Children deprived of loving care have reduced white matter in crucial parts of the brain compared to those raised in a better environment. The observations are not surprising in light of the well-known behavioral effects of neglect, but what this study has done is identify and measure the areas of the brain most affected.

The encouraging aspect of the study is that the damage may be reversible if children receive good care from 24 months; but even if this proves right, it is not clear how late is too late to prevent lifelong injury.

The Ceausescu government of Romania banned both contraception and abortion, leading to hundreds of thousands of abandoned children. Conditions in the institutions, wrongly called orphanages, in which they were kept were always awful, but became worse in the 1980s as the economy collapsed. After the fall of the regime international charities struggled to address the problem, although there remains debate as to how much conditions have improved.

In an attempt to salvage something from this horrifying humanitarian disaster, scientists and charities have been studying the effects on children. The institutions provided a chance to determine the effects on children raised in conditions where nutrition and shelter were (sometimes) adequate, but caretakers had no time to provide meaningful human interactions, even if they wanted to.

The Bucharest Early Intervention Project allocated a group of two year old children randomly, so that some remained in institutions while others were placed in foster care. Several rounds of studies have been done on these children, who are now in their late teens.

A paper in JAMA Pediatrics compares images of the brains of the children at the ages of two and eight, taken by diffusion tensor imaging, a form of MRI. The sample included 26 institutionalized children: 23 who were given foster care from 24 months and 20 from a control group of the local community.

Those who spent their childhoods in orphanages had significantly less developed white matter in at least four parts of the brain. Unsurprisingly, brain regions responsible for emotion are particularly heavily affected, but so are those associated with maintaining attention, executive function and even sensory processing.

The progress of the same children has also been studied in other ways, reaching similar conclusions.

At the age of eight, children who had once been in the orphanage but were then placed in foster care fell between the other two groups in the state of their white matter. The researchers concluded that their brains more closely resembled those of the children raised by their parents. However, a larger sample size is needed for confidence in this conclusion, and hopefully opportunities for further studies of this sort will be sparse.

The ethics of studying children raised in such conditions remain controversial, but with 8 million children worldwide living in institutions the significance is huge. Many charities are available for those wanting to make an immediate difference, both to assist in finding foster homes and to enable struggling parents to keep children.

– Stephen Luntz