Romanian Orphan studies: Institutionalisation

• Context around the Romanian Orphans study:

  • Research on maternal deprivation has turned to orphan studies as a means of studying the effects of deprivation on emotional and intellectual development
  • Former Romanian president Nicolai Ceauçescu required Romanian women in the 1990s to have 5 children, abortion and contraception were illegal
  • Many Romanian parents could not afford to keep their children and the children ended up in huge orphanages with very poor conditions
  • After the 1989 Romanian revolution many of the children were adopted, some by British parents. Rutter looked into the effects of institutional care and consequent institutionalisation
• Rutter's procedure:

  • Rutter et al (2011) followed a group of 165 Romanian Orphans for many years as part of the English and Romanian adoptee project (ERA)
  • The orphans had been adopted by families in the UK. The aim of the ERA has been to investigate the extent to which good care could make up for poor early experiences in institutions
  • Physical, cognitive and emotional development has been assessed at ages 4, 6 , 11, 15 and 22-25 years. A group of 52 children from the UK adopted around the same time have served as a control group.
• Rutter's findings: Disinhibited attachment

  • In terms of attachment, there appeared to be a difference in outcome related to whether adoption took place before or after 6 months
  • Children adopted after 6 months showed signs of disinhibited attachment. Symptoms include attention-seeking, clinginess and social behaviour directed indiscriminately towards all adults, both familiar and unfamiliar
  • In contrast those children adopted before the age of six months rarely displayed disinhibited attachment
• Bucharest early intervention (BEI) project: Zeanah et al's procedure

  • Assessed attachment in 95 Romanian children aged 12-31 months who had spent most of their lives in institutional care (90% on average)
  • Compared to a control group of 50 children who had never lived in an institution. Their attachment type was measured by suing the strange situation
  • Carers were asked about unusual social behaviour including clingy, attention-seeking behaviour directed inappropriately towards all adults ( a measure of disinhibited attachment)
• Zeanah et al's findings:

  • 74% of the control group were classed as securely attached in the strange situation. However, only 19% of the institutional group were securely attached.
  • In contrast, the description of disinhibited attachment applied to 44% of institutionalised children as opposed to less than 20% of the controls.
• What are the effects of institutionalisation on disinhibited attachment?

  • Children who have spent their early lives in an institution often show signs of disinhibited attachment, being equally friendly and affectionate towards familiar people and strangers
  • This is highly unusual behaviour as most children in their second year show stranger anxiety
  • Rutter (2006) has explained disinhibited attachment as an adaptation to living with multiple caregivers during the critical period which is a sensitive period for attachment formation
  • In poor quality institutions, like those in Romania, a child might have 50 carers but doesn't spend enough time with any one of them to be able to form a secure attachment
• Effects of institutionalisation on intellectual disability:

  • In Rutter's study most children showed signs of intellectual disability when they arrived in Britain. However, most of those adopted before they were 6 months old caught up with the control group by age 4
  • It appears that, like emotional development, damage to intellectual development because of institutionalisation can be recovered provided adoption takes place before the ages of 6 months - the age at which attachment forms
• Strength - Real world application

  P - One strength of the Romanian Orphanage studies is their application to improve conditions for the children growing up outside their family home

  E - Studying Romanian orphans has improved psychologists understanding of the effects of early institutional care and how to prevent the worst of these effects. This has led to improvements in the conditions experienced by looked-after children.

  E - For example, children's homes now avoid having large numbers of caregivers for each child, and now have one or two 'keyworkers' who play a central role in their emotional care.

  L - This means that children in institutional care have a chance to develop normal attachments and disinhibited attachment is avoided.
• Strength - Fewer confounding variables

  P - Another strength of the Romanian studies is the lack of confounding variables

  E - There were many orphan studies before the Romanian orphans became available to study (e.g. orphans studied during the second world war). Many of the children studied in orphanages had experienced varying degrees of trauma, and it is difficult to disentangle the effects of neglect, physical abuse and bereavement from those of institutional care

  E - However, the children from Romanian orphanages had, in the main, been handled over by loving parents who could not afford to keep them.

  L - This means that results were much less likely to be confounded by other negative early experiences and thus have higher internal validity.
• Counterpoint:

  • On the other hand, studying children from Romanian orphanages might have introduced different confounding variables
  • The quality of care in these institutions was remarkably poor, with children receiving very little intellectual stimulation or comfort.
  • This means that the harmful effects seen in studies of Romanian orphans may represent the effects of poor institutional care rather than institutional care per se.
• Limitation - lack of adult data

  P - One limitation of the Romanian orphanage studies is the current lack of data on adult development

  E - The latest data from the ERA study looked at the children in their early to - mid - 20s. This means that we do not currently have data to answer some of the most interesting research questions about the long-term effects of early institutional care

  E - These research questions include the lifetime prevalance of mental health problems and participants' success in forming and maintaining adult romantic and parental relationships. It will take a long time to gather this data because of the longitudinal design of the study, i.e. the same ppts are followed for a long time

  L - This means it will be some time before we know more completely what the long term effects are