Institutionalisation and deinstitutionalisation of children 1: a systematic and integrative review of evidence regarding effects on development
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Institutionalization and neglect can result in delayed cognitive development.
“Institutionalization and neglect can result in long-term negative effects, including impaired physical growth, delayed cognitive development, and increased risk for psychological disorders.”
From Long-term cardiometabolic effects of early institutionalization and foster care: Evidence from the Bucharest Early Intervention Project (2026) · cites this paper as van Ijzendoorn et al., 2020
The Lancet Group Commission section reports delayed cognitive development among children in institutional care, and the Conclusion says the evidence favors a causal role for institutionalisation in adverse outcomes. The review discusses deprivation within institutions, but these passages do not establish the same cognitive effect for neglect outside institutional care. (LLM, conf=0.82)
Experimental — accuracy not yet measuredFoster care, compared with institutional care, is associated with better developmental outcomes and improved physical and mental health in children.
“Receiving foster care, compared to institutional care, has been associated with better developmental outcomes and improved physical and mental health in children (Bos et al., 2011; van Ijzendoorn et al., 2020).”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as van Ijzendoorn et al., 2020
The Summary and the comparison with the Bucharest Early Intervention Project report better growth and cognitive outcomes for children placed in foster care rather than continuing institutional care. The paper does not establish improvement across physical and mental health generally: its meta-analytical discussion says recovery in socioemotional problems was largely absent and that too few studies assessed health after deinstitutionalisation. (LLM, conf=0.87)
Experimental — accuracy not yet measuredEarly institutional care is associated with long-lasting adverse outcomes across neurodevelopmental, cognitive, socioemotional, and physical health domains.
“Early institutional care is associated with long-lasting adverse outcomes across neurodevelopmental, cognitive, socioemotional, and physical health domains.”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Van IJzendoorn et al., 2020
The Summary (page unavailable) reports adverse associations with physical growth, cognition, attention, socioemotional development, and mental health. The claim overgeneralizes their persistence: the same section reports significant recovery in growth and cognition after children leave institutions, though not in attention. The review also describes lasting symptoms after extended institutional care. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLater placement (i.e., after 24 months of age) and more placement disruptions have been linked to less favorable outcomes (i.e., no group-level differences among FCG compared to CAUG).
“whereas later placement (i.e., after 24 months of age) and more placement disruptions have been linked to less favorable outcomes (i.e., no group-level differences among FCG compared to CAUG) (Van IJzendoorn et al., 2020).”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Van IJzendoorn et al., 2020
The Lancet Group Commission section (page unavailable) reports that several BEIP outcomes were less affected in children institutionalised for under 24 months than in those institutionalised longer, supporting the later-placement portion. The Comparison with the Bucharest Early Intervention Project section (page unavailable) does not establish that later placement or more placement disruptions eliminated group-level differences between foster care and care as usual; it says foster-care children consistently had higher IQ than the care-as-usual group. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEarlier placement into foster care (i.e., before 24 months of age) and greater placement stability have been consistently linked to more resilient outcomes across various domains.
“Earlier placement into foster care (i.e., before 24 months of age) and greater placement stability have been consistently linked to more resilient outcomes across various domains”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Van IJzendoorn et al., 2020
The Lancet Group Commission section reports that several outcomes were less affected among BEIP children who spent under 24 months in institutions and concludes that earlier removal generally improves prospects for recovery. But the Comparison with the Bucharest Early Intervention Project section says age at foster placement affected some improving domains and not others. The Parent and family resources section links family-structure stability to educational outcomes, not foster-placement stability to resilient outcomes across domains. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Psychosocial deprivation in both institutional and family-based contexts is linked to delays in cognitive, physical, and socioemotional development.
“Given that psychosocial deprivation both in institutional and family-based contexts is linked to delays in cognitive, physical, and socioemotional development (2,(4)(5)(6), understanding the impact of interventions that aim to promote recovery from early neglect is a public health priority.”
From A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation (2023) · cites this paper as [2]
The Meta-analytical results section (page not available in our copy) links institutional care to delays in physical growth and cognition and to smaller differences in socioemotional development. Its comparisons with children in family care do not establish that psychosocial deprivation within family-based settings is linked to those delays, so the family-based part of the claim is not supported by this paper. (LLM, conf=0.88)
Experimental — accuracy not yet measuredInstitutionalization and neglect can result in increased risk for psychological disorders.
“Institutionalization and neglect can result in long-term negative effects, including impaired physical growth, delayed cognitive development, and increased risk for psychological disorders.”
