The Impact of Early Institutionalization Experience on Child Development: Biological Indicators, Physiological Mechanisms, Behavioral Characteristics

Objective. Systematization and generalization of research data on the impact of early institutionalization on biological indicators of children's development, and a description of the underlying physiological mechanisms and relations between biological indicators and their behavioral manifestations in children.

Background. Early deprivation is a significant social-psychological factor that dramatically affects the subsequent mental health and development of children. To date, a wide amount of data on the biological effects of early institutional deprivation has been accumulated in the research literature while this information is little represented in Russia. To understand the specificity of the biological and behavioral development of children with institutionalization experience transferred from Russian institutions into domestic adoptive or foster care families there is a need to analyze, systematize and generalize information on bio-behavioral consequences of early institutionalization.

Conclusions. Research results indicate in children with early institutional experience a significant change in biological development manifested in negative changes in morphofunctional development and microstructural organization of the brain, and characteristics of its activity, in cortisol secretion, violations of immunity, changes in DNA methylation profiling, in microbiome. Biological changes and their behavioral correlates are associated with such institutional conditions as the severity of deprivation and duration of institutionalization (the age of the child's transfer from institution to family). In order to prevent developmental, somatic and mental health disorders associated with the long-term impact of early deprivation, the state policy in the field of early childhood and the work of the professional society have to fulfil the rights of the child to live in the family in relationship with sensitive and responsive emotionally available primary caregivers.

1. Ministerstvo prosveshcheniya Rossiiskoi Federatsii. Podderzhka detei-sirot i detei, ostavshikhsya bez popecheniya roditelei [Electronnyi resurs] [Ministry of Education of the Russian Federation Support for orphans and children left without parental care]. URL: https://edu.gov.ru/activity/main_activities/orphans?ysclid=lggurt7aod922170332 (Accessed 22.04.2023). (In Russ.).

2. Muhamedrahimov R.J., Tuman'yan K.G., Chernego D.I., Aslamazova L.A. Privyazannost' u detei s opytom institutsionalizatsii. Chast' II. Osobennosti privyazannosti u detei, prozhivayushchikh v zameshchayushchikh sem'yakh [Attachment in children with experience of institutionalization. Part 2. Living in substitute families]. Psikhologicheskii zhurnal = Psychological Journal, 2020. Vol. 41, no. 6, pp. 48–56. DOI:10.31857/S020595920012586-0 (In Russ.).

3. Problema sirotstva v sovremennoi Rossii: Psikhologicheskii aspect [The Problem of Orphanhood in Modern Russia: Psychological Aspect]. In Makhnach A.V., Prikhozhan A.M., Tolstykh N.N. (eds.). Moscow: Publ. Institute of Psychology Russian Academy of Science, 2015. 670 p. (In Russ.).

4. Bakermans-Kranenburg M.J., Bunkers K.M., Dobrova-Krol N.A., Engle P., Fox N.A., Gamer G., Goldman P., Greenberg A., Groark C.J., Groza V., Gunnar M.R., Johnson D.E., Juffer F., Kreppner J.M., LeMare L., McCall R.B., Muhamedrahimov R.J., Nelson C.A., Palacios J., Zeanah C.H. The Development and Care of Institutionally Reared Children // Child Development Perspectives. 2012. Vol. 6. № 2. P. 174–180. DOI:1111/j.1750-8606.2011.00231.x
5. Bakermans-Kranenburg M.J., Steele H., Zeanah Ch.H., Muhamedrahimov R.J., Vorria P., Dobrova-Krol N.A., Steele M., van IJzendoorn M.H., Juffer F., Gunnar M.R. Attachment and emotional development in institutional care: Characteristics and catch up // Monographs of the Society for Research in Child Development. 2011. Vol. 76. № 4. P. 62–91. DOI:10.1111/j.1540-5834.2011.00628.x
6. Belkaid Y., Hand T.W. Role of the microbiota in immunity and inflammation // Cell. 2014. Vol. № 1. P. 121–141. DOI:10.1016/j.cell.2014.03.011
7. Bick J., Lipschutz R., Tabachnick A., Biekman B., Katz D., Simons R., Dozier M. Timing of adoption is associated with electrophysiological brain activity and externalizing problems among children adopted internationally // Developmental Psychobiology. 2022. Vol. 64. P. 1–15. DOI:1002/dev.22249
8. Bick J., Zhu T., Stamoulis C., Fox N.A., Zeanah C., Nelson C.A. Effect of early institutionalization and foster care on long-term white matter development a randomized clinical trial // JAMA Pediatrics. 2015. Vol. 169. № 3. P. 211–219. DOI:1001/jamapediatrics.2014.3212
