IN 2000, professor of pediatrics Charles Nelson went on a trip that would change the course of his life—and the lives of dozens of others. As an expert in developmental neuroscience, Nelson was accompanying two colleagues on a visit to St. Catherine’s Orphanage in Bucharest, Romania, which was part of a network of state-run orphanages established by the former dictator Nicolae Ceaușescu. A series of disastrous policy decisions by Ceaușescu had resulted in more than 170,000 Romanian children being abandoned to these institutions throughout the 1980s, where they were victims of severe neglect.
By the time Nelson arrived, Ceaușescu had been out of power for more than a decade, but the situation in the orphanages remained dire. One of Nelson’s colleagues who ran an international adoption clinic had noted that many children reared in such institutions developed neurodevelopmental problems, including attention deficit hyperactivity disorder (ADHD), autism, and a host of pathological behaviors; these observations matched Nelson’s own impressions on meeting young orphans in Bucharest. He and his colleagues wanted to know why institutional rearing so often led to disability and psychopathology.
His visit marked the beginning of the Bucharest Early Intervention Project (BEIP), a first-of-its-kind study on the long-term effects of psychosocial deprivation on children raised in institutions. When Nelson and his colleagues originally established the project, they enrolled 136 institutionalized Romanian children whose average age was 20 months and randomly assigned them to remain in the institution or be adopted by a foster family. They also enrolled 72 children who had never been in an institution as a control group. For the past 22 years, he and his colleagues have followed the lives of these Romanian orphans to understand how their early experience affected their subsequent neurocognitive development. The research, described in more than 100 papers and a book, traces the profoundly negative effects of psychosocial deprivation on both behavioral and brain development.
The project’s most recent research revealed that children who were removed from the institutions and raised in foster homes exhibited faster and more dramatic paring of brain matter in the prefrontal cortex from age 8 to age 16 than children who remained in the institutions.
Among children who grew up in these orphanages, “The regions of the brain where changes were most pronounced are regions that are involved in higher order social and cognitive abilities, which help explain increases in things like ADHD,” says professor of psychology Katie McLaughlin. “These findings show that far and away the best thing we can do to support healthy brain development, and development across other domains, is to ensure that children have access to stable caregiving.”