From Long-term cardiometabolic effects of early institutionalization and foster care: Evidence from the Bucharest Early Intervention Project (2026) · cites this paper as van Ijzendoorn et al., 2020
Transitioning from institutional care to a family-based setting, such as foster care, is associated with improved health outcomes in the years immediately following the move out of institutional environments.
“Transitioning from institutional care to a family-based setting, such as foster care, is associated with improved health outcomes in the years immediately following the move out of institutional environments”
From Long-term cardiometabolic effects of early institutionalization and foster care: Evidence from the Bucharest Early Intervention Project (2026) · cites this paper as van Ijzendoorn et al., 2020
Institutionalization and neglect can result in impaired physical growth.
“Institutionalization and neglect can result in long-term negative effects, including impaired physical growth, delayed cognitive development, and increased risk for psychological disorders.”
From Long-term cardiometabolic effects of early institutionalization and foster care: Evidence from the Bucharest Early Intervention Project (2026) · cites this paper as van Ijzendoorn et al., 2020
Experimental — accuracy not yet measuredIn institutions, staff often have little training and lack time and resources to provide consistent, high-quality care to children.
“In institutions, staff often have little training, and lack time and resources to provide consistent, high-quality care to children (Van IJzendoorn et al., 2020;Zeanah et al., 2003).”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Van IJzendoorn et al., 2020
Early institutionalization is a severe form of early life adversity characterized by marked psychosocial deprivation that can have profound, long-lasting adverse effects on development.
“Early institutionalization is a severe form of early life adversity characterized by marked psychosocial deprivation that can have profound, long-lasting, adverse effects on development (Van IJzendoorn et al., 2020).”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Van IJzendoorn et al., 2020
More time spent in institutional care is associated with greater and more persistent developmental delays, with physical growth exhibiting the strongest effects, followed by cognitive and socioemotional development.
“There is also evidence that more time spent in institutional care is associated with greater and more persistent developmental delays, with physical growth exhibiting the strongest effects, followed by cognitive and socioemotional development (Nelson et al., 2007;Van IJzendoorn et al., 2020).”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Van IJzendoorn et al., 2020
Millions of children raised without parents in institutional care experience severe psychosocial deprivation because of high child-to-caregiver ratios and lack of nurturing care.
“Unfortunately, millions of children being raised without parents experience severe deprivation in the context of institutional care, where high child-to-caregiver ratios and lack of nurturing care lead to psychosocial neglect even when survival needs are met (1,2).”
From A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation (2023) · cites this paper as [2]
A meta-analysis of observational studies found no indication of recovery in children's socioemotional functioning.
“For instance, although the BEIP findings are consistent with other studies indicating substantial recovery for cognitive development and physical growth, in contrast to the current findings of, on average, improved symptoms of psychopathology, the meta-analysis of observational studies does not indicate recovery in children's socioemotional functioning.”
From A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation (2023) · cites this paper as [2]
The BEIP results align with other studies that show substantial recovery in cognitive development and physical growth.
“For instance, although the BEIP findings are consistent with other studies indicating substantial recovery for cognitive development and physical growth, in contrast to the current findings of, on average, improved symptoms of psychopathology, the meta-analysis of observational studies does not indicate recovery in children's socioemotional functioning.”
From A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation (2023) · cites this paper as [2]
Differences between the observational studies and the BEIP may stem from the BEIP's experimental design, which controlled for confounders, and from the foster care intervention possibly providing higher quality care than is typical after deinstitutionalization.
“Differences in findings between these observational studies and the BEIP may be related to the experimental design of the BEIP, which controlled for confounders (e.g., bias in selection of children for deinstitutionalization), and to the foster care intervention possibly delivering higher quality care than is typical following deinstitutionalization (2).”
From A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation (2023) · cites this paper as [2]
Van IJzendoorn et al. (2020) suggest that the disagreement about whether policy should focus on eliminating, transforming or improving is linked to a need for consensus on how evidence related to care settings is interpreted.
“Van IJzendoorn et al. (2020) suggest that this ' disagreement as to whether policy should focus on eliminating, transforming or improving ' (p.703) is linked to a need for consensus on how evidence related to care settings is interpreted.”
From Residential care as an alternative care option: A review of literature within a global context (2022) · cites this paper as van IJzendoorn et al., 2020
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X. CONCLUSIONS: OVERVIEW OF FINDINGS FROM THE ERA STUDY, INFERENCES, AND RESEARCH IMPLICATIONS
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Self-citationAttachment goes to court: child protection and custody issues
Forslund, T., Granqvist, P., van IJzendoorn, M. H., Sagi-Schwartz, A., Glaser, D., Steele, M., Hammarlund, M., Schuengel, C., Bakermans‐Kranenburg, M. J., Steele, H., et al. (2021) · Attachment & Human Development · doi:10.1080/14616734.2020.1840762 · Cited by 163 · see citing works
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“Similarly, fear of exposure indicating fear and worries adolescents have about the safety of themselves and their families, are salient predictors of adverse mental health outcomes among adolescents (Braun-Lewensohn et al., 2009; Guo, Feng, Wang, & van IJzendoorn, 2020; Polimanti et al., 2019).”
