5.6: Relationship Deprivation
- Page ID
- 198005
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)The Importance of Relationships
Studies of children experiencing profound neglect have proved particularly informative in elucidating the role of experience, such as the quality of caregiving, during critical periods of brain development. This research has led to insights into the nature, timing, and duration of the key experiences young children must have to set them on a pathway of healthy development; they also speak to the importance of intervening early in the lives of children experiencing early adversities, such as neglect. Unfortunately, textbooks on infants and toddlers overly rely upon rare cases of extreme deprivation in an attempt to demonstrate the important role of social relationships for early brain development (i.e., Maguire-Fong, 2015). The problem with this approach is that cases of extreme deprivation are rare–they do not represent the common experiences of the majority of infants and toddlers (Belsky & De Haan, 2011). Furthermore, suggesting strategies for caregivers based off of child institutionalization research is difficult due to the rarity and severity of the experiences. While research on the outcomes of children who have experienced extreme psychosocial deprivation, such as the children in the Bucharest Early Intervention Project, can help us understand the relationship between early brain development and early relationships, it should not be the foundation for practice-based applications. [1]
The use of institutional care for abandoned or orphaned infants and children has remained a common practice throughout the world (Browne, Hamilton-Giachritsis, Johnson, & Ostergren, 2006; UNICEF, 2015), despite evidence that institutional environments are harmful for healthy physical and psychological development, especially for young children. Many institutions have high child-to-caregiver ratios, have highly regimented schedules with extended periods where children are left alone, and have very little engagement with caregivers (Castle et al., 1999; Nelson, 2007; Smyke, Zeanah, Fox, & Nelson, 2007). The consequences of these rearing conditions often include physical growth restriction, a wide range of behavioral problems, and deficits in cognitive function (Maclean, 2003; Nelson, Fox, & Zeanah, 2014). [2]
Extreme deprivation also dramatically alters neural architecture and functioning. A number of neuroimaging studies have examined the impact of early experiences in post-institutionalized adoptees. For example, neuroscience has shown decreased gray and white matter volumes (Mehta et al., 2009, Sheridan et al., 2012), increased amygdala volume (Mehta et al., 2009, Tottenham et al., 2010), decreased cerebellar volumes (Bauer et al., 2009), and disrupted connectivity between the frontal and temporal lobes (Eluvathingal et al., 2006) in previously institutionalized children compared to controls not institutionalized. Together these studies demonstrate that typical neural development is altered as a result of early extreme social deprivation. [3]
Brain tissue primarily composed of myelinated axons
Located on the side of the head, and is associated with hearing, memory, emotion, and some aspects of language
Part of the limbic system and has an essential role in the processing of memory and emotional responses
Bucharest Early Intervention Project
The Bucharest Early Intervention Project (BEIP) examines the outcomes for children originally placed in institutions in Bucharest, Romania who were assessed comprehensively and then randomized to foster care or remained in institutional care as usual and followed longitudinally. The BEIP is the first study to experimentally examine the physical, psychological, and neural sequelae of institutional caregiving and the developmental trajectories of children removed and placed into a foster care intervention (Smyke et al., 2009, Zeanah et al., 2003). Random assignment of these children provides an opportunity to examine the effects of the foster care intervention and repeated assessments over the children's life have allowed examination of changes in development associated with enrichment of their early care environment. [4]
Early findings from the BEIP indicate that children placed in foster care at or below 24 months of age had higher IQ scores at 54 months of age (Nelson et al., 2007), more mature patterns of brain activity at eight years of age (Vanderwert et al., 2010), and more secure attachments to their adult caregivers at forty-two months of age (Smyke et al., 2010). [5]
