A Comparison of the effects of preterm birth and institutional deprivation on child temperament

Both preterm birth and early institutional deprivation are associated with neurodevelopmental impairment—with both shared and distinctive features. To explore shared underlying mechanisms, this study directly compared the effects of these putative risk factors on temperament profiles in six-year-olds: Children born very preterm (<32 weeks gestation) or at very low birthweight (<1500 g) from the Bavarian Longitudinal Study (n = 299); and children who experienced >6 months of deprivation in Romanian institutions from the English and Romanian Adoptees Study (n = 101). The former were compared with 311 healthy term born controls and the latter with 52 nondeprived adoptees. At 6 years, temperament was assessed via parent reports across 5 dimensions: effortful control, activity, shyness, emotionality, and sociability. Very preterm/very low birthweight and postinstitutionalized children showed similarly aberrant profiles in terms of lower effortful control, preterm = −0.50, 95% CI [−0.67, −0.33]; postinstitutionalized = −0.48, 95% CI [−0.82, −0.14], compared with their respective controls. Additionally, postinstitutionalized children showed higher activity, whereas very preterm/very low birthweight children showed lower shyness. Preterm birth and early institutionalization are similarly associated with poorer effortful control, which might contribute to long-term vulnerability. More research is needed to examine temperamental processes as common mediators of negative long-term outcomes following early adversity.

Early adversity and children's regulatory deficits: Does postadoption parenting facilitate recovery in postinstitutionalized children?

Children reared in orphanages typically experience the lack of stable, reliable caregivers and are at increased risk for deficits in regulatory abilities including difficulties in inhibitory control, attention, and emotion regulation. Although adoption results in a radical shift in caregiving quality, there remains variation in postadoption parenting, yet little research has examined postadoption parenting that may promote recovery in children experiencing early life adversity in the form of institutional care. Participants included 93 postinstitutionalized children adopted between 15 and 36 months of age and 52 nonadopted same-aged peers. Parenting was assessed four times during the first 2 years postadoption (at 2, 8, 16, and 24 months postadoption) and children's regulation was assessed at age 5 (M age = 61.68 months) and during kindergarten (M age = 71.55 months). Multiple parenting dimensions including sensitivity/responsiveness, structure/limit setting, and consistency in routines were examined. Both parental sensitivity and structure moderated the effect of preadoption adversity on children's emotion regulation while greater consistency was associated with better inhibitory control and fewer attention problems. Results support the notion that postadoption parenting during toddlerhood and the early preschool years promotes better regulation skills following early adversity.

Disinhibited social engagement in postinstitutionalized children: Differentiating normal from atypical behavior

The most commonly reported socially aberrant behavior in postinstitutionalized (PI) children is disinhibited social engagement (DSE; also known as indiscriminate friendliness). There is no gold standard for measurement of this phenomenon nor agreement on how to differentiate it from normative behavior. We adopted a developmental psychopathology approach (Cicchetti, 1984) to study this phenomenon by comparing it to normative social development and by studying its patterns over time in 50 newly adopted PI children (16–36 months at adoption) compared with 41 children adopted early from foster care overseas and 47 nonadopted (NA) controls. Using coded behavioral observations of the child's interaction with an unfamiliar adult, atypical behaviors were differentiated from normative behaviors. Principal components analysis identified two dimensions of social disinhibition. The nonphysical social dimension (e.g., initiations, proximity) showed wide variation in NA children and is therefore considered a typical form of sociability. Displays of physical contact and intimacy were rare in NA children, suggesting that they represent an atypical pattern of behavior. Both adopted groups demonstrated more physical DSE behavior than NA children. There were no group differences on the nonphysical factor, and it increased over time in all groups. Implications for understanding the etiology of DSE and future directions are discussed.

Postadoption parenting and socioemotional development in postinstitutionalized children

Children adopted from institutions (e.g., orphanages) overseas are at increased risk of disturbances in social relationships and social understanding. Not all postinstitutionalized children exhibit these problems, although factors like the severity of deprivation and duration of deprivation increase their risk. To date, few studies have examined whether postadoption parenting might moderate the impact of early adverse care. Three groups were studied: postinstitutionalized and foster care children both adopted internationally and nonadopted children reared in their families of origin. The Emotional Availability (EA) Scales were assessed at 18 months in parent–child dyads. Parent emotional availability was found to predict two aspects of social functioning shown in previous studies to be impaired in postinstitutionalized children. Specifically, EA positively correlated with emotion understanding at 36 months; in interaction with initiation of joint attention at 18 months and group, it predicted indiscriminate friendliness as scored from a parent attachment interview at 30 months. Among the postinstitutionalized children but not among the children in other groups, higher EA scores reduced the negative association between initiation of joint attention and indiscriminate friendliness, thus suggesting that parenting quality may moderate the effects of early institutional deprivation.

Infants' responsiveness, attachment, and indiscriminate friendliness after international adoption from institutions or foster care in China: Application of Emotional Availability Scales to adoptive families

In a short-term longitudinal design we investigated maternal sensitivity, child responsiveness, attachment, and indiscriminate friendliness in families with children internationally adopted from institutions or foster care in China. Ninety-two families with 50 postinstitutionalized and 42 formerly fostered girls, aged 11–16 months on arrival, were studied 2 and 6 months after adoption. Maternal sensitivity and child responsiveness were observed with the Emotional Availability Scales, attachment was assessed with the Strange Situation procedure, and mothers reported on children's indiscriminate friendliness. The postinstitutionalized children showed less secure attachment, whereas the former foster children did not differ from the normative distribution of attachment security. However, at both assessments the two groups of adopted children showed more disorganized attachments compared to normative data. Adoptive mothers of postinstitutionalized and former foster children were equally sensitive and their sensitivity did not change over time. Postinstitutionalized and former foster children did not differ on indiscriminate friendliness, but children with more sensitive adoptive mothers showed less indiscriminate friendliness. The former foster children showed a larger increase in responsiveness over time than the postinstitutionalized children, suggesting that children's responsiveness is more sensitive to change than attachment, and that preadoption foster care is more beneficial for the development of children's responsiveness after adoptive placement than preadoption institutional care.