Mechanisms of neuroplasticity linking early adversity to depression: developmental considerations
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“Research studies conducted in human children who have experienced institutional care and were deprived of psychosocial input support this formulation, although it is difficult in these studies to disentangle the effects of timing from the duration of deprivation (for a review, see [85]).”
BackgroundAdoption and trauma: Risks, recovery, and the lived experience of adoption
Brodzinsky, D. M., Gunnar, M. R., & Palacios, J. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105309 · Cited by 111 · see citing works
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Unwin, H. J. T., Hillis, S. D., Cluver, L. D., Flaxman, S. R., Goldman, P., Butchart, A., Bachman, G. L., Rawlings, L. B., Donnelly, C. A., Ratmann, O., et al. (2022) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(22)00005-0 · Cited by 89 · see citing works
“26,27 It is also important to understand that mothers, fathers, and grandparents all matter, but with some differences in effects that vary by culture and context.”
Self-citationHoward, A. H., Roberts, M., Mitchell, T., & Wilke, N. G. (2023) · Adversity and Resilience Science · doi:10.1007/s42844-023-00088-y · Cited by 50 · see citing works
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Self-citationA Comparative Analysis of Residential Care: A Five-Country Multiple Case-Design Study
James, S., Wilczek, L., Kilian, J., Timonen-Kallio, E., Bravo, A., del Valle, J. F., Formenti, L., Petrauskienė, A., Pivorienė, J., & Rigamonti, A. (2021) · Child & Youth Care Forum · doi:10.1007/s10566-021-09666-6 · Cited by 39 · see citing works
“All of this has contributed to a ‘broad-brushing’ of residential care, which has been particularly detrimental in discussions on the developmental outcomes related to “institutions” and resultant policies (Goldman et al., 2020; Ijzendoorn et al., 2020; Stockholm Declaration, 2003).”
BackgroundResilience Processes in Development: Multisystem Integration Emerging from Four Waves of Research
Masten, A. S., Narayan, A. J., & Wright, M. O. (2023) · Springer eBooks · doi:10.1007/978-3-031-14728-9_2 · Cited by 39 · see citing works
Caregiver–child proximity as a dimension of early experience
Barnett, W., Hansen, C. L., Bailes, L. G., & Humphreys, K. L. (2022) · Development and Psychopathology · doi:10.1017/s0954579421001644 · Cited by 37 · see citing works
“Children raised in institutional settings, specifically where caregiving and associated physical touch and responsive interactions are limited (Smyke et al., 2002), have exhibited higher risk for behavioral, emotional, and social problems (van IJzendoorn et al., 2020).”
BackgroundKooijmans, R., Langdon, P. E., & Moonen, X. (2022) · Methods in Psychology · doi:10.1016/j.metip.2022.100102 · Cited by 37 · see citing works
King, L. S., Guyon-Harris, K. L., Valadez, E. A., Radulescu, A., Fox, N. A., Nelson, C. A., Zeanah, C. H., & Humphreys, K. L. (2023) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220672 · Cited by 29 · see citing works
“Unfortunately, millions of children being raised without parents experience severe deprivation in the context of institutional care, where high child-to-caregiver ratios and lack of nurturing care lead to psychosocial neglect even when survival needs are met (1, 2).”
Self-citationTrauma- and Stressor-Related Disorders
(2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9780890425787.x07_trauma_and_stressor_related_disorders · Cited by 32 · see citing works
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Self-citationHammarlund, M., Granqvist, P., Elfvik, S., Andram, C., & Forslund, T. (2022) · Attachment & Human Development · doi:10.1080/14616734.2022.2087699 · Cited by 26 · see citing works
“For example, disrupted attachments, like prolonged, involuntary and/or repeated separations from attachment figures, are linked to highly adverse developmental outcomes, especially when occurring in early childhood (e.g. Jones-Mason et al., 2021; van IJzendoorn et al., 2020).”
BackgroundWhat was learned from studying the effects of early institutional deprivation
Gunnar, M. R., & Bowen, M. (2021) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2021.173272 · Cited by 26 · see citing works
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The limits of the attachment network
Bakermans‐Kranenburg, M. J. (2021) · New Directions for Child and Adolescent Development · doi:10.1002/cad.20432 · Cited by 21 · see citing works
Self-citationWebb, C., Bennett, D. L., & Bywaters, P. (2022) · Social Policy and Society · doi:10.1017/s147474642200001x · Cited by 21 · see citing works
“This re fl ects wider calls to invest in preventive services to improve the support offered to children and families, deinstitutionalise children, and reduce health inequalities (Goldman et al. , 2020; van IJzendoorn et al. , 2020).”
