Institutionalization of orphaned and unwanted children has been a long-standing Western tradition, and only in the last century has society begun to realize the damning ramifications of the practice on children. This form of care still remains common in a few former Soviet countries, tragically condemning children to a life of stunted development. This article, then, will tackle the effects of institutionalization of children in former Soviet countries in particular, starting first with the history of institutionalization practices the typical institutionalization experience is like in former Soviet orphanages, and then its profound effects on physical well-being, intelligence, and socio-emotional development.
However, both institutionalization and the medical model approach remains prevalent in former Soviet countries, with several hundred Russian orphans still living in orphanages.
Infants in these orphanages are fastidiously kept for, well-groomed and well-fed, but human interaction is minimal. Infant-to-staff range anywhere from tomeaning that infants receive only a bare minimum of human interaction. Frequently, they are frequently left in cribs for a good majority of the day and only receive interaction with staff when their basic needs, like feeding and bathing, are met at predetermined times, and the rest of the time, they must lie in their own feces and urine.
Staff members rarely hold or cuddle infants, and they routinely ignore crying, both due to policy and due to the sheer number of other children they must attend to. The actual orphanage environment is no more stimulating. Many orphanages lack proper schools and provide no educational or entertainment material for the children to peruse, meaning they must provide their own stimulation. The sight of children staring blankly into space for lack of anything better to do is tragically common.
The physical effects of such a deprived environment have been long noted. At one Romanian orphanage, most children were below the 20th percentile for height and weight, rendering them more vulnerable to disease. It is not unheard of for such children to grow three to four inches in just a six-month time span after being adopted. While most health problems resolve within a year of adoption, children nonetheless remain smaller than their non-adopted peers throughout childhood. The longer the orphanage stay, the shorter the child tends to be for their age.
Complementing this physical stunting are motor skill development problems, like possessing low muscle tone and not demonstrating age-appropriate motor skills. Like the other physical effects mentioned above, these motor skill problems resolve themselves in more stimulating environments.
Why Internationally Adopted Children Are at Risk for RAD
Of course, the effects of institutionalization do not limit themselves to merely physical development. Perhaps the most well-documented effect is on attachment. John Bowlby noted that all children need a stable, responsible caregiver to attach to; without one, a child is set up to have difficulty with relationships later in life.
By definition of being institutionalized, however, children in orphanages do not have a caregiver to attach to, as staff members work on shifts, may switch jobs, and have other children to care for—there is no one dedicated long-term to an individual child. Generally, children who are institutionalized after the age of two and have had quality care during their infancy are not terribly affected by this indifference, but children who enter institutions before the age of one tend to do quite poorly.
These children realize early on that no one particularly cares about them. Infants in nurseries are eerily silent, a direct result of learning early on that their vocalized distress will never be rewarded with attention.
They frequently fail to attach to anyone, and, unused to physical contact, are highly sensory and tactively defensive and recoil from human contact if it is given.April The psychological effect on child's behavior produced by living in orphanage did not attract the attention of scientists until the first international adoptees from Romania arrived to America. The last US orphanage was closed almost 70 years ago, and the notion of "orphanage behavior" disappeared from the researchers' radar.
But when adoption of children from the overseas orphanages reached big numbers during the last two decades, the monster returned but was not recognized. It was given many fancy names, from "institutional autism" to "attachment disorder. The situation with attachment diagnoses was even more complex see my article Attachment disorder: are we trying to fit square pegs into the round holes? In fact, in many cases this was a post-orphanage behavior, magnified by an early childhood trauma and reinforced by the abrupt loss of first language and new negative circumstances.
We all intuitively understand that an institutional culture must be the breeding ground for institutional behavior among children who do not get adequate care and proper mediation from adults in their early most formative years, are continuously traumatized, and often forced into survival mode.
We do not have any reliable research on these depraving forces, but we do see the psychological effects and consequences of these conditions for children in their post-institutional period, which I will identify and describe based on my observations and on hundreds of psychological assessments I have conducted over 20 years. Post-Orphanage Behavior POB syndrome is a cluster of learned acquired behaviors that could have been adaptive and effective in orphanages but became maladaptive and counter-productive in the new family environment.
I believe that to some extent we can initially observe some patterns of POB in the majority of post-institutionalized children. As one can see further, some characteristics of POB may even contradict each other e. In fact, the illogical combination of seemingly opposite characteristics is the very essence of POB. Though it is difficult to trace the direct link between certain environmental conditions affecting a former orphanage resident with the resulting psychological traits of the growing up person who now lives in the family - it's always a complex combination of biological and social aspects - we have to identify the main patterns of expected and common post-orphanage behavior and separate temporary from long-term psychological problems.
