Inhibitory control and working memory in post-institutionalized children

Effects of early institutionalization involving psychosocial deprivation on cognitive functioning 60 years later: Findings of the LifeStories project

BACKGROUND

Institutionalization involving psychosocial deprivation affects child development negatively. However, there are few longitudinal studies, and no prospective study has yet examined the consequences of institutionalization in late adulthood.

OBJECTIVE

Investigating effects of psychosocial deprivation on cognitive functioning 60 years later.

PARTICIPANTS AND SETTING

A population-based survey of institutionalized infants and toddlers was conducted in Switzerland from 1958 to 1961 (n = 387; Mage = 0.93 years, SD = 0.53, 48 % female, 48 % Swiss nationality). In parallel, a comparison group of 399 family-raised children were assessed (Mage = 0.85 years, SD = 0.50, 46 % female, 100 % Swiss nationality). Six decades later, data on cognitive functioning were collected for 88 of the institutionalized group (Mage = 62.63 years, SD = 1.32), and 148 of the comparison group (Mage = 65.06, SD = 1.32).

METHODS

Standardized tests were used: the Brunet-Lézine Developmental Test in early childhood and a short form of the Wechsler Adult Intelligence Scale in late adulthood.

RESULTS

Formerly institutionalized individuals scored lower on cognitive functioning (d = - 0.67, p < .001), with the greatest difference in working memory (d = -0.78, p < .001). Longer duration of institutionalization increased the risk of lower cognitive functioning, indicating a dose-response effect. Institutionalization's impact on adult cognitive functioning was mediated by early childhood developmental status but not by later educational attainment.

CONCLUSIONS

This study confirms the early experience hypothesis, indicating that early life conditions have lasting effects on human development, even into late adulthood.

Childhood adversity is associated with reduced BOLD response in inhibitory control regions amongst preadolescents from the ABCD study

Adolescence is characterized by dynamic neurodevelopment, which poses opportunities for risk and resilience. Adverse childhood experiences (ACEs) confer additional risk to the developing brain, where ACEs have been associated with alterations in functional magnetic resonance imaging (fMRI) BOLD signaling in brain regions underlying inhibitory control. Socioenvironmental factors like the family environment may amplify or buffer against the neurodevelopmental risks associated with ACEs. Using baseline to Year 2 follow-up data from the Adolescent Brain Cognitive Development (ABCD) Study, the current study examined how ACEs relate to fMRI BOLD signaling during successful inhibition on the Stop Signal Task in regions associated with inhibitory control and examined whether family conflict levels moderated that relationship. Results showed that greater ACEs were associated with reduced BOLD response in the right opercular region of the inferior frontal gyrus and bilaterally in the pre-supplementary motor area, which are key regions underlying inhibitory control. Further, greater BOLD response was correlated with less impulsivity behaviorally, suggesting reduced activation may not be behaviorally adaptive at this age. No significant two or three-way interactions with family conflict levels or time were found. Findings highlight the continued utility of examining the relationship between ACEs and neurodevelopmental outcomes and the importance of intervention/prevention of ACES.

[Formula: see text] Neural and behavioral indicators of cognitive control in preschoolers with and without prenatal opioid exposure

Prenatal opioid exposure is one consequence of the opioid epidemic, but effects on child development remain poorly understood. There is emerging evidence that children exposed to opioids in utero exhibit elevated emotional and behavioral problems, which may be partially due to alterations in cognitive control. Using multiple methods (i.e., neuropsychological, behavioral, and event-related potential [ERP] assessments), the present study examined differences in emotional, behavioral, and cognitive control difficulties in preschool-aged children with (n = 21) and without (n = 23) prenatal opioid exposure (Mage = 4.30, SD = 0.77 years). Child emotional and behavioral problems were measured with a caregiver questionnaire, indicators of cognitive control were measured using developmentally appropriate behavioral (i.e., delay discounting, Go/No-Go) and neuropsychological (i.e., Statue) tasks, and electroencephalogram was recorded to error and correct responses in a Go/No-Go task. ERP analyses focused on the error-related negativity (ERN), an ERP that reflects error monitoring, and correct-response negativity (CRN), a component reflecting performance monitoring more generally. Opioid exposure was associated with elevated difficulties across domains and a blunted ERN, reflecting altered cognitive control at the neural level, but groups did not significantly differ on behavioral measures of cognitive control. These result replicate prior studies indicating an association between prenatal opioid exposure and behavioral problems in preschool-aged children. Further, our findings suggest these differences may be partially due to children with prenatal opioid exposure exhibiting difficulties with cognitive control at the neural level. The ERN is a potential target for future research and intervention efforts to address the sequelae of prenatal opioid exposure.

