Children, foster care and orphanages

When Nicolae Ceauşescu took power in Romania in 1965, he believed that his country needed a larger work force. He decreed, said Charles H. Zeanah Jr., M.D., Sellars-Polchow Professor of Psychiatry at Tulane University, that all women must bear five children.

The economy didn’t improve, Zeanah told an audience at pediatric grand rounds in May, but more children entered the country’s orphanages. “Children with a history of institutional rearing have a high risk of psychological and social problems,” Zeanah said. In 2000, Zeanah and Charles Nelson, Ph.D., of Harvard and Nathan Fox, Ph.D., of the University of Maryland began a four-year study of 136 children who ranged in age from 7 to 33 months, and found that their development lagged in most areas. Half of the 136 children were then placed in foster care, previously unavailable in Bucharest, and half remained in institutions.

Foster care enhanced development in most areas, but complete recovery was rare. For cognitive development and attachment, recovery seemed to have more to do with the timing of interventions than their duration. Children who entered foster care before their second birthday, Zeanah said, were more likely to recover from the severe deprivations of Romanian orphanages.