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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 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 measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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 cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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 measuredThe cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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 cited source says what the claim attributes to it.
In the citing paper
“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 cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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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“To address this, policy makers and academics alike have called for a transition from residential to family-based models of care for children separated from biological parental care (Dozier et al., 2014; United Nations, 1989, 2019; Van IJzendoorn, et al., 2020), sometimes referred to as deinstitutionalisation. nongover…”
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“Early institutionalisation, which generally entails exposure to at least some form of psychosocial neglect, is known to compromise multiple aspects of children’s development (van IJzendoorn et al., 2020).”
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“After placement in adoptive families with improved caregiving, adoptees show notable developmental catch-up and recovery following the possible adverse effects of early institutionalization [12, 32–34].”
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“This could be explained by the lower quality of caregiving, the lower availability of professional caregivers, poor interactions with children, and the absence of stable caregivers for each child in institutions (McCall, 2013; van IJzendoorn et al., 2020).”
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Metadata
- 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
- 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 › Sociology and Political Science › 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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