A matter of habit? Stressful life events and cognitive flexibility in 15-month-olds

Exposure to chronic stress is associated with habitual learning in adults. We studied the origins of this association by examining the link between stressful life events and infant cognitive flexibility. The final sample consisted of N = 72 fifteen-month-old infants and their mothers. Mothers completed a survey on pre- and postnatal negative life events. To assess chronic stress physiologically, infant and maternal hair cortisol concentrations were determined for cortisol accumulation during the past 3 months. Each infant participated in two cognitive tasks in the laboratory. An instrumental learning task tested infants' ability to disengage from a habituated action when this action became ineffective (Seehagen et al., 2015). An age-adequate version of the A-not-B task tested infants' ability to find a toy at location B after repeatedly finding it at location A. Correlations between cortisol concentrations and postnatal negative life events (number, perceived impact) did not yield significance. Infant and maternal hair cortisol concentrations were not correlated. Infants' ability to shift to a new action in either task, controlled for acute stress, correlated neither with pre- and postnatal negative life events nor with cortisol concentrations. Taken together, these results indicate that the potential link between long-term stress exposure and cognitive flexibility might not be present in samples with low levels of psychosocial stress.

Family-based care buffers the stress sensitizing effect of early deprivation on executive functioning difficulties in adolescence

We examined whether family care following early-life deprivation buffered the association between stressful life events (SLEs) and executive functioning (EF) in adolescence. In early childhood, 136 institutionally reared children were randomly assigned to foster care or care-as-usual; 72 never-institutionalized children served as a comparison group. At age 16 years, adolescents (n = 143; 54% female; 67.1% Romanian) self-reported recent SLEs, completed a battery of memory and EF tasks, and completed a go/nogo task in which mediofrontal theta power (MFTP) was measured using electroencephalogram. More independent SLEs predicted lower EF and more dependent SLEs predicted lower MFTP, but only among adolescents with prolonged early deprivation. Findings provide preliminary evidence that family care following early deprivation may facilitate resilience against stress during adolescence on EF.

Associations of Early-Life Threat and Deprivation With Executive Functioning in Childhood and Adolescence: A Systematic Review and Meta-analysis

IMPORTANCE

Many studies have demonstrated an association between early-life adversity (ELA) and executive functioning in children and adolescents. However, the aggregate magnitude of this association is unknown in the context of threat and deprivation types of adversity and various executive functioning domains.

OBJECTIVE

To test the hypothesis that experiences of deprivation are more strongly associated with reduced executive functioning compared with experiences of threat during childhood and adolescence.

DATA SOURCES

Embase, ERIC, MEDLINE, and PsycInfo databases were searched from inception to December 31, 2020. Both forward and reverse snowball citation searches were performed to identify additional articles.

STUDY SELECTION

Articles were selected for inclusion if they (1) had a child and/or adolescent sample, (2) included measures of ELA, (3) measured executive functioning, (4) evaluated the association between adversity and executive functioning, (5) were published in a peer-reviewed journal, and (6) were published in the English language. No temporal or geographic limits were set. A 2-reviewer, blinded screening process was conducted.

