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The Deprived Human Brain

Developmental deficits among institutionalized Romanian children—and later improvements—strengthen the case for individualized care

Charles A. Nelson III, Elizabeth A. Furtado, Nathan A. Fox, Charles H. Zeanah Jr.

Figure 1. In a Romanian home for abandoned childrenClick to Enlarge ImageIn 1989, Nicolai Ceausescu, the Communist dictator who ruled Romania for 24 years, was executed by firing squad. A revolution followed, which led to a new government and then exploration by an inquisitive West of a country previously hidden from most of the world. Close to 170,000 abandoned children were discovered languishing in state-run institutions. Most were “social orphans,” boys and girls given up by poor families. Children with medical needs were common too, abandoned because of stigma tied to their disorders or because parents couldn’t afford their care.

How did this tragedy arise? In 1966, Ceausescu decided that Romania’s surest path to power would be to increase its economic production. In his mind, that required more human capital. So Ceausescu outlawed contraception, forbade abortion and taxed families who produced fewer than five children. The birthrate skyrocketed and poverty radiated. Because many families could not afford to keep all the children they were coerced into having, Ceausescu expanded a network of institutions where the state vowed to raise abandoned children. Rather than being stigmatized, child abandonment became implicitly endorsed, a cultural shift in Romania. Increasing numbers of children were brought to institutions early in life. Parents retained legal ties to their children and some visited. A fair number, however, simply disappeared from the lives of their infants and children.

Shortly after the 1989 coup, Western media documented horrific conditions in these institutions. Young children were found confined in cribs with filthy bedding and little sensory stimulation. In any given institution, the ratio of young children to “caregiver” might be 15 to one. Staff often had little education and no training in child development. Regimentation ruled. Children were simultaneously placed on rows of plastic pots for toileting, wore similar haircuts (regardless of gender), were dressed alike and were fed on schedule, in a largely silent, mechanical manner. Nutrition was inadequate. In some institutions, older children were physically or sexually abused.

In 2000, our research team began assessing young children in Romanian institutions. By then, the institutions had improved significantly and remained, in the minds of many, acceptable destinations for very young children. By assessing these children, however, we documented multiple ways that institutional life can hinder normal brain development in young children. We also observed how children improve after they are placed in quality foster care. The findings encouraged changes in Romania but have much wider implications. Governments worldwide, we have concluded, should not wait too long before finding good homes for the millions of children estimated to be living in institutions worldwide today.

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