Stereotypies in children with a history of early institutional care
Open accessAbstract
OBJECTIVES: To investigate the prevalence of stereotypies in children with a history of early institutional care, evaluate the efficacy of a foster care intervention compared with institutional care on the course of stereotypies, and describe correlates in language, cognition, and anxiety for children who exhibit stereotypies. DESIGN: Randomized controlled trial. SETTING: Institutions in Bucharest, Romania. PARTICIPANTS: One hundred thirty-six children with a history of early institutional care. Intervention Comparison of a foster care intervention with continued care as usual in an institution. MAIN OUTCOME MEASURES: The presence of stereotypies as well as outcomes in language, cognition, and anxiety. RESULTS: At the baseline assessment prior to placement in foster care (average age of 22 months), more than 60% of children in institutional care exhibited stereotypies. Follow-up assessments at 30 months, 42 months, and 54 months indicated that being placed in families significantly reduced stereotypies, and with earlier and longer placements, reductions became larger. For children in the foster care group, but not in the care as usual group, stereotypies were significantly associated with lower outcomes on measures of language and cognition. CONCLUSIONS: Stereotypies are prevalent in children with a history of institutional care. A foster care intervention appears to have a beneficial/moderating role on reducing stereotypies, underscoring the need for early placement in home-based care for abandoned children. Children who continue to exhibit stereotypies after foster care placement are significantly more impaired on outcomes of language and cognition than children without stereotypies and thus may be a target for further assessments or interventions.
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Scores for both types of RAD and stereotypies distinguish children with histories of institutional rearing from never institutionalized children.
“Scores for both types of RAD and stereotypies also distinguish children with histories of institutional rearing from never institutionalized children.2, 22”
From Recovering from early deprivation: attachment mediates effects of caregiving on psychopathology (2012) · cites this paper as [22]
Children placed in foster care in the BEIP had significantly fewer symptoms of internalizing disorders, attachment disorders, and stereotyped movement disorders than children who continued institutional care.
“To date, investigators have reported that children placed in foster care had significantly fewer symptoms of internalizing disorders, 6 attachment disorders, 21 and stereotyped movement disorders 22 compared to children receiving continued institutional care.”
From Recovering from early deprivation: attachment mediates effects of caregiving on psychopathology (2012) · cites this paper as [22]
Children with a history of institutionalization have an increased likelihood of demonstrating repetitive movements such as stereotypies.
“Children with a history of institutionalization also have an increased likelihood of demonstrating repetitive movements such as stereotypies.17”
From Social communication difficulties and autism in previously institutionalized children (2015) · cites this paper as [17]
High-quality foster care adds to the growing list of developmental domains that are altered in children with a history of institutionalization and can be improved by foster care.
“this adds to the growing list of developmental domains that are altered in children with a history of institutionalization and can be improved by foster care, including attachment,15, 23, 24 stereotypies,17 language,38–40 cognition,31, 41 depression, anxiety,42, 43 and growth.44”
From Social communication difficulties and autism in previously institutionalized children (2015) · cites this paper as [17]
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- Authors
- Bos, K. J., Zeanah, C. H., Smyke, A. T., Fox, N. A., & Nelson, C. A.
- Affiliations
- Boston Children's Hospital (US)
- Tulane University (US)
- Venue
- Archives of Pediatrics & Adolescent Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2010-05-01
- Volume
- 164
- Issue
- 5
- Pages
- 406-11
- ISSN
- 1072-4710 (ISSN-L)
- PMC
- PMC4086785
- OpenAlex
- W2150979813
- Cited by
- 63
- References
- 27
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 2 · 2021: 7 · 2020: 3 · 2019: 8 · 2018: 1 · 2017: 6 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 8
- FWCI
- 19.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH091363)
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Health Sciences › Veterinary › Small Animals › Animal Behavior and Welfare Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- stereotypy, foster care, institutionalized children, abandoned children, language development, cognitive development, anxiety
- MeSH terms
- Mental Disorders, Child Development, Child Welfare, Child, Institutionalized, Child, Preschool, Cognition, Female, Foster Home Care, Humans, Infant, Male, Psychiatric Status Rating Scales, Psychosocial Deprivation, Romania, Stereotyping, Prevalence, Chi-Square Distribution, Caregivers, Statistics, Nonparametric, Reactive Attachment Disorder
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