulates such as tactile, proprio-
ceptive and vestibular).

Other risks related to the infant’s
milieu and often found in combination

Karyn B Purvis and
David R Cross are
Associate Directors
of the Institute of
Child Development
and Professors of
Psychology, Texas
Christian University

Ron Federici is a
Neuropsychologist,
Federici &
Associates

Dana Johnson is
Director of the
Division of
Neonatology and
Director of the
International
Adoption Clinic,
University of
Minnesota

ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007 39

L Brooks McKenzie
is an MA-Doctoral
student, Texas
Christian University

Key words:
international adoption,
adoption, child behav-
iour, attachment,
sensory, self-regulation,
intervention, camp

with maternal deprivation include nutri-
tional deprivation, maltreatment (Johnson,
2000) and experiences that have been
characterised as global deprivation
(Rutter and the ERA study team, 1998;
Gunnar 2001). This occurs when environ-
ments fail to meet most, if not all, of the
child’s basic needs, including those for
nutrition, physical and social stimulation
and relationships. Based on the presence
of these risk factors, either singly or in
combination, children adopted from
foster care or institutional care have been
shown to be at serious risk for a variety of
delays and developmental impairments
(Beckett et al, 2006; Rutter et al, 2007).

There have been many reviews of the
international adoption literature which
delineate the impact of early deprivations
(Johnson, 2000; Gunnar, 2001). The
evidence suggests that the consequences
of early and severe deprivation can be
divided into two broad categories. The
f irst incorporates def icits that tend to be
rectified once children are placed in
adoptive homes. These include physical
growth, general intellectual performance
and language (Rutter and the ERA study
team, 1998; Gunnar, 2001; Beckett et al,
2006). The deficits in the second category
do not remit so easily after adoption and
appear to be specif ically related to
maternal deprivation (Ainsworth, 1962;
Gunnar, 2001; Beckett et al, 2006).
Likewise, domestically adopted children
have often experienced similar depriva-
tions due to neglect and abuse (Purvis,
Cross and Sunshine, 2007).

In the following discussion, we will
divide these enduring deficits into three
sub-categories: attachment, self-
regulation and behaviour. Although these
categories are often discussed as indep-
endent aspects of a child’s functioning,
there is growing understanding of the
relationship between them, based on
common developmental histories and
underlying neuropsychological processes
(Schore, 1994; Siegel, 1999).

Recent research with post-institutional-
ised (PI) children has documented that
maternally and/or globally deprived
children are at risk of enduring attach-
ment disturbances (Rutter et al, 2007) and
other developmental impairments

(Beckett et al, 2006). Specif ically, unlike
previous findings that emphasise the
effect of time on children’s development,
the English and Romanian Adoptees
study found that infants who endured
more than six months of institutional
deprivation were at risk regardless of
duration of deprivation beyond that point
and were showing severe deficiencies
well into childhood.

Children for whom attachments have
been def icient may also have experienced
a lack of sensory input and inadequate
opportunities for transactional experi-
ences with their social and physical
environments (Johnson, 2000; Gunnar,
2001). This lack of opportunity denies the
infant occasion to develop skills of self-
regulation with regard to behaviour and
sensation. These abilities to self-regulate
appear to emerge from the matrix of early
caregiver–child interactions (Schore,
1994; Sroufe, 1996) and, if undeveloped,
may affect the child’s future interactions
with peers and the environment. Sensory
deficits, which may result from these
environmental deprivations, are concep-
tualised as disturbances in the child’s
ability to process, integrate and modulate
sensory input (Kranowitz, 1998). The
inability to process even the most basic
sensory stimuli places the child at risk for
concomitant behavioural problems
(Rutter and the ERA study team, 1998;
Farina, Leifer and Chasnoff, 2004; Juffer
and van IJzendoorn, 2005; Meese, 2005)
and poor peer relationships (Gunnar,
2001).