Heterogeneity in caregiving-related early adversity: Creating stable dimensions and subtypes
Nikolaidis, A., Heleniak, C. M., Fields, A., Bloom, P. A., VanTieghem, M., Vannucci, A., Camacho, N. L., Choy, T., Gibson, L., Harmon, C., et al. (2022) · Development and Psychopathology · doi:10.1017/s0954579421001668 · Cited by 21 · see citing works
Residential care as an alternative care option: A review of literature within a global context
Giraldi, M., Mitchell, F., Porter, R. B., Reed, D., Jans, V., McIver, L., Manole, M., & McTier, A. (2022) · Child & Family Social Work · doi:10.1111/cfs.12929 · Cited by 18 · see citing works
Howard, A. R. H., Gwenzi, G. D., Taylor, T., & Wilke, N. G. (2023) · Child & Family Social Work · doi:10.1111/cfs.13006 · Cited by 23 · see citing works
Mental health of children and young people in the WHO Europe region
Tarasenko, A., Josy, G., Minnis, H., Hall, J., Danese, A., Lau, J. Y. F., Cortese, S., Stringaris, A., Redlich, C., & Ougrin, D. (2025) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2025.101459 · Cited by 21 · see citing works
Frimpong‐Manso, K., Agbadi, P., & Deliege, A. (2022) · Global Studies of Childhood · doi:10.1177/20436106221077699 · Cited by 18 · see citing works
“…are the main formal alternative care option for orphans and separated children (OSC) despite data, particularly from industrialized countries, showing that they hinder healthy child development and cause significant delays in several developmental areas (Roche, 2019; Van IJzendoorn et al., 2020).”
BackgroundCognitive Development in Infancy and Childhood
Gauvain, M. (2022) · Cambridge University Press eBooks · doi:10.1017/9781108955676 · Cited by 20 · see citing works
Shawar, Y. R., & Shiffman, J. (2023) · Globalization and Health · doi:10.1186/s12992-023-00975-0 · Cited by 26 · see citing works
“While efforts exist to improve data collection, [62, 64] difficulties persist in detecting the number of vulnerable and orphaned children.”
BackgroundCáceres, I., Moreno, C., Román, M., & Palacios, J. (2021) · Early Childhood Research Quarterly · doi:10.1016/j.ecresq.2021.07.002 · Cited by 17 · see citing works
Omari, F., Chrysanthopoulou, S. A., Embleton, L., Atwoli, L., Ayuku, D., Sang, E., & Braitstein, P. K. A. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2020-003644 · Cited by 20 · see citing works
Cameranesi, M., Chimney, K., & Shooshtari, S. (2022) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2022.104360 · Cited by 16 · see citing works
The specificity principle in adoption
Bornstein, M. H., & Suwalsky, J. T. D. (2021) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2021.101264 · Cited by 15 · see citing works
Braitstein, P. K. A., DeLong, A. K., Ayuku, D., Ott, M. A., Atwoli, L., Galárraga, O., Sang, E., & Hogan, J. W. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.25365 · Cited by 16 · see citing works
“5 for families and 60 for institutions, (5) an intraclass correlation governing cluster effects of 0.”
BackgroundPerry, N. B., Donzella, B., & Gunnar, M. R. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105578 · Cited by 16 · see citing works
Self-citationAntecedents to Child Placement in Residential Care: A Systematic Review
Wilke, N. G., Howard, A. R. H., Todorov, S., Bautista, J., & Medefind, J. (2022) · Institutionalised Children Explorations and Beyond · doi:10.1177/23493003221082333 · Cited by 15 · see citing works
“…example, multiple studies that did not meet eligibility criteria mentioned sex trafficking of the parent or child as an antecedent (Debnath & Wadia, 2021; Islam, 2014; Khondkar et al., 2017), rural children needing a place to stay in the city (Vadlamudi, 2016) and lack of housing (Vasudevan, 2014).”
BackgroundHjern, A., Palacios, J., Vinnerljung, B., Manhica, H., & Lindblad, F. (2020) · EClinicalMedicine · doi:10.1016/j.eclinm.2020.100643 · Cited by 14 · see citing works
“Another significant distal risk factor amongst adoptees is early adversity, such as childhood maltreatment and institutionalization, with a longer duration of such exposure linked to poorer outcomes [10,11].”