DATA EXTRACTION AND SYNTHESIS

PRISMA guidelines were used to guide data extraction and article diagnostics (for heterogeneity, small study bias, and p-hacking). Article quality was assessed, and data extraction was performed by multiple independent observers. A 3-level meta-analytic model with a restricted maximum likelihood method was used. Moderator analyses were conducted to explore heterogeneity.

MAIN OUTCOMES AND MEASURES

Primary outcomes included measures of the 3 domains of executive functioning: cognitive flexibility, inhibitory control, and working memory.

RESULTS

A total of 91 articles were included, representing 82 unique cohorts and 31 188 unique individuals. Deprivation, compared with threat, was associated with significantly lower inhibitory control (F1,90 = 5.69; P = .02) and working memory (F1,54 = 5.78; P = .02). No significant difference was observed for cognitive flexibility (F1,36 = 2.38; P = .12). The pooled effect size of the association of inhibitory control with deprivation was stronger (Hedges g = -0.43; 95% CI, -0.57 to -0.29) compared with threat (Hedges g = -0.27; 95% CI, -0.46 to -0.08). The pooled effect size of the association of working memory with deprivation was stronger (Hedges g = -0.54; 95% CI, -0.75 to -0.33) compared with threat (Hedges g = -0.28; 95% CI, -0.51 to -0.05).

CONCLUSIONS AND RELEVANCE

Experiences of both threat and deprivation in childhood and adolescence were associated with reduced executive functioning, but the association was stronger for exposure to deprivation. Efforts to address the consequences of ELA for development should consider the associations between specific dimensions of adversity and specific developmental outcomes.

The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence

BACKGROUND

Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment - the large-scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s -we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

METHODS

Adult neuropsychological functioning was assessed across five domains (inhibitory control, emotion recognition, decision-making, prospective memory and IQ) in 70 previously institutionalized adoptees (mean age = 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age = 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires.

RESULTS

Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory.

CONCLUSIONS

These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair long-term neuropsychological functioning across the lifespan - effects that are linked specifically to deprivation-related adult ADHD symptoms.

Transcriptomic signature of early life stress in male rat prefrontal cortex

Early life stress (ELS) is associated with adverse mental health outcomes including anxiety, depression and addiction-like behaviours. While ELS is known to affect the developing brain, leading to increased stress responsiveness and increased glucocorticoid levels, the molecular mechanisms underlying the detrimental effects of ELS remain incompletely characterised. Rodent models have been instrumental in beginning to uncover the molecular and cellular underpinnings of ELS. Limited nesting (LN), an ELS behavioural paradigm with significant improvements over maternal separation, mimics human maternal neglect. We have previously shown that LN leads to an increase in one of the behavioural measures of anxiety like-behaviours in rats (percent of entries in the EPM open arm). Here we assessed gene expression changes induced by ELS in rat prefrontal cortex by RNA-sequencing. We show that LN leads primarily to transcriptional repression and identify a molecular signature of LN in rat PFC that is observed across ELS protocols and replicable across rodent species (mouse and rat).

Sensitive periods in executive function development

Executive functions (EFs) are cognitive processes that support flexible goal pursuit. Healthy development of EFs during childhood is critical for later life outcomes including health, wealth and educational attainment. As such it is crucial to understand how EFs can be supported and protected against insult. Here we examine whether there are sensitive periods in the development of EFs, by drawing on deprivation and enrichment studies in humans. While there is suggestive evidence that pre-6 months of age constitutes a sensitive period for EF development, given the higher-order nature of EF, we argue for the possibility of multiple sensitive periods of constituent processes. We identify relevant future questions and outline a research agenda to systematically test for sensitive period in EF development.

