Cognitive Legacy of Early Institutionalization: A Closer Look

Social policy in Romania traditionally included placing abandoned children in institutions, not in foster care. In this study conducted in Romania, researchers investigated differences in cognitive abilities among children raised in institutions, in foster care, or in the homes of their biological families. The investigators randomized 136 children institutionalized at or shortly after birth to remain in institutions or to be raised in foster families recruited by the investigators. Controls were 72 typically developing, sex- and age-matched children raised within their families. Age-appropriate standard cognitive testing was performed at baseline and at 30, 42, and 54 months. Although the status of some children changed during the study, analyses were based on initial placement.

Compared with the control group, both the foster-care and the institutionalized groups had substantially lower mean cognitive scores at 42 months (103.4 vs. 85.7 and 77.1, respectively) and at 54 months (109.3 vs. 81.0 and 73.3, respectively). The foster-care group had significantly higher scores than the institutionalized group at both assessments. At 42 months, but not at 54 months, younger age (≤24 months) at foster-care placement was associated with significantly stronger improvement in scores. Controls’ scores were similar to those in other comparable populations.