BackgroundGlobal out-of-home childcare and world culture
Ulybina, O. (2022) · International Journal of Comparative Sociology · doi:10.1177/00207152221110090 · Cited by 13 · see citing works
“National policies are influenced by rival, competing international norms, and national policy adoption occurs not in a cohesive, homogeneous, but rather a heterogeneous, even divided, world cultural environment (Hadler and Symons, 2018; Van Der Bly, 2007).”
BackgroundInfluentialSand, H., Sticca, F., Eichelberger, D. A., Wehrle, F. M., Simoni, H., Jenni, O. G., & Lannen, P. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107718 · Cited by 13 · see citing works
Explaining the Cross-National Pattern of Policy Shift toward Childcare Deinstitutionalization
Ulybina, O. (2022) · International Journal of Sociology · doi:10.1080/00207659.2022.2031488 · Cited by 13 · see citing works
Kontomichalos-Eyre, S. A., Lake, A. J., & McGillivray, J. (2022) · Children and Youth Services Review · doi:10.1016/j.childyouth.2022.106697 · Cited by 13 · see citing works
Valge, M., Meitern, R., & Hõrak, P. (2021) · Evolution and Human Behavior · doi:10.1016/j.evolhumbehav.2021.11.004 · Cited by 12 · see citing works
Babo, F., Mota, C. P., Santos, B., Matos, P. M., & Carvalho, H. (2023) · Child Abuse Review · doi:10.1002/car.2843 · Cited by 14 · see citing works
Bush, N. R., Sullivan, A. D. W., & Noroña-Zhou, A. N. (2025) · Annual Review of Psychology · doi:10.1146/annurev-psych-072225-121053 · Cited by 12 · see citing works
The Neurophysiological Impact of Touch-Based Therapy: Insights and Clinical Benefits
Bonanno, M., Papa, G. F. S., & Calabrò, R. S. (2024) · Journal of Integrative Neuroscience · doi:10.31083/j.jin2312214 · Cited by 12 · see citing works
Koponen, A., Nissinen, N.-M., Gissler, M., Autti-Rämö, I., Kahila, H., & Sarkola, T. (2022) · The Naturalist · doi:10.1177/14550725221110190 · Cited by 12 · see citing works
Punaks, M., & Lama, S. (2020) · Institutionalised Children Explorations and Beyond · doi:10.1177/2349300320975547 · Cited by 11 · see citing works
Wilke, N. G., & Howard, A. R. H. (2021) · Children & Society · doi:10.1111/chso.12486 · Cited by 11 · see citing works
Morais, F., Mota, C. P., Matos, P. M., Santos, B., Costa, M., & Carvalho, H. (2023) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2023.2202888 · Cited by 11 · see citing works
“Although there are complex dimensions associated with RC outputs, such as multiple drivers for children entering institutions or variations in the quality of care provided, institutionalization has been found to have detrimental effects on developmental (M. H. van IJzendoorn et al., 2020).”
BackgroundRosenthal, E. (2021) · International Journal of Disability and Social Justice · doi:10.13169/intljofdissocjus.1.1.0095 · Cited by 10 · see citing works
“In fact, studies in different parts of the world show that 80–90% of children placed in congregate care have at least one living parent (Van IJzendoorn et al., 2020, p.4).”
BackgroundInfluentialWalakira, E., Nnyombi, A., Ssenfuuma, J. T., Kyamulabi, A., Kato, F., Natukunda, H. P. M., Lange, L., & Oliver, D. (2022) · Global Studies of Childhood · doi:10.1177/20436106221087297 · Cited by 10 · see citing works
Koponen, A. M., Nissinen, N., Gissler, M., Kahila, H. K., Autti‐Rämö, I., & Sarkola, T. (2022) · Children and Youth Services Review · doi:10.1016/j.childyouth.2022.106683 · Cited by 10 · see citing works
“The result is in line with studies among normative samples which show that placement instability is harmful to emotional development (Gypen et al., 2017; Rubin et al., 2007; Stott, 2012; Tarren-Sweeney, 2008a; 2008b; Van IJzendoorn et al., 2020; Vinnerljung & Sallnäs, 2008).”
BackgroundResultInfluentialHoubrechts, M., Bijttebier, P., Calders, F., Goossens, L., Leeuwen, K. G. V., Noortgate, W. V. D., & Bosmans, G. (2023) · Child Development · doi:10.1111/cdev.13911 · Cited by 10 · see citing works
Souverein, F., Hales, H., Anderson, P., Argent, S. E., Bartlett, A. E. A., Blower, A., Delmage, E., Enell, S., Henriksen, A.-K., Koomen, K., et al. (2022) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.2234 · Cited by 10 · see citing works
“Additional risks of adverse experiences in secure settings include neglect, violence and sexual abuse (e.g., Medway Safeguarding Children Board, 2019; Spielman, 2021; van Ijzendoorn et al., 2020).”
