Introduction InstitutionalizationInstitutionalization is defined as any large congregate care facility in which round-the-clock professional supervision supplants the role of family-like caregivers [1]. Children are institutionalized due to different factors like abandonment, orphaning, maltreatment and also physical or mental disabilities. Many authors have related the institutionalization with a lack of stimulation in different spheres like motor, cognitive and social-affective [2-4], since factors like the absence of personalized treatment according to the ratio between infants and caregivers (15:1) [5] and the lack of quality care of caregivers [6,7] since the poor commitment for wellbeing of infants and the poor response and insensibility for the necessities of the infants [8], the round-toclock type of work [1], the constant rotation of caregiver [9] and the lack of professional training of caregivers [8] among others deficiencies. Therefore, institutionalization has been associated with consequences in brain and behavioral development.
Institutionalization and brain/cognitive affectationAmong brain areas affected by institutionalization, the institutionalized children often present lower volume of the prefrontal, temporal and parietal areas [10,11] than non-institutionalized children. In addition, post institutionalized children present abnormities in some bundles that connect the different cortical areas. In this regard, several recent studies have reported a lower fractional anisotropy values in the left uncinate fasciculus and in the superior longitudinal fascicule in post institutionalized children compared to children without this personal background [12,13]. In a functional level, Chugani et al. [14] reported a reduction in glucose metabolism in the amygdala and hippocampus during rest conditions in post institutionalized children compared to never institutionalized children and neurological patients. In the EEG, it has been found a higher fronto-central and fronto-temporal coherence in institutionalized children compared to children that were previously institutionalized but were adopted before 24 months old [15]. Also, it has been found a generalized lower alpha power which is positively related to social skills according to a maturational patter found on institutionalized children placed on a foster care home before 20 months of age [16]. Finally, it has been demonstrated that the more time for children living in institutional settings, the more affectation this population suffers [17].In relation with behavioral and cognitive consequences, diverse studies have found that the institutionalized children present impulsivity [18], social problems and delinquent behavior [19], as well as, affectation in cognitive functions like working memory, inhibitory control, memory for faces and visual attention [2,5]. Talking about social abilities, it has been demonstrated that children that was previously institutionalized and were randomly assigned to a foster care intervention program have better social abi...