Institutional life damages a child's intellect

A new study provides scientific proof that placing children in foster care rather than an institution can reverse the damage of severe neglect on a child's development.

Although it has always been suspected and in many ways accepted, that children who are placed in institutions suffer both emotionally and physically there has been little scientific evidence on the intellectual costs.

Studies carried out on children who were abandoned in orphanages during Romania's notorious communist-era showed both physical and emotional effects but little was known about the intellectual damage inflicted.

Now a study by researchers from Harvard Medical School has found that placing such children in foster care boosted there intelligence.

The study began in the capital Bucharest in 2000 when Romania did not have a foster care system and involved 136 children all under 31 months who were living in six institutions.

The children chosen were all healthy.

Dr. Charles Nelson, the lead researcher and his team, by conducting an extensive advertising programme to recruit foster parents, after screening, found 56 suitable families.

Of the children, sixty eight with an average age of 21 months were placed in these homes, siblings were kept together while the remainder of the children stayed in the institutions.

A group of 72 children who lived with their biological families in Bucharest were used as a comparison.

Dr. Nelson who is a professor of pediatrics, says babies reared in such environments are often left in cots lying on their backs for hours on end with little outside stimulation or close contact with a care giver; as a result they often have greatly diminished IQs and many would meet the criteria for mental retardation in the United States.

The researchers found that overall, the children placed in foster care performed better when tested at ages 3-1/2 and 4-1/2 than those who stayed behind but there remained some lingering deficits - their IQ scores were almost 10 points below the children who had never lived in an institution.

IQ (intelligence quotient) is a measure of aspects of intelligence such as language, reasoning, planning and problem solving.

The results show children who were moved to foster care enjoyed an average eight- to 10-point gain in IQ, but the researchers say children who were placed in foster care before age 2 had a 12 to 15 point increase in their IQ.

Such a boost could mean for some children the difference between borderline retardation and average intelligence.

Dr. Nelson says the intervention worked best for kids placed under age 2, but even then it did not completely erase the negative effects.

He says the findings suggest there may be a sensitive period spanning the first two years of life within which the onset of foster care exerts a maximal effect on cognitive development.

Nelson says the older a child is when they leave an institution, the more likely it is that they may have some developmental problems and the more difficult it may be to amend those problems.

For the study high-quality foster care was used but this is often not the norm in many countries says Dr. Nelson; but studies comparing the impact of foster care of varying quality are apparently being carried out.

The research is credited with influencing child-care changes in Romania, and the Romanian government has now barred institutionalizing children less than 2 years old unless the child is severely disabled.

UNICEF too now uses the data to prompt numerous countries which still depend on state-run orphanages to adopt foster care systems.

The researchers say they hope the findings will help to guide policy in countries with large populations of abandoned children.

The study which was requested by the Romanian government, was funded by the John D. and Catherine T. MacArthur Foundation and is published in the journal Science.