9. Bowlby J. Attachment and loss. Vol. 1: Attachment. NY: Tavistock Institute of Human Relations, 1969. 428 p.
10. Buxton J.L., Suderman M., Pappas J.J., Borghol N., McArdle W., Blakemore A.I.F., Hertzman C., Power C., Szyf M., Pembrey M. Human leukocyte telomere length is associated with DNA methylation levels in multiple subtelomeric and imprinted loci // Scientific Reports. 2014. Vol. 4. P. 4954. DOI:1038/srep04954
11. Callaghan B.L., Fields A., Gee D.G., Gabard-Durnam L., Caldera C., Humphreys K.L., Goff B., Flannery J., Telzer E.H., Shapiro M., Tottenham N. Mind and gut: Associations between mood and gastrointestinal distress in children exposed to adversity // Development and Psychopathology. 2020. Vol. 32. № 1. P. 309–328. DOI:10.1017/S0954579419000087
12. Carlson M., Earls F. Psychological and neuroendocrinological sequelae of early social deprivation in institutionalized children in Romania // Annals of the New York Academy of Sciences. 1997. Vol. 801. № 1. Р. 419–428. DOI:10.1111/j.1749-6632.1997.tb51936.x
13. Chernego D.I., Martin C., Bernard K., Muhamedrahimov R.J., Gordon M.K., Dozier M. Effects of institutional rearing on children's diurnal cortisol production // Psychoneuroendocrinology. 2019. Vol. 106. P. 161–164. DOI:1016/j.psyneuen.2019.04.010
14. Danese A., McEwen B.S. Adverse childhood experiences, allostasis, allostatic load, and age-related disease // Physiology and Behavior. 2012. Vol. 106. P. 29–39. DOI:10.1016/j.physbeh.2011.08.019
15. Debnath R., Tang A., Zeanah C.H., Nelson C.A., Fox N.A. The long-term effects of institutional rearing, foster care intervention and disruptions in care on brain electric alactivity in adolescence // Developmental Science. 2020. Vol. 23. № 1. e12872. DOI:10.1111/desc.12872
16. DePasquale C., Lawler J., Koss K., Gunnar M. Cortisol and Parenting Predict Pathways to Disinhibited Social Engagement and Social Functioning in Previously Institutionalized Children // Journal of Abnormal Child Psychology. 2020. Vol. 48. P. 797–808. DOI:1016/j.psyneuen.2018.01.003
17. Dobrova-Krol N.A., van IJzendoorn M.H., Bakermans-Kranenburg M.J., Juffer F. Effects of perinatal HIV infection and early institutional rearing on physical and cognitive development of children in Ukraine // Child Development. 2010. Vol. 81. № 1. 237–251. DOI:10.1111/j.1467-8624.2009.01392.x
18. Dobrova-Krol N.A., van IJzendoorn M.H., Bakermans-Kranenburg M.J., Cyr C., Juffer F. Physical growth delays and stress dysregulation in stunted and non-stunted Ukrainian institution-reared children // Infant Behavior and Development. 2008. Vol. 31. № P. 539–553. DOI:10.1016/j.infbeh.2008.04.001
19. Dozier M., Kaufman J., Kobak R., O’Connor T.G., Sagi-Schwartz A., Scott S., Shauffer C., Smetana J., van IJzendoorn M.H., Zeanah C.H. Consensus statement on group care for children and adolescents: A statement of policy of the american orthopsychiatric association // American Journal of Orthopsychiatry. 2014. Vol. 84. № 3. P. 219–225. DOI:1037/ort0000005
20. Drury S.S., Theall K., Gleason M.M., Smyke A.T., De Vivo I., Wong J.Y., Nelson C.A. Telomere length and early severe social deprivation: linking early adversity and cellular aging // Molecular Psychiatry. 2012. Vol. 17. P. 719–727.