BackgroundDetecting orphanage trafficking and exploitation
Nhep, R., Deck, S., van Doore, K. E., & Powell, M. B. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106813 · Cited by 9 · see citing works
“The closed nature of institutions, lack of transparency, and abuse of power and dependency inherent to institutional abuse, make residential care facilities high-risk environments for victim coercion or harm (Spr ¨ ober et al., 2014; van Ijzendoorn et al., 2020).”
BackgroundGutterswijk, R. V., Kuiper, C. H. Z., Harder, A. T., Bocanegra, B. R., van der Horst, F. C. P., & Prinzie, P. (2022) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2022.2100561 · Cited by 9 · see citing works
“…an essential element of this criticism (Weis et al., 2005) and are caused by occupational and psychosocial deprivation, coercion, repression (Van Ijzendoorn et al., 2020), deviancy training (Souverein et al., 2013; Weis et al., 2005), or the restriction of autonomy of the adolescents (Ryan &…”
BackgroundInfluentialBaghdadi, F., Rauktis, M. E., Hands, C., John, A. M., Khanom, A., Mhamdi, S. E., Soussi, A., & Snooks, H. A. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.107382 · Cited by 9 · see citing works
Anthropometrics of Estonian children in relation to family disruption
Valge, M., Meitern, R., & Hõrak, P. (2021) · Evolution Medicine and Public Health · doi:10.1093/emph/eoab022 · Cited by 9 · see citing works
“Further, extensive meta-analyses have shown that brain growth and function of institutionalized children are more strongly suppressed than height and show incomplete catch-up after adoption from orphanages to foster homes [15, 16].”
BackgroundResultInfluentialMkinga, G., Kirika, A., Nkuba, M. G., Mgode, S., Huth, M., & Hecker, T. (2022) · Developmental Child Welfare · doi:10.1177/25161032221099979 · Cited by 9 · see citing works
“These and previous findings encourage efforts at minimizing the number of children living in institutions (van IJzendoorn et al., 2020).”
BackgroundPractice and Policy Regarding Child Neglect: Lessons from Studies of Institutional Deprivation
Zeanah, C. H., & King, L. S. (2022) · Annual Review of Developmental Psychology · doi:10.1146/annurev-devpsych-121020-031658 · Cited by 8 · see citing works
Self-citationHernandez, K., Barbosa‐Ducharne, M., & Soares, J. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.107144 · Cited by 8 · see citing works
The impact of daily affective touch on cortisol levels in institutionalized & fostered children
Nikolaeva, E. I., Александровна, Д. Е., Mayorova, L. A., & Portnova, G. V. (2024) · Physiology & Behavior · doi:10.1016/j.physbeh.2024.114479 · Cited by 12 · see citing works
Probing the content of affective semantic memory following caregiving‐related early adversity
Vannucci, A., Fields, A., Bloom, P. A., Camacho, N. L., Choy, T., Durazi, A., Hadis, S. S., Harmon, C., Heleniak, C. M., VanTieghem, M., et al. (2024) · Developmental Science · doi:10.1111/desc.13518 · Cited by 8 · see citing works
Lewis, L. R., Lopez, R. A., Hunt, R. H., Hodel, A. S., Gunnar, M. R., & Thomas, K. M. (2024) · Brain and Cognition · doi:10.1016/j.bandc.2024.106183 · Cited by 9 · see citing works
Self-citationSand, H., Sticca, F., Wehrle, F., Eichelberger, D., Simoni, H., Jenni, O., & Lannen, P. (2024) · International Journal of Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106917 · Cited by 9 · see citing works
“Recovery from psychosocial deprivation is thought to be more difficult when children are exposed to it for a longer duration (van Ijzendoorn et al., 2020).”
InfluentialThe importance of responsive parenting for vulnerable infants
Korom, M., & Dozier, M. (2021) · Advances in child development and behavior · doi:10.1016/bs.acdb.2021.03.001 · Cited by 11 · see citing works
Coughlan, B., Woolgar, M., van IJzendoorn, M. H., & Duschinsky, R. (2021) · Development and Psychopathology · doi:10.1017/s0954579421000882 · Cited by 8 · see citing works
“Furthermore, child institutionalisation (a key risk factor for RAD/DAD; American Psychiatric Association, 2013) is also linked with attentional, cognitive, andsocioemotional difficulties (van IJzendoorn et al., 2020) and in some cases quasi-autistic behaviours (Rutter et al., 2007).”