Inhibitory control in trauma-exposed youth: A systematic review

The aim of this systematic review was to provide insight in inhibitory control (prepotent response inhibition and interference control) in trauma-exposed youth from a developmental perspective and exploring the effects of prolonged stress. A systematic search was conducted, resulting in 1722 abstracts. Of those, 33 studies met inclusion criteria. Twelve studies measured prepotent response inhibition (Go/no-go and Stop-signal task), 20 studies measured interference control (Flanker and Stroop task), and one measured both. Some studies indeed found evidence for prolonged trauma exposure impeding both subcomponents of inhibitory control, although others did not. At a later age, inhibitory control problems on task performance seem to disappear. However, distinct patterns of brain activity may suggest that those individuals employ compensation strategies. Together, the findings may suggest that non-specific inhibitory control problems occur after prolonged trauma exposure, with older youth possibly employing compensation strategies on the tasks. Future studies may provide a clearer picture of the compensation strategies and the circumstances in which they become visible.

The neurocognitive profiles of children adopted from care and their emotional and behavioral problems at home and school

Adoptees' mental health problems in childhood and later life are well described, but little attention has been paid to domestically adopted children's emotional and behavioral problems and neurocognitive profiles. The aim of this study was to describe the neurocognitive profiles of domestically adopted children in the UK and their parent- and teacher-rated emotional and behavioral problems. Forty-five children (M age = 75.96 months, SD = 12.98; 51.1% female) who were placed for adoption from public care at a M age of 22.14 months (SD = 14.21) completed a battery of age standardized neurocognitive tests, and adoptive parents and school teachers rated their emotional and behavioral problems. Children had more emotional and behavioral problems than the general population and over a fifth scored low (> 1 SD below the expected range for their age) in 5/6 neurocognitive tasks. Children who scored low on the non-verbal reasoning task were more likely to have more parent- and teacher-rated behavioral problems, and children's performance on the inhibitory control and cognitive flexibility tasks were associated with parent-rated behavioral problems. Children's verbal reasoning scores were positively associated with both parent- and teacher-rated emotional problems. Children who were adopted later in childhood scored significantly lower in non-verbal reasoning. Although longitudinal studies are needed to clarify the nature of neurocognitive functioning as a marker for later mental health problems, our findings underscore the importance of using comprehensive assessments to better recognize adopted children's difficulties and inform appropriate intervention initiatives.

An Event-Related Potentials Study of Executive Functioning in Adults With a History of Institutionalization

The current study investigated the long-term effects of institutionalization on the inhibitory control of young adults raised in orphanages using the color-word Stroop task. We examined whether young adults raised in institutions (IC group; n = 24; M = 22.17 years, SD = 6.7) would demonstrate poorer behavioral performance and atypical neural response to incongruent stimuli compared to their peers raised in biological families (Biological Family Care, BFC group; n = 28; M = 22.25 years, SD = 4.9). Accuracy analysis revealed that all participants were less accurate in the incongruent condition, however, no group differences were found. Reaction time analysis showed that the institutional care (IC) group was overall slower than the BFC. No significant differences in neural response to stimuli incongruence were identified. The absence of group differences in the interference condition can be explained by the low complexity of the Stroop task in the current study. The IC group showed a reduced P3 event-related potential component on both the congruent and incongruent trials. Findings suggest general attention difficulties in this population, rather than inhibitory control deficits.

Early life stress and brain function: Activity and connectivity associated with processing emotion and reward

Investigating the developmental sequelae of early life stress has provided researchers the opportunity to examine adaptive responses to extreme environments. A large body of work has established mechanisms by which the stressful experiences of childhood poverty, maltreatment, and institutional care can impact the brain and the distributed stress systems of the body. These mechanisms are reviewed briefly to lay the foundation upon which the current neuroimaging literature has been built. More recently, developmental cognitive neuroscientists have identified a number of the effects of early adversity, including differential behavior and brain function. Among the most consistent of these findings are differences in the processing of emotion and reward-related information. The neural correlates of emotion processing, particularly frontolimbic functional connectivity, have been well studied in early life stress samples with results indicating accelerated maturation following early adversity. Reward processing has received less attention, but here the evidence suggests a deficit in reward sensitivity. It is as yet unknown whether the accelerated maturation of emotion-regulation circuits comes at the cost of delayed development in other systems, most notably the reward system. This review addresses the early life stress neuroimaging literature that has investigated emotion and reward processing, identifying important next steps in the study of brain function following adversity.

