Practice

Teaching: Ethical Research to Help Romania’s Abandoned Children 

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More teaching resources in this Observer: Understanding Our Inner Darkness May Shed Light into Humanity’s Common Good


Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2023). Romania’s Abandoned Children: The Effects of Early Profound Psychosocial Deprivation on the Course of Human Development. Current Directions in Psychological Science32(6), 515-521.

What happens when children experience parental neglect? As Romania’s communist regime collapsed in the late 1980s, wrenching stories of neglect emerged. Nicolae Ceaucescu had outlawed abortion and punished families who had fewer than five children, and many families had children they could not afford to raise. By 1990, over 170,000 Romanian children were institutionalized. 

In many countries, abandoned children are placed with extended family or in foster care. But Romania believed its long tradition of institutionalized care was best. Rotating shifts of caregivers typically supervised 12 to 16 children each. Children were safe and fed, but lacked nurturing, emotionally responsive social relationships. 

Psychologists know from animal research that early social neglect affects brain development, with cognitive, social, and emotional consequences. But how can we assess neglect in humans? Institutionalized children’s deficits might reflect pre-existing neurobiological conditions or early deprivation. Consider, then, one of psychology’s most important clinical trials, the Bucharest Early Intervention Project (BEIP; Nelson et al., 2023). 

BEIP began when a Romanian government official invited three American developmental scientists to Bucharest. The research team studied 180 institutionalized children at about 22 months of age. The researchers assessed the children’s IQ, language development, mental health attachment security, physical development, and brain anatomy. After eliminating those with genetic or neurobiological disorders, 68 children were randomly assigned to a high-quality foster care program with local families, while 68 remained institutionalized. Foster care was non-existent in Bucharest so the research team recruited, trained, funded, and monitored foster care families. The researchers also tracked a community sample of children who had never been institutionalized.  

Read all of the articles from the November/December Observer.

As of 2023, the participants are about 22 years old, and their outcomes are summarized in Nelson et al.’s Current Directions piece. First, the foster care children had better developmental outcomes on almost all dimensions. For example, compared to remaining institutionalized, the fostered children showed a 7 to 9 point increase in IQ. They also grew physically larger and had better attachment security, language, and peer relationships (Almas et al., 2015; Humphreys et al., 2020; Smyke et al., 2010). The foster children’s brain development also improved (Debnath et al., 2020; Sheridan et al., 2022). Only in a few domains, such as ADHD diagnosis and gray matter volume, did researchers not observe a benefit of foster care. 

Second, the team documented critical developmental periods. The younger children were when placed into foster care, the more they benefitted. Children who started foster care before 24 months had the largest improvements. 

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