21. Elwenspoek M.M.C., Sias K., Hengesch X., Schaan V.K., Leenen F.A.D., Adams P., Turner J.D. T cell immunosenescence after early life adversity: association with cytomegalovirus infection // Frontiers in Immunology. Vol. 8. P. 1263. URL: http://hdl.handle.net/10993/32680
22. Esposito E.A., Jones M.J., Doom J.R., MacIsaac J.L., Gunnar M.R., Kobor M.S. Differential DNA methylation in peripheral blood mononuclear cells in adolescents exposed to significant early but not later childhood adversity // Developmental Psychopathology. 2016. Vol. 28. P. 1385–1399. DOI:1017/S0954579416000055
23. Fox S.E., Levitt P., Nelson C.A. How the timing and quality of early experiences influence the development of brain architecture // Child Development. 2010. Vol. 81. № P. 28–40. DOI:10.1111/j.1467-8624.2009.01380.x
24. Greenough W.T., Black J.E., Wallace C.S. Experience and brain development // Child Development. 1987. Vol. 58. № P. 539–559.
25. Goldman P.S., Bakermans-Kranenburg M.J., Bradford B., Christopoulos A., Ken P.L.A., Cuthbert C., Duchinsky R., Fox N.A., Grigoras S., Gunnar M.R., Ibrahim R.W., Johnson D., Kusumaningrum S., Agastya N.L.P.M., Mwangangi F.M., Nelson C.A., Ott E.M., Reijman S., van IJzendoorn M.H., Sonuga-Barke E.J.S. Institutionalization and deinstitutionalization of children 2: policy and practice recommendations for global, national, and local actors // The Lancet Child and Adolescent Health. 2020. Vol. 4. № 8. P. 606–633. DOI:1016/S2352-4642(20)30060-2
26. Gunnar M.R., Bowen M. What was learned from studying the effects of early institutional deprivation // Pharmacology Biochemistry and Behavior. Vol. 210. P. 173–272. DOI:10.1016/j.pbb.2021.173272
27. Gunnar M.R., DePasquale C.E., Reid B.M., Donzella B. Pubertal stress recalibration reverses the effects of early life stress in postinstitutionalized children // Proceedings of the National Academy of Sciences of the United States of America. 2019. Vol. 116. № 48. P. 23984–23988. DOI:1073/pnas.1909699116
28. Gunnar M.R., Quevedo K. The neurobiology of stress and development // Annual Review of Psychology. Vol. 58. P. 145–173. DOI:10.1146/annurev.psych.58.110405.085605
29. Gunnar M.R., Reid B.M. Early Deprivation Revisited: Contemporary Studies of the Impact on Young Children of Institutional Care // Annual Review of Developmental Psychology. Vol. 1. P. 93–118. DOI:10.1146/annurev-devpsych-121318
30. Humphreys K.L., Esteves K., Zeanah C.H., Fox N.A., Nelson C.A., Drury S.A. Accelerated telomere shortening: tracking the lasting impact of early institutional care at the cellular level // Psychiatry Research. 2016. Vol. 246. P. 95–100. DOI:1016/j.psychres.2016.09.023
31. Koss K.J., Mliner S.B., Donzella B., Gunnar M.R. Early adversity, hypocortisolism, and behavior problems at school entry: A study of internationally adopted children // Psychoneuroendocrinology. Vol. 66. P. 31–38. DOI:10.1016/j.psyneuen.2015.12.018
32. Koss K.J., Mliner S.B., Donzella B., Gunnar M.R. Early adversity, hypocortisolism, and behavior problems at school entry: a study of internationally adopted children // Psychoneuroendocrinology. Vol. 66. P. 31–38. DOI:10.13140/RG.2.1.2672.2800
33. Kroupina M.G., Fuglestad A.J., Iverson S.L., Himes J.H., Mason P.W., Gunnar M.R., Miller B.S., Petryk A., Johnson D.E. Adoption as an intervention for institutionally reared children: HPA functioning and developmental status // Infant Behavior and Development. 2012. Vol. 35. № 4. P. 829–837. DOI:1016/j.infbeh.2012.07.011
34. Kumsta R., Kreppner J., Kennedy M., Knights N., Rutter M., Sonuga-Barke E.J. Psychological Consequences of Early Global Deprivation // European Psychologist. Vol. 20. № 2. Р. 138–151. DOI:10.1027/1016-9040/a000227
35. Kumsta R., Marzi S.J., Viana J., Dempster E.L., Crawford B., Rutter M., Sonuga- Barke E.J. Severe psychosocial deprivation in early childhood is associated with increased DNA methylation across a region spanning the transcription start site of CYP2E1 // Translational Psychiatry. Vol. 6. № 6. P. e830. DOI:10.1038/tp.2016.95
