ATT 10 - Romanian orphan studies

Question 1

What are orphan studies?

Answer 1

• These concern children placed in care because their parents cannot look after them
• An orphan is a child whose parents have either died or have abandoned them permanently

Question 2

What is institutionalisation?

Answer 2

• A term for the effects of living in an institutional setting
• The term ‘institution’ refers to a place like a hospital or an orphanage where people live for long, continuous periods of time
• In such places there is often very little emotional care provided
• In attachment research we are interested in the effects of institutional care on children’s attachment and subsequent development

Question 3

What is disinhibited attachment?

Answer 3

• A type of insecure attachment where children do not form close attachments
• Such children will treat strangers with inappropriate familiarity (overfriendliness) and may be attention-seeking

Question 4

Who conducted Romanian orphan studies? And what specifically did they investigate?

Answer 4

• Michael Rutter et al (2011) => English and Romanian adoptee (ERA) study
• Charles Zeanah et al (2005) => Bucharest early intervention (BEI) project

Question 5

What was the procedure of the ERA romanian oprhan study?

Answer 5

• Michael Rutter and colleagues (2011) have followed a group of 165 Romanian orphans for many years as part of the English and Romanian adoptee (ERA) study
• The orphans had been adopted by families in the UK
• The aim of the ERA has been to investigate the extent to which good care could make up for poor early experiences in institutions
• Physical, cognitive and emotional development has been assessed at ages 4, 6, 11, 15 and 22-25 years
• A group of 52 children from the UK adopted around the same time have served as a control group

Question 6

What were the findings of the ERA romanian oprhan study?

Answer 6

• When the children first arrived in the UK, half the adoptees showed signs of delayed intellectual development, and the majority were severely undernourished
• At age 11 the adopted children showed differential rates of recovery that were related to their age of adoption
• The mean IQ of those children adopted before the age of six months was 102, compared with 86 for those adopted between six months and two years and 77 for those adopted after two years
• These differences remained at age 16 (Beckett et al. 2010)
• ADHD was more common in 15- and 22-25-year-old samples (Kennedy et al. 2016)
• In terms of attachment, there appeared to be a difference in outcome related to whether adoption took place before or after six months
• Those children adopted after they were six months showed signs of a particular attachment style called disinhibited attachment
• Symptoms include attention-seeking, clinginess and social behaviour directed indiscriminately towards all adults, both familiar and unfamiliar
• In contrast those children adopted before the age of six months rarely displayed disinhibited attachment

Question 7

What was the procedure of the BEI romanian oprhan study?

Answer 7

• Charles Zeanah et al. (2005) conducted the Bucharest early intervention (BEI) project, assessing attachment in 95 Romanian children aged 12-31 months who had spent most of their lives in institutional care (90% on average)
• They were compared to a control group of 50 children who had never lived in an institution
• Their attachment type was measured using the Strange Situation
• In addition, carers were asked about unusual social behaviour including clingy, attention-seeking behaviour directed inappropriately at all adults (a measure of disinhibited attachment)

Question 8

What were the findings of the BEI romanian oprhan study?

Answer 8

• The researchers found that 74% of the control group were classed as securely attached in the Strange Situation
• However, only 19% of the institutional group were securely attached
• In contrast, the description of disinhibited attachment applied to 44% of institutionalised children as opposed to less than 20% of the controls

Question 9

What are the effects of institutionalisation?

Answer 9

• Disinhibited attachment
• Intellectual disability

Question 10

How is disinhibited attachment caused by institutionalisation?

Answer 10

• Children who have spent their early lives in an institution often show signs of disinhibited attachment, being equally friendly and affectionate towards familiar people and strangers
• This is highly unusual behaviour - remember that most children in their second year show stranger anxiety
• Rutter (2006) has explained disinhibited attachment as an adaptation to living with multiple caregivers during the sensitive period for attachment formation
• In poor quality institutions, like those in Romania, a child might have 50 carers but doesn’t spend enough time with any one of them to be able to form a secure attachment

Question 11

How is intellectual disability caused by institutionalisation?

Answer 11

• In Rutter’s study most children showed signs of intellectual disability when they arrived in Britain
• However, most of those adopted before they were six months old caught up with the control group by age four
• It appears that, like emotional development, damage to intellectual development as a result of institutionalisation can be recovered provided adoption takes place before the age of six months - the age at which attachments form

Question 12

What are the strengths of romanian orphanage studies?

Answer 12

• Has real world applications
• Lack of confounding variables

Question 13

What are the real world applications of romanian orphange studies?

Answer 13

• One strength of the Romanian orphanage studies is their application to improve conditions for children growing up outside their family home
• Studying the Romanian orphans has improved psychologists’ understanding of the effects of early institutional care and how to prevent the worst of these effects (Langton 2006)
• This has led to improvements in the conditions experienced by looked-after children, i.e. children growing up in the care system
• For example, children’s homes now avoid having large numbers of caregivers for each child
• Instead, the children tend to have one or two ‘key workers’ who play a central role in their emotional care
• Also, institutional care is now seen as an undesirable option for looked-after children
• Considerable effort is made to accommodate such children in foster care or to have them adopted instead
• This means that children in institutional care have a chance to develop normal attachments and disinhibited attachment is avoided

Question 14

How do romanian orphange studies lack confounding variables?

Answer 14

• One strength of the Romanian studies is the lack of confounding variables.
• There were many orphan studies before the Romanian orphans became available to study (e.g. orphans studied during the Second World War)
• Many of the children studied in orphanages had experienced varying degrees of trauma, and it is difficult to disentangle the effects of neglect, physical abuse and bereavement from those of institutional care
• However, the children from Romanian orphanages had, in the main, been handed over by loving parents who could not afford to keep them
• This means that results were much less likely to be confounded by other negative early experiences (higher internal validity)

Question 15

What are the limitation of romanian orphanage studies?

Answer 15

• Lack data on adult development
• Socially sensitive
• May have introduced different confounding variables

Question 16

How does studying children from romanian oprhanges introduce different confounding variables?

Answer 16

• On the other hand, studying children from Romanian orphanages might have introduced different confounding variables
• The quality of care in these institutions was remarkably poor, with children receiving very little intellectual stimulation or comfort
• This means that the harmful effects seen in studies of Romanian orphans may represent the effects of poor institutional care rather than institutional

Question 17

How do romanian orphange studies lack data on adult development?

Answer 17

• One limitation of the Romanian orphanage studies is the current lack of data on adult development
• The latest data from the ERA Study looked at the children in their early- to mid-20s
• This means that we do not currently have data to answer some of the most interesting research questions about the long-term effects of early institutional care
• These research questions include the lifetime prevalence of mental health problems and participants’ success in forming and maintaining adult romantic and parental relationships
• It will take a long time to gather this data because of the longitudinal design of the study, i.e. the same participants are followed over a long period
• This means it will be some time before we know more completely what the long-term effects are for the Romanian orphans. It is possible that late-adopted children may ‘catch up’

Question 18

How are romanian orphanage studies socially sensitive?

Answer 18

• One limitation of the Romanian orphan studies is that they are socially sensitive because the results show that late-adopted children typically have poor developmental outcomes
• Results have been published while the children have been growing up, meaning that their parents, teachers and anyone else who knew them might have lowered their expectations and treated the adopted children differently
• This might even have created a self-fulfilling prophecy
• On the other hand, much has been learned from the Romanian orphan studies that might benefit future institutionalised or potentially institutionalised children