These deficits of behavioural self-
regulation may develop along at least
three pathways. First, institution- or
foster-reared children may have been
denied the opportunity to develop the
self-regulatory processes associated with
sensitive and responsive maternal care
(Schore, 1994), processes that are
believed to help prevent problematic
childhood behaviours (Calkins and Fox,
2002). Second, these children may have
been denied the opportunity of develop-
ing pro-social behaviours that ordinarily
evolve by virtue of normative socialisa-
tion in the home environment (Grusec,
Davidov and Lundell, 2002). Third,
maternally deprived children may have

40 ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007

developed behaviours and/or survival
strategies that are considered antisocial,
and hence maladaptive, by their adoptive
families and society, but which were
perfectly adaptive in the ecologies where
they lived, learned and needed to survive
before being adopted (Farina, Leifer and
Chasnoff, 2004). Thus, parents who adopt
children from institutions abroad or from
the foster care system at home are faced
with the possibility that their adopted
child will have problems in the three
different areas of development cited
above: attachment, self-regulation and
pro-social behaviour.

A scarcity of interventions for the
family in crisis has led to the develop-
ment of a therapeutic day camp for these
families and children described below.
The crux of the approach is the triad of
attachment, sensory processing and pro-
social behaviour. These areas are treated
simultaneously as they are believed to be
inextricably connected.

Attachment, sensory and behavioural
activities all take place within an environ-
ment of felt safety. This concept of felt
safety is critical as research has shown
how chronic hypothalamic-pituitary-
adrenal (HPA) axis activity prevents
learning in animals (Garner, Wood and
Pantelis, 2007). This atmosphere of felt
safety creates an environment designed to
lessen the chronic anxiety that has been
associated with fearful and/or deficient
interactions with caregiver and environ-
ment, often a result of institutionalisation.
The freedom from chronic anxiety allows
cognitive and emotional processes to
begin to develop.

The f irst pillar of our therapeutic triad,
attachment, was addressed with prepared
scripts and nurturing activities, such as
those found within Theraplay® principles
developed by Jernberg and Booth (1998).
The second pillar, a sensory-rich environ-
ment, was centred around activities
designed to stimulate repeatedly the three
internal senses – tactile, proprioceptive
and vestibular (Kranowitz, 1998) – and
included manual exploration, play and
intimate touch. Pro-social behaviour, the
third pillar, employed scripts, scenarios
and video recordings as a means of
allowing the child opportunity to practise,

model and witness appropriate behav-
ioural interactions.

It is the purpose of the research
reported here to help fill a void by pro-
viding data and analysis from a thera-
peutic summer camp for special needs
children. Its ultimate purpose is to
demonstrate that efficacious interventions
for some of the most damaged children
are possible and to impel researchers and
clinicians to pursue these strategies, as
well as focusing upon the known deficits
and pathology associated with severe
deprivation.

Methods

Participants
Camp participants comprised 19 children
with histories of early deprivation and/or
maltreatment, living in the United States.
Most were adopted from orphanages in
Eastern Europe (n = 16). Two were
adopted from the custody of Child
Protective Services and one was living
with a biological parent but had a history
of severe deprivation. Children were
enlisted through local parent support
groups and by referral from child and
family therapists. Participants were
divided into two separate groups by age,
which ranged from three to 14 years. The
mean age of the younger group was 5.7
years (range: 4–9), while mean age of the
older group was 10.7 (range: 10–13).
Females (n = 10) slightly outnumbered
males (n = 9). Of the post-
institutionalised (PI) children, nine were
adopted from Russian orphanages, four
from Romanian orphanages and two from
other countries. Among the PI children,
most entered the orphanage at birth (n =
8). Mean length of orphanage stay was
three years four months, whereas mean
age at the time of adoption was four years
eleven months.

Of parents who spent time in the
foreign orphanage from which their child
was adopted, most (n = 9) reported the
absence of toys or other forms of environ-
mental stimulation. Some parents (n =8)
reported mixed sleeping arrangements,
ten parents were aware of profound
emotional and physical neglect, four
reported physical abuse and four that

ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007 41

their adoptive child had been sexually
abused in the orphanage. Parents of both
children adopted through Child Protective
Services cited neglect and/or abuse as the
reason for the child’s being placed in
protective custody. The child participant
living with a birth parent had been
separated from the other birth parent due
to severe abuse.

