Iii. Attachment and Emotional Development in Institutional Care: Characteristics and Catch Up

Abstract

Attachment has been assessed in the extreme environment of orphanages, but an important issue to be addressed in this chapter is whether in addition to standard assessment procedures, such as the Strange Situation, the lack of a specific attachment in some institutionalized children should be taken into account given the limits to the development of stable relationships in institutionalized care. In addition, this chapter discusses disinhibited or indiscriminately friendly behavior that is often seen in institutionalized children. Enhanced caregiving quality alone appears to be insufficient to diminish indiscriminate behavior, at least in some children, as evidenced by the persistence of indiscriminate behavior in children adopted out of institutions into adoptive families. We suggest that the etiology and function of indiscriminate friendly behavior may be different for institutionalized versus not-institutionalized children. In the first case it may reflect a distortion or disruption of early attachment relationships, in the latter case it is likely to result from the lack of expected input in the form of contingent interactions with a stable caregiver in early life. We try to delineate infant and caregiver characteristics that are associated with secure attachment in institutional settings, given the inevitable fact that large numbers of infants worldwide are being raised, and will be raised, in contexts of institutional care. We conclude that much further study is needed of the development of children’s attachments following adoption out of an institutional setting.

Neural Correlates of Face Familiarity in Institutionally Reared Children With Distinctive, Atypical Social Behavior

“…While there are indications in the literature on EEG spectral power that such hypoactivation might not be exclusive to face processing (Marshall et al, 2004;Tarullo et al, 2011;Vanderwert et al, 2010), it is likely that the networks involved in face processing are particularly affected by institutional rearing (Moulson et al, 2009b). This would be consistent with behavioral data indicating that the socio-emotional domain is particularly susceptible to effects of institutional rearing, often with quite persistent effects (Bakermans-Kranenburg et al, 2011). The finding of neural correlates associated with IB is also consistent with the idea of experience-dependent programming advanced in the introduction, as an explanation of the frequent persistence of IB well into the post-institutional period.…”

Deviations from the Expectable Environment in Early Childhood and Emerging Psychopathology

“…Two major patterns of disordered behavior in young children have been described: (1) a pattern characterized by emotionally constricted and socially unresponsive behavior known as reactive attachment disorder (RAD), and (2) a pattern defined by lack of expected reticence about interacting with unfamiliar adults and violation of social boundaries known as disinhibited social engagement disorder (DSED). In this selective review, we will limit ourselves to studies of the indiscriminate social behavior of DSED because it is more common and has been better studied than RAD (see reviews in Bakermans-Kranenburg et al, 2011;Rutter et al, 2009;Zeanah and Gleason, in press). …”

Quality of institutional care and early childhood development

“…Nevertheless, research consistently chronicles adverse effects of institutional rearing on children's development, particularly in the social-emotional domain (Bakermans-Kranenburg et al, 2011). Indeed, increased emotional/behavioural problems in general and disturbed attachment behaviour in particular are consistently reported among institutionally-reared children.…”

“…The fact remains, however, that only a few studies of institutionalised children have directly assessed the proximate process of caregiving quality and related it to child adjustment and attachment behaviour (Bakermans-Kranenburg et al, 2011). Accordingly, the current study examines the anticipated contribution of both distal institutional characteristics (i.e., structural and organisational aspects of the institution) and proximal, caregiving ones (i.e., relationship with the primary caregiver) to children's disturbed attachment behaviour and emotional/behavioural problems.…”