Romanian children who had been stuck in orphanages in which they had almost no direct interactions with their caretakers had been studied extensively by a group of researchers, as described in the book Romania’s Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery by Charles A. Nelson, Charles H. Zeanah, and Nathan Fox.
Generally, the longer these children were in the orphanages, and the earlier they got there, the more damage to their cognitive abilities, social skills, and stress tolerance there was later in childhood after they were adopted by foster families. Some of them even showed reduced circumferences of their skulls. Hard to imagine that was not permanent damage. Most affected children did seem to show some recovery in their development after adoption, but did not seem to get back completely to normal.
They were not followed much past adolescence in the original study. However, according to a follow-up study described by the BBC, many of these young children adopted by UK families in the early 90s are still experiencing mental health problems even in adulthood (https://www.bbc.com/news/health-39055704).
Despite being brought up by caring new families, this newer long-term study of 165 Romanian orphans found emotional and social problems were commonplace. Initially, all 165 had struggled with developmental delays and malnourishment. While many who spent less than six months in an institution showed remarkable signs of recovery by the age of five or six, children who had spent longer periods in orphanages had far higher rates of social, emotional and cognitive problems during their lives.
Common issues included difficulty engaging with other people, forming
relationships, and problems with concentration and attention levels which
continued into adulthood. This group was also three to four times more likely
to experience emotional problems as adults, with more than 40% having had contact
with mental health services. Despite their low IQs returning to normal levels
over time, they had higher rates of unemployment than other adopted children
from the UK and Romania.
Interestingly, one in five of them seemed to have been unaffected by the neglect they experienced. A small
percentage, to be sure, but if the types of experiences these children had
cause permanent brain damage, how is this even possible?
In current literature
about the effects on the brain of trauma, the common opinion expressed by
experts is that they are irreversible. Brain changes that are seen in various
neurological evaluative procedures - such as different brain scans - do not seem to
go away.
I, on the other hand,
have theorized that the effects of trauma on the brain may be reinforced by
continued interactions with primary attachment figures, whether they be natural
or adoptive parents. If this is going on, the brain changes would not go away. Neural plastic changes leading to this would not happen.
But, people may say, many
of these traumatized Romanian orphans were adopted into loving families! If
what I believe may be true actually is true, why do scars remain in 80% of these
orphans?
Answering this question
definitively is extremely difficult to do. Surely, due to variations in the
genetics of the orphans, some may have been more vulnerable to permanent brain
damage than others. I mean, smaller skulls? But again, on average, and not in
all of them. Also, the experiences of the orphans in the orphanage probably
varied significantly, with a few of them possibly exposed to more helpful
caretakers than the others.
What is rarely discussed
is how difficult it is to raise children who have been traumatized in the way
the orphans had been. They were difficult children with huge behavior
problems, and how to provide proper boundaries in a loving manner is something
that many parents of very normal children have difficulty doing. No matter how
well intentioned the parents may be. Some of these parents might get help from knowledgeable
family therapists, but most do not. So in some ways, the children may be
continuously further traumatized by angry and frustrated parents who don’t have
a clue as to how to best interact with them.
In the original study, there was some
preliminary evidence that interventions by therapists with the adoptive parents
were helpful, but such interventions did not usually take place. Even when they did,
the quality of therapy the parents receive could vary widely.
So addressing the family
dynamics of these adoptive families of adult survivors of the Romanian
orphanage, so that these behavioral and cognitive deficits are no longer being
triggered and reinforced, might possibly lead in many cases to a reversal of both the psychological
deficits as well as the brain changes caused by the original trauma.
I like to think so.
