Rutter et al (2011) followed a group of 165 Romanian orphans as part of the ERA study, and found greater outcomes for children adopted before 6 months old.
Kennedy et al (2016) suggest ADHD is more common if children have experienced the negative effects of institutional care early in life.
Individual differences cannot be ignored in cases following institutional care, some children may respond better than other when adopted.
There are several ethical issues when studying children who have experienced institutional care.
Many studies investigating the negative effects are longitudinal, where participantattrition is greater.
Many studies investigating institutional care give a good insight into how children form attachments in real life, so have high ecological validity.
Many studies looking at the negative effects of institutional care are socially sensitive.
There may be negative implications for some children following the research into the effects of institutionalisation.