The adoptive families were primarily
two-parent households (n = 15), with high
levels of education. Eight mothers and six
fathers had completed college; four
mothers and f ive fathers had completed
some form of graduate education. Most
fathers were in professional careers (n =
7) or owned their own business (n = 5).
Mean age of the parents was 46.8 for
fathers and 42.1 for mothers. Family
income in the upper range (over $100,000
a year) was reported by four of the
families, while most (n = 8) cited annual
incomes between $50,000 and $100,000.

Camp schedule
The camp was conducted at Texas Chris-
tian University (TCU), using campus
facilities. The schedule was set up to
allow parents to drop off the children in
the morning and pick them up in the
afternoon. The schedule of events
throughout the day was intended to allow
for a variety of interventions and activi-
ties, while providing for intensive
supervision and guidance from camp
staff. Staff praised children for pro-social
behaviours, modelled behaviours, gave
corrective guidance and provided a safe
base for the children to explore their new
surroundings and experiences. Camp
participants were divided into two age
groups: three to nine and ten to 14. Camp
was held in two consecutive sessions,
each lasting three weeks, with younger
children in Session 1 and older children
in Session 2. There was a one-week
interval between sessions during which
support staff continued planning, prepara-
tion and re-structuring for the older
children’s camp. Prior to each session,
each child was assigned a ‘buddy’, an
undergraduate student who had been
trained in the therapeutic techniques
employed and who would shadow, model
behaviour and bond with the children

over the course of the camp.
Session 1 started with the scheduled

hours of 8.30 am to 5.30 pm. At the end
of the first week, due to parent reports of
child fatigue, the afternoon portion was
scaled back to 3:30 pm, with child care
provided for parents whose work sched-
ules prohibited early pick-up. Beginning
in the second week and continuing
throughout Sessions 1 and 2, camp was
conducted on the new schedule.

Owing to the extensive nature of
scheduling and programme interaction,
the following is only a brief description of
the daily camp programme, which con-
sisted of a series of small group activities
with explicit therapeutic goals. Activities
were designed to be (a) attachment rich,
(b) sensory rich and (c) behaviourally
structured, as outlined in The Hope
Connection: A manual for kids under
construction (Purvis and Cross, 2003).

Attachment-rich experiences
During the initial development of this
programme, there was little information
available about attachment-based inter-
ventions due to the scarcity of literature
at the time. In an attempt to address the
deficits experienced by the children, work
done by clinicians working within an
attachment framework (eg Jernberg and
Booth, 1998) was reviewed. In doing so,
we focused on three core principles. First,
we created an environment of felt safety,
thereby recreating one of the core func-
tions of secure parent-infant attachments
(Bowlby, 1973; Simpson, 1999). Second,
we devised scripts that explicitly encoded
fundamental aspects of attachment
relationships. For example, the ‘Attach-
ment Ritual’ was observed each morning.
Part of this scripted interaction consists of
two simple questions asked of the parent
by the camp staff: ‘May I be the boss of
[your child] today?’ and ‘If [your child]
would like a hug, may I give [your child]
one?’ These scripts are designed to
replicate artif icially lessons of trust and
authority, enabling the child to understand
that they are not in control of the camp
but that they are valued and can receive
affection. Third, we included numerous
opportunities for nurturing behaviours
and activities, many of which were based

42 ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007

on Theraplay® principles mentioned
earlier.

Sensory-rich experiences
The camp environment was permeated
with safe, playful sensory experiences. At
the start of each day, children participated
in a ‘Crash-n-Bump’ activity designed by
occupational therapists to activate the
three internal senses – tactile, proprio-
ceptive and vestibular. Crash-n-Bump
activity is designed with components such
as a small mini-trampoline, a ladder to
climb, from which the children jump into
a pool of balls or foam squares, and a
crawl-through tunnel.

Beginning with Crash-n-Bump, a
major physical activity was scheduled
every two hours throughout the day. For
continuing sensory input, children had
free access to sensory items such as
bubble gum and ‘fidgets’, for instance
pressure balls to squeeze when feeling
anxious, which were always available
provided the children asked their buddy
in an acceptable fashion. The camp
schedule was orchestrated so that children
would benef it from a regular and
programmed sensory diet designed to
help them regulate attention, activity
levels and emotional state (Kranowitz,
1998; see also Johnson, 2000).

Cognitive-behavioural structure
Other small group activities were
developed to provide active reinforcement
of behavioural scripts. These (Abelson,
1981) were developed to structure the
children’s activity and to help promote
their self-monitoring and self-regulating
skills (see, for example, Goldstein and
Cisar, 1992). A script is a clear, brief
auditory reminder/instruction as to what
is acceptable and pro-social behaviour.
Often children from severely deprived
and/or abusive backgrounds have diffi-
culty with auditory processing. Therefore,
lengthy disciplinary lectures or complex
instructions are lost on them. Typical
scripts, like ‘Obey the first time’ and
‘Treat others with respect’ are designed to
convey expectations to the child in a very
concise manner. This approach capitalises
on developmental insights about the role
of scripts in social behaviour (Hudson,

Shapiro and Sosa, 1995, 1997) and is
closely related to psychosocial interven-
tions, such as cognitive problem-solving
skills training (Kazdin, 2002).

Buddy-child dyads would demonstrate
their script rehearsal to the rest of the
group while being videotaped. Later,
during snack time, the children would
receive feedback while watching them-
selves on video. Other scripts addressed
the end of the day, remembering fun
activities, resolving conflict between
campers or campers and buddies and,
finally, looking forward to tomorrow’s
events.

Assessments
Assessments of children’s progress
included both parent report and child
report measures. One parent report
measure was completed only as a pre-test
measure, the TCU Survey of the Inter-
national Adoption Experience (Purvis,
Cross and Ware, 1999). Parent report
instruments that were completed as pre-
and post-test measures included the Child
Behaviour Checklist (CBCL), Beech
Brook Attachment Disorder Checklist
(Beech Brook) and Randolph Attachment
Disorder Questionnaire (RADQ).

In addition to the parent report items,
children produced self and family draw-
ings (Kaplan and Main, 1986). The family
drawings were scored on the principles of
art therapy (eg use of colour, detail and
elaboration) and on a set of attachment-
related criteria identif ied by Fury,
Carlson and Sroufe (1997), for instance
the child figure’s proximity to that of the
parent figure. Validity of the family
drawings has been established in studies
showing (a) that the family drawings of
children with different attachment
histories are reliably different (Fury et al,
1997) and (b) that children with different
attachment histories differ in their
attention to, and memory for, attachment-
relevant information in family drawings
(Kirsh and Cassidy, 1997).

Results
The design of the study is a one-group
pre-test, post-test design, without a
control group. Clearly, from a design
standpoint, it would have been desirable

ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007 43

to have a control group with random
assignment of children to each group.
Nevertheless, the argument has been
made by clinical methodologists that
valuable information can emerge from
designs that are not randomised trials
(Kazdin, 2003). Specifically, Kazdin
argues that simple pre-test and post-test
designs can yield valid results if there is
corroborating evidence for no change
prior to the experiment.

Evidence of this kind was obtained
from the TCU survey of the adoption
experience, in which parents were asked
to report both retrospectively on their
children’s behaviours at the time of
adoption and at the time of the survey
(given at pre-testing). A sampling of child
problem behaviours, with frequencies of
at least five, is shown in Table 1.

The frequencies in Table 1 reflect a
pattern we have seen both in this sample
and in the larger sample of adoptive
parents who completed the TCU survey. It
can be seen that there are decreases in
problems that might be described as
internalising behaviours (eg, shy, anxious,
fearful), although parents report that
between a quarter and a third of these
adopted children continue to experience
these problems. Conversely, there are
increases in problems that might be
def ined as externalising behaviours (eg
manipulating, lying, verbal aggression).
These and other data collected from the

parents prior to the summer camp suggest
that many families were distressed by
their children’s behaviours and that these
difficulties were not improving.

