Abstract
This study investigated the effects of early institutional care on memory and executive functioning. Subjects were participants in the Bucharest Early Intervention Project (BEIP) and included institutionalized children, children with a history of institutionalization who were assigned to a foster care intervention, and community children in Bucharest, Romania. Memory and executive functioning were assessed at the age of 8 years using the Cambridge Neuropsychological Test and Automated Battery (CANTAB). As expected, children with a history of early institutional care performed worse on measures of both visual memory and executive functioning compared to their peers without a history of institutional care. In comparing children randomly assigned to the foster care intervention with their peers who had continued care in the institution, initial comparisons did not show significant differences on any of the memory or executive functioning outcomes. However, for one of the measures of executive functioning, after controlling for birth weight, head circumference, and duration of time spent in early institutional care, the foster care intervention was a significant predictor of scores. These results support and extend previous findings of deficits in memory and executive functioning among school-age children with a history of early deprivation due to institutional care. This study has implications for the millions of children who continue to experience the psychosocial deprivation associated with early institutional care.
Highlights
Psychosocial deprivation can lead to problems in social functioning, including indiscriminate behaviors, inattention/overactivity, and problems in forming adaptive social relationships with peers and adults (Chisholm, 1998; Kreppner et al, 2001; Zeanah et al, 2005)
In this study we address the following questions: (1) Do children who have been exposed to early deprivation associated with institutional care perform differently on tests of visual memory and executive function than their peers without a history of early institutional care? (2) Among children who have a history of early institutional care, do children assigned to a foster care intervention perform differently than their peers who have continued care in the institution, and if so, is there an effect of age of placement into foster care or duration of institutional care? (3) Are there other likely variables that we can identify that may contribute to the findings in these domains among this group of children, such as birth weight or head circumference?
The results indicate deficits in both of these domains among children with a history of early institutional care, suggesting a pattern of impairment in this population associated with specific neural structures, for example, the medial temporal lobe and the prefrontal cortex
Summary
Psychosocial deprivation can lead to problems in social functioning, including indiscriminate behaviors, inattention/overactivity, and problems in forming adaptive social relationships with peers and adults (Chisholm, 1998; Kreppner et al, 2001; Zeanah et al, 2005) These effects appear to persist long after a child is placed in a family with stable and supportive caregiving. A short list of experience-expectant features of the environment might include access to a caregiver, adequate nutrition, sensory and cognitive stimulation, and linguistic input While this list of environmental features may seem obvious, children reared in settings of profound deprivation—such as in institutions— lack most elements of what should be an “expectable” environment. This deprivation from environmental input during sensitive periods of development may lead to underspecification and miswiring of circuits in the immature nervous system
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