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In 1989, the images coming out of Romanian children’s homes shocked the world. They showed children in cots staring blankly, sometimes tied down, and very clearly neglected. The state of these children reflected the state of Romanian society at the end of the communist regime under Ceausescu, which had left the country in tatters. The children had ended up in these badly equipped and understaffed state-run homes because their families were too poor to feed them. “These children are an example of extreme neglect,” says neuropsychologist Nora Raschle. “They didn’t experience the close relationships and care that are so important for young children.” The severity of the conditions made these children’s homes an interesting area for researchers.
Starting in the year 2000, 136 young children from six children’s homes in Bucharest were accompanied by a group of US researchers as part of a scheme called the Bucharest Early Intervention Project (BEIP). First, the children were examined and then assigned to foster families. Later, their development was compared with children who had not been sent to live with foster families, and with other children who had never lived in a children’s home. “The Bucharest children who had been in homes showed anomalies in their cognitive and social abilities and their mental health,” says Raschle. “This provided researchers with evidence for the effect of extreme early childhood neglect on development.” Nora Raschle is a neuroscientist at the University of Zurich’s Jacobs Center for Productive Youth Development. As assistant professor, she researches the socio-emotional development of children and adolescents. One of the ways she does this is by examining how the brain develops. Our brains are not fully mature until the age of 22 to 25. “That means there’s a long period of time in which our environment and experience contribute to shaping our brains,” says Raschle. These influences may be positive, but things can also go wrong along the way. Raschle is interested in both sides of the coin: typical developmental paths and those associated with developmental and psychiatric disorders. However, she emphasizes that “the knowledge we have today about positive development is heavily based on studies which looked at extremely negative circumstances” – such as those in the Bucharest children’s homes.
The early phase of the brain’s development plays an important role, because this is when the building blocks for later differentiation and behavior are laid. Raschle compares this early phase with the foundations of a tower. If the foundations are not stable, the tower could collapse at some point. So what do young children need for their brains to develop in a healthy way? The answer, research tells us, is attention and stimulation. They also need orientation and structures which they can rely on. These things are established in a process of give and take between the child and their caregiver, a process which has been called “serve and return”. This tennis term describes how a baby initiates an exchange by babbling, making facial expressions, gesticulating or saying words, and adults respond with their own facial expressions and words. This back and forth helps children develop and consolidate their cognitive and emotional abilities.
The process is reflected in the brain, where neural connections are continually being created or trimmed. When children experience neglect, for example by not receiving enough stimulation and feedback from their environment, it is harder for these connections to be formed. “This can contribute to mental disorders and lifelong health-related, cognitive and emotional problems,” says Raschle. For example, adults who were severely neglected as children are more likely to have a low IQ or to have difficulty forming relationships.
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Parents are also important as role models, for example in how they deal with stress or cope with difficult situations.
When a child’s need for attention and stimulation is not met, in extreme cases the result can be toxic, as an excessive stress reaction is triggered. This leads to an increase in the supply of the stress hormone cortisol. Cortisol is a vital, life-preserving hormone because it releases the energy we need to flee from danger, for example. And in the morning, cortisol helps us get out of bed and get going.
If we suffer from permanent stress, however, it’s a different story: “If the body is constantly on high alert and has the feeling it must permanently fight for survival, the biological effect changes,” says Raschle. In this case, the toxic stress leads to neuronal connections in the brain not being made, or existing ones being severed. And constant stress wreaks havoc on the balance of cortisol in our bodies, which can cause anxiety, depression, and cardiovascular problems. That’s the bad news. The good news is that the sooner childhood neglect is recognized, the greater the chance that severe long-term consequences can be avoided.
The Bucharest study showed that the Romanian children who were sent from the children’s homes to foster families at an early age were partially able to balance out the changes in their brain functioning and deficits in emotional bonding, language and cognition. According to the study authors, the earlier the children went to live with a foster family, the better they recovered.
The children in the Bucharest study had experienced an extreme form of neglect. “For most children things are not so bad, thank goodness,” says Nora Raschle, “but thanks to studies like this one we know what an important role early childhood caregivers have.” This is particularly true of parents. In the long-term study SMILIES, the Jacobs Center is therefore researching children’s brain development in the family context (see box). The study is tackling questions such as how similar children and their parents are in socio-emotional processing, and how children develop the ability to process and regulate emotions, and to get along with others.
Parents and other people close to the child are not only central for the development of a child’s brain because of the stimulation they provide. “Parents are important as role models, for example in how they deal with stress or cope with difficult situations,” explains Raschle. “Children also watch how their parents maintain positive relationships and cultivate friendships.” Good role models can therefore show children how to positively shape their lives and help them to deal with obstacles.
Parents also give children the things they need most of all: love, security and affection. These aspects are extremely important for children’s socio-emotional development. “Positive experiences in early childhood strengthen our future selves. They boost our ability to forge friendships and form romantic partnerships,” says Raschle. These positive social relationships are a core element of a happy life.