Institutionalization and Its Effects on Childhood Brain Development and Social Skills

Institutionalization and its effects on childhood brain development and social skills 22,000 infants and children adopted into the U.S. each year. 8 million children, 0-8 years old, in orphanages, most in Eastern Europe and Asia. Institutionalization can be considered an Adverse Childhood Experience. Studies show that institutionalization affects brain development. Dose-response relationship: longer stays in orphanages put children at higher risks for behavioral disorders. Effects: social, behavioral, cognitive, neuro-physiological Institutionalized Rearing versus Maternal Care Maternal care in first year of life sets the model for behavior and stress management for the rest of life. Conditions may range from poor to very harmful. Inconsistent peer groups Lack of play time Inadequate food and clothing Low emotional tones Lack of sensitive nurturing Lack of emotional stimulation Constant detachment Inattention to individual needs 1:20 caregiver to child ratio Few interactions with caregivers 60-100 different caregivers within first 2 years Brain Development ACE Cycle Absent, inadequate or incorrect expected environment conditions More ACE’s More stress Greater emotional reactivity Larger amygdala Damaged frontal cortex Smaller brain volume Smaller corpus callosum Possible Development Delayed psychomotor and speech development Quasi-autistic Attention-Deficit/Hyperactivity Disorder (ADHD) 20.7% of PI to 3.4% of NI Lower IQ Impulsivity Poor emotional expression and recognition Difficulty being empathetic and sympathetic Indiscriminate/Disinhibited Reactive Attachment Disorder Lack of social model for behavior Indiscriminate sociability Attachment to unfamiliar adults Willingness to leave with unfamiliar adults Adolescent Behaviors Attention-seeking mechanisms may be triggered as survival mechanisms for orphans accustomed to neglect. Difficulty in recognizing affection or care from adoptive parents Hesitancy to trust and to ask for help Insecurity about being abandoned again Not coming home Not going to school Alcohol and substance abuse Indiscriminate socialization, especially with others who are bad influences Difficulty handling stress Heightened perception of threats and negative emotions Research How institutionalized children perceive negativity Emotional Go-No Go Paradigm Compared to NI, PI children institutionalized for longer (more than 15 months) made more errors identifying neutral faces when distracted by negative faces. Institutionalized children are more reactive to negative emotions. Research Studies Author of Paper Study Referenced Felicia Iftene (2004) Children Age at Testing 34 PI 13-16 yrs Mitul Mehta (2009) The English and Romanian Adoptees Study 14 PI ȳ=16.2 yrs 11 NI (England) ȳ=16.0 yrs 136 PI 6-30 mo Margaret Sheridan (2010) Bucharest Early Intervention Project Nim Tottenham (2010) 72 NI Age-matched (Romania) 38 PI ȳ=101mo 40 NI (U.S.) Age-matched Time in Orphanage Adoption Institution Location Location 6-36 mo Romania Canada (1980s) Romania ȳ=24.7 mo Romania England (1980s) 6 mo-8 yrs Romania Foster Care in Romania 9-28 mo E. Europe, Asia U.S. Neuroplasticity Earlier adoption linearly associated with better development. PI adopted before 6 months old repaired their cognitive development faster than PI adopted after 6 months old. PI adopted before 15 months old more likely to reach the same development rate as NI. PI relocated to foster care before 24 months old had greater development catch-up than PI relocated after 24 months old. By 6 years old, PI adopted before 6 months old had same IQ’s as NI while PI adopted after 6 months old still had the lowest scores.