7.1.4, 7.1.9 - Privation and recovery

Privation and developmental opportunity

Privation describes a missing opportunity to develop a stable attachment relationship, rather than the loss of a bond that already existed.

A child may receive adequate food and shelter yet have little repeated interaction with one familiar caregiver. High staff turnover or impersonal group care can restrict opportunities to learn who will notice and respond. In this attachment account, the missing relationship may affect comfort seeking, emotional regulation and expectations of other people. Reduced language interaction and play can separately restrict cognitive development.

Deprivation concerns disruption of an established relationship. Research papers sometimes use “deprivation” for severe early institutional adversity generally, so their title does not resolve whether attachment privation occurred. Institutional residence is not proof that every child lacked a bond: some children have contact with family or form selective relationships with staff. Researchers need evidence about care and relationships.

The outcome question is also more precise than “Was the child damaged?” Recovery might mean improved physical growth, language, cognitive test performance, selective attachments or peer relationships. Change in one domain does not establish recovery in all domains. Research compares change across time and against an appropriate comparison group, rather than treating adoption or a new placement as automatic proof of complete recovery.

Tizard and Hodges: different domains of recovery

Following children after a change in care allows researchers to ask whether later relationships and cognitive outcomes develop in the same way.

Tizard and Hodges’ 1978 follow-up reassessed 51 children at age eight who had spent their first two to seven years in institutions and had previously been studied at about four and a half. Seven still lived in institutions; others had been adopted, fostered or returned to their biological families. Psychological testing and information from parents and teachers were used to investigate later development. This was a longitudinal follow-up of naturally occurring placements, not random assignment to adoption.

The publisher’s original summary reports that adopted children had the highest mean IQ and reading achievement. It also reports a discrepancy between informants: parents did not identify more problems in former institutional children than in comparison children, while teachers identified many differences from classmates. The authors linked some cognitive differences to adoptive families’ higher social class and the circumstances of children returned to their families. Thus “better scores after adoption” is not a clean measure of the effect of forming an attachment alone. Tizard and Hodges’ primary summary

The findings show why recovery must be assessed across settings and domains. A child may function well in the home yet experience peer or school difficulties; parent and teacher reports need not ask about identical behaviour. Multiple informants broaden the evidence, but disagreements require interpretation rather than selecting whichever report fits a theory. The follow-up also challenges the claim that early institutional experience necessarily prevents later cognitive achievement.

Placement groups may differ in earlier adversity and later resources. Families who adopt were not randomly selected to receive particular children, and restored families’ circumstances may differ. These factors limit causal comparisons. The available primary summary does not establish that every child had been completely unattached or specify all later attachment measures, so those stronger claims are not needed to interpret this evidence.

The ERA study: timing and catch-up

The English and Romanian Adoptees study examined developmental change after a major improvement in the care environment following severe early adversity.

Rutter’s 1998 report studied 111 Romanian children who entered the UK before age two and compared them at age four with 52 children adopted within the UK before six months. The purpose was to investigate the extent of catch-up after severe early privation. Measures included physical growth and general cognitive development. This report’s sample should not be confused with larger samples in later ERA follow-ups.

At entry, many Romanian children had severe developmental and physical difficulties. At age four, catch-up in growth and cognition was nearly complete among those who had entered the UK before six months. Those placed later also showed substantial improvement, although their group had remaining cognitive difficulties on average. Earlier entry was the strongest predictor of age-four cognitive functioning in that report. Rutter’s original 1998 abstract