Deprivation and Disruption

An Interview with Council Member Charles A. Nelson

What light has your work in Romania shed on the effects of early deprivation on early development?

We've followed these children until approximately 54 months of age. In virtually every aspect of development we've looked at -- cognition, brain development, social-emotional development, physical development, language -- institutionalization negatively affects development in profound ways. However, the news is better for foster care. We've seen improvement in many, but not all, aspects of development when children are placed in foster care. For example, their physical growth catches up rapidly once they're placed in a foster home, their language and cognitive development improve, and they start to form healthier attachments. But for most children in foster care, some aspects of social behavior and brain development still seem to be impaired. We don't know if those areas of development simply don't improve as a result of foster care, or if they are just slower to respond to intervention.

What are you seeing in terms of the links between deprivation and brain development?

When we look at electroencephalograms (EEG), which provide recordings of brain electrical activity, we find abnormal patterns in children who are institutionalized. These patterns show higher than normal activity in some brain areas and lower than normal in others. We often see the same pattern of abnormal activity in children who are exposed to adverse early environments, and also in children with learning disorders. We also find that when we do cognitive testing (for example, having children differentiate between facial expressions or between a caregiver's face and a stranger's face) while we record brain activity, the groups differ in how their brains respond. Some of the patterns of brain activity that we typically see in healthy children appear to be altered in the institutionalized kids. This is important because the ability to recognize faces and facial expressions is a central aspect of social functioning. If children's brains are responding abnormally to facial expressions, this might indicate that they are having difficulty processing social signals. Interestingly, these patterns seem to normalize among the children placed in foster care.

Overall, what has the Romanian project taught you?

We're finding that intervening early, when the brain architecture underlying certain developmental abilities appears to be most plastic, probably makes a difference in how rapidly the brain can adapt and how close it can get to a normal rate of development. When we observed EEG recordings, we found that children placed in foster care generally didn't show normally expected brain activity by 42 months of age. But if you look at the handful of children who were placed in foster care very early, say before 22 months of age, and therefore have spent the most time in foster care, their pattern of brain activity appears to be normalizing and looks more like that of typically developing children.

We've also looked at language development. We're finding that, at 30 months of age, children who were placed in foster care at the earliest ages (before 18 months) and have spent the longest time in foster care show definite gains in language ability, while children who have spent less time in foster care improve only slightly, and children who remain in institutions show little if any gain in language skills. We don't know at this point if these improvements are the result of earlier placement or longer time in a family setting, but our future research should shed some light on that question.

We do know, however, that early intervention, such as removing young children from a deprived environment like an institution, appears to make it easier for them to catch up in terms of language ability, attachment, brain development, and a number of other aspects of development. We'll be following these children as they get older to learn more about their long-term outcomes.

Can you identify ways in which the science of brain development—and your research specifically—could have an impact on public policy?

In Romania, our research on how early deprivation affects brain development has influenced the government's position on how to care for children, by encouraging them to move children out of institutions and establish foster care as a viable alternative. We have also increased the Romanian government's awareness of the advances made over the last several decades in child development, in general, through conferences and training. And we have impressed upon the government and the Romanian child protection system the importance of having a solid scientific basis for their decision-making when it comes to young children.

What about policy in the United States?

The foster care system in the United States is often criticized, but this project demonstrates that high quality foster care can have tremendously positive benefits. That's the important thing --- the quality of care. So a desired effect of our Romania project would be to get policy makers in that country, as well as in the U.S., to pay attention to the quality of foster care. Another positive outcome would be to get the court system to pay closer attention to situations where kids are living in profound deprivation. Our research shows that the courts and child protection system in the U.S. need to do a better job expediting permanent placement in a more timely fashion, because of the timing effects we are starting to see in our research. We need to educate the judiciary and the child protection community about the science so they can make better decisions.

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