A team of American and Romanian researchers have published a 16 year study which provides scientific evidence that child neglect in the first two years of life creates irreparable effects on brain development.
The study is part of the Bucharest Early Intervention Project (BEIP), a joint collaboration between researchers at Tulane University, the University of Maryland, and Boston Children’s Hospital. The study, which began in the fall of 2000, seeks to examine
the effects of early institutionalization on brain development and to examine the impact of high quality foster care as an intervention for children who have been placed in institutions.
Since 2002, 80 scientific papers have been published on the results of the BEIP, as wells in hundreds of magazines, newspapers and television spots. In 2014, the study results were published in a book and can be found at http://www. bucharestearlyinterventionproject.org
The findings of the BEIP team contributed to the decision taken by Romanian authorities to send abandoned newborns into foster care instead of orphanages. Despite this change in policy, there are still at least 70 traditional orphanages in Romania, which serve as homes to approximately 20,000 children.
Since 2011, Florin Tibu has been a lead Romanian researcher in the BEIP. The results of the study were shared in an exclusive interview with PressOne.
PRESSONE – WHAT WAS THE HYPOTHESIS THAT DROVE THIS STUDY ON THE NEGLECT OF CHILDREN?
Florin Ţibu: The study began in 2000 and I joined the team in 2003. There are older studies carried out in England that suggested children who were raised in institutions often had developmental issues. But there were also people who claimed that children were sometimes better off in orphanages.
The prior studies were not conclusive in demonstrating which areas of the developing brain were impacted by institutionalization. The studies also failed to reveal whether there is a critical age at which the effects of institutionalized living cannot be reversed.
One of the important discoveries that we made is in identifying the physiological mechanisms by which affective and sensory deprivation can lead to psychiatric, behavioral, emotional, and intelligence problems.
The study has now brought a clear understanding that the effects of neglect during the first two years of life are permanently devastating.
Specifically, we are talking about a lower IQ than we would typically expect from a child who spent their first two years in a normal setting. A child who has been institutionalized lacks the ability to define common words as well as the ability to successfully retain information.
They also have a lesser capacity to form relationships and to manage their emotions when they become agitated or troubled.
The experiment room from the Saint Catherine’s Social Services Complex where the study took place.
PRESSONE – HOW MANY CHILDREN PARTICIPATED IN THE BUCHAREST EARLY INTERVENTION STUDY?
136 children from Bucharest were recruited for our study. These were children who had been placed in institutions right after they were born. The children were placed into two study groups.
The first study group spent their childhood in an institution. The second group consisted of children who were either adopted into families or raised by foster parents that were trained by our team.
We also studied a group of 72 children, recommended by family physicians, who were born and raised by the same family. This control group was important in allowing us to determine how the experimental groups compared to the development norm.
Many of the 136 children from our randomized experimental groups ended up being adopted.
This pleased us greatly as the children’s feeling of belonging and experiencing unconditional parental love is the best thing that could ever happen to a child who has undergone so much trauma.
PRESSONE – HOW DO YOU DEFINE NEGLECT?
Neglect has to do with sensory and affective deprivation. In other words, the lack of having a principal caregiver who provides the same things a mother provides to her newborn.
For example, if a child is not touched on a daily basis or is not given the opportunity to look at different objects or faces, her eyes will not be given the opportunity to focus. She won’t have the opportunity to partake in the regular eye exercises that a newborn partakes in.
This has a negative effect on the nervous system. In simple terms, the neural network which would normally be developed, begins to deteriorate.
Children raised by mothers who experience domestic abuse also experience the permanent effects of neglect.
One of the recurring neurodevelopmental disorders we see in our institutionalized children is ADHD. About 25 percent of these children are diagnosed with the disorder, as opposed to 3-5% in the general population.
One of the reasons is the thinning of the cerebral cortex, particularly in the prefrontal area. We studied the brains of institutionalized eight-year- old children using Nuclear Magnetic Resonance (N.M.R.) and found that many of their cerebral cortexes are thinner than those of other children.
At the behavioural level, this manifests itself through a lowered ability to control emotion and a greater inability to plan actions and inhibit impulses.
PRESSONE – WHAT DO YOU MEAN BY HIGH QUALITY FOSTER CARE AND HOW DOES THIS COMPARE TO THE NORM IN ROMANIA?
Good foster care requires a great deal of training. Abandoned or abused children come with lots of special needs. We invested a lot of time in training the foster parents in our study to create a comparison to institutionalized children.
In 2014, we published a paper comparing the behavioural effects of children in high quality foster care and the State foster care system. The study showed a statistically significant benefit to girls.
Our foster care parents were recruited locally, assisted by a team of well-trained social workers and were supervised through weekly contact
with developmental specialists from the United States. This supervision continued through all 4 years of the intervention. In the early phases of the intervention, the social workers were available “on call” for support and advice 24 hours per day. Groups of support and training were implemented as well, and all children were visited weekly.
It is unclear whether the State provided sufficient resources to assure children’s well-being in foster care. For example, the paucity of clinical psychologists and social workers (both specializations that were banned during the last two decades of Communism) could have limited the training and support offered by the local authorities to foster parents.
TO WHAT EXTENT CAN A CHILD’S DEVELOPMENT BE AFFECTED WHILE IN THE WOMB?
I spent a few years of my life in England studying this specific phenomenon. There is serious reason to believe that maternal stress or trauma experienced during pregnancy will have a long-term effect on the child, regardless of how welcoming the post-natal conditions may be.
Science is slowly evolving in regards to this area of study but there seems to be some intrauterine programming that takes place, ultimately impacting the behaviour of the child and their mental health.
PRESSONE – TO WHAT EXTENT CAN POSTPARTUM DEPRESSION LAY THE FOUNDATION FOR THE NEGLECT OF A NEWBORN BABY?
We cannot draw parallels here to children who are institutionalized unless we’re talking about an extreme case in which the mother’s depression impedes her ability to care for the child’s basic needs. That would mean she cannot hug, change, feed or put her child to sleep.
There are studies which indicate that children raised by mothers who suffer from severe depression have a lower level of intelligence and are also predisposed to depression themselves. I do not believe these cases are as powerful or as visible as those of children who have been institutionalized. Institutions are an extreme form of neglect.
WHAT DO YOU MEAN BY OVER STIMULATED AND HOW DOES IT AFFECT THEIR DEVELOPMENT?
I’m thinking about the parents who ask too much from their children, due to the desire to offer them the best of life. I know parents who force their kindergarten-aged children into four after school activities: from piano to foreign languages and horseback riding. It’s too much.
The essential components of development end up being neglected. Children aren’t given the space to develop profound relationships. Their normal rhythm of development is sacrificed for the sake of obtaining specific results.
Consequently, some of the risks include poor emotional development along with feelings of seclusion, depression or anxiety. Overstimulation decreases the possibility of being able to form lasting and natural relationships with peers or even adults. There is also a risk of developing a false perception of life.
WHAT ARE YOUR OWN PERSONAL WISHES IN REGARDS TO THE BUCHAREST EARLY INTERVENTION PROJECT?
I desire to see Romania publically apologize for the mistakes it committed during communism. Through institutionalization, it destroyed thousands of lives and suppressed the lives of thousands of others. I don’t want this to ever repeat itself.
I want Romania to do more than it’s currently doing. To become a country with the best practices in caring for vulnerable children, particularly because we have been exposed to so much evil.
It is necessary to speed up the process of removing children from institutions and to develop a properly trained foster care system.