Showing papers in "Monographs of The Society for Research in Child Development in 2010"

I. investigating the impact of early institutional deprivation on development: background and research strategy of the english and romanian adoptees (era) study

Abstract: This monograph is concerned with the mid adolescent follow-up of a group of adoptees from Romania and from within the United Kingdom who were first assessed at the age of 4 years (or 6 years in the case of the oldest children). After describing the structure of this monograph, this chapter provides the background as it applied at the time that the study began, and then goes on to outline the overall research strategy and the measures relevant for the first assessment at age 4 years. The research literature with respect to other studies is considered here only in relation to the state of knowledge at the time our research began. Research findings since then are discussed separately in later chapters according to the topics considered in each individual chapter. This chapter then goes on to summarize, briefly, some of the key findings from the follow-ups undertaken up to the age of 11 years. The details of the measures, as relevant for the followup up to age 15 years, are provided in the second chapter.

V. Differentiating developmental trajectories for conduct, emotion, and peer problems following early deprivation.

Abstract: The development of conduct and emotional problems involves a complex interplay between environmental and genetic factors (Rutter, Moffitt, & Caspi, 2006). The child-rearing environment contributes to this process (Sonuga-Barke et al., 2009). Gross deviations, such as those seen in abusive (Huizinga et al., 2006) or neglectful homes (Hoeve et al., 2008), or where the parent has serious mental health problems (Murray, Halligan, Adams, Patterson, & Goodyer, 2006), have been shown to contribute to the initial onset and persistence of emotional and conduct problems during childhood and adolescence. Even more subtle variations in the quality of care associated with parental availability and high levels of early nonmaternal child care (Belsky et al., 2007), the quality and sensitivity of care (Green & Goldwyn, 2002), and parental approaches to discipline (Sheehan & Watson, 2008) may negatively affect outcomes in these domains. Given the apparent importance of early child-rearing factors in children’s behavioral and emotional adjustment, it was predicted at the start of the ERA study that children brought up in institutional settings such as those experienced by the Romanian adoptees in the ERA project would be at an increased risk for conduct and emotional problems. In these settings, normal patterns of individual care and attention from a parent were replaced by minimal care by multiple staff in a setting with little or no social or cognitive stimulation so that children were exposed to multiple psychosocial risks. In fact, the data linking institutional care to conduct and emotional problems are very mixed, and the findings from previous studies are both patchy and limited by their cross-sectional nature. For instance, Gunnar and Van Dulmen (2007) reported that although institutional rearing was in general associated with attention, thought, and social problems, there was no association with anxiety/depression or delinquent behavior/aggression. Irrespective of institutional history, these problems were only associated with adoption after 24 months. Ames and colleagues (Fisher, Ames, Chisholm, & Savoie, 1997) found that soon after MONOGRAPHS OF THE SOCIETY FOR RESEARCH IN CHILD DEVELOPMENT

III. Deprivation-specific psychological patterns.

Abstract: It has come to be generally accepted that the psychopathological effects of psychosocial stress and adversity are diagnostically nonspecific (McMahon, Grant, Compas, Thurm, & Ey, 2003). There is a good deal of supporting evidence in support of this assumption, even though it may be that the nonspecificity has been exaggerated through a failure to take account of comorbidity (Shanahan, Copeland, Costello, & Angold, 2008). Thus, although ‘‘natural experiments’’ have confirmed the reality of environmental mediation of causation, in the case of sexual abuse in childhood (Kendler, Kuhn, & Prescott, 2004), its risk effects span a range of diagnoses. In other words, knowing that someone has experienced sexual abuse does not enable a confident prediction at an individual level as to what psychopathology will be evident (see Glaser, 2008). Conversely, there is not a pattern of psychopathology that tells one that the disorder must have been due to sexual abuse. Much the same applies to other acute and chronic psychosocial stresses and adversities, such as physical abuse, exposure to family violence, exposure to severe family discord and conflict, and the experience of multiple negative life events carrying long-term threat. Accordingly, at the time that we started the study, our expectation, like those of other researchers, was that we would find the same with respect to institutional deprivation. It came very much as a surprise, therefore, that we found at age 6 no evident increase in the common varieties of emotional and behavioral problems that constitute the majority of mental health clinic referrals (Kreppner et al., 2007; Rutter et al., 1999). In sharp contrast, what we did find were four patterns that were strongly associated with institutional deprivation and that rarely occurred in other children within our sample. These comprised quasi-autism (Q-A; Rutter et al., 1999; Rutter, Kreppner et al., 2007), disinhibited attachment (DA; O’Connor, Bredenkamp, Rutter, MONOGRAPHS OF THE SOCIETY FOR RESEARCH IN CHILD DEVELOPMENT

IV. Developmental course of deprivation-specific psychological patterns: early manifestations, persistence to age 15, and clinical features.

