Specificity and heterogeneity in children's responses to profound institutional privation

BACKGROUND: The sequelae of profound early privation are varied. AIMS: To delineate the behavioural patterns that are specifically associated with institutional privation. METHOD: A group of 165 children adopted from Romania before the age of 42 months were compared at 4 years and 6 years with 52 non-deprived UK children adopted in infancy. Dysfunction was assessed for seven domains of functioning. The groups were compared on which, and how many, domains were impaired. RESULTS: Attachment problems, inattention/overactivity, quasi-autistic features and cognitive impairment were associated with institutional privation, but emotional difficulties, poor peer relationships and conduct problems were not. Nevertheless, one-fifth of children who spent the longest time in institutions showed normal functioning. CONCLUSIONS: Attachment disorder behaviours, inattention/overactivity and quasi-autistic behaviour constitute institutional privation patterns.