In addition to cognitive and behavior research, neuroscience has revealed intriguing findings from the BEIP project. At the baseline assessment, infants living in institutions showed markedly decreased power in both alpha and beta activity and increased theta power compared to the never institutionalized community controls (Marshall, Fox, & the BEIP core group, 2004). The pattern of higher theta and lower alpha power is one that is associated with attention-deficit/hyperactivity disorder (ADHD) and other learning disabilities (Barry, Clarke, & Johnstone, 2003, Barry et al., 2009, Chabot, di Michele, & Prichep, 2005, McLaughlin et al., 2010), the former (lower alpha power) being highly prevalent among previously institutionalized children (Bos et al., 2011, Kreppner et al., 2001, Wiik et al., 2011, Zeanah et al., 2009). [6]
One of the most common neurodevelopmental disorders of childhood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active
Earlier removal from institutionalized care and placement into foster care was beneficial, as infants placed at younger ages showed increasing alpha power relative to infants placed in foster care at older ages (Marshall et al., 2008). The effect of timing of placement in foster care became clear by the time the children were 8-years-old. As can be seen in Figure \(\PageIndex{1}\), infants placed into foster care before 24 months had brain electrical activity that was nearly indistinguishable from children in the non-institutionalized control group while those placed after 24 months were almost identical to the children who remained in institutionalized care (Vanderwert et al., 2010). [7]
Brain structure at 9 years of age revealed that exposure to institutional rearing was associated with smaller gray and white matter volume and global reductions in cortical thickness. Randomization out of institutional care and into foster care was associated with greater white matter integrity (Bick et al., 2015). [9]
In longitudinal followup studies when the children were adolescents, children moved into foster care early on showed better cognitive, physical, social and mental health outcomes and less severe psychopathology as teenagers than did those who continued to receive institutional care (Humphreys et al., 2022; King et al., 2023; Wade et al., 2022; Wade et al., 2023).
The findings from the BEIP project highlight the importance of an early and high quality caregiving environment, particularly for children exposed to early psychosocial deprivation, for promoting healthy brain development. [10]
Despite years of research demonstrating negative outcomes, the global prevalence of institutionalized care of children remains high with a median estimate of 5.37 million children around the world in institutionalized care in 2015 (Desmond et al., 2020). The largest estimated number of children living in institutions was found in South Asia, followed by Europe and central Asia. North America had the lowest prevalence among all regions.
While extreme deprivation studies can be important to learn from, they do not represent the social experiences that most children, especially in the United States, have. Thus, we must also look at more common social experiences and how individual differences in caregiving are related to important differences in children’s brain development (Ilyka, Johnson, & Lloyd-Fox, 2021). The following sections will explain how secure attachment and sensitivity can support optimal infant toddler brain development.
Attributions:
- [1] Nelson et al., (2019). How early experience shapes human development: The case of psychosocial deprivation. Neural Plasticity, 2019, 1676285.
- [2] Vanderwert et al., (2016). Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project. Developmental Cognitive Neuroscience, 17, 68-75. CC by 4.0
- [3] Vanderwert et al., (2016). Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project. Developmental Cognitive Neuroscience, 17, 68-75. CC by 4.0
- [4] Vanderwert et al., (2016). Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project. Developmental Cognitive Neuroscience, 17, 68-75. CC by 4.0
- [5] Nelson et al., (2019). How early experience shapes human development: The case of psychosocial deprivation. Neural Plasticity, 2019, 1676285.
- [6] Vanderwert et al., (2016). Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project. Developmental Cognitive Neuroscience, 17, 68-75. CC by 4.0
- [7] Vanderwert et al., (2016). Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project. Developmental Cognitive Neuroscience, 17, 68-75. CC by 4.0
- [8] Image from Vanderwert et al., (2010). Timing of intervention affects brain electrical activity in children exposed to severe psychosocial neglect. PLoS One, 5(7), e11415. CC-BY
- [9] Sheridan et al., (2022). Early deprivation alters structural brain development from middle childhood to adolescence. Science Advances, 8(40), eabn4316. CC BY-NC
- [10] Vanderwert et al., (2016). Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project. Developmental Cognitive Neuroscience, 17, 68-75. CC by 4.0