Postinstitutionalized children frequently demonstrate persistent socioemotional difficulties. For example, some postinstitutionalized children display an unusual lack of social reserve with unfamiliar adults. This behavior, which has been referred to as indiscriminate friendliness, disinhibited attachment behavior, and disinhibited social behavior, was examined by comparing children internationally adopted from institutional care to children internationally adopted from foster care and children raised by their biological families. Etiological factors and behavioral correlates were also investigated. Both groups of adopted children displayed more disinhibited social behavior than the nonadopted children. Of the etiological factors examined, only the length of time in institutional care was related to disinhibited social behavior. Disinhibited social behavior was not significantly correlated with general cognitive ability, attachment-related behaviors, or basic emotion abilities. However, this behavior was negatively associated with inhibitory control abilities even after controlling for the length of time in institutional care. These results suggest that disinhibited social behavior might reflect underlying deficits in inhibitory control. Keywords international adoption; postinstitutionalized children; indiscriminate friendliness; disinhibited social behavior; inhibitory control Interest in the impact of institutionalization has seen a resurgence due to the increased number of children adopted from institutions and the percentage of postinstitutionalized children exhibiting difficulties (Fisher, Ames, Chisholm, & Savioe, 1997; Rutter & the English and Romanian Adoptees [ERA] Study Team, 1998). These children also provide an opportunity to study the effects of a circumscribed period of deprivation and the potential for recovery following a dramatic change in context. In the current study, atypical behavior characterized by an eagerness to interact with unfamiliar adults was investigated in postinstitutionalized children several years postadoption. Since this behavior is believed to result from the absence of a consistent, responsive caregiver (Chisholm, Carter, Ames, & Morison, 1995; O'Connor, Bredenkamp, Rutter, & the ERA Study Team, 1999), children who received more individualized care due to placement in foster care prior to adoption were included as a Correspondence to: Jacqueline Bruce.Correspondence regarding this article should be addressed to: Jacqueline Bruce Oregon Social Learning Center 10 Shelton McMurphey Boulevard Eugene, OR, 97401-4928 Phone: 541-485-2711 Fax: 541-485- NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript comparison group. Behavioral correlates speculated to underlie this behavior, including attachment-related behaviors, basic emotion abilities, and inhibitory control abilities, were also explored. International Adoption: Incidence, Preadoption Experiences, and OutcomesMore than 226,000 children were internationally adopted into the United States betwe...

Maltreated foster children are subjected to a range of early adverse experiences, including neglect, abuse, and multiple caregiver disruptions. Research suggests that such disturbances alter the development and subsequent functioning of the hypothalamic-pituitary-adrenocortical system. The current study was designed to investigate morning cortisol levels in 117 foster children and 60 low-income, nonmaltreated children. Maltreatment and foster care placement experiences were coded from official records. Analyses revealed that the foster children were significantly more likely than the nonmaltreated children to have low morning cortisol levels. Additionally, specific maltreatment experiences were significantly associated with the foster children's morning cortisol levels. Foster children with low morning cortisol levels experienced more severe physical neglect than the other foster children. In contrast, foster children with high morning cortisol levels experienced more severe emotional maltreatment. These results suggest that specific early adverse experiences have differential effects on the functioning of the hypothalamic-pituitaryadrenocortical system. Keywords cortisol; preschool-aged children; foster care; physical neglect; emotional maltreatmentIn the United States, there are 513,000 children in foster care and 311,000 children enter foster care each year (U.S. Department of Health and Human Services, 2006). Foster children are exposed to a host of early adverse experiences, including neglectful and/or abusive care and repeated caregiver disruptions. It is not surprising, therefore, that numerous studies have found foster children to be an exceptionally high-risk group. Foster children exhibit physical, cognitive, and socioemotional disparities compared to their peers (Leslie, Gordon, Ganger, & Gist, 2002;Pears & Fisher, 2005;Zima et al., 2000). These children are also at risk for anxiety disorders, affective disorders, and disruptive behavior disorders (Casey Family Programs, 2005;Clausen, Landsverk, Ganger, Chadwick, & Litrownik, Contact information for corresponding author: Jacqueline Bruce, Oregon Social Learning Center, 10 Shelton McMurphey Boulevard, Eugene, OR, 97401-4928, Phone: 541-485-2711, Fax: 541-485-7087. * Dr. Levine is now deceased. NIH Public Access Author ManuscriptDev Psychobiol. Author manuscript; available in PMC 2010 January 1. Garland et al., 2001). Although there is considerable evidence of negative outcomes among foster children, little is known about the biological mechanisms underlying the association between early adverse experiences and later maladaptation in this population. Moreover, there is limited research examining the differential impact of specific dimensions of early adverse experiences on these mechanisms. The current study was aimed at examining the impact of maltreatment and foster care placement experiences on one possible biological mechanism, the hypothalamic-pituitary-adrenocortical (HPA) system.The HPA system serves two distinct functions: maintaining t...

This article summarizes the research on the developmental outcomes of postinstitutionalized children and discusses the implications for social policy. Postinstitutionalized children often reach their adoptive families with varying degrees of physical growth retardation, cognitive delays, and socioemotional problems. Many children demonstrate remarkable recovery following adoption. Unfortunately, some of the children continue to display significant problems that require professional intervention. It appears that the children's recovery may be influenced by their early experiences with their birth family and in institutional care, and there is suggestive evidence that postadoption experiences also play a role. These findings indicate that preadoption and postadoption services may support the outcome of postinstitutionalized children.

Young children in foster care are exposed to high levels of stress. These experiences place foster children at risk for poor social, academic, and mental heath outcomes. The role of adverse events in stimulating neurobiological stress responses presumably plays a role in shaping neural systems that contribute to these problems. Systematic and developmentally well-timed interventions might have the potential to change developmental trajectories and promote resilience. Moreover, understanding how specific dimensions of early adversity affect underlying stress response systems and how alterations in these systems are related to later psychosocial outcomes might facilitate more precise and targeted interventions. Data are drawn from two ongoing randomized trials involving foster infants/toddlers and preschoolers. Consistent with prior animal models of early adversity, these studies have shown that early adversity-particularly neglect, younger age at first foster placement, and higher number of placements-is associated with altered hypothalamic-pituitary-adrenal (HPA) axis function. The interventions under investigation have produced evidence that it is possible to impact many areas that have been negatively affected by early stress, including HPA axis activity, behavior, and attachment to caregivers.

False belief understanding was investigated in maltreated (N = 203), low socioeconomic status (SES) nonmaltreated (N = 143), and middle SES nonmaltreated (N = 172) 3- to 8-year-old children. Contrasts among the three groups provided an opportunity to examine the impact of family contextual influences on theory of mind development. Specifically, child maltreatment served as an “experiment of nature” in order to elucidate theory of mind abilities. Two false belief tasks and language assessments were administered. Among children with a verbal mental age of 49 months or greater, maltreatment was related to delays in the development of theory of mind, beyond the influence of chronological age and SES. The occurrence of maltreatment during the toddler period, onset during the toddler years, and physical abuse were features of maltreatment associated with delay in the development of theory of mind. Findings are discussed in terms of the influence of harsh caregiving on the development of theory of mind. Implications for the understanding of normal developmental processes are highlighted.