L11 - Romanian Orphan Studies: Effects Of Institutionalisation

Question 1

what is institutionalisation?

Answer 1

• When babies and children are placed in an institution - which is living arrangements outside the family/family home
• in a building such as a hospital, mental home or orphanage where due to unfortunate circumstances, are unable to be looked after by parents or caregivers in their normal home/family

Question 2

what is an institution

Answer 2

• place where people live for as period of time as opposed to day care or outpatient care where people go home every day

Question 3

2 negative consequences of institutionalisation

Answer 3

• The child adopting rules and norms of the institution that can impair functioning
• Leading to loss of personal identity, deindividuation etc.

Question 4

Why was institutionalisation studied?

Answer 4

• due to Romania’s events - as without natural events can’t/hard to study privation
• Nicolae Ceausescu (dictator) tried to boost the population of Romania - encouraged large families and banned abortion
• meant many kids went to orphanages, world found out when regime collapsed in 1989
• more than 100000 orphans in 600 state-run orphanages
• children spent their days alone in cribs with very little stimulation – cognitive or emotional – were malnourished and uncared for

Question 5

Key study

Answer 5

Rutter and Songua-Barke (2010)

Question 6

Rutter and Songua-Barke (2010) procedure

Answer 6

• study started in early 1990’s, published in 2010
• study called ‘ERA’ - Early Romanian Adoptees
• studied 165 Romanian children who spent early lives in Romanian institutions so suffered the effects of institutionalisation
• children were then adopted by british families - were in 3 age categories
• adoptees were tested at regular intervals (ages 4, 6, 11 and 15 years) to assess their physical, cognitive and social development
• also interviewed parents and teachers
• progress compared to a control group of 52 British children adopted in the UK before the age of 6 months

Question 7

3 age categories

Answer 7

1) 54 adopted before the age of 6 months
2) 57 adopted between the ages of 6 months and 2 years
3) 54 adopted between the ages of 2-4 years.

Question 8

Study findings

Answer 8

• at time of adoption Romanians were behind on all measures of physical, social, emotional and cognitive development compared to British
• most were severely malnourished and half showed signs of mental retardation
• by the age of 4, some of the Romanian children had caught up with their British counterparts – especially those children adopted before the age of 6 months

Question 9

what did follow ups show?

Answer 9

• Romanian children adopted after the age of 6 months and thus experienced a longer period of institutional care, were more likely to suffer social, emotional and cognitive deficits.

For example, at age 11, the mean IQ for the children was:

Adopted before 6 months – 102

Adopted between 6 months and 2 years – 86

Adopted between 2-4 years – 77
IQ differences also remained when the children were 16 years of age

Question 10

what else did the study find

Answer 10

• children adopted between the ages of 2-4 years were more likely to suffer mental health issues
• Many of the Romanian children adopted after the age of six months also showed signs of ‘disinhibited attachment’
• Symptoms included attention seeking, clingy, and social behaviour directed indiscriminately towards all adults, both familiar and unfamiliar

Question 11

Zeanah et al.

Answer 11

• known as the Bucharest Early Intervention Project
• compared 95 Romanian children who had spent about 90% of their lives in an orphanage compared to a control group of 50 children who had never been in an institution
• The children were aged between 12 and 31 months and assessed using the Strange Situation
• The results showed that 74% of the control group were securely attached compared to 19% of the institutional group
• 65% of this group were classified as Type D – disorganised attachments
• Furthermore the description of disinhibited attachment applied to 44% of this group compared to less than 20% of the controls

Question 12

Rutter & Songua-Burke (2010) evaluation

Answer 12

• not knowing the conditions of the orphanages in Romania before the children entered the UK
• ethical issues such as consent of the children would have been an issue – for example, these children did not give their permission to take part as they were too young.
• only some of the children received detailed clinical investigations so it is difficult to fully generalise the findings
• natural experiment - there may have been many extraneous variables which could have affected the findings of this study such as quality of care received from the parents of the adopted children

Question 13

Study conclusion

Answer 13

• Institutional care does not always mean that children will not recover as was shown in Rutters’ study especially with the British and Romanian children adopted before the age of 6 months
• However, Rutters study does show that if conditions in an institution are appalling (as they would have been in Romania) then this can lead to long term consequences for these children
• This study also supports the idea that the effects of institutionalisation can be minimised if the children are adopted as young as possible (e.g. before the age of 6 months).

