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From difficulty speaking to the risk of rape, the harms experienced by the estimated eight million children who grow up in institutions are extensive.

Infants need a loving and consistent caregiver. But many children who grow up in institutions, such as orphanages, don’t get this, and the people who look after them are often poorly trained. Institutional life is often highly regulated and isolated, lacking in stimulation, and children are very limited in what they can do.

“A child in the first two years of life might be exposed to dozens of caregivers, and as a result their ability to form attachments and relationships with other people is compromised,” according to Charles Nelson, Professor of Pediatrics at Harvard Medical School.

The body of research points in a clear direction: children are stymied mentally, emotionally and physically by their experiences in institutions, as well as being subjected to the risk of abuse.

While improvements may be possible if interventions come in time, these effects stay with children throughout their lives, greatly damaging their future prospects and burdening society at large.

Here, Apolitical breaks down the evidence on how children are harmed when they grow up in these environments.

Mental and Emotional Development

The first years of a child’s life are critical for their brain’s health. The survival of neurons and synapses and development of neural circuits — the human brain’s communications network — are highly dependent on an infant’s environment and experiences.

“When a child is growing up in a neglectful environment, the instructions [to the brain from a child’s experiences] are less than clear, so as a result, the brain can easily get mis-wired,” according to Nelson, who is also a principal investigator on the Bucharest Early Intervention Project, which examines the effects of early institutionalisation on development.

“As children get older their ability to interact with peers can be disturbed”

A lack of cognitive or linguistic stimulation is also a reason why many children who were institutionalised have lower IQs and poorer language skills compared to those who grew up in a more stable environment, said Nelson.

Poor mental development can manifest itself in children in other ways, including attention deficit hyperactivity disorder (ADHD) and poor social skills.

“As they get older their ability to interact with peers can be disturbed,” said Nelson.

The lack of a loving caregiver often leads to attachment disorders in children, who frequently display emotionally vulnerable behaviours, such as excessive trust, which can contribute to other problems, such as exploitation, later in life.

Physical Development

The sparse and regimented lifestyle that often characterises institutions can also harm the physiology of infants and children housed in them.

“Undernutrition and limited opportunities for physical activity may compromise development of bone and muscle,” said Daniel Belsky, Assistant Professor of Epidemiology at Columbia University.

"Though Belsky stresses research on the relationship between psychological wellbeing and physical development is still in its “early days”, he said there “is clearly a correlation”."

He added that “pathogens prevalent in over-crowded and poorly maintained settings can stress the developing immune system in ways that increase vulnerability to disease and infection in later life.”

Though Belsky stresses research on the relationship between psychological wellbeing and physical development is still in its “early days”, he said there “is clearly a correlation”.

High-stress environments can cause “wear and tear” on children’s developing biological systems. “This accumulates across the life course, ultimately leading to chronic disease and disability,” said Belsky.

In Romania, Nelson’s team found children in institutions have accelerated telomere shortening; telomeres are part of human cells which protect DNA strands, and shorten as we age. But this deterioration can be increased by stress, among other factors. “Those with the shortest telomeres are those whose caregivers who reported the worst health,” Nelson said. “There does seem to be an association there.”

Abuse

Institutions frequently lack sufficient scrutiny and oversight, so ensuring the safety of children within them is difficult.

Abuse may take the form of physical punishment, such as the 37.5 per cent of children in Romanian institutions who told a 2002 Unicef survey they had suffered beatings, or sexual violence, experienced by nearly a quarter of children in the same poll.

Levels of violence elsewhere may be higher – 63 per cent of children in Kazakh institutions have been subjected to violence – but data is lacking.

Trafficking children – sometimes disguised as intercountry adoption – is also believed to exist within some institutions.

Long Term Effects

Without timely intervention, the harms caused to development are persistent.

The Bucharest Early Intervention Project found effects such as cognitive behaviours observed in infancy were still present at the age of 16 years.

A new study will soon determine if the same symptoms exist aged 21, and can be considered permanent.

For babies who were placed in institutions from a very young age and spent more than several years there, “even in the very best therapeutic environment, it’s possible their recovery would be far from complete and they will continue to have problems,” said Nelson, even while some effects may be reduced.

Research suggests that after two years of age, it is increasingly difficult to reverse the neurological effects of institutionalisation, though children vary individually in their resilience and ability to recover in some ways.

People who have grown up in care are greatly vulnerable and often marginalised.

Nelson is concerned over the ability of institutionalised children to have intimate and professional relationships later in life. “Can they wind up being integrated into the fabric of society so they can hold down a job and contribute to the community?” he said.

Often, this is not the case. Lacking a family or community, youngsters can leave care poorly prepared for life outside, having experienced combinations of the above factors and other difficulties.

In addition to being more susceptible to mental health problems, research shows people who leave institutions are more likely to be homeless, be abused, engage in drug use and criminality and have children early — who are also more likely to end up in care. Levels of education and stable employment are low. — Will Worley

(Picture credit: Pixabay)