News: News Archives
Neglect During Infancy Can Affect
Children for Years, Scientists Report
Many children who were neglected in orphanages during the first months of their life encounter a distinct set of developmental challengeslasting for years after they've been adopted by attentive parents, scientists said today at the American Association for the Advancement of Science (AAAS) Annual Meeting. Biological insights into these difficulties may suggest ways to improve the lives of some troubled children, and shed light on how the brain develops in early childhood.
In the last decade, in the United States alone, the number of children adopted by U.S. families from other countries has increased from 7,000 to 17,000, according to Seth Pollak of the University of Wisconsin-Madison. Today, approximately 85 percent of these children have spent some part of their lives in institutions.
The panelists were careful to point out that, overall, internationally adopted children have progressed well, considering the challenges they have faced.
"Our concern is how to inform others about the early experiences these kids have hadbut we don't want to sent the message that people shouldn't adopt these kids, that they're damaged," Pollak said.
"One of the nice things, from a scientific standpoint, is that [many internationally adopted children] move from the worst to the best environments," said Megan Gunnar of the University of Minnesota. "The lives of kids in the U.S. foster care system continue to have disruptions, so what we're learning speaks a great deal to our understanding of maltreatment and neglect."
Some of the most obvious ways that the development of institutionalized children has been impaired, such as physical growth, seem to be temporary. Once children have been placed in families, they tend to catch up with other children in their age group, the researchers have found.
Yet, parents have been concerned that certain social and emotional difficulties remain, Pollak said.
"Many of the parents complain that they need to take their kids to many specialists, but we don't have a knowledge base about these children," Pollak said. "Healthcare providers are trying their best to pull together stuff like what we know about attention deficit disorder, bereavement, etc., and it doesn't fit exactly right. These diagnoses are close, but not really capturing the problems these kids are having."
For example, many children who spent some of their early lives in institutions don't form close bonds with their parents. They tend to be indiscriminately friendly toward all adults, while, according to normal development patterns, they should be somewhat wary of strangers, Pollak noted.
These developmental challenges can last long after the children have been living in their new homes. Thomas O'Connor of the Institute of Psychiatry has compared a group of children adopted into the United Kingdom from seriously deficient orphanages in Romania with a group of adopted children born in the United Kingdom who were not subjected to institutional deprivation.
O'Connor and his colleagues have found that some of the children from Romania continue to have difficulty with social interactions at ages 4, 6, and even 11.
Now in the early stages of a long-term study, Charles Nelson of the University of Minnesota has found that infants' and toddlers' abilities relating to intellectual development, language, and forming attachments with certain adults improved significantly once they have left institutions for foster care.
Brain activity also rebounded from abnormally low levels once the children entered foster care, Nelson found.
Thus, many of the effects of neglect seem to be reversible, at least in early years of life. As Nelson's study continues, he hopes to determine whether there is a specific age range during which this reversal process is most effective.
Distinct biological differences may be responsible, at least in part, for the developmental challenges facing post-institutionalized children, according to new research by Pollak and Gunnar.
Pollak and his colleagues conducted detailed behavioral studies of children adopted from Eastern Europe, and found what they say is an unusual pattern. The children have difficulty integrating auditory information and following instructions, but are not impulsive, as children with attention deficit disorder typically are. The adopted children also showed some unusual clumsiness and difficulty playing with peers, Pollak and his colleagues report.
These differences may stem from defects in the brain's neural circuitry, Pollak said. Specifically, they may involve the prefrontal cortex, which participates in cognitive and emotional tasks, and the cerebellum, which helps control motor skills. Both brain structures are still developing throughout early childhood, and other types of brain studies have identified links between each structure and certain types of tests Pollak's team gave the children in their study.
Processing problems in the prefrontal cortex have also been implicated in attention deficit disorder, mental retardation, pervasive developmental disorders, the effects of chemotherapy in brain cancer, and even head injury.
"But, these kids don't look like any of those known profiles," Pollak said.
Neglect in early life may also affect the body's system for handling stress, Gunnar has found. The hormones produced by the so-called hypothalamic-pituitary-adrenocortical, or "HPA," system, help the body respond to immediate stresses, such as responding to danger. But, they can have negative effects when produced over the long term, according to Gunnar.
Gunnar and her colleagues found that levels of cortisol, the primary stress hormone in humans, were higher at "baseline levels" (not in obviously stressful conditions) than normal in children who had received inadequate care before being adopted. To determine this, the researchers studied saliva samples, collected daily by parents, of children adopted from Romanian orphanages and children raised in the homes where they were born.
They had similar findings in a second study, which looked at children from 27 countries, divided into three groups: children adopted from institutions providing inadequate care, children adopted from institutions providing at least adequate care, and children who had received at least adequate care in foster or family homes before being adopted.
Although they did find elevated baseline cortisol levels in the group receiving inadequate care, Gunnar noted that 78 percent of internationally adopted children showed normal baseline levels.
"The bottomline is yes, we actually see some long-term effects [of inadequate care], but you shouldn't generalize to all kids from orphanages," Gunnar said.
14 February 2003