Abstract: Chapter III (Kumsta et al.) presented findings on the designation of deprivation-specific psychological patterns (DSPs) and on the testing of the internal and external validity of the concept of a DSP. The starting point was the meeting of particular criteria at age 6 and persistence of impairment to age 11. In this chapter, we turn to our findings on the developmental course of DSPs. Because the postulate was that the DSP resulted from profound institutional deprivation, it is necessary to begin with findings on what the children were like at the time of leaving institutional care. The evidence is relevant to scientific question about continuities and discontinuities in individual differences in the children’s functioning in the institutions and the manifestation of DSPs that persisted at least up to age 11Fsome 71 years after adoption. It is also relevant to the practical question of whether prospective adoptive parents could identify children in the institutions who were likely, or unlikely, to show persisting DSPs postadoption. We next turn to the features of the four postulated DSPs between the ages of 6 and 11 yearsFstarting with quasi-autism (Q-A). The features as shown at age 6 were described in chapter III (Kumsta et al.) and will not, therefore, be repeated here. The emphasis is on both continuities and discontinuities (including change of pattern) over this age period. Chapter III (Kumsta et al.) indicated the criteria used for persistence to age 11, and here, by contrast, we focus on a qualitative description of what the children were like. In the case of the children with Q-A, we were able to use the detailed clinical assessments undertaken by M. R. together with the systematic ADOS and ADI-R findings. In addition, we have detailed findings on mental health and special educational service usage. In order to focus on MONOGRAPHS OF THE SOCIETY FOR RESEARCH IN CHILD DEVELOPMENT

A commentary on deprivation‐specific psychological patterns: effects of institutional deprivation

Abstract: This monograph will likely become a classic. It provides critical insights into identifying which threads to pull in the "web of causation" (see chapter IX) to discern the impact of adverse early life experiences, and it provides guidance regarding how to identify patterns of behavior that are likely to reflect the impact of such experiences. Not everyone will agree with all the decisions and, hence, all the conclusions made by these authors. Indeed, I have concerns about some of them as I discuss below. However, the authors provide access to their deliberative process in such a rich way that the reader can follow not only what they did but also the many considerations behind their choices, their own equivocating and reversals as more data accumulated, and the broad theoretical concerns that guided their decisions. Because "natural experiments" always confront researchers with difficult choices among never perfect options, their decision to provide a detailed discussion of their deliberative process, in addition to the richness of their data and the importance of their topic, is what makes this a likely classic in the field.

X. conclusions: overview of findings from the era study, inferences, and research implications

Abstract: In this monograph, we have brought the findings of the English and Romanian Adoptee (ERA) study up to age 15 years and, in so doing, have focused especially on the question of whether there are deprivation-specific psychological patterns (DSPs) that differ meaningfully from other forms of psychopathology. For this purpose, our main analytic strategy was to compare the subgroup of young people who had received institutional care in Romania that persisted up to at least the age of 6 months and a pooled comparison group that comprised the remainder of the sample. In chapter II, we presented the evidence that there were no significant variations among the three subgroups that made up the pooled comparison group. A large proportion of this pooled comparison group came from the 52 individuals adopted before the age of 6 months from within the United Kingdom, who had not experienced institutional care or other major deprivation experiences. In addition, there were 45 children who had experienced institutional care that had ceased before the age of 6 months. Finally, there was a small group of 21 Romanian individuals who had come from a severely deprived background but who had not experienced institutional care. In the young people who experienced institutional deprivation, we found that a cut-off at 6 months marked the division between those without appreciable sequelae and those with a substantial proportion of persisting deficits. Because we found that the rate of deficits in the group who had experienced institutional care for 46 months did not vary according to the duration of institutional care, we pooled the entire group of individuals experiencing institutional care up to at least the age of 6 months. We found that these two pooled groups differed substantially and significantly in the rate of maladaptive outcomes. The details of the evidence justifying this pooling and a two-way comparison are provided in chapter II. Because of our interest in exploring the possibility of DSPs, our main subdivision within the above 6-month group was between those individuals showing the putative DSPs and those showing other forms of psychopathology or not showing deficits at all.

VII. Physical growth and maturation following early severe institutional deprivation: do they mediate specific psychopathological effects?

Abstract: Our previous work (Rutter et al., 2007) and the data reported in the preceding chapters of this monograph (chapter 4; Kreppner et al.) provide conclusive evidence of the persistent nature of the negative impact of early severe deprivation. Institutional deprivation, despite the good outcomes for many, was often associated with substantial impairment and disorder across a wide range of psychopathological domains at all follow-up ages. We have argued previously that this degree of persistence despite adoption into well functioning and nurturing families (chapter 8; Castle, Beckett, Rutter & Sonuga-Barke). Also, the considerable degree of continuity of problems seen at the level of individual cases (Kreppner et al., 2007), provides strong prima facie evidence that the effects of deprivation are associated with early established and fundamental neurobiological alterations (Mehta et al., 2009), although it remains to be seen what specific brain mechanisms are involved and whether different neurobiological components have specific effects on outcomes. There are a number of general mechanisms through which deprivation-related early adversity might operate to produce such long lasting effects (Rutter & O'Connor, 2004). Children who spent their early years in the Romanian institutions were exposed to multiple putative risks of diverse kinds (chapter 1; Rutter, Sonuga-Barke & Castle). The very poor quality and quantity of food provided, reflected in the substantial levels of subnutrition found amongst adoptees at the time of entry into the

The Better Beginnings, Better Futures project: Findings from grade 3 to grade 9: I. Introduction.

