According to UNICEF, there are upwards of eight million children worldwide being raised under various types of institutional care (what we typically refer to as orphanages).(a)
Children raised in these settings have an increased incidence of developmental delay and deficits in cognition. Previous studies have found structural changes in the brain(b) that accompany a lifetime of institutional rearing and may be responsible for these cognitive delays and deficits. One hypothesis is that institutional settings provide a “deprived environment” with less stimulation than a child would otherwise be exposed to, leading to slower brain development.
In Romania, the Bucharest Early Intervention Project was initiated to test whether improving the environment of a child through foster care would improve brain structure and function.(c) In this particular study, the authors compared the size of various regions of the brain in children who either spent their whole lives in institutions, their whole lives outside of institutions, or switched from an institutional setting to foster care within the first three years of life.1 The researchers found that growing up in an institution was associated with decreased amounts of gray matter, and that being moved to foster care did not change this trend. Like gray matter, the amount of white matter was also decreased by a lifetime of institutional care; however, children who were switched to a foster care setting showed a trend towards increased white matter volume.(d)
The current study reinforces previous findings that institutional care is associated with brain deficits and finds evidence that at least some of these deficits (such as gray matter changes) may be established within the first three years of life. By identifying quantifiable physical changes in the brain that result from institutional rearing, the researchers have also found good measures of the effectiveness of potential interventions. While the results were not definitive, there was an indication that moving children to foster care may reduce or prevent some of the structural changes associated with a lifetime of institutional care, specifically those related to levels of white matter in the brain. If these results hold up, the next step will be figuring out how best to apply this knowledge in order to improve outcomes for the most disadvantaged children.
- Margaret A. Sheridan, Nathan A. Fox, Charles H. Zeanah, Katie A. McLaughlin, Charles A. Nelson III (2012) “Variation in neural development as a result of exposure to institutionalization early in childhood,” Proceedings of the National Academy of Science of the United States, 109 (32) : 12927-12932.
- (a) While orphanages are rare in modern-day America, which primarily uses foster care in child welfare cases, they are still common in other parts of the world.
- (b) Specifically, decreases in the amounts of gray and white matter have been found in the brains of children raised in institutional settings. Gray matter is the outer region of the brain composed of the “bodies” of our neurons. It is thought to be important for overall brain function and the processing of external signals. White matter is composed of axons extending from those same cells to different regions of the brain. It is thought to be important for learning and higher cognition.
- (c) Romanian orphanages have a particularly notorious history. The communist government led by Nicolae Ceaușescu from 1965 to 1989 forbade contraception and abortion, leading to high birth rates and child abandonment. Thousands of children languished in orphanages under horrifying conditions that shocked the world when exposed after the fall of Ceaușescu’s government in 1989.
- (d) Analysis showed a statistically significant difference in white matter levels between institutionalized and non-institutionalized children. However, there was no statistically significant difference between either the institutionalized and institution-to-foster-care children or the non-institutionalized and institution-to-foster-care children. While this suggests that the institution-to-foster-care children fall somewhere in between the two other groups, no definitive statistical conclusions can be drawn in this regard.