In order to evaluate The Hope
Connection directly, repeated measures
(ANOVAs) were performed, using a two-
factor design with one between-subjects
factor (SESSION: Younger vs Older) and
one within-subjects factor (TIME: Pre-
test vs Post-test). The results for the Child
Behaviour Checklist are summarised in
Table 2, which displays pre-test and post-
test means, as well as the number of
children in the clinical range on both
occasions.

Of the internalising subscales
(withdrawn, somatic complaints, anxious/
depressed), there was only one significant
effect and that was a significant
SESSION main effect for the anxious/
depressed subscale ( F(1,17) = 9.14, MSe
= 46.62, p = .008). As can be seen in
Table 2, the means on this subscale are
substantially higher for the older children
than for the younger ones.

As for the externalising subscales
(delinquent behaviour and aggressive
behaviour), there was also only one
significant effect and that was a
significant TIME main effect for the
aggressive behaviour subscale (F(1,17) =
5.01, MSe = 24.19, p = .039). As shown in
Table 2, there were decreases from pre-
test to post-test for both sessions.
Although the decrease in aggressive
behaviour, as reported by the parents, was
smaller for the older children than for the
younger ones, the interaction was non-
significant (F(1,17) = 1.60, MSe =
24.195, p = .223).

With regard to the four CBCL
subscales not included in the internalising
or externalising composites, there were
significant effects on all but the social
problems subscale. There was a signifi-
cant TIME main effect for the thought
problems subscale (F(1,17) = 8.97, MSe =
1.26, p = .008), indicating a signif icant
decrease from pre-test to post-test for
both age groups.

Similarly, there was a significant
TIME main effect for the attention
problems subscale (F(1,17) = 7.67, MSe =
5.30, p = .013), indicating a signif icant

Table 1
Number of parents (n = 14) reporting that their internationally
adopted children displayed common problem behaviours at the time of
adoption and at the time of the survey (pre-test)

Frequency
Behaviour Time of adoption Time of survey

Shy 5 1

Anxious 7 4

Fearful 8 3

Excessive eating 9 5

Bedwetting 8 4

Manipulative 6 8

Lying 2 6

Verbal aggression 1 6

Physical aggression 5 3

44 ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007

decrease for all of the children attending
The Hope Connection. Finally, there was
a signif icant TIME main effect for the
other problems subscale (F(1,17) = 6.24,
MSe = 14.66, p = .024), again indicating
a signif icant decrease for all of the
campers. No other main effects or
interactions were statistically significant.

Taken together, these results indicate
that there were significant decreases in
problem behaviour from pre-test to post-

test on four subscales of the Child
Behaviour Checklist: thought problems,
attention problems, aggressive behaviour
and other problems.

A similar pattern was found for the
parent report measures of attachment.
Results for all of the attachment measures
are shown in Table 3, displaying pre-test
and post-test means and standard
deviations for both camp sessions
(younger and older). There was a

Table 2
Descriptive statistics for subscales of the Child Behaviour Checklist, displayed by group (younger vs older) and time of
testing (pre-test vs post-test).

Younger group Older group
Subscale Pre-test Post-test Pre-test Post-test

Withdrawn
Mean 3.9 2.3 4.4 4.3
S.D. (4.1) (3.6) (3.7) (3.7)
No. clinical 2 1 4 3

Somatic complaints
Mean 1.4 1.6 2.1 2.3
S.D. (1.6) (2.8) (2.1) (2.1)
No. clinical 1 2 1 1

Anxious/depressed
Mean 5.4 2.3 10.9 10.2
S.D. (5.8) (2.3) (5) (7.4)
No. clinical 2 0 4 4

Social problems
Mean 4.6 3.7 5.7 5.4
S.D. (3.1) (2.7) (3.2) (4.0)
No. clinical 3 1 5 3

Thought problems
Mean 2.5 1.2 3.1 2.2
S.D. (2.7) (1.9) (2.8) (2.9)
No. clinical 3 1 4 2

Attention problems
Mean 8.3 5.6 10.4 9.0
S.D. (4.8) (3.7) (5.9) (6.5)
No. clinical 4 1 5 4

