Disinhibited attachment constitutes a valid, and handicapping, clinical pattern that is strongly associated with an institutional rearing.

Cognitive outcomes at age 11 of 131 Romanian adoptees from institutions were compared with 50 U.K. adopted children. Key findings were of both continuity and change: (1) marked adverse effects persisted at age 11 for many of the children who were over 6 months on arrival; (2) there was some catch-up between ages 6 and 11 for the bottom 15%; (3) there was a decrease of 15 points for those over 6 months on arrival, but no differentiation within the 6-42-month range; (4) there was marked heterogeneity of outcome but this was not associated with the educational background of the adoptive families. The findings draw attention to the psychological as well as physical risks of institutional deprivation.

Attachment disorder behaviours, inattention/overactivity and quasi-autistic behaviour constitute institutional privation patterns.

Economic and Social Research Council, Medical Research Council, Department of Health, Jacobs Foundation, Nuffield Foundation.

The current study extends previous research on a sample of children adopted into the United Kingdom following severe early deprivation and a comparison sample of nondeprived, within-country, early adoptees. We assessed 165 children adopted from Romania and 52 U.K. adoptees at age 6 years. Longitudinal data (at age 4 and 6 years) were available on 111 Romanian adoptees placed into U.K. homes before 24 months of age and on all U.K. adoptees. Results indicated that there was considerable catch-up among late-placed Romanian children from entry into the United Kingdom to age 6, but as a group they exhibited lower cognitive scores and general developmental impairment compared with earlier adopted Romanian children. In addition, the resilience suggested at the assessment at age 4 years was maintained longitudinally, but there was no further evidence of catch-up or recovery.