Self-citationSensory processing challenges as a novel link between early caregiving experiences and mental health
Leal, A. S. M., Alba, L. A., Cummings, K. K., Jung, J., Waizman, Y. H., Moreira, J. F. G., Saragosa-Harris, N. M., Ninova, E., Waterman, J., Langley, A. K., et al. (2022) · Development and Psychopathology · doi:10.1017/s0954579422000633 · Cited by 7 · see citing works
Advancing global and transnational approaches to the study of out-of-home childcare
Ulybina, O. (2023) · Childhood · doi:10.1177/09075682231170151 · Cited by 7 · see citing works
“There is a widespread consensus among practitioners that institutions provide “ suboptimal caregiving environments ” and are harmful to children (van IJzendoorn et al., 2020: 703).”
Backgroundde Abreu, P. E., Kumsta, R., & Wealer, C. (2023) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106522 · Cited by 8 · see citing works
Theorizing pathways to resilience among orphaned adolescents in institutional care in India
Mishra, R., & Sondhi, V. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.105972 · Cited by 7 · see citing works
Orphanage tourism and orphanage volunteering: implications for children
van Doore, K. E., & Nhep, R. (2023) · Frontiers in Sustainable Tourism · doi:10.3389/frsut.2023.1177091 · Cited by 7 · see citing works
Global prevalence of institutional care for children: a call for change
Zeanah, C. H., & Humphreys, K. L. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(20)30055-9 · Cited by 7 · see citing works
Self-citationPeñarrubia, M., Sória, I. N., Palacios, J., & Fenollar-Cortés, J. (2021) · Children · doi:10.3390/children8050405 · Cited by 8 · see citing works
“Many children in the world are unable to live with their biological family due to various factors, including inadequate parenting style, neglect, and abuse [1].”
BackgroundGelderen, L. V. R., Ellis‐Davies, K., Vecho, O., Rubio, B., Carone, N., Frau, C., Schiavetto, C., Runze, J., Jorgensen, T. D., Bos, H., et al. (2025) · Attachment & Human Development · doi:10.1080/14616734.2025.2572578 · Cited by 6 · see citing works
“This variation might be linked to negative experiences encountered before adoption (e.g. Dozier & Rutter, 2016; Van IJzendoorn et al., 2020).”
Radityaputra, R., Baidawi, S., & Mendes, P. (2026) · Children and Youth Services Review · doi:10.1016/j.childyouth.2026.108777 · Cited by 6 · see citing works
Frimpong‐Manso, K., Cudjoe, E., Agbadi, P., Abdullah, A., Deliege, A., & Bansal, A. (2023) · Child & Family Social Work · doi:10.1111/cfs.13081 · Cited by 6 · see citing works
Hunsley, J. L., Razuri, E. B., Kamanzi, D. N., Sullivan, H., Call, C. D., Styffe, E. J., & Hategekimana, C. (2021) · Journal of Children s Services · doi:10.1108/jcs-09-2020-0056 · Cited by 6 · see citing works
Gairal‐Casadó, R., Yeste, C. G., Pascual, A. M., & Cuxart, M. P. (2021) · The British Journal of Social Work · doi:10.1093/bjsw/bcab087 · Cited by 6 · see citing works
Preventing maltreatment in institutional care: A cluster-randomized controlled trial in East Africa
Hecker, T., Mkinga, G., Kirika, A., Nkuba, M. G., Preston, J. M., & Hermenau, K. (2021) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2021.101593 · Cited by 6 · see citing works
“Recent research has shown that interventions in institutional care settings, even short-term caregiver trainings, can improve children ’ s living conditions and development (Hermenau et al., 2017; Werner et al., 2016).”
Child care institutions in India: Caregivers' solutions to challenges in childcare
Wanglar, E. (2021) · Child & Family Social Work · doi:10.1111/cfs.12889 · Cited by 6 · see citing works
Apedaile, D., DeLong, A., Sang, E., Ayuku, D., Atwoli, L., Galárraga, O., & Braitstein, P. K. A. (2022) · BMC Public Health · doi:10.1186/s12889-022-12521-5 · Cited by 9 · see citing works
“However, little is known about the impact of different care environments on educational attainment, despite considerable attention to both the lack of education among OSCA as well as the negative impacts of institutions [24].”