Delinquent behaviour
Mean 3.5 2.1 3.6 3.2
S.D. (3.2) (2.5) (2.3) (2.7)
No. clinical 3 1 5 0

Aggressive behaviour
Mean 16.9 11.3 15.0 13.4
S.D. (10.0) (6.3) (8.9) (8.7)
No. clinical 4 1 2 3

Other problems
Mean 11.1 6.6 9.8 8.1
S.D. (5.7) (3.7) (4.1) (7.5)
No. clinical N/A N/A N/A N/A

ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007 45

signif icant TIME main effect for the
Beech Brook positive subscale (F(1,12) =
9.35, MSe = 0.22, p = .010), indicating a
notable increase in positive attachment
behaviours as measured by this
instrument. This main effect was
complemented by a significant main
effect on the Beech Brook negative
subscale (F(1,12) = 8.01, MSe = 0.29, p =
.015), indicating a notable decrease in
negative attachment behaviours. In
addition, there was a significant TIME
main effect for the RADQ measure
(F(1,16) = 13.16, MSe = 164.26, p =
.002), which corresponded to a
signif icant decrease in attachment
disturbance.

As can also be seen in Table 3, family
drawings exhibited a similar trend as the
parent-report measures of attachment.
Analysis revealed a significant increase in
positive family drawing scores (F(1,11) =
5.57, MSe = 10.87, p = .038) and a
signif icant decrease in negative family
drawing scores (F(1,11) = 6.52, MSe =
18.37, p = .027). These differences
indicate changes in the children’s
attachment representations that

complement the parents’ observations
about their children’s behaviours.

Discussion
As evinced by statistical and anecdotal
evidence, the 19 children participating in
The Hope Connection made progress in
their social and emotional functioning.
Although these gains were more pronoun-
ced for children in the younger group,
differences in change between the two
groups were not statistically signif icant.

The progress made by these children
could be seen not only quantitatively in
the assessments reported here but also in
numerous anecdotal reports from the
parents, and in qualitative observations
made by camp staff. For example, one of
the younger participants had only spoken
a few words, despite being with his
adoptive family for over two years.
During the course of the intervention, he
became an active participant in conver-
sations with camp staff and his family,
often speaking in lengthy sentences for a
child of his age. Another boy had never
looked his parents in the eye and never
said ‘I love you’. By the end of camp he

Table 3
Descriptive statistics for the attachment measures (Beech Brook, RADQ and family drawings) displayed by group
(younger vs older) and time of testing (pre-test vs post-test).

Younger group Older group
Subscale Pre-test Post-test Pre-test Post-test

Beech Brook
Positive scale
Mean 2.3 3.0 2.5 2.9
S.D. (0.8) (0.9) (0.8) (0.6)

Beech Brook
Negative scale
Mean 1.7 1.1 1.5 0.8
S.D. (0.9) (0.6) (1.3) (0.6)

Randolph Attachment
Disorder Questionnaire
Mean 50.0 29.6 47.4 36.9
S.D. (22.2) (22.5) (21.3) (18.9)

Family drawings
Positive score
Mean 6.6 9.3 9.9 13.3
S.D. (3.4) (6.1) (6.2) (3.7)

Family drawings
Negative score
Mean 15.5 12.0 11.5 6.4
S.D. (2.2) (6.0) (6.7) (4.0)

46 ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007

was hugging his parents, making eye
contact and verbally expressing his
affection.

An important feature of the results is
that improvements in the children’s
behaviours tended to occur in the
aforementioned domains thought to be
most resistant to developmental catch-up
following adoption: attachment, self-
regulation and pro-social behaviour. All
three measures of attachment (Beech
Brook, RADQ and family drawings)
showed signif icant improvements in
attachment-relevant behaviours.

Furthermore, two of the CBCL
subscales showing significant improve-
ment – attention problems and thought
problems – may be interpreted as the
subscales relevant to executive func-
tioning and self-regulation. A third CBCL
subscale showing signif icant improve-
ments – aggressive behaviour – is
believed to have bearing upon pro-social
behaviour. The final significant CBCL
result, decreases on the other problems
subscale, is also interesting as this
subscale includes items tapping into
aberrant behavioural issues (especially
eating and sleeping) commonly displayed
by internationally adopted children
(Johnson, 2000).

