Specificity and heterogeneity in children's responses to profound institutional privation

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Abstract
Background: The sequelae of profound early privation are varied.Aims: To delineate the behavioural patterns that are specifically associated with institutional privation.Method: A group of 165 children adopted from Romania before the age of 42 months were compared at 4 years and 6 years with 52 non-deprived UK children adopted in infancy. Dysfunction was assessed for seven domains of functioning. The groups were compared on which, and how many, domains were impaired.Results: Attachment problems, inattention/overactivity, quasi-autistic features and cognitive impairment were associated with institutional privation, but emotional difficulties, poor peer relationships and conduct problems were not. Nevertheless, one-fifth of children who spent the longest time in institutions showed normal functioning.Conclusions: Attachment disorder behaviours, inattention/overactivity and quasi-autistic behaviour constitute institutional privation patterns.