Romanian Orphan Studies: Effects of Institutionalisation

Who did Rutter study?

165 Romanian orphans adopted in Britain at 4, 6, 11 and 15 years old. 52 British adoptees (control).

At what age were the effects of institutionalisation particularly negative?

6 months - 2 years

In the Bucharest Early Intervention Project, how did the control group and institutional group differ?

74% of control = securely attached, 65% of institutionalised were disorganized attached.

The Bucharest Early Intervention Project - Findings

74% of the control group were securely attached in the Strange Situation. → Only 19% of the institutional group were securely attached, with 65% being classified with disorganised attachment. Disinhibited attachment applied to 44% of institutionalised children as opposed to less than 20% of the controls.

Who did Zeanah study in 2005?

95 children (12-31 months who were institutionalised), 50 children (control).

Institutionalisation

A term for the effects of living in an institutional setting. The term 'institution' refers to a place like a hospital or an orphanage where children live for long, continuous periods of time. In such places there is often very little emotional care provided. In attachment research we are interested in the effects of institutional care on children's attachment and subsequent development.

Romanian Orphan Studies: Effects of Institutionalisation - Physical development

Children who are institutionalised are usually smaller. Lack of emotional care could affect growth hormones causing underdevelopment (Gardner, 1972). → Therefore emotional disturbances may affect the production of growth hormones.

Effects of institutionalisation

Disinhibited attachment and mental retardation

From research, describe 3 effects of institutionalisation

Disinhibited attachment, disorganised attachment, mental retardation, undernourishment.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: Real-life application E.g:

E.g: Orphanages and children's homes now avoid having large numbers of caregivers for each child and instead ensure that a much smaller number of people, perhaps 1 or 2, play a central role for the child. This person is called a key worker. Having a key worker means that children have the chance to develop normal attachments and helps avoid disinhibited attachment. This shows that such research has been immensely valuable in practical terms.

What did Rutter find?

IQ significantly dropped, mental retardation, disinhibited attachment.

Effects of institutionalisation: Mental retardation

In Rutter's study most children showed signs of retardation when they arrived in Britain. Most of those adopted before they were 6 months old caught up with the control group by the age of 4. Appears that, like emotional development, damage to intellectual development as a result of institutionalisation can be recovered provided adoption takes place before the age of 6 months - age at which attachments form.

Orphan studies

These concern children placed in care because their parents cannot look after them. An orphan is a child whose parents have either died or have abandoned them permanently.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: Fewer extraneous variables than other orphan studies

Many of the studies before the Romanian orphans involved children who had experienced loss or trauma before they were institutionalised. E.g: May have experienced neglect, abuse or bereavement. These children were often traumatised by their experiences and suffered bereavement. It was very hard to observe the effects of institutionalisation in isolation because the children were dealing with multiple factors which functioned as confounding participant variables. In the case of Romanian orphans, it has been possible to study institutionalisation without these confounding variables, which means the findings have increased internal validity.

Rutter's ERA (English and Romanian Adoptee) Study - Procedure

Michael Rutter and colleagues, 2011, followed a group of 165 Romanian orphans adopted in Britain to test to what extent good care could make up for poor early experiences in institutions. Physical, cognitive and emotional development has been assessed at ages 4, 6, 11 and 15 years old. A group of 52 British children adopted around the same time had served as a control group.

Differences between institutional care and family care - Institutional care

No attachment figure. Bored. Less sociable. More aggressive. Less intelligent. Not cared for well. Less toys. Less interaction.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: Ethical issues

One of the methodological issues for Rutter's ERA project is that the children were not randomly assigned to conditions. The researchers did not interfere with the adoption process, which means that those children adopted early may have been the more sociable ones, a confounding variable. To control for such variables, another major investigation of fostering versus institutional care, did use random allocation. In the Bucharest Early Intervention project, Romanian orphans were randomly allocated to institutional care or fostering. This is methodologically better because it removes the confounding variable of which children are chosen by parents but it raises ethical issues.

