In communist Romania, many children were given up by their parents and given to local orphanages. Because of the poor economic situation in the country, these orphanages were poorly funded and overcrowded.  This meant that the conditions for the children were not acceptable.  Most children experienced malnutrition; some children experienced abuse and neglect. 

The following news clip looks at the situation in Romania in 1989.

Rutter (2007) wanted to investigate the progress of orphans under the age of 2 brought to Britain for adoption in the 1990s. Rutter wanted to find whether it was separation from the mother or the severe circumstances in Romania that was responsible for any adverse effects.

144 Romanian adoptees from Romanian institutions who were adopted by UK families. An age-stratified random sample method was used within the range of 0 to 42 months of age for UK entry. For comparison, they used a group of 52 domestic adoptees who had not experienced a depriving institutional experience and were less than 6 months old at the time of adoption.

Rutter studied three groups:

• Adopted before the age of 6 months
• Adopted between 6 months and 2 years
• Adopted after the age of two (late adoptees)

Both the British and Romanian adoptees were first assessed at the age of 4 years. Data was then collected again at the age of 6 and then a final assessment was carried out at age 11.

Semi-structured interviews were carried out with the adoptive parents to discuss the attachment style. Height and head circumference were measured. Tests, such as the Denver Developmental Quotient, were also administered for cognitive functioning and attachment.

For those who spent between 6 and 24 months in an institution, 12% of children demonstrated cognitive impairment at age 6. For those who were in the institution for more than 24 months, 36% demonstrated significant cognitive impairment.

In the original assessments, the average score for all Romanian orphans was 63. For those over 6 months old, the average was 45. Physical development was also poor; 51% of them were in the bottom 3% of the population for weight. The orphans were shorter in height than was normal for their age and had smaller head circumferences.

The researchers also observed an “unusually high level of attentional difficulties.” This could partially explain the lower academic performance and cognitive growth.

Many of the children displayed disinhibited attachment - characterized by a lack of close, confiding relationships, rather indiscriminate friendliness, and clingy, attention-seeking behaviour, a relative lack of differentiation in response to adults, a tendency to go off with strangers, and a lack of checking back with a parent in anxiety-provoking situations. Disinhibited attachment was still persistent in many of the children at age 11, although it became less frequent as they got older.

However, at the age of 4, the two groups of adopted children showed no significant differences in either intellectual or physical development for children adopted before the age of 6 months. There were also no significant attachment disorders for those who were adopted before the age of 6 months. However, a cognitive deficit remained in those children who had been adopted later.

According to Rutter, there was a response-dose relationship between institutionalization and both cognitive impairment and attachment disorders - that means, those that spent a longer time in the institution were more likely to have more persistent cognitive deficiencies and disinhibited attachment.

• The negative outcomes shown by the Romanian children could be overcome through adequate substitute care;
• Intervention should take place before 6 months of age;
• A child’s separation from its mother alone is not sufficient to cause negative outcomes as the British children had been separated but were not developmentally delayed.

These are some of the strengths of the study.

• The study supports the findings of Bowlby regarding the role of a sensitive period - that is, under 2.5 years.
• A substantial proportion of the parents that adopted children already had children of their own.
• The degree of deprivation was unusually severe.
• Almost all children had been placed in the institution in early infancy. This eliminates the factor that they were placed there because of a mental or physical disability.
• There had been no adoptions from institutions in Romania prior to 1989. Therefore, there was not the problem of selectivity of the children remaining in an institution.
• With the exception of the Roma children, the adopted Romanian children were ethnically similar to their adoptive parents, ruling out that they would suffer discrimination in their new community which may influence development.

Kreppner, O’Connor, Dunn & Andersen Wood (2010) confirmed the findings with a study of 104 Romanian orphans adopted into British families before the age of 2 compared to 50 British adoptees. Analysis for group differences between UK adoptees and the Romanian adoptee groups indicated a general tendency for the UK adoptees to engage in higher frequencies of pretend play, role play, and referencing others’ mental states than Romanian adoptees.

Zeanah, Smyke, Koga & Carlson (2005) investigated the relationship between disinhibited attachment and institutionalization. 95 Romanian children aged 12 - 31 months, who had spent most of their lives in institutions, took the Strange Situation test. Only 19% of the institutional group was classified as securely attached, compared to 74% of the control group. However, the study was not longitudinal so it could not report on change over a period of time.

It is difficult to separate out the variable of malnutrition. Rutter found that there was a persistent cognitive deficit at age six in the children who were in the institutions the longest. This appeared to be the case most often in those that had suffered from malnutrition.