Harsh conditions in childhood have long-term effects

VANCOUVER — Living in harsh conditions in an orphanage early in life has long-lasting consequences for a child’s social skills, a new study finds.

Children who spent their first two years in Romanian orphanages behaved abnormally in social interactions with other children, even years after leaving the institution. Life in an orphanage was also linked to brain abnormalities, Charles Nelson of Harvard Medical School reported February 17 at the annual meeting of the American Association for the Advancement of Science.

“I think this work nails the really important issues in trying to understand the effects of early life experiences,” said psychologist Janet Werker of the University of British Columbia in Vancouver.

For more than a decade, Nelson and colleagues have followed 136 children who were abandoned at birth and placed in orphanages in Bucharest, Romania — Spartan environments where the children spent hours staring at a white wall and followed a highly regimented schedule of activities. The kids received very little attention from caregivers.

Nelson and his team arranged for half of these children to move into individual homes for foster care. (A bias against foster care in Romania made the situation unusual.) Called the Bucharest Early Intervention Project, the experiment offered a way to test the importance of a good environment.

Echoes of a hard start in life persisted long after the orphans had moved into a home, the team found. At age 8, kids who spent their first 2 years or longer in the orphanage before moving to foster care had profound deficits in how they interacted with other children. These children couldn’t carry on a conversation normally and had other social problems.

But kids who escaped an orphanage before they turned 2 were able to recover normal social skills, performing as well as children who had been raised in their own homes.

In addition to behavioral problems, the children raised in an orphanage showed brain differences, too. MRI brain scans revealed that kids who were institutionalized had dramatically lower volumes of gray matter — which contains the brain’s nerve cells —than children who grew up normally in their own home. Whether or not the child moved to a foster home didn’t matter: Living in an orphanage for any amount of time was tied to reduced gray matter.

But the story was different for another kind of brain tissue: The volume of white matter — tissue that carries nerve cell signals around the brain — was lower for kids who were in an orphanage for two or more years, but the volume was greater in children who left the orphanage before age 2. The results suggest that white matter, a brain tissue that is thought to be heavily responsive to the environment, may be able to bounce back from an early rough start.

“Institutional care should be considered the last resort,” Nelson said. “And effort should be made to place a child as soon as possible.”