Institutional care

Orphanages lacked both medicines and washing facilities. Children were subject to sexual and physical abuse. Bedrooms were infested with fleas and rats. Rain would often come through the roof. At 18, most orphans would be kicked out onto the street to fend for themselves.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: The Romanian orphanages were not typical

Possible that the conditions were so bad that results cannot be applied to understanding the impact of better quality institutional care or indeed any situation where children experience deprivation. This is a limitation of the Romanian orphan studies because the unusual situational variables mean the studies may after all lack generalisability.

Romanian Orphan Studies: Effects of Institutionalisation - Context

Romania's orphan problem began under the communist rule of Nicolai Ceaucescu who banned abortion and denied access to contraception at a time of severe food and energy shortages. Many Romanians abandoned their newborn children, leaving thousands to suffer at under-funded, state-run orphanages. Many psychologists have used this to study the long term effects of deprivation. Tragic opportunity to look at the effects of institutional care and the consequent institutionalisation arose in Romania in the 1990s. Nicolai Ceaucescu, former president, required Romanian women to have 5 children. After the 1989 revolution many of the children were adopted, some by British parents.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: The Romanian orphanages were not typical - E.g:

Romanian orphanages had particularly poor standards of care, especially when it came to forming any relationship with the children, and extremely low levels of intellectual stimulation. This is a limitation of the Romanian orphan studies because the unusual situational variables mean the studies may after all lack generalisability.

What method did Zeanah use to measure their attachment?

Strange Situation

Differences between institutional care and family care - Family care

Strong emotional attachment. More sociable. Care for well.

Romanian Orphan Studies: Effects of Institutionalisation - Physical development: Garner case study

Studied case study of an 8 month old girl who had been fed through a tube due to a malformation. Her mom would never cuddle her for fear of dislodging the tube. 8 months old = she was withdrawn and physically stunted and she was admitted to hospital. With the attention of hospital staff, she thrived off the attention and returned to normal. → Therefore emotional disturbances may affect the production of growth hormones.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: Real-life application

Studying the Romanain orphans has enhanced our understanding of the effects of institutionalisation. Such results have led to improvements in the way children are cared for in institutions (Langton, 2006). This shows that such research has been immensely valuable in practical terms.

Romanian Orphan Studies: Effects of Institutionalisation - Evaluation: The long-term effects are not yet clear

The studies described have now followed up fostered and adopted orphans into their mid-teens and found some lasting effects of early experience, in particular for those adopted late. However, it is too soon to say with certainty whether children suffered short or long term effects. It may be that the children who spent longer in institutions and currently lag behind in intellectual development or display attachment difficulties may still 'catch up' as adults. Equally, early adopted/fostered children who appear to have no issues now may experience emotional problems as adults.

Effects of institutionalisation: Disinhibited attachment

Typical effect of spending time in an institution. Equally friendly and affectionate towards people they know well or who are strangers that they have just met. → Highly unusual behaviour - most children in 2nd year show stranger anxiety. Rutter, 2006, explained it as an adaptation to living with multiple caregivers during the sensitive period for attachment formation. In poor quality institutions, a child might have 50 carers none of whom they see enough to form a secure attachment.

Rutter's ERA (English and Romanian Adoptee) Study - Findings

When they first arrived in the UK, half of the adoptees showed signs of delayed intellectual development and the majority were severely undernourished. At 11 years old, the adopted children showed differential rates of recovery that were related to their age of adoption. → Mean IQ of children adopted before 6 months was 102, compared with 86 for those adopted between 6 months and 2 years, and 77 for those adopted after 2 years. → These differences remained at 16 years old (Beckett et al, 2010). Appeared to be a difference in outcome, in terms of attachment, relating to whether adoption took place before or after 6 months. Children adopted after 6 months showed signs of an attachment style called disinhibited attachment. → Include attention seeking, clinginess and social behaviour directed indiscriminately towards all adults, both familiar & unfamiliar. Children adopted before 6 months rarely displayed disinhibited attachment.

The Bucharest Early Intervention Project - Procedure

Zeanah et al, 2005, assessed attachment in 95 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. Attachment type was measured using the Strange Situation. + carers were asked about unusual social behaviour including clingy, attention-seeking behaviour directed inappropriately at all adults (disinhibited attachment).