Children adopted after school: the effects of early deprivation on their development – The results of the main studies
Studies have shown that, even in the absence of severe forms of material deprivation, early institutional care is associated with a higher risk of outsourcing problems and attention than non-institutionalized children raised in the family.
This contribution is the latest in a series of three articles on the subject. In the first article, a general examination of the current situation regarding orphanages and institutions for minors was carried out. In the second article the main researches on the topic were presented, the results of which will be illustrated today in the following article.
Studies that used the CBCL rating scale found similar evidence: deinstitutionalized minors showed higher levels of behavioral problems, in particular externalizing disorders (aggressive behavior and breaking rules) and attention disorders, compared to unadopted minors .
A strong positive correlation was also found between age at the time of adoption and behavioral problems, manifested in particular by the group of teenagers (12-18 years).
Studies have therefore shown that, even in the absence of severe forms of material deprivation, early institutional care is associated with a higher risk of outsourcing problems and attention than non-institutionalized children raised in the family and that the rate of problems behavioral increases significantly with age at the time of adoption, particularly for children exposed to institutional deprivation for more than 18 months from birth.
Late adopted children tend to show more internalizing / outsourcing difficulties, thinking, attention and social behavior disorders than early adopted peers.
Raaska and colleagues, after demonstrating the highest incidence of learning difficulties in adopted children (33.2% compared to 10% of the general population), identified the variables that are often associated with these deficits.
In addition to the age at the time of adoption, the gender and the country of origin, they found a final compromising factor, represented by the number of institutions changed: under the school aspect, in fact, the children who were transferred from a institution to the other, are disadvantaged compared to those who remained in a single structure for the entire duration of the institutionalization.
The most compromised in school skills were minors from Eastern European and African institutions and male subjects. In contrast, females and minors from Asian institutions showed higher levels of adaptation and significantly higher school performances.
The ultimate goal of the study was to evaluate the extent to which school difficulties were related to attachment disorders such as RAD (Reactive Attachment Disorder) and DSED (Disinhibited Social Engagement Disorder): the association was highly significant. Considering that attachment disorders appear in preschool, the study allows us to focus attention on children at risk even before school entry.
The Wiik study, consistent with previous literature (Beverly et al. 2008, Gunnar et al. 2007, Kreppner et al 2001), also showed that 23% of post institutionalized children exhibit ADHD symptoms and that especially children with Prolonged institutional histories, valued from eight to eleven years, are at risk of developing the disorder.
Over the years, several other studies on the topic of institutionalization have confirmed this relationship and have found the presence of a more specific disorder, identifiable as inattention / overactivity (translated by the authors with the term inattention-hyperactivity I / O), which is generated precisely from this early life experience (Goldfarb, 1945; Taylor, 1994; Ames, 1997; Fisher et al., 1997; Rutter and ERA Study Team, 1998, 2001; Kreppner, O’Connor and Rutter, 2001; Roy, Rutter and Pickles, 2000, 2004).
Attention was also paid to the difficult reversibility of the disorder in adolescence, in the face of the early neurobiological alterations highlighted by these subjects (Stevens et al., 2007). Rutter and colleagues (1998) stressed, however, that if adoption was early and the quality of care offered by the adoptive family was good, it is possible to decrease the extent of the disorder.
Wiik’s study also showed that the risk of ADHD depends more on the early experiences of children than on their country of origin: the persistence of attention problems years after adoption provides support for the hypothesis that inattention and impulsiveness may be part of the post-institutional syndrome (Kreppner et al., 2001).
One of the most important discoveries on the issue of institutionalization is probably represented by the importance of interactions with cargivers. In 2007, Smyke and colleagues highlighted a strong correlation between the quantity and quality of interactions and children’s cognitive development and skills. However, due to the nature of the data, it is not possible to determine whether more compromised children required less attention or whether poor care led to such delays.
Both directions may plausibly have occurred over time: children who receive better care quality can use their interactions with caregivers to gain a more complex knowledge of the environment and its role within it, reaching greater skills.
However, the results can be considered reliable since subjects with severe handicaps (fetal alcohol syndrome or severe cerebral palsy) were excluded from the experimental sample. The observation of the video recordings showed that often the children in the institution did not have a caregiver available to satisfy their needs and that they were not involved in interactions, conversations with peers or creative games.
In this study, the quality of interaction and care by the caregiver was highly correlated with three of the evolutionary spheres considered: development quotient (DQ), adaptive behavior and skills, while the percentage of time spent in the institution only at sphere of problem behavior. This shows that the mere fact of residing in an institution is less powerful than the micro-environment constituted by each child with his / her reference caregiver.
It is not surprising that older children, in this study as in the previous ones, showed a higher level of cognitive impairment than the younger ones: this is compatible with the widely proven idea that cognitive ability deteriorates with the progress of institutional assistance.
It is important to underline that these results confirm what has already been found in the previous 50 years in various studies concerning the characteristics of the development of minors raised in the institution.
The radical change in the environment that occurs when profound institutional deprivation precedes adoption creates a “natural experiment” that can be used to test hypotheses about the effects of early deprivation.
This article has focused attention on some studies that have observed adoptive children’s behavior and learning, highlighting how some factors may influence their cognitive and behavioral development.
The factors analyzed, correlated with different degrees of adaptation in the period following adoption, are:
The results of the research analyzed provide strong support for the idea that exposure to institutional care, especially if for a period of time longer than 18 months, has a profound effect on the development of children. The studies taken into consideration have shown a higher incidence for post-institutionalized children of disorders:
These alterations seem to be due to inadequate quality of care, understood as: imbalance in the numerical relationship between children and educators, excessive staff turnover, poor tactile, visual and auditory stimulations, rare and ill-directed moments of social interaction between adults and children , inability to experience moments of warmth, rare opportunities for free play between peers and for free or guided discovery of the environment.
What has already been supported by an interdisciplinary evolutionary perspective is confirmed: it is within a stable, warm and empathic relationship that the child acquires the essential skills for healthy psycho-physical development (Monti et al.2010). In this regard, interventions aimed at improving institutions should be the ultimate goal of research, as these institutions do not seem destined to disappear very soon (Smyke et al. 2007).
To improve living conditions within institutions, some interventions can be considered. At the level of the microsystem, that is to say of relationships for two (child-adult), the numerical relationship between children and operators could be diminished and staff turnover could be discouraged, making it easier to establish a preferential relationship. It would also be desirable to train the operators of the structures on the important role they play in raising children and on how to carry out their duties by placing the child at the center. Finally, it would be appropriate to allow minors to take part in sports or other activities, which can increase their sense of self-efficacy, stimulating socialization among peers (Cyrulnik and Malaguti, 1999).
Lastly, to implement the resources at the macro-system level, it would be appropriate to work in order to build a resilient community thanks also to the information and dissemination of the negative effects on the child development of these contexts, in order to arrive at real changes in social policies (Emiliani, 2004).