Is sub-nutrition necessary for a poor outcome following early institutional deprivation?

Dev Med Child Neurol. 2008 Sep;50(9):664-71. doi: 10.1111/j.1469-8749.2008.03065.x.


Institutional deprivation is multifaceted and includes adverse psychosocial and nutrition-related components. In this study we partitioned these risks in relation to cognitive impairment and mental ill health, and explored the mediating role of reduced head/brain size. There were 138 participants (61 males, 77 females) in the study. Participants were Romanian adoptees who had experienced at least 2 weeks of early institutional deprivation. The sample was stratified on the basis of duration of deprivation (high risk >6 mo in institutions) and sub-nutrition (i.e. 1.5 SD below UK age-related norms for weight at UK entry). UK children adopted before 6 months of age and a group of non-institutionally deprived Romanian children constituted the comparison groups. Duration of deprivation was associated with smaller head circumference, lowered IQ, and increased mental heath problems, independently of effects found for sub-nutrition on head circumference and IQ. The mediating role of head circumference was limited to either sub-nourished (IQ) or non-sub-nourished (inattention/overactivity and disinhibited attachment) subgroups. Many negative effects of early deprivation, including stunted brain growth, occur without sub-nutrition: psychosocial deprivation plays a major role in neurodevelopmental effects of deprivation. Further studies of functional and structural neuroanatomy following institutional deprivation are required to delineate the role of brain development in its effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adoption / psychology*
  • Child
  • Child Development*
  • Child, Institutionalized / psychology*
  • Child, Preschool
  • Cognition Disorders / etiology*
  • Cognition Disorders / pathology
  • Female
  • Health Surveys
  • Humans
  • Infant
  • Intelligence
  • Male
  • Malnutrition / complications*
  • Malnutrition / pathology
  • Malnutrition / psychology
  • Mental Disorders / etiology
  • Mental Disorders / pathology
  • Psychosocial Deprivation*
  • Retrospective Studies
  • Risk