The Damaging Effects of Orphanages on the Brain
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The first few years of life are of the utmost importance for brain development. During this time, the brain undergoes dramatic changes as connections between brain areas are formed and pruned in response to early life experiences and the environment. These connections can shape both brain architecture and the way it functions. As a result, the environment a child is exposed to must meet certain criteria for them to thrive. Unfortunately, it is not always possible for children to be raised in a nurturing home environment and, in some cases, children may be placed in institutional care settings such as orphanages. In recent months, an orphan crisis has emerged as a result of the Russian invasion of Ukraine. This puts timely emphasis on the importance of understanding how orphanages can affect brain development and life outcomes.
To investigate the effects of early childhood institutionalisation, researchers have been studying children who were exposed to extremely deprived settings during their early years. One such group are children who were placed in Romanian orphanages at a young age during the communist leader Ceausescu’s regime, which lasted over 20 years. Often, these children had little opportunity for social interaction, received limited care, and were undernourished. Many of these children were later adopted internationally into families. Time-limited exposure to this environment before adoption provided a unique opportunity to study the effects of deprivation on brain development over time.
For more than 30 years researchers have followed the Romanian adoptees, hoping to answer questions about development. While some previous studies have focused on behavioural outcomes, one recent paper, published in Proceedings of the National Academy of Sciences, examined brain development in this group. This was part of the larger English and Romanian Adoptees study, led by researchers at King’s College London. The sample in this paper includes 67 Romanian adoptees who were placed in orphanages during the first few weeks of life and spent between 3 and 41 months in institutional care before being adopted into family homes in the United Kingdom. This group was compared to 21 adoptees who had been born in the United Kingdom and who had not been exposed to deprived environments.
One of the most common ways of evaluating brain structure and function is through the use of magnetic resonance imaging or MRI. This is a non-invasive technique that allows researchers to capture clear images of the brain. Using MRI, the researchers scanned the brains of each of the participants who were between the ages of 23 and 28 years old at the time. Comparing deprived and non-deprived groups allowed the researchers to address whether deprivation in early life was associated with changes in brain structure.
The results from the scans showed that the Romanian adoptees had smaller brains than the group who had not been exposed to early institutionalisation. In fact, on average, the brains of the deprived group were 8.6% smaller than their peers. It was also found that the length of time spent in institutions was linked to the size of the brain, so the longer the child remained in an orphanage the more likely they were to have reduced brain volume. Researchers estimated that every month spent in deprivation was associated with an approximately 0.3% reduction in brain volume. The researchers accounted for a number of other potential contributing factors in their analyses, including genetic influence, physical growth, and measures of nutrition. However, it is difficult to determine exactly how these other features of orphanages interact with the deprived environment to affect brain development.
A profound outcome of this study is the finding that these structural differences are still evident in young adulthood. This suggests that even after being adopted into enriched environments the brain is unable to completely recover following extreme deprivation. Further, the reduction in brain volume was related to lower IQ scores and higher rates of attention deficit hyperactivity disorder (ADHD) symptoms in the Romanian adoptees. In sum, the findings from this research are consistent with the idea that extreme adversity early in life can have severe long-term effects on brain development and behavioural outcomes.
Based on these findings, it is abundantly clear that the environment a child is exposed to can influence their brain development. It is essential that countries worldwide work towards minimising the numbers of children in institutions to allow future generations to thrive. While many countries have moved away from the orphanage model of childcare, there are still circumstances where these settings are prevalent. There are reports that currently around 100,000 children in Ukraine are living in orphanages with restricted care as a result of the ongoing conflict with Russia. During times of war, institutional settings can quickly become detrimental and deprive children of even the basic levels of care. As many people flee the country, children can be left stranded in orphanages and may even be at a higher risk for trafficking and exploitation. Evidence from studies related to these extreme conditions highlights the importance of minimising the duration of time spent in orphanages or institutions.
If you are interested in learning more about the orphan crisis in Ukraine, please check out the links below:
Original article: Mackes, N. K., Golm, D., Sarkar, S., Kumsta, R., Rutter, M., Fairchild, G., Mehta, M. A., Sonuga-Barke, E. J. S., and on behalf of the ERA Young Adult Follow-up team (2020). Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment. Proceedings of the National Academy of Sciences of the United States of America, 117(1), 641–649.
https://doi.org/10.1073/pnas.1911264116