While many children are born into supportive and loving families, others are less fortunate – abandoned and raised in institutions. A new study now suggests that these children are at an increased risk of developing behavioral symptoms similar to those seen in children with autism.
Published in the Journal of the American Academy of Adolescent Psychiatry, the study demonstrates the children raised in institutions were more likely to develop social behaviors associated with autism such as impaired social communication. These behaviors improved when the children were moved into child-centered foster family care.
The study is part of the Bucharest Early Intervention Project (BEIP) – a research collaboration between Tulane University, University of Maryland and Boston Children’s Hospital investigating the effects of early institutionalization on brain and behavior development.
“With approximately 8 million children growing up in institutions around the world and 75% of child abuse cases in the United States classified as neglect, it is an issue that demands our attention and concern,” the BEIP state.
For the study, a total of 136 children abandoned at birth in Bucharest, Romania, were examined. These children were randomly assigned to either continue to receive institutional care or to be placed in high-quality family-centered foster care.
At the time of being assigned a form of care, the children had an average age of 23 months. At the age of 10, 117 of the children were then assessed further by the researchers.
The caregivers of the children completed the Social Communication Questionnaire (SCQ) – a method of screening for autism spectrum disorders, assessing behaviors and communication skills. An age-matched group of 100 children that had never been institutionalized was also assessed as a point of comparison.
Any children whose SCQ results suggested possible autism were referred for a full neurodevelopmental assessment for the disorder.
The researchers observed that five children who had received institutional care – two from the foster care group and three who had continued to receive institutional care – met the Diagnostic and Statistical Manual of Mental Disorders criteria for autism spectrum disorder.
Conversely, none of the never-institutionalized children met the criteria. In all areas of the SCQ, the researchers found that children with a history of institutionalization exhibited significantly more deviant behavior than the never-institutionalized group.
Children who received family-centered foster care displayed more typical social behaviors than the children who continued to receive institutional care, suggesting that an early intervention of foster care can improve behaviors associated with autism.
Senior author of the study, Charles A. Nelson of Boston Children’s Hospital and Harvard Medical School, makes it clear that psychosocial deprivation does not play a part in the vast majority of autism cases, in which children are raised in caring families.
“Although the institutionalized children with autism resemble children with autism in the general population, the origins of their symptoms are very different,” he states.
“We believe that both groups suffer deprivation, but of different types: in institutionalized children, the deprivation comes from their environment, while in the general population, the autism itself causes a kind of deprivation, making it harder for children to perceive and understand social cues.”
Autism spectrum disorder is characterized by repetitive behavior and social impairment such as difficulty with communication. Symptoms are typically identified within the first 2 years of a child’s life. The BEIP suggest that placement into foster care before the age of 2 years is optimum for enhancing a child’s development.
The BEIP state that they are currently conducting a follow-up assessment on the children as they reach 12 years of age and early adolescence, examining data to determine any lasting effects of the intervention.
Recently, Medical News Today reported on a study of preschool children with autism spectrum disorder that identified several different developmental trajectories for the condition.