36. Kumsta R., Schlotz W., Golm D., Moser D., Kennedy M., Knights N., Kreppner J., Maughan B., Rutter M., Sonuga-Barke E. HPA axis dysregulation in adult adoptees twenty years after severe institutional deprivation in childhood // Psychoneuroendocrinology. Vol. 86. P. 196–202. DOI:10.1016/j.psyneuen.2017.09.021
37. Leneman K.B., Donzella B., Desjardins C.D., Miller B.S., Gunnar M.R. The slope of cortisol from awakening to 30 min post-wake in postinstitutionalized children and early adolescents // Psychoneuroendocrinology. 2018. Vol. 96. P. 93–99. DOI:10.1016/j.psyneuen.2018.06.011
38. Lumos Lumos’ contribution to the public consultation on EU funds in the area of values and mobility: ending volunteering in institutions for children. 2018. URL: https://lumos.contentfiles.net/media/documents/document/2018/04/18_01_30__Lumos_contribution_values_and_mobility.pdf (Accessed 24.04.2023).
39. Mackes N.K., Golm D., Sarkar S., Kumsta R., Rutter M., Fairchild G., Mehta M.A., Sonuga-Barke E.J.S. Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment // PNAS. 2020. Vol. 117. P. 641–649. DOI:1073/pnas.1911264116
40. Marshall P.J., Fox N.A. A comparison of the electroencephalogram between institutionalized and community children in Romania // Journal of Cognitive Neuroscience. 2004. Vol. 6. № 8. P. 1327–1338. DOI:1162/0898929042304723
41. Marshall P.J., Reeb B.C., Fox N.A., Nelson C.A., Zeanah C.H. Effects of early intervention on EEG power and coherence in previously institutionalized children in Romania // Developmental Psychopathology. 2008. Vol. 20. № 3. P. 861–880. DOI:1017/S0954579408000412
42. McCall R.B., Muhamedrahimov R.J., Groark Ch.J., Palmov O.I., Nikiforova N.V., Salaway J., Julian M. The development of postinstitutionalized versus parent-reared Russian children as a function of age at placement and family type // Development and Psychopathology. 2016. Vol. 28. № 1. P. 251–264. DOI:1017/S0954579415000425
43. McLaughlin K.A., Sheridan M.A., Tibu F., Fox N.A., Zeanah C.H., Nelson C.A. Causal effects of the early caregiving environment on development of stress response systems in children // Proceedings of the National Academy of Sciences of the United States of America. 2015. Vol. 112. № 18. P. 5637–5642. DOI:1073/pnas.1423363112
44. Mehta M.A., Golembo N.I., Nosarti C., Colvert E., Mota A., Williams S.C.R., Rutter M., Sonuga-Barke E.J.S. Amygdala, hippocampal and corpus callosum size following severe early institutional deprivation: The English and Romanian Adoptees study pilot // Child Psychological Psychiatry. 2009. Vol. 50. P. 943–951. DOI:1111/j.1469-7610.2009.02084.x
45. Miller G.E., Chen E., Parker K.J. Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms // Psychological Bulletin. Vol. 137. № 6. P. 959–997. DOI:10.1037/a0024768
46. Moulson M.C., Fox N.A., Zeanah C.H., Nelson C.A. Early adverse experiences and the neurobiology of facial emotion processing // Developmental Psychology. Vol. 45. № 1. P. 17–30. DOI:10.1037/a0014035
47. Muhamedrahimov R.J., Arintcina I.A., Solodunova M.Y., Anikina V.O., Vasilyeva M.J., Chernego D.I., Tsvetkova L.A., Grigorenko E.L. Structural characteristics of the institutional environment for young children // Psychology in Russia: State of the Art. 2016. Vol. 9. № 3. P. 103–112. DOI:11621/pir.2016.0307
48. Muhamedrahimov R.J., Shabalina E.V., Palmov O.I., Nikiforova N.V. Caregiver-Child Interaction in Children Placed into Different Types of Russian Families Following an Institutional Intervention // Adoption Quarterly. Published online 22 Dec 2022. DOI:1080/10926755.2022.2156640
49. Mulheir G. Ending institutionalisation: an analysis of the financing of the deinstitutionalisation process in Bulgaria. Lumos. 2015. URL: https://bettercarenetwork.org/sites/default/files/Finance_BG_online_final_2.pdf (Accessed 24.04.2023).