BackgroundHecker, T., Mkinga, G., Hartmann, E., Nkuba, M. G., & Hermenau, K. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000286 · Cited by 6 · see citing works
“Though family-based care generally promotes the best outcomes for children [5], current challenges in developing countries, such as the lack of financial resources, governmental support, and professional social-work infrastructure as well as an increasing number of children in need [4], result in the lack of family-ba…”
BackgroundTelomere Erosion and Depressive Symptoms Across Development Following Institutional Care
Heleniak, C. M., Goff, B., Gabard-Durnam, L. J., Telzer, E. H., Humphreys, K. L., Lumian, D. S., Flannery, J., Caldera, C., Shapiro, M., Louie, J., et al. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2023.06.011 · Cited by 6 · see citing works
Popularity Brings Better Sales or Vice Versa: Evidence from Instagram and OpenTable
Lasmi, H., Lee, C. H., & Ceran, Y. (2021) · Global Business Review · doi:10.1177/09721509211044302 · Cited by 11 · see citing works
Coughlan, B., Woolgar, M., van IJzendoorn, M. H., & Duschinsky, R. (2021) · Apollo (University of Cambridge) · doi:10.17863/cam.71976 · Cited by 6 · see citing works
Self-citationSonuga-Barke, E. J. S., Hanć, T., Stehli, A., Trampush, J. W., Kennedy, M., Kreppner, J., Rutter, M., & Swanson, J. M. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105427 · Cited by 6 · see citing works
Self-citationGreeson, J. K. P., Gyourko, J. R., Wasch, S., & Page, C. S. (2024) · Child & Family Social Work · doi:10.1111/cfs.13154 · Cited by 5 · see citing works
“It is globally recognized that children best develop in families, and there is a preference for family-based care over residential care or residing on the streets (Coren et al., 2013; United Nations General Assembly, 2019; van IJzendoorn et al., 2020).”
BackgroundFoster, S., Schofield, G., Geoghegan, L., Hood, R., Sagi-Schwartz, A., Bakkum, L., Hutchinson, D., Balk, W., Devine, R., Steele, M., et al. (2025) · Social Work Education · doi:10.1080/02615479.2025.2531859 · Cited by 23 · see citing works
Self-citationDozier, M., Smetana, J. G., Allen, J. P., Bakermans‐Kranenburg, M. J., Benner, A. D., Burton, L. M., Campione‐Barr, N., Carlo, G., Dodge, K. A., Fuligni, A. J., et al. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108495 · Cited by 4 · see citing works
Self-citationDevelopmental outcomes across foster care, adoption, and child welfare services: a mini review
Solerdelcoll, M., Sugranyes, G., & Baeza, I. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1691850 · Cited by 5 · see citing works
“Although all three care systems aim to safeguard children ’ s wellbeing, the developmental trajectories they offer diverge markedly (2).”
Makhoul, Z., Ndonji, M., Long, J. M., Moore, C., Lunda, E., Mwandileya, W. S., & TAREN, D. L. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1331907 · Cited by 5 · see citing works
Timing of exposure to household poverty and adolescent mental health problems
Koyama, Y., Isumi, A., & Fujiwara, T. (2025) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796025000162 · Cited by 5 · see citing works
“Seminal research on socio-emotional outcomes of institutionalized children supported the importance of the early childhood environment, suggesting the first 2 years of life as the sensitive period (Gabard-Durnam and McLaughlin, 2020; van Ijzendoorn et al. , 2020).”
Hjern, A., Palacios, J., & Vinnerljung, B. (2021) · Psychological Medicine · doi:10.1017/s003329172100355x · Cited by 5 · see citing works
Mishra, R., & Sondhi, V. (2022) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2022.2097153 · Cited by 5 · see citing works
“Some of the contributing factors include a low caregiver-to-child ratio, staff lacking adequate child-care training and poor living standards (Van Ijzendoorn et al., 2020).”
BackgroundIdentifying clientelism in orphanages: a conceptual model
Nhep, R. (2024) · Children s Geographies · doi:10.1080/14733285.2024.2318362 · Cited by 5 · see citing works
- Authors
- 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.
- Affiliations
- University of Cambridge (GB)
- University of Maryland, College Park (US)
- University of Minnesota (US)
- Boston Children's Hospital (US)
- Tulane University (US)
- King's College London (GB)
- Corresponding author
- Sonuga-Barke, Edmund J S
- ORCID
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 7
- Issue
- 8
- Pages
- 703-720
- ISSN
- 2215-0366 (ISSN-L)
- OpenAlex
- W3036167712
- Cited by
- 306
- References
- 107
- Citations by year
- 2026: 59 · 2025: 48 · 2024: 51 · 2023: 39 · 2022: 51 · 2021: 46 · 2020: 11 · 2019: 1
- FWCI
- 50.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Scopus (Elsevier) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- institutional care, deinstitutionalization, institutionalization, child development, child well-being, institutionalized children, quality of care, family-based care
- MeSH terms
- Adolescent, Attention, Child, Child Development, Developmental Disabilities, Child, Preschool, Cognition, Cost-Benefit Analysis, Deinstitutionalization, Female, Humans, Infant, Institutionalization, Male
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