Below we will look at several components of post-orphanage behavior. They are most common among international adoptees, but there may be some additional traits which I do not review here like hoarding, stealing, habitual lying, and other anti-social acts reported by adoptive parents. Poor self regulation A peculiar combination of rigid routine with ongoing uncontrollable changes in the environment is typical for foreign institutions: constant turnover of caregivers and frequent transfers of children between institutions create unpredictability in living arrangements and lead to a tremendous sense of instability and lack of control.
On the other hand, children's everyday routines are fixed with rigid schedules, virtually no personal choices, and no private possession of toys or other goods. As a result of this everyday routine combined with sudden uncontrollable change, there is a minimal need for behavioral self-regulation, long-term planning, or a need to practice goal-directed consistent behavior.
The orphanage residents live in a "reactive" mode, surviving "one day at a time. These are only a small sample of the characteristics of immature self-regulation, which, being a part of POB, may appear as symptoms of ADHD and other neurologically-based disorders. Mixed maturity Poor self-regulation often comes across as phenomenon of mixed maturity, when the same post-institutionalized child at times may demonstrate the behavior of an older child and at times of a much younger one.
For example, in terms of self-care and performed chores, a child may be well advanced for their age, may tend to interact more with older children and have interests advanced for their age, but in reaction to stress and frustration they may behave in a way that is usually expected from a child several years their junior.
This obvious inconsistency is very confusing for parents and teachers. Self-parenting Self-parenting in adopted children not to be confused with the psychological technique of "inner talk" promoted by Dr. Pollard is, in essence, an attempt to assume the role of parent, thus denying the actual parents their major social role. Post-institutionalized children may: Constantly attempt tasks that are normally beyond their age level abilities and skills.
Resort to taking "justice" into their own hands in their relationships with peers instead of appealing to adults in resolving conflicts as is expected at a certain age.It is our hope that adoptive families, prospective families and adoption professionals will gain insight into how attachment and trauma issues present themselves in children adopted from China, Russia, Korea and other countries. However, much of the information about attachment and trauma applies to children who have been adopted domestically, especially if there has been abuse or neglect in one or more homes.
If you are an adoptive parent, we hope this information will help you determine whether or not your child needs help. If you are a prospective adoptive parent, we want to give you a realistic view of what it is like to parent a child who has suffered as a result of her pre-adoption childhood.What Caring For Child With R.A.D. Was Like for State Rep., Wife
If you are an adoption professional, please use this website as a resource for clients and staff to help parents be fully prepared in caring for their precious children. One of the main observations we hear from new members who are just starting to recognize attachment as an issue is that their doctors, teachers, early intervention therapists, friends, extended family and sometimes even spouses do not see or recognize the problems a parent can notice in their child. When reaching out for help, parents are often told to "stop worrying, your child just needs time to adjust" or "it's a typical childhood phase" or "she'll grow out of it.
If you have a gut feeling that something is 'not right' the best gift you can give your child is to find out what the problem is and how to treat it.
Many members here have learned the hard way that if left untreated, relatively mild attachment issues do not go away. They re-appear a few years later, in much more difficult forms. This website was put together primarily so that new families will not have to suffer what many of us suffered while trying to get the help and support we needed in order to help our children.
It is important to remember that we cannot be held responsible for what happened to our children before we adopted them, but we owe it to them, as their parents, to help them heal. The content selected for the website is intended to share information about various therapies, and although certain articles speak to the success some families have had with those therapies, the website is not intended as an endorsement of any particular therapeutic course of treatment.
Families with children with possible trauma and attachment issues are urged to seek medical advice. If a family begins a therapy without medical advice, they do so at their own risk.
Children may have unusual or unique reactions to various types of therapies and "one-size-does-not-fit-all" when dealing with these issues. Updated May4. May not be reproduced in any form without written permission of the authors.
It's easy to get started. Call me at or e-mail me. I will respond within 24 hours. Parents who have adopted internationally as well as domestically are welcome to join.The disorder, treatment, and cause s are complicated.
The State Of Orphanages In Eastern Europe and the Post-Institutionalised Child
For youngsters, however, treatment often includes counseling and parent education. Sadly, most research remains unclear on the cause of Avoidant Personality Disorder, but some research points to the infant and child disorder Reactive Attachment Disorder RAD as being the beginning of many woes. Children most frequently diagnosed with RAD include children who have been in orphanages, institutions for mental health, or foster care agencies. The disorder includes an inability to develop appropriate emotional bonds with adults as a result of an early life experience of negative experiences or lack of human connection.
