only in romania
Just kidding and no offense to my Romanian bretheren.
I just read an article published in the Dec. 21, 2007 issue of Science Magazine entitled “Cognitive Recovery in Socially Deprived Young Children: The Bucharest Early Intervention Project” which reported the results of a randomized controlled trial looking at the cognitive outcomes of orphan children who were institutionalized versus those who were not. Wow. Didn’t know it was ethical to do a randomized controlled trial on that kind of a thing–randomizing orphans to either stay institutionalized or go to a foster family? Sounds like someone’s IRB dropped the ball on this one…
Anyway, here’s the abstract from the article:
In a randomized controlled trial, we compared abandoned children reared in institutions to abandoned children placed in institutions but then moved to foster care. Young children living in institutions were randomly assigned to continued institutional care or to placement in foster care, and their cognitive development was tracked through 54 months of age. The cognitive outcome of children who remained in the institution was markedly below that of never-institutionalized children and children taken out of the institution and placed into foster care. The improved cognitive outcomes we observed at 42 and 54 months were most marked for the youngest children placed in foster care. These results point to the negative sequelae of early institutionalization, suggest a possible sensitive period in cognitive development, and underscore the advantages of family placements for young abandoned children.
And surprise surprise, the institutionalized orphans did not fare as well. I guess, as my old friend and mentor who gave this article to me said, you never know the answer until you do the trial.
April 25th, 2009 at 12:49 pm
HA! so i guess at this point i should share that i am originally from romania…and that while we lived there my dad actually worked with a charity to help some of Bucharest’s street children, so i have over the years met some of the homeless children which chose to come and live in a sort of orphanage in our home town. so let me first say that you should not give so much credit to the study by assuming IRB’s exist. and second, if you ever walked into an orphanage there, you would wonder why they even neeeeeed to study the problem-just to give an example, the solution to the large child-to-caregiver ratio is to tie the kids to their beds so that they can’t hurt themselves or others kids or do anything else for that matter.
as for the randomized part, i’m going to assume that it probably means that the compared the kids which were “randomly” and luckily adopted to the ones who weren’t.
April 26th, 2009 at 4:26 pm
What would be really unethical would have been to have never done a study in the first place- because institutional and governmental inertia would have stopped any meaningful change.
Having said that randomising children who have no caregivers to give informed consent is more than just a little bit of a grey area I agree. But in a resource poor environment it may be ethically defensible as a pragmatic investigation of what was already going to happen.
And now they have rock solid social policy evidence that this needs to stop. But will they act on it?
April 30th, 2009 at 2:23 pm
iar – my assumption was that any orphanage would be a horrible place to be raised and it sounds like it may be even worse in romania. i agree, i’m still not convinced that this study really needed to have been done…
antipode – “But will they act on it?” Do they ever act on it? More than likely people will point to this study (whose results are not that earth shattering) as evidence but nothing will get done about for a long time…