Romania's Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery

415 Pages·2014·1.19 MB·English

by  Charles A. Nelson

ROMANIA’S
ABANDONED
CHILDREN

ROMANIA’S
ABANDONED
CHILDREN
Dep ri va tion, Brain Development, and
the Struggle for Recovery
Charles A. Nelson
Nathan A. Fox
Charles H. Zeanah
HArvArd UNiversity Press
Cambridge, Massachusetts, and London, Engl and
2014
Copyright © 2014 by the President and Fellows of Harvard College
All rights reserved
Printed in the United States of America
Library of Congress Cataloging-i n-P ublication Data
Nelson, Charles A. (Charles Alexander)
Romania’s abandoned children : dep ri vat ion, brain development, and the
struggle for recovery / Charles A. Nelson, Nathan A. Fox, Charles H. Zeanah.
pages cm
Includes bibliographical references and index.
ISBN 978- 0- 674- 72470- 9 (alk. paper)
1. Abandoned children- - Romania- - Psychology. 2. Abandoned children- -
Deinstitutionalization- - Romania. 3. Dep riv a tion (Psychology).
I. Fox, Nathan A. II. Zeanah, Charles H. III. Title.
HV887.R6N45 2014
362.7309498-- dc23 2013017625
To Gwen and Colin; to Betsy, Rebecca, and David; and to
Paula, Emily, Katy, and Melanie . . . for everything

Contents
Preface ix
1. The Beginning of a Journey 1
2. Study Design and Launch 19
3. The Hist ory of Child Institutionalization
in Romania 39
4. Ethical Considerations 70
5. Foster Care Intervention 94
6. Developmental Hazards of
Institutionalization 124
7. Cognition and Language 154
8. Early Institutionalization and
Brain Development 182
9. Growth, Motor, and Cellular Find ings 211
10. Socioemotional Development 227
11. Psychopathology 266
12. Putt ing the Pieces Together 300
References 335
Notes 369
Acknowledgments 383
Index 391

Preface
This book is the culmination of more than a de cade of research on
currently and previously institutionalized children, along with chil-
dren from the community who were never institutionalized. Al-
though the story takes place in Romania, the implications for chil-
dren around the world are considerable. UNICEF estimates that as
many as 70 to 100 million children worldwide are orphans, with
8 million living in institutions. (UNICEF de fines an orphan as
a child who has lost at least one parent.) The estimated num-
ber of children living in institutions is surely low, given that many
poor countries relying on institutional care do not keep reliable
rec ords.
This number will most likely grow in coming years, for two rea-
sons. First, wars and illnesses like AIDS will leave more children
without parents. Second, the number of children being adopted
internationally, at least by U.S. families, has dropped considerably
(from a high of about 20,000 in the early 2000s to approximately
12,000 in 2010 to about 10,000 in 2012). In the face of such a large
and complex public health challenge, the U.S. government has been
exploring ways to implement evidenced-b ased strategies among
children living outside of family care.
Und er stand ing what happens to children who experience pro-
found early dep ri va tion is essential: it will improve our sci ent ific
un der standi ng of the role of experience in brain development, and
it will guide governments on how best to care for parentless chil-
ix