Question 13

Disinhibited Attachments

Answer 13

• 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
• This is highly unusual behaviour as most children at about 2 years still show stranger anxiety
• Rutter (2006) has explained disinhibited attachment as an adaptation to living with multiple carers during the critical period for attachment formation
• In poor quality institutions like those in Romania, a child might have 50 carers – none of who they see enough to form secure attachments

Question 13

Other studies of Romanian Orphans

Answer 13

Le Mare and Audet (2006)
Zeanah et al. (2005)

Question 13

Le Mare and Audet (2006)

Answer 13

• longitudinal study of 36 Romanian orphans adopted to families in Canada
• researchers studies the orphans physical growth and health
• adopted orphans were physically smaller than a matched control group at age four and a half years but the difference had disappeared by age 11 – this was also the case for physical health
• This study suggests that recovery is possible from the effects of institutionalisation on physical development

Question 14

Effects of Institutionalisation

Answer 14

• Physical underdevelopment
• Intellectual underfunctioning (mental retardation)
• Disinhibited attachment
• Poor parenting
• Quasi-Autism

Question 15

Physical underdevelopment

Answer 15

children in institutional care are usually physically small, research has shown (e.g. Gardner, 1972) that lack of emotional care rather than poor nourishment is the cause of what has been called deprivation dwarfism.

Question 16

Intellectual underfunctioning (mental retardation)

Answer 16

• cognitive development is also affected by emotional deprivation as shown in Skodak and Skeels (1949) study.
• They found that these children scored poorly on intelligence tests.
• However, when some of these children were transferred to a different institution where some inmates gave the children emotional care, the IQ scores improved by up to 30 points.

Question 17

Disinhibited attachment

Answer 17

• form of insecure attachment where children do not discriminate between people they choose as attachment figures.
• Such children will treat unfamiliar people with inappropriate familiarity and show over-friendliness and can even be attention seeking.

Question 18

Poor Parenting

Answer 18

• Harlow showed that monkeys raised in isolation or with a surrogate mother went on to become poor parents.
• Similarly, Quinton et al. (1984) who compared a group of 50 women who had been raised in institutions with a control group of women reared at their normal homes.
• When the women were in their 20s it was found that the ex-institutional women were really struggling to be good parents, as many of their children also spent time in care.

Question 19

Quasi-Autism

Answer 19

type of autism that can only occur due to institutionalisation

Question 20

Evaluation of Institutionalisation studies

Answer 20

strengths
- real-life application
- value of longitudinal studies
- few extraneous variables
weaknesses
- ethical issues
- individual differences

Question 21

real-life application

Answer 21

• Studying the Romanian orphans has enhanced our understanding of the effects of institutionalisation
• Such results have led to improvements in the way the children are cared for in institutions (Langton, 2006)
  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 only one or two people, play a central role for the child.
• This person is called a key worker and having a key worker means that children have the chance to develop normal attachments and helps avoid disinhibited attachment.
• This shows that Rutter’s research has been immensely valuable in practical terms.
• Another real life application from the research that we have learned, is that if adoption is to happen – it needs to happen whilst the baby is as young as possible (e.g. in Rutters study, babies adopted before the age of 6 months – had no significant problems)
• Also, it is necessary for a child to still be within the critical period (first 2-3 years of life) if they are to be adopted.

Question 22

value of longitudinal studies

Answer 22

• the importance of the Romanian Orphan studies were that they were longitudinal – meaning that the same children were followed up through many years – this means that we are more able to understand the effects of institutionalisation and whether they are forever or can be reversed

Question 23

fewer extraneous variables

Answer 23

• there were many orphan studies before the ERA but often these studies involved children who had experienced loss or trauma before they were institutionalised.
  e.g they may have experienced neglect, abuse or bereavement. These children were thus already ready traumatised even before they were studied.
• so it was difficult to observe the effects of institutionalisation in isolation because the children were dealing with too many factors – this lead to confounding variables interfering with the findings of the studies.
• In the ERA study, it was possible to study institutionalisation without any extraneous variables which means the findings of the ERA have increased the internal validity which means that we can be more confident about the effects of institutionalisation.

Question 24

ethical issues

Answer 24

• an ethical issue associated with many of the Romanian Orphan studies is consent of the adoptees and their parents.
  e.g. there was no consent taken from the actual orphans.
• Another ethical issue which is important to take into consideration is the psychological harm that may have been caused to the parents and children in this study
  e.g. being ‘participants’ in a piece of research carried out over a long period of time would have created worry and pressure (especially for the children who went back to their parents) and may have impacted on the findings of this study.
• More importantly – there is also an issue of social sensitivity – for example, studying children who are in an orphanage being adopted can have unforeseen consequences for the children and their parents especially if the research is used to make generalisations about adoption and then published.

Question 25

individual differences

Answer 25

• some research suggests that individuals who do not form a primary attachment within that early critical period are unable to recover.
• But this is not true of all children who experience institutionalisation.
• In all of the studies, some children are not as affected as others – there are individual differences.
• Rutter has suggested that it might be that some of the children did receive special care in the institution because they smiled more or were just ‘cute’ – this means that they did have some attachment experiences.
• This means that we need to be cautious in drawing conclusions about the effects of institutionalisation being permanent and irreversible