Background: To assess the mental health and behavioral problems of children in institutional placements in Jordan\nto inform understanding of current needs, and to explore the effects of placement change on functioning and staff\nperceptions of goodness-of-fit.\nMethods: An assessment was completed of 134 children between 1.5 12 years-of-age residing in Jordanian\norphanages. The Child Behavior Checklist was used to assess prevalence rates of problems across externalizing and\ninternalizing behavior and DSM-IV oriented subscales. Also included was caregiver perceived goodness-of-fit with\neach child, caregiving behavior, and two placement change-clock variables; an adjustment clock measuring time\nsince last move, and an anticipation clock measuring time to next move.\nResults: 28% were in the clinical range for the internalizing domain on the CBCL, and 22% for the externalizing\ndomain. The children also exhibited high levels of clinical range social problems, affective disorder, pervasive\ndevelopmental disorder, and conduct problems. Internalizing problems were found to decrease with time in\nplacement as children adjust to a prior move, whereas externalizing problems increased as the time to their next\nage-triggered move drew closer, highlighting the anticipatory effects of change. Both behavioral problems and the\nchange clocks were predictive of staff perceptions of goodness-of-fit with the children under their care.\nConclusions: These findings add to the evidence demonstrating the negative effects of orphanage rearing, and\nhighlight the importance of the association between behavioral problems and child-caregiver relationship pathways\nincluding the timing of placement disruptions and staff perceptions of goodness-of-fit.
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