Abstract: Although comprehensive and ecological approaches to early childhood prevention are commonly advocated, there are few examples of long-term follow-up of such programs. In this monograph, we investigate the medium- and long-term effects of an ecological, community-based prevention project for primary school children and families living in three economically disadvantaged neighborhoods in Ontario, Canada. The Better Beginnings, Better Futures (BBBF) project is one of the most ambitious Canadian research projects on the long-term impacts of early childhood prevention programming to date. Bronfenbrenner's ecological model of human development informed program planning, implementation, and evaluation. Using a quasi-experimental design, the BBBF longitudinal research study involved 601 children and their families who participated in BBBF programs when children were between 4 and 8 years old and 358 children and their families from sociodemographically matched comparison communities. We collected extensive child, parent, family, and community outcome data when children were in Grade 3 (age 8–9), Grade 6 (age 11–12), and Grade 9 (age 14–15). The BBBF mandate was to develop programs that would positively impact all areas of child's development; our findings reflect this ecological approach. We found marked positive effects in social and school functioning domains in Grades 6 and 9 and evidence of fewer emotional and behavioral problems in school across the three grades. Parents from BBBF sites reported greater feelings of social support and more positive ratings of marital satisfaction and general family functioning, especially at the Grade 9 follow-up. Positive neighborhood-level effects were also evident. Economic analyses at Grade 9 showed BBBF participation was associated with government savings of $912 per child. These findings provide evidence that an affordable, ecological, community-based prevention program can promote long-term development of children living in disadvantaged neighborhoods and produce monetary benefits to government as soon as 7 years after program completion.

IX. Risk, causation, mediation, and moderation.

Abstract: Throughout this monograph, there has been frequent reference to levels of risk, inference of causation, testing for mediating variables, and the need to consider possible moderating influences. In this chapter, we review what is meant by these concepts, and then seek to pull together the findings from the English and Romanian Adoptee (ERA) studies that were relevant for these issues. When the findings have been presented in detail in earlier chapters, we simply summarize the main salient points. However, with respect to possible genetic moderation of the effects of institutional deprivation, we present new data because these were not considered in earlier chapters. There was a time when most developmental research, particularly that dealing with social development, moved blithely ahead using cross-sectional studies to investigate developmental processes without consideration of the multiple complex ways in which these processes may work together or separately. That is no longer acceptable (Kraemer et al., 1997; Kraemer, Stice, Kazdin, Offord, & Kupfer, 2001; Murray, Farrington, & Eisner, 2009; Rutter, 1988, 2009). Not only must the various processes, and their interplay, be clearly conceptualized, but also it will be essential to pit different refutable causal hypotheses against each other (Lahey, D'Onofrio, & Waldman, 2009; Rutter, 2003, 2006b).

II. Methods and measures used for follow-up at 15 years of the English and Romanian Adoptee (ERA) study.

Abstract: This chapter covers the methods and measures used in the ERA study, with a special focus on age 15 outcomes. First, we outline the sample participation rate for the 15-year follow-up-the percentages in all cases referring to the numbers at the time of initial sample contact. We then describe the measures used in this monograph, starting with those obtained at first contact with respect to functioning at the time of leaving institutional care. Because the group definitions relevant to the follow-up at age 15 are based on assessments at 6 and 11 years of age, we deal with the measures in those assessments first. At 11 years of age, we used a range of specific cognitive tests that might be of predictive value and those are detailed next. Then we discuss measures employed at the 15-year follow-up and those relevant to possible autism as used by Rutter in the separate assessment at 18-20 years. The monograph is structured around the possibility of deprivation-specific psychological patterns (DSPs), and hence on the strategies needed to test for them (see Rutter et al. in chapter I). Accordingly, the next section of this chapter deals with that strategy and details the measures taken to test the assumption's underlying the strategy. In our published papers concerning the 11-year follow-up, we tested whether outcomes were affected by the fact that some parents adopted mainly for altruistic reasons and others because of infertility-affected outcomes. Here we repeat this analysis in relation to DSPs. Similarly, we report findings on gender differences. The longitudinal study involved obtaining DNA for genotyping to examine the possibility that genetic features moderated the young people's response to institutional deprivation. Accordingly, in the next section of the chapter, we outline our genotyping approach. The final section of this chapter describes the statistical techniques we employed in our analyses.