Although the evidence points to
improvements in the behaviour of the
campers, several caveats are in order. The
first and most obvious is the lack of a
comparison group. The argument we
present is that the simple pre-test/post-
test design employed here is valid, based
on two separate sources of evidence.
First, the data from the TCU Survey of
the International Adoption Experience
indicate that, with regard to externalising
behaviours, the campers’ problem
behaviours were worsening prior to camp.
Second, there is the fact that many, if not
most, of the families who enrolled their
adopted children in The Hope Connection
were desperate for help and looked upon
this therapeutic summer camp as their last
hope for saving their disintegrating
families. Many families had attempted
other interventions and, for the majority,
the situation was deteriorating and the
improvements reported here are reversals
of that downward trend.

The lack of a control group leaves the
possibility that the effects seen are an
outcome of camp attendance rather than
what took place. The authors do not
believe that this is the case as these
children typically do not cope well with
change, novel sensory stimulation and
behavioural demands, or with other
radical changes associated with attending
a strange camp in an unfamiliar place. It
is believed that attendance at a
mainstream summer day camp would be
impossible for these children, due to the
inevitable behavioural and emotional
difficulties that would arise. With the
stressors that camp attendance placed
upon their fragile behavioural inhibition
systems, the effects reported here could
even be viewed as that much more
encouraging.

A second caveat concerns the
measurements used in this study, which
entails both strengths and weaknesses. A
strength of the study is that a variety of
target constructs were assessed. Addition-
ally, the changes in the campers’ behav-
iours were consistent across different
measures and, in the case of attachment,
across both parent and child report
measures. However, the methodology
would have been stronger if more direct
assessments of the children themselves
had been employed and if these had
included both behavioural (eg observa-
tion) and physiological (eg salivary
cortisol) measures to balance the parent-
report data. This is an area that we have
identif ied as a major priority for future
studies. Another area of weakness may be
the absence of any direct measures of
sensory processing. The lack of a pre-test
and post-test measure is a methodological
shortcoming but the inclusion of sensory-
rich environments is believed to be a
necessary part of the intervention. These
findings indicate that the lack of acquired
sensory processing skills prohibit pro-
social engagement with others and an
inability to process properly one’s
environment. This is also an area for
future research.

Other issues relating to the measure-
ment plan are the lack of a follow-up
assessment and small sample size. An
informal phone interview was conducted

ADOPTION & FOSTERING VOLUME 31 NUMBER 4 2007 47

f ive months after the summer camp. From
this we found that some of the families
found it difficult to sustain the gains
made at camp. Based on this feedback,
we plan follow-up assessments for future
studies and are providing continued
support services for the families whose
children attend. Much greater emphasis
will be placed on the family and on
follow-up support, as family participation
was minimal and follow-up measures
would further validate this intervention
model. Sample size remains small due to
necessity: funding limitations and the
intensity of the intervention prohibit large
groups of participants.

Despite these caveats, the current
f indings add to the knowledge base of
intervention-based research in the area of
special needs and international adoption,
as recent meta-analyses have duly noted
the scarcity of research with internation-
ally adopted children (Juffer and van
IJzendoorn, 2005; Meese, 2005).
Specifically, the need is for empirically-
based interventions that will enable
parents, as well as the professionals who
support them, to intervene successfully
with emotionally damaged children. In
this regard, our research complements
Dozier and colleagues’ work with foster
carers of infants in their striving to
provide an empirical basis for
intervention with adopted children,
especially those with backgrounds of
emotional trauma (Dozier, Albus et al,
2002; Dozier, Higley et al, 2002).

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© Karyn B Purvis, David R Cross, Ron
Federici, Dana Johnson and L Brooks McKenzie
2007

Note: Please contact authors for camp manual
and detailed descriptions of camp interventions
– L.B.McKenzie@tcu.edu