Working memory moderates the association between early institutional care and separation anxiety symptoms in late childhood and adolescence

Adverse caregiving, for example, previous institutionalization (PI), is often associated with emotion dysregulation that increases anxiety risk. However, the concept of developmental multifinality predicts heterogeneity in anxiety outcomes. Despite this well-known heterogeneity, more work is needed to identify sources of this heterogeneity and how these sources interact with environmental risk to influence mental health. Here, working memory (WM) was examined during late childhood/adolescence as an intra-individual factor to mitigate the risk for separation anxiety, which is particularly susceptible to caregiving adversities. A modified "object-in-place" task was administered to 110 youths (10-17 years old), with or without a history of PI. The PI youths had elevated separation anxiety scores, which were anticorrelated with morning cortisol levels, yet there were no group differences in WM. PI youths showed significant heterogeneity in separation anxiety symptoms and morning cortisol levels, and WM moderated the link between caregiving and separation anxiety and mediated the association between separation anxiety and morning cortisol in PI youth. Findings suggest that (a) institutional care exerts divergent developmental consequences on separation anxiety versus WM, (b) WM interacts with adversity-related emotion dysregulation, and (c) WM may be a therapeutic target for separation anxiety following early caregiving adversity.

Early Neglect and the Development of Aggression in Toddlerhood: The Role of Working Memory

Previous research has provided evidence for the robust relation between maltreatment and the development of externalizing behavior, including aggression. However, less empirical attention has been given to the specific role of neglect. The current study aimed to examine the role of working memory in the association between early neglect and aggression in toddlerhood. Longitudinal data were collected from 89 infants and their biological mothers when the infant was approximately 12, 26, and 38 months old. History of neglect was assessed at 12 months using official Child Protective Service records. Working memory and mental development were assessed at 26 months. Aggression was measured using maternal report at 38 months. Data were analyzed using structural equation modeling, and mediation was tested using 95% asymmetric confidence intervals. Results indicated that infants who experienced neglect exhibited poorer working memory abilities, specifically spatial working memory, and higher rates of aggression in toddlerhood. In addition, spatial working memory mediated the relation between neglect and aggression, suggesting that this may be one promising target for intervention.

Risk taking, decision-making, and brain volume in youth adopted internationally from institutional care

Early life stress in the form of early institutional care has been shown to have wide-ranging impacts on the biological and behavioral development of young children. Studies of brain structure using magnetic resonance imaging have reported decreased prefrontal volumes, and a large literature has detailed decreased executive function (EF) in post-institutionalized (PI) youth. Little is known about how these findings relate to decision-making, particularly in PI youth entering adolescence-a period often characterized by social transition and increased reliance upon EF skills and the still-maturing prefrontal regions that support them. As decision-making in risky situations can be an especially important milestone in early adolescence, a clearer knowledge of the relationship between risky decision making and prefrontal structures in post-institutionalized youth is needed. The youth version of the Balloon Analogue Risk Task and a two-deck variant of the Iowa Gambling Task were used to assess risky decision-making in post-institutionalized youth and a community control group (N = 74, PI = 44, Non-adopted = 30; mean age = 12.93). Participants also completed a structural MRI scan for the assessment of group differences in brain structure. We hypothesized that participants adopted from institutions would display poorer performance on risky-decision making tasks and smaller brain volumes compared to non-adopted youth. Results indicated that later-adopted participants made fewer risky decisions than those experiencing shorter periods of deprivation or no institutional rearing. Further, decreased prefrontal volumes were observed in later-adopted youth and were significantly associated with task performance. Our results suggest that changes in risky-decision making behavior and brain structure are associated with the duration of early institutional care.