For example, children in orphanages who are rarely held or spoken to often develop symptoms of RAD. Reactive attachment disorder is a reare condition, but when it does occur, treatment is often complicated. It is a lifelong challenge and process of teaching the individual to trust others and increase self-esteem.
Most children who have been severely abused, neglected, or traumatized are often diagnosed with RAD. A new foster family may find it even more difficult to develop healthy attachments with this child.
In such situations, a child is re-routed through the foster care system multiple times. Not only will the frequent change in foster families further damage the child, but so too will the inability to develop healthy relationships with caregivers or foster families.
Some children with RAD develop into teenagers with PTSD post-traumatic stress disordersevere anxiety disorders, and even depression. There are two specific types of responses that children with RAD exhibit:. Children with RAD may develop controlling tendencies that lead to anger management difficulties, substance abuse, or delinquency. Unfortunately, many youths cling to gangs or marginalized groups of young people who engage in delinquent behaviors.
Both avoidant personality disorder and reactive attachment disorder have similar etiologies. Hill strives to help clients to realize and actualize their strengths in their home environments and in their relationships within the community. Visit her at Anchored-In-Knowledge or Twitter and Youtube Youtube If you are interested in scheduling a telehealth family consultation, feel free to let me know.
Or via RSS Feed. Find help or get online counseling now. There are two specific types of responses that children with RAD exhibit: Inhibited : a child with inhibited personality traits often refrains from developing emotional bonds with others and tends to shun relationships. Consider my discussion on Avoidant Personality Disorder from last week. A child may also exhibit signs of liking you and trusting you one moment, and disliking and not trusting you another moment.
Dis-inhibited : a child with disinhibited personality traits often searches for love, approval, and affection from anyone, including strangers. This is the child who may ask to sit on a strangers lap, ask for a hug from a stranger, or might become too trusting too soon.
Some youngsters, especially teens may desire a romantic relationship with a teacher, therapist, or other adult and fantasize about the possibility. Stricter boundaries with compassion are very much needed in such cases. As always, feel free to share your comments and experiences. Psych Central. Last updated: 20 Jun Statement of review: Psych Central does not review the content that appears in our blog network blogs. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central.
Published on PsychCentral. All rights reserved. Hot Topics Today 1. What an honor. No one will be out this and all of a sudden These individuals are difficult soUntil the s, the orphanages of Romania were notorious for their harsh, overcrowded conditions. Those perceptions have been borne out in new research that finds growing up in such an environment can change the brain for good.
Institutionalization in early childhood can alter a child's brain and behavior in the long run, the research finds. Fortunately, early intervention can stave off the effects. The study, conducted with children growing up in Romanian orphanagesreveals changes in the brain composition of kids who spent their first years in institutions versus those who were randomly assigned to foster care. The findings point to a "sensitive period" in the brain for social development, said study researcher Nathan Fox, a child development researcher at the University of Maryland.
The finding adds to evidence that early childhood experiences can have lasting impacts on the brain, with one recent study showing that child abuse may shrink regions in the brain's hippocampus. For 13 years, Fox and his colleagues have been following a group of children who lived as babies in orphanages around Bucharest, Romania. Although these institutions are called orphanages, Fox said, many of the children have living parents who had given the babies up to the state.
After the fall of Romanian dictator Nicolae Ceausescu inthe plight of children living in these orphanages came to the forefront. Institutions were understaffed, abuse was rampant, and neglect was a way of life.
Early Neglect Alters Kids' Brains
Today, Fox said, the situation has improved — it's now illegal to institutionalize a child under 2 in Romania, for example. But the infants in the latest study came to the orphanages in a time when conditions were still poor, he said.
There was very little training for caregivers and a very bad ratio of caregivers to children. At the invitation of the then-Minister for Child Protection in Romania, Fox and his colleagues screened babies at six orphanages in Bucharest and assigned them randomly to either stay where they were or to go to foster homes foster parents were paid for the care of the children until the kids reached age 4. Ever since, the researchers have been following the children, who are now 12, and evaluating their brains and behaviors.
The latest results come from the children's 8-year-old checkup, which included brain scans using magnetic resonance imaging MRI and electroencephalography EEG ; while MRI reveals brain structure, EEG shows electrical brain activity.
They found that early institutionalization changed both the structure and the function of the brain. Any time spent in an institution shrunk the volume of gray matteror brain cell bodies, in the brain.
