The neurodevelopmental sequelae of early deprivation were examined by testing (N = 132) 8 and 9 year old children who had endured prolonged versus brief institutionalized rearing or rearing in the natal family. Behavioral tasks included measures that permit inferences about underlying neural circuitry. Children raised in institutionalized settings showed neuropsychological deficits on tests of visual memory and attention, as well as visually mediated learning and inhibitory control. Yet, these children performed at developmentally appropriate levels on similar tests where auditory processing was also involved and on tests assessing executive processes such as rule acquisition and planning. These findings suggest that specific aspects brain-behavioral circuitry may be particularly vulnerable to post-natal experience.Over the past decade, increased attention has been devoted to the development of children who have spent some or all of their lives in institutional care (Johnson, 2001). The increase in adoption of institutionalized children has heightened concerns about long-term effects of early deprivation. While the deprivation experienced by children in institutional settings is often impossible to accurately quantify, the environments many of these children endure fall below the quality needed to sustain normal physical and behavioral development. As evidence, institutionalized infants/toddlers lose about 1 month of linear growth for every 2-3 months in institutional care (Johnson, 2001) with behavioral development exhibiting similar dramatic delays retardation (Gunnar, 2001). When institutionalized children are placed in families, marked improvements in physical, social, and cognitive functioning is typically observed, yet many of the children maintain persistent behavioral problems (Ames, 1997; NIH Public Access Author ManuscriptChild Dev. Author manuscript; available in PMC 2011 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript Hodges & Tizard, 1989;Rutter, 1998;Verhulst et al., 1990;Verhulst et al., 1992). The developmental difficulties experienced by many of these children raise questions about the effects of early deprivation including factors such as failure to provide adequate nutrition, medical care, stimulation, and the lack of consistent and supportive caregiving relationships. Although early research emphasized the significance of maternal deprivation, Rutter (1981) rightly noted that many other types of stimulation needed for normal development are also deficient in these environments.The critical questions that emerge from the plight of these children concern which aspects of inadequate stimulation result in cascading developmental effects, which developmental processes are most affected by inadequate early care, and specification about how the transfer to more normative caregiving can foster growth and recovery following institutionalization. Institutionalized children have experienced highly species atypical deprivation; in many countries the instit...

Background-Experience in institutional/orphanage care has been linked to increased mental health problems. Research suggests children adopted from institutions experience specific difficulties related to inattention/overactivity. Evidence of internalizing and conduct problems relative to non-adopted peers has been found in early childhood and early adolescence, but problems may not differ from other adopted children. This study clarifies the understanding of behavioral and emotional symptoms of post-institutionalized (PI) children during middle childhood.

Objective-Children adopted internationally from institutions are a growing population presenting to professional care providers. Although postinstitutionalized (PI) children are adopted from multiple world regions, current knowledge is predominantly based on those adopted from Romania and Eastern European countries. This study examines and compares developmental outcomes of PI children adopted from multiple world regions.Method-Five to 11 years after adoption, 8-through 11-year-old PI children (N = 91), children internationally adopted early from foster care (N = 109), and nonadopted children (N = 69) completed screening measures assessing vision, hearing, growth, and cognitive and language abilities. Parents completed questionnaires on service utilization, school performance, preadoptive history, and postadoption environment.Results-Forty-four percent of PI children's growth was stunted (height <10th percentile) at adoption. At assessment, although physically smaller, nearly all PI children had average growth parameters. Relative to nonadopted children and children adopted early from foster care, PI children performed more poorly on cognitive and language screens with increased time in institution related to lower performance. Notably, group means on these measures were within the average range. PI children were more likely to be falling behind academically and to use intervention services. Family environment did not differ between PI and nonadopted children. There were few differences for PI children by world region of adoption once accounting for duration of institutionalization.Conclusions-Despite currently living in similar environments, PI children have specific needs that differ from early-adopted and nonadopted children. Consideration of multiple factors, including length of institutionalization, is essential when providing care for these children. Keywordsinstitutional care; early deprivation; international adoption; physical growth; school performance Throughout recent decades, the number of children adopted into the United States from institutional (e.g., orphanage) conditions overseas has grown. Between 1998 and 2008, >215,000 children entered the United States through adoption,1 with estimates that 85% of internationally adopted children spend some or all of their lives in institutions before adoption. 2 Conditions within these institutions are often marked by high levels of deprivation. For example, children in these settings are often undernourished, receive poor medical care, spend Copyright © 2009 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript much of their time unoccupied, and quality of their interactions with caregivers is frequently poor.3 Institutionalized children may be left in cribs or placed on the floor to play alone, thus resulting in inadequate motor and cognitive stimulation.2 Postinstitutionalized (PI) children come from all regions of the developing world. They represent a significant and growing population with specific needs to be addressed ...

SUMMARY Homelessness represents a context of extreme poverty and risk for child development. This study compared the relative influence of two classes of risk in the context of homelessness. Levels of socioeconomic resource-related risk and negative lifetime events were examined with respect to morning cortisol levels and cortisol response to a set of cognitive tasks. Participants were 66 children between the ages of 4 and 7 years staying in an emergency shelter for families. Adversities largely reflecting family level negative life events predicted higher levels of morning cortisol and differences in initial level and change over the course of the session of cognitive tasks. In contrast, a socioeconomic cumulative risk score was not associated with morning or session-related differences in cortisol.

Internationally adopted postinstitutionalized (PI) children are at risk for lower levels of emotion understanding. This study examined how postadoption parenting influences emotion understanding and whether lower levels of emotion understanding are associated with behavior problems. Emotion understanding and parent mental state language were assessed in 3-year-old internationally adopted PI children (N = 25), and comparison groups of children internationally adopted from foster care (N = 25) and nonadopted (NA) children (N = 36). At 5.5-year follow-up, PI children had lower levels of emotion understanding than NA children, a group difference not explained by language. In the total sample, parent mental state language at age 3 years predicted 5.5-year emotion understanding after controlling for child language ability. The association of parent mental state language and 5.5-year emotion understanding was moderated by adoption status, such that parent mental state language predicted 5.5-year emotion understanding for the internationally adopted children, but not for the NA children. While postadoption experience does not erase negative effects of early deprivation on emotion understanding, results suggest that parents can promote emotion understanding development through mental state talk. At 5.5 years, PI children had more internalizing and externalizing problems than NA children, and these behavioral problems related to lower levels of emotion understanding.