50. Naumova O.Y., Lee M., Koposov R., Szyf M., Dozier M., Grigorenko E.L. Differential patterns of whole-genome DNA methylation in institutionalized children and children raised by their biological parents // Development and Psychopathology. Vol. 24. № 1. P. 143–155. DOI:10.1017/S0954579411000605
51. Naumova O.Y., Rychkov S.Y., Kornilov S.A., Odintsova V.V., Anikina V.O., Solodunova M.Y., Grigorenko E.L. Effects of early social deprivation on epigenetic statuses and adaptive behavior of young children: a study based on a cohort of institutionalized infants and toddlers // PLosOne. 2019. Vol. № 3. P. e0214285. DOI:10.1371/journal.pone.0214285
52. Nelson C.A., Fox N.A., Zeanah C.H. Romania’s abandoned children: deprivation, brain development and the struggle for recovery. Cambridge: Harvard University Press, 2014.
53. Nelson C.A., Zeanah C.H., Fox N.A. How early experience shapes human development: The case of psychosocial deprivation // Neural Plasticity. 2019. 2019. DOI:10.1155/2019/1676285
54. Oliveira P.S., Fearon P., Belsky J., Mesquita A.R., Sampaio A., Pinal D., Soares I. Neural correlates of face familiarity in institutionalized children and links to attachment disordered behavior // Child Psychological Psychiatry. 2023. Vol. 64. P. 736–746. DOI:1111/jcpp.13728
55. Olsavsky A.K., Telzer E.H., Shapiro M., Humphreys K.L., Flannery J., Goff B., Tottenham N. Indiscriminate amygdala response to mothers and strangers after early maternal deprivation // Biological Psychiatry. 2013. Vol. 74. P. 853–860. DOI:10.1016/j.biopsych.2013.05.025
56. Ovchinnikova I., Zhukova M.A., Luchina A., Petrov M.V., Vasilyeva M.J., Grigorenko E.L. Auditory Mismatch Negativity Response in Institutionalized Children // Frontiers in Human Neuroscience. 2019. Vol. 13. P. 1–8. DOI:10.3389/fnhum.2019.00300
57. Parker S.W., Nelson C.A. An event-related potential study of the impact of institutional rearing on face recognition // Development and Psychopathology. Vol. 17. № 3. P. 621–639. DOI:10.1017/S0954579405050303
58. Parker S.W., Nelson C.A. The impact of early institutional rearing on the ability to discriminate facial expressions of emotion: an event-related potential study // Child Development. Vol. 76. № 1. P. 54–72. DOI:10.1111/j.1467-8624.2005.00829.x
59. Petrowski N., Cappa C., Gross P. Estimating the number of children in formal alternative care: Challenges and results // Child Abuse and Neglect. Vol. 70. P. 388–398. DOI:10.1016/j.chiabu.2016.11.026
60. Quevedo K., Johnson A.E., Loman M.L., Lafavor T.L., Gunnar M. The confluence of adverse early experience and puberty on the cortisol awakening response // International Journal of Behavioral Development. 2012. Vol. 36. № 1. P. 19–28. DOI:1177/0165025411406860
61. Reid B.M., Coe C.L., Doyle C.M., Sheerar D., Slukvina A., Donzella B., Gunnar M.R. Persistent skewing of the T-cell profile in adolescents adopted internationally from institutional care // Brain, Behavior, and Immunity. 2019. Vol. 77. P. 168–177. DOI:1016/j.bbi.2019.01.001
