Risk and Developmental Heterogeneity in Previously Institutionalized Children

Abstract

This manuscript presents an overview of the developmental outcomes of children adopted from institutional care. I describe how institutional care is a risk factor for typical human development and describe the areas of development, both behavioral and neurobiological, that are most vulnerable to this risk. Also described is variation in outcome and resilience, where some children thrive despite exposure to adverse rearing conditions. I conclude with an emphasis on heterogeneity in outcome, describing how the risk associated with institutional care is not a deterministic factor, but rather an influential one.

The Importance of Early Experiences for Neuro-Affective Development

“…Institutional care, even the best of circumstances, provides suboptimal caregiving (although it is often a better alternative to other options) because the care is not consistent (multiple staff members, rotating shifts) and is provided by care workers who are responsible for several infants and children at once (Gunnar, Bruce, & Grotevant, 2000;Taneja, et al, 2002;Tirella, et al, 2008;The St. Petersburg-USA Orphanage Research Team, 2008). For children that are adopted out of institutional care by families, there is a wide range of outcomes, where some children struggle more than others and some phenotypes are impacted more than others (discussed in Tottenham, 2012b). Nonetheless, at the group level, previously institutionalized (PI) youth are at elevated risk for mental health difficulties (Bos, et al, 2011;M.…”

“…Nonetheless, at the group level, previously institutionalized (PI) youth are at elevated risk for mental health difficulties (Bos, et al, 2011;M. R. Gunnar, et al, 2000;Gunnar & van Dulmen, 2007;Nelson, Furtado, Fox, & Zeanah, 2009;Rutter, 1998;Rutter & O'Connor, 2004;Tottenham, 2012b;). Emotion-related difficulties are common following early caregiver deprivation, and research has examined the nature and timing of these difficulties.…”

The Importance of Early Experiences for Neuro-Affective Development

“…Petersburg-USA Orphanage Research Team, 2008). For children that are adopted out of institutional care by families, there is a wide range of outcomes, where some children struggle more than others and some phenotypes are impacted more than others (discussed in Tottenham, 2012b). Nonetheless, at the group level, previously institutionalized (PI) youth are at elevated risk for mental health difficulties (Bos, et al, 2011; M.…”

Early-life stress has persistent effects on amygdala function and development in mice and humans

“…Children adopted from these orphanages provide a unique opportunity to assess the effects of ELS with a discrete timing and offset (12,13). However, it is unclear to what extent emotional and behavioral dysregulation reported in this population is the result of the orphanage experience of disorganized care or attributable to preexisting conditions (e.g., prenatal exposure to substances, maternal malnutrition, and/or congenital disorders) (12). Moreover, we know little about the long-term effects of such early-life experiences and whether they reverse after the stressor is removed.…”