Rapid Infant Prefrontal Cortex Development and Sensitivity to Early Environmental Experience

Over the last fifteen years, the emerging field of developmental cognitive neuroscience has described the relatively late development of prefrontal cortex in children and the relation between gradual structural changes and children's protracted development of prefrontal-dependent skills. Widespread recognition by the broader scientific community of the extended development of prefrontal cortex has led to the overwhelming perception of prefrontal cortex as a "late developing" region of the brain. However, despite its supposedly protracted development, multiple lines of research have converged to suggest that prefrontal cortex development may be particularly susceptible to individual differences in children's early environments. Recent studies demonstrate that the impacts of early adverse environments on prefrontal cortex are present very early in development: within the first year of life. This review provides a comprehensive overview of new neuroimaging evidence demonstrating that prefrontal cortex should be characterized as a "rapidly developing" region of the brain, discusses the converging impacts of early adversity on prefrontal circuits, and presents potential mechanisms via which adverse environments shape both concurrent and long-term measures of prefrontal cortex development. Given that environmentally-induced disparities are present in prefrontal cortex development within the first year of life, translational work in intervention and/or prevention science should focus on intervening early in development to take advantages of this early period of rapid prefrontal development and heightened plasticity.

Memory and Executive Functioning in 12-Year-Old Children With a History of Institutional Rearing

We examined visual recognition memory and executive functioning (spatial working memory [SWM], spatial planning, rule learning, and attention shifting) in 12-year-olds (n = 150) who participated in the Bucharest Early Intervention Project, a randomized controlled trial of foster care for institutionally reared children. Similar to prior reports at 8 years of age, institutionally reared children showed significant deficits in visual recognition memory and SWM. Deficits in attention shifting and rule learning were also apparent at this time point. These data suggest that early experiences continue to shape the development of memory, learning, and executive functioning processes in preadolescence, which may explain broader cognitive and learning difficulties commonly associated with severe early life neglect.

False Belief Performance of Children Adopted Internationally

PURPOSE

The purpose of this study was to explore relationships among adoption, individual, and family variables on false belief performance of children adopted internationally (CAI).

METHOD

Using a quasiexperimental design, thirty-five 4-year-old children adopted from Asian and Eastern European countries before age 2 years were compared with a U.S. group of 33 nonadopted 4-year-old children on a standardized English-language measure, 3 false belief tasks, and a go/no-go inhibition measure.

RESULTS

The adopted group differed significantly from the U.S. nonadopted group in expressive language and false belief performance. For the adopted group, inhibition measures were significantly correlated with core language scores. Core language scores and number of older siblings predicted false belief performance.

CONCLUSIONS

Similar to children who are not adopted, language competence and living with older siblings positively influenced social understanding in CAI. Because CAI experience interrupted language acquisition and live with fewer older siblings, they are at risk of having weaker language competence and social understanding in their adopted language. When working with CAI, practitioners should assess social communication, language competence, and inhibition skills. They should assist adoptive families in providing socially mentored opportunities for their children to observe and interact with older children.

Child violence experiences in institutionalised/orphanage care

Institutions are not necessarily good environments for children. In the face of challenges such as HIV, Ebola, poverty, conflict and disaster the numbers have grown rather than reduced. Some countries have closed institutions down -driven by findings that cognitive developmental delay is associated with institutional care. Yet insight into abuse and violence within institutionalised settings is neglected. Maltreatment -violence and abuse -may be an issue. This systematic review series addresses violence and abuse experiences in institutionalised care, exploring firstly the frequency of abuse/violence in institutions, secondly any interventions to reduce such violence or abuse and thirdly the perpetrators of such violence or abuse. The final systematic review updates the findings on cognitive delay associated with institutionalised care. With a violence lens, cognitive delay may well be considered under the umbrella of neglect. Maltreatment and abuse may be a driver of cognitive delay. The keyword search covered several electronic databases and studies were included for data abstraction if they met adequacy criteria. Eight studies were identified on the prevalence of abuse in institutions and a further three studies reported on interventions. Only one study was identified documenting peer on peer violence in institutions. Sixty-six studies were identified examining cognitive development for institutionalised children. All but two of these record cognitive deficits associated with institutionalisation. Only two asked about violence or abuse which was found to be higher in institutionalised children. Overall the abuse experiences of children in institutions are poorly recorded, and in one study violence was associated with high suicidal attempts. The major intervention pathway for ameliorating cognitive challenge seems to be placement out of the institutions which shows benefits and redresses some cognitive outcomes - yet not a total panacea. The single study providing training and monitoring of harsh punishment and maltreatment showed immediate and decided reductions. This data suggest, despite the paucity of studies, violence and abuse, by commission or omission is prevalent in institutions, has an effect on child well-being and is amenable to intervention. Simple training or more complex structures to place children within conducive alternative environments (or to avoid institutionalised placements in the first place) seem to be the main pathway of intervention.