62. Reid B.M., Horne R., Donzella B., Szamosi J.C., Coe C.L. Microbiota-immune alterations in adolescents following early life adversity: A proof of concept study // Developmental Psychobiology. 2020. Vol. 63. № 5. P. 851–863. DOI:1002/dev.22061
63. Sheridan M.A., Mukerji C.E., Wade M., Humphreys K.L., Garrisi K., Goel S., Patel K., Fox N.A., Zeanah C.H., Nelson C.A., Mclaughlin K.A. Early deprivation alters structural brain development from middle childhood to adolescence // Science Advances. Vol. 8. № 40. P. eabn4316. DOI:10.1126/sciadv.abn4316
64. Short A.K., Baram T.Z. Early-life adversity and neurological disease: age-old questions and novel answers // Nature Reviews Neurology. 2019. 15. № 11. P. 657–669. DOI:10.1038/s41582-019-0246-5
65. Stern D.N. The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. New York: Basic Books, 1985. 352 p.
66. Tarullo A.R., Garvin M.C., Gunnar M.R. Atypical EEG power correlates with indiscriminately friendly behavior in internationally adopted children // Developmental Psychology. 2011. Vol. 47. P. 417–431. DOI:10.1037/a0021363
67. Tottenham N. The importance of early experiences for neuro-affective development // The Neurobiology of Childhood. 2014. Vol. 16. P. 109–129. DOI:1007/7854_2013_254
68. van IJzendoorn M.H., Bakermans-Kranenburg M.J., Duschinsky R., Fox N.A., Goldman P.S., Gunnar M.R., Johnson D.E., Nelson C.A., Reijman S., Skinner G.C.M., Zeanah C.H., Sonuga-Barke E.J.S. Institutionalisation and deinstitutionalisation of children 1: a systematic and integrative review of evidence regarding effects on development // The Lancet Psychiatry. 2020. Vol. № 8. P. 703–720. DOI:10.1016/S2215-0366(19)30399-2
69. van IJzendoorn M.H., Palacios J., Sonuga-Barke E.J.S., Gunnar M.R., Vorria P., McCall R.B., le Mare L., Bakermans-Kranenburg M.J., Dobrova-Krol N.A., Juffer F. Children in institutional care: Delayed development and resilience // Monographs of the Society for Research in Child Development. 2011. Vol. 76. № 4. Р. 8–30. DOI:1111/j.1540-5834.2011.00626.x
70. Vanderwert R.E., Marshall P.J., Nelson C.A., Zeanah C.H., Fox N.A. Timing of intervention affects brain electrical activity in children exposed to severe psychosocial neglect // PLoS ONE. 2010. Vol. 5. № 7. P. 3–7. DOI:1371/journal.pone.0011415
71. Vanderwert R.E., Zeanah C.H., Fox N.A., Nelson C.A. Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project // Developmental Cognitive Neuroscience. 2016. Vol. 17. P. 68–75. DOI:1016/j.dcn.2015.12.004
72. Wade M., Fox N.A., Zeanah C.H., Nelson C.A., Drury S.S. Telomere length and psychopathology: specificity and direction of effects within the Bucharest early intervention project // Child and Adolescent Psychiatry. 2020. Vol. 59. P. 140–148. DOI:1016/j.jaac.2019.02.013
73. Woodhouse S., Miah A., Rutter M. A new look at the supposed risks of early institutional rearing // Psychological Medicine. 2018. Vol. 48. P. 1–10. DOI:1017/S0033291717001507
74. Zeanah C.H., Gunnar M.R., McCall R.B., Kreppner J.M., Fox N.A. Sensitive Periods // Monographs of the Society for Research in Child Development. 2011. Vol. 76. № 4. P. 147–162. DOI:10.1111/j.1540-5834.2011.00631.x