Kids who stayed in the orphanages instead of going to foster care also had less white matter, or the fat-covered tracts between brain cell bodies, than kids who, at a young age, moved in with families. Staying in an orphanage instead of foster care also resulted in lower-quality brain activity as measured by EEG, Fox said. Teachers indicated these same kids were also worse off socially.
Part of the difference in the kids' behavior appeared to be explained by how warmly and securely bonded they were to their main caregiver, the researchers report this week in the journal Proceedings of the National Academy of Sciences. In fact, past research has shown children of nurturing mothers had hippocampus volumes 10 percent larger than children whose mothers were not as nurturing.Language: English French.
This article presents an overview of literature on the psychiatric sequelae of institutionalization from an attachment perspective in children adopted from Romanian Orphanages. We compare the psychiatric presentations of Romanian Canadian adoptees to same age Romanian adoptees within Romania. Early institutionalization in conditions of neglect and deprivation has a major impact on subsequent biopsychosocial development of children whether they are adopted in Canada or in Romania.
Studies on the effects of maternal deprivation in the first year of life demonstrate that children show delayed psychomotor and speech development, lack of novelty seeking, poor emotional expression, lack basic trust and they do not seek adults when in distress. Ainsworth, ; Ainsworth, ; Ainsworth and Bell, These effects are also evident in observations of children institutionalized between 1 and 4 years of age who show the three phases of Protests, Despair and Detachment Bowlby J, In deprivation through separation the phase of detachment is constantly present in addition to other problems such as inattention and over activity, social and cognitive developmental delay which may not return to normal levels even when a nurturing environment is provided Kaler and Freeman, ; Kreppner et al, ; Farruggia.
My Casey’s story — a tragic end to the adoption of a baby with attachment disorder
Trasler asserts that in the early years of childhood, humans tend to interpret the separation from the parents as a withdrawal of affection, which causes difficulties in reorganizing other and later attachments to the caretakers in foster homes Trasler, All these are projected in the developing limbic circuits and right hemisphere Schore, The maturation of these capacities of the right brain depend on experiences, which are encoded in the attachment relationship between the infant and the primary attachment figure Schore Maternal care in the first year of life helps to organize behavioral responses to later stresses.
Attachment disorder behaviors and quasiautistic behaviors constitute institutional privation patterns and are associated with duration of privation Rutter et al. A three year follow-up study of attachment and indiscriminate friendliness, compared children who had spent at least 8 months in Romanian orphanages to Canadian non adopted non institutionalized children and children who had spent less than 4 months in an orphanage There were problems evident in indiscriminate friendliness, sociability and insecure attachment patterns Chisholm, ; Zeanah et al.
Children adopted from institutions are at dramatically increased risk for disturbances, although the majority of such children do not demonstrate problems. Both the duration of deprivation and the post institutional caregiving environment seem to be importantly related to outcome.
Long after children become attached to adoptive parents, a number of them continue to exhibit indiscriminate sociability Zeanah, But the fact that the others do not present these kinds of problems perhaps speaks to their environmental and cognitive resilience. The later is supported by a more recent follow-up study of adoptees to the UK that shows even of those with longest duration of deprivation at least one fifth have no major problems Rutter et al In Romanian Communist Party decreed all families to have at least four children, forbidding birth control and abortions.
The peasants and the gypsies had large families, while others avoided conception by other means or terminated pregnancies by self-induced or back street abortions. This led to many unwanted pregnancies, high maternal mortality, increased congenital malformations and frequent abandonment of children. Inafter the collapse of the Communist regime, there were 47, children in orphanages.
These children were not only victims of general economic disaster and the lack of qualified staff, but also of the effects of insufficient heating, light, food, medicines, and lack of single use syringes, which led to increased frequency of AIDS. In most cases, there was no communication from the natural family, no names or identity papers for the children.Hoping to help lift the veil of secrecy and shame that too often surrounds parents struggling with attachment issues, Traster describes how with work, commitment, and acceptance, she and her husband have been able to close the gulf between them and their daughter to form a loving bond, and concludes by providing practical advice, strategies, and resources for parents and caregivers.
Enter your mobile number or email address below and we'll send you a link to download the free Kindle App. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required. To get the free app, enter your mobile phone number. This book will stay with you long after you close the cover. Fewer follow the story years down the road, as parents and child knit themselves into a family.
Their struggle with love and loss, frustration and disappointment, fear and hope will chill and ultimately thrill anyone who is a parent —through birth or adoption—or who is thinking about becoming one. The adoption world—and everyone surrounding it meaning everyone —needs to better understand the realities that affect so many children being adopted from orphanages today. The timing of this starkly honest book could not be better. She and her husband are the parents of nine children: four by birth and five by adoption.
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