Executive Function in Previously Institutionalized Children

In studies of children adopted from institutions, being raised in an institution has been associated consistently with an increased risk of persistent cognitive, academic, and social-emotional problems. These findings raise questions about the neurocognitive mechanisms that contribute to these negative outcomes. Theory and models based on studies of animals indicate that development of the prefrontal cortex (PFC) and executive function (EF) may be particularly susceptible to environmental influences during early childhood. In this article, we review recent studies of postinstitutionalized children that examined EF components such as inhibitory control, working memory, shifting, and planning. We then describe emerging research on the structure and function of the PFC. Converging evidence suggests both EF difficulties and alterations in development of the PFC following early institutionalization. We conclude by discussing possible explanations for these findings and implications for prevention and intervention, and by offering suggestions for ongoing research.

The development of postinstitutionalized versus parent-reared Russian children as a function of age at placement and family type

A total of 149 children, who spent an average of 13.8 months in Russian institutions, were transferred to Russian families of relatives and nonrelatives at an average age of 24.7 months. After residing in these families for at least 1 year (average = 43.2 months), parents reported on their attachment, indiscriminately friendly behavior, social-emotional competencies, problem behaviors, and effortful control when they were 1.5-10.7 years of age. They were compared to a sample of 83 Russian parents of noninstitutionalized children, whom they had reared from birth. Generally, institutionalized children were rated similarly to parent-reared children on most measures, consistent with substantial catch-up growth typically displayed by children after transitioning to families. However, institutionalized children were rated more poorly than parent-reared children on certain competencies in early childhood and some attentional skills. There were relatively few systematic differences associated with age at family placement or whether the families were relatives or nonrelatives. Russian parent-reared children were rated as having more problem behaviors than the US standardization sample, which raises cautions about using standards cross-culturally.

Regulatory skill as a resilience factor for adults with a history of foster care: a pilot study

Individuals with a history of foster care (FC) are at elevated risk for emotion regulation-related mental illness. The purpose of the current study was to characterize regulatory function in a group of adults with a history of FC (N = 26) relative to those without a history of FC (N = 27) and how regulatory function moderates adverse caregiving-related outcomes (daily cortisol production and trait anxiety). Self-report items (anxiety, emotion regulation strategies, inhibitory control, caregiving history) were collected along with more objective measures (computerized task and salivary cortisol). Inhibitory control was assessed via self-report and a computerized task (emotional face go/nogo). Results showed that for adults with a history of FC, higher levels of inhibitory control were associated with higher accuracy on the emotional face go/nogo task and greater reported use of the emotion regulation strategy cognitive reappraisal. Greater use of cognitive reappraisal in turn was associated with healthier stress-related outcomes (decreased trait anxiety and steeper sloped cortisol production throughout the day). Dose-response associations were observed between self-reported regulatory skills and FC experiences (i.e., number of placements and age when exited foster care). These findings suggest that adverse caregiving can have long-term influences on mental health that extend into adulthood; however, individual differences in regulatory skills moderate these outcomes and may be an important target for intervention following caregiving adversity.