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Good Foster Care Helps Neglected Kids Thrive

Study of Romanian orphans shows that better diet, close attention makes all the difference

MONDAY, April 5 (HealthDay News) -- Even for children who begin life with serious neglect, sensitive and loving foster care can help bring them physically and mentally on par with other kids, a long-running study of Romanian orphans shows.

While the study compared the progress of orphans growing up in institutions and then placed in foster care, its lessons apply to all children, said Dr. Dana E. Johnson, a pediatrics professor at the University of Minnesota and the lead author of a report in the April 5 online edition of Archives of Pediatrics & Adolescent Medicine.

"Kids do not reach their full potential unless they have a nurturing environment in which to grow," Johnson said.

He and colleagues in other academic centers began their study of 136 infants in six Bucharest orphanages, average age 21 months, in 1999.

Conditions in the orphanages were less than ideal, Johnson said, with too few caregivers tasked with caring for many orphans. Food is available, he said, but "without individual care, these kids may not get enough to eat. These kids are not being fed according to their individual needs."

Orphans also got less attention because in such settings, "caregiver actions are based on efficiency and expediency rather than being responsive to child-based cues," the authors wrote.

The study was conducted, in part, to answer questions about how much benefit foster care can bring to children, Johnson said.

Half the children remained in the orphanages, the other half were assigned to a foster care program. Their physical and mental progress has been assessed periodically.

The latest report looks at the children's physical development. At the beginning of the study, the institutionalized children were below average in measures of growth and development. The deficits were greatest for those with low birth weights, less than 5.5 pounds.

The children placed in foster care showed rapid increases in height and weight. By 12 months, all were in the normal range for height and 90 percent were in the normal range for weight. The children left in institutions lagged in both measurements.

Diet does appear to play a role, Johnson said, probably because close attention was not being paid to their eating habits. "If someone is not paying attention, they probably are not getting enough to eat," he said.

But food intake is just one aspect of eating, Johnson added. "So much of our interactions occur while children are eating," he said.

The study also showed that children whose height caught up to normal levels also had improved thinking, learning and memory abilities. "Each incremental increase of one in standardized height scores between baseline and 42 months was associated with a mean increase of 12.6 points in verbal IQ," the report said.

There is a biological explanation for the relationship, said Nathan A. Fox, a human development professor at the University of Maryland and a member of the research team.

"Psychosocial stimulus interacts with the physiological system," Fox said. "It increases production of growth hormone and reduces stress. Providing adequate psychosocial stimulus is necessary for growth."

While it is not clear whether such maltreatment can affect the development of psychological disorders, "physical growth and development, brain growth and activity, all of those have shown the effects of intervention," Fox said.

"Kids require a good diet, but they also require good nurture," Johnson said. "Without both those factors, kids will not do well."

More information

There's more on child development at the U.S. Centers for Disease Control and Prevention.

SOURCES: Dana E. Johnson, M.D., Ph.D, professor, pediatrics, University of Minnesota, Minneapolis; Nathan A. Fox, Ph.D, professor, human development, University of Maryland, College Park; April 5, 2010, online edition, Archives of Pediatrics & Adolescent Medicine

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