Romanian Orphanages

An estimated 100,000 Romanian children were in orphanages at the end of 1989, when communism ended. The high number is linked to the pro-family policies pursued by former dictator Nicolae Ceausescu. In 1966, the regime banned abortions and contraceptives to keep the population from shrinking after World War II.

I remember hearing about these children long ago. Today, I was reminded of them by a link to an article in The Atlantic. Maybe what I heard about was the public execution by firing squad of Romania’s last Communist dictator, Nicolae Ceaușescu, who’d ruled for 24 years. This past Christmas day was the 30th anniversary of that execution and the discovery of his network of “child gulags,” in which an estimated 170,000 abandoned infants, children, and teens were being raised. Believing that a larger population would beef up Romania’s economy, Ceaușescu had curtailed contraception and abortion, imposed tax penalties on people who were childless, and celebrated as “heroine mothers” women who gave birth to 10 or more. Parents who couldn’t possibly handle another baby might call their new arrival “Ceauşescu’s child,” as in “Let him raise it.”

To house a generation of unwanted or unaffordable children, Ceauşescu ordered the construction or conversion of hundreds of structures around the country. Signs displayed the slogan: the state can take better care of your child than you can.

At age 3, abandoned children were sorted. Future workers would get clothes, shoes, food, and some schooling in Case de copii—“children’s homes”—while “deficient” children wouldn’t get much of anything in their Cămin Spital Pentru Copii Deficienţi, a Home Hospital for Irrecoverable Children. The Soviet “science of defectology” viewed disabilities in infants as intrinsic and uncurable. Even children with treatable issues—perhaps they were cross-eyed or anemic, or had a cleft lip—were classified as “unsalvageable.”

In an era devoted to fighting malnutrition, injury, and infection, the idea that adequately fed and medically stable children could waste away because they missed their parents was hard to believe. Their research led to the then-bold notion, advanced especially by John Bowlby, that simply lacking an “attachment figure,” a parent or caregiver, could wreak a lifetime of havoc on mental and physical health.

In the decade after the fall of Ceaușescu, the new Romanian government welcomed Western child-development experts to simultaneously help and study the tens of thousands of children still warehoused in state care. Researchers hoped to answer some long-standing questions: Are there sensitive periods in neural development, after which the brain of a deprived child cannot make full use of the mental, emotional, and physical stimulation later offered? Can the effects of “maternal deprivation” or “caregiver absence” be documented with modern neuroimaging techniques? Finally, if an institutionalized child is transferred into a family setting, can he or she recoup undeveloped capacities? Implicitly, poignantly: Can a person unloved in childhood learn to love?

In the fall of 2000, the Bucharest Early Intervention Project was launched. The BEIP study would become the first-ever randomized controlled trial to measure the impact of early institutionalization on brain and behavioral development and to examine high-quality foster care as an alternative.

The researchers employed Mary Ainsworth’s classic “strange situation” procedure to assess the quality of the attachment relationships between the children and their caregivers or parents. In a typical setup, a baby between nine and 18 months old enters an unfamiliar playroom with her “attachment figure” and experiences some increasingly unsettling events, including the arrival of a stranger and the departure of her grown-up, as researchers code the baby’s behavior from behind a one-way mirror.

100 percent of the local community kids living with their parents were found to have fully developed attachment relationships with their mothers. That was true of only 3 percent of the institutionalized kids. Nearly two-thirds displayed contradictory, jerky behaviors, perhaps freezing in place or suddenly reversing direction after starting to approach the adult. 13 percent were deemed “unclassified,” meaning they displayed no attachment behaviors at all.

As early as 2003, it was evident to the BEIP scientists and their Romanian research partners that the foster-care children were making progress. Children taken out of orphanages before their second birthday were benefiting from being with families far more than those who stayed longer. The next year, the Romanian government banned the institutionalization of children under the age of 2. Since then, it has raised the minimum age to 7, and government-sponsored foster care has expanded dramatically.

Meanwhile, the study continued. When the children were reassessed in a “strange situation” playroom at age 3.5, the portion who displayed secure attachments climbed from the baseline of 3 percent to nearly 50 percent among the foster-care kids, but to only 18 percent among those who remained institutionalized—and, again, the children moved before their second birthday did best. The benefits for children who’d achieved secure attachments accrued as time went on. At age 4.5, they had significantly lower rates of depression and anxiety and fewer “callous unemotional traits” (limited empathy, lack of guilt, shallow affect) than their peers still in institutions.

Sadly, about 40 percent of teenagers in the study who’d ever been in orphanages, in fact, were eventually diagnosed with a major psychiatric condition. Their growth was stunted, and their motor skills and language development stalled.

My source for today’s blog has much more content. Can an Unloved Child Learn to Love ? by Melissa Fay Greene in The Atlantic.