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Short Description: Historically, institutions have been the most com- mon form of care for orphaned and abandoned
children throughout the world, and they remain so today. Because institutional rearing often involves
social and even material deprivation
Content Inside: Journal of Child Psychology and Psychiatry 48:2 (2007), pp 210218
doi:10.1111/j.1469-7610.2006.01694.x
The caregiving context in institution-reared and family-reared infants and toddlers in Romania
Anna T. Smyke,1 Sebastian F. Koga,1 Dana E. Johnson,2 Nathan A. Fox,3 Peter J. Marshall,4 Charles A. Nelson,5 Charles H. Zeanah,1 and the BEIP Core Group
1
Tulane University, USA; 2University of Minnesota, USA; 3University of Maryland, USA; 4Temple University, USA; 5 Harvard University, USA
Background: We assess individual differences in the caregiving environments of young children being raised in institutions in Romania in relation to developmental characteristics such as physical growth, cognitive development, emotional expression, and problem and competence behaviors. Method: Videotaped observations of the child and favorite caregiver in their `home' environment were coded for caregiving quality, and this was related to child characteristics. Child emotional reactivity was assessed during responses to interactional tasks. Cognitive development was assessed from child responses to the Bayley Scales of Infant Development. Data regarding problem behaviors and competence were obtained from caregiver report. Children reared in institutions were compared on all of these measures to never institutionalized children to assist gauging degree of impairment. Results: Children raised in institutions demonstrated marked delays in cognitive development, poorer physical growth, and marked deficits in competence. Individual differences in caregiving environment were associated with cognitive development, competence, and negative behavior among these young children being reared in institutions. Conclusions: These data confirm previous findings regarding deficits associated with institutional care and extend our understanding of the impact of individual differences in caregiving quality on the development of young children in institutions. Keywords: Infancy, orphans, institutionalization, caregiving quality, cognitive deficits, physical growth, emotional expression, competence. Abbreviations: BEIP, Bucharest Early Intervention Project; BSID-II, Bayley Scales of Infant Development II; DQ, Developmental Quotient; IG, institution group; ITSEA, InfantToddler Social Emotional Assessment; MDI, Mental Development Index; NIG, never institutionalized group; ORCE, Observational Record of the Caregiving Environment.
Historically, institutions have been the most common form of care for orphaned and abandoned children throughout the world, and they remain so today. Because institutional rearing often involves social and even material deprivation, disturbances of growth, cognitive development, and language as well as greater levels of problem behaviors have been noted for more than 50 years among young children raised in institutions (MacLean, 2003; Zeanah, Smyke, & Settles, 2006). Studies published in the past 15 years have demonstrated impairments in young children being raised in Romanian institutions and in those adopted out of institutions. Children being raised in institutions have demonstrated cognitive delays, serious impairments in social behavior (Smyke, Dumitrescu, & Zeanah, 2002; Zeanah, Smyke, Koga, & Carlson, 2005), and abnormalities of cortisol regulation compatible with high levels of stress (Carlson & Earls, 1997). Young children adopted out of institutional care often have persisting cognitive, socioemotional, and health problems (Castle et al., 1999; Fisher, Ames, Chisholm, & Savoie, 1997; Gunnar, 2000; Johnson, 2000; Rutter et al., 1999).
Conflict of interest statement: No conflicts declared.
Despite this, Rutter and colleagues (2001) noted surprising variability in the degree to which children were affected by their institutional experience and significant, if not full, recovery has been observed among many children adopted out of Romania (Fisher et al., 1997). Interestingly, although studies of children adopted out of institutions have shown that many early developmental deficits improve, they have not shown consistently that individual differences in outcomes are related to individual differences in adoptive family environments. This raises the question of whether differences noted in children adopted out of institutions may relate to differences in the caregiving environments of the institutions from which they were adopted. Variability in quantity and quality of care has been noted across and within institutions in previous research, but too few studies have included direct observations of quantity and quality of care in institutions for young children. In fact, better quality institutions have been associated with less cognitive impairment in children raised there (Roy, Rutter, & Pickles, 2000; Tizard & Rees, 1974; Vorria et al., 1998). Still, demonstrating associations between caregiving characteristics in institutions and individual characteristics of the children being raised there has not been reported. Institutional rearing in Romania often has
Ó 2007 The Authors Journal compilation Ó 2007 Association for Child and Adolescent Mental Health. Published by Blackwell Publishing, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA
