ROMANIAN ORPHAN STUDIES
SPECIFICATION: PRIVATION:ROMANIAN ORPHAN STUDIES AND THE EFFECTS OF INSTITUTIONALISATION
RUTTER’S CRITIQUE OF BOWLBY’S MATERNAL DEPRIVATION HYPOTHESIS
A leading developmental psychologist, Michael Rutter, broadly agreed with Bowlby that early relationships were crucial. However, he believed Bowlby’s hypothesis lacked scientific precision. In particular, Rutter criticised Bowlby for failing to operationalise what he meant by “deprivation.” Did it mean short-term separation? Loss of a formed bond? Or is there an absence of any attachment at all?
Rutter argued that Bowlby blurred these ideas and did not distinguish between very different experiences, each of which could have different outcomes. As a result, Bowlby’s conclusions — particularly around emotional and behavioural difficulties like “affectionless psychopathy” — lacked scientific clarity.
In Rutter’s view, Bowlby may have been observing the effects of privation, not deprivation, but without precise definitions, it wasn't easy to draw valid conclusions. Despite this, Rutter acknowledged that Bowlby was right about one thing: young children need stable, loving, continuous care to develop normally.
DEPRIVATION, SEPARATION, OR PRIVATION?
Rutter made a clear distinction between three different concepts:
Separation refers to a temporary absence of the primary caregiver, such as a hospital stay or time away from home.
Deprivation is when an already formed attachment is broken or disrupted over time.
Privation is when a child never forms an attachment in the first place, typically due to extreme neglect or institutionalisation.
Rutter believed that many adverse outcomes Bowlby attributed to deprivation resulted from privation, which has far more serious and lasting consequences.
THE IMPORTANCE OF OPERATIONAL CLARITY
Rutter’s most important contribution was arguably methodological. He criticised Bowlby’s lack of clarity in defining maternal deprivation. For example:
Was a child deprived if a mother returned to work?
Did a hospital stay count?
Was a child with multiple caregivers deprived?
The claims could not be tested, falsified, or compared without clear definitions. Rutter’s work brought a more scientific and nuanced lens to the study of early attachment, pushing for more precise definitions, more rigorous methods, and the use of triangulated research, including case studies, longitudinal studies, and cross-cultural comparisons.
THE ROMANIAN ORPHAN STUDIES (1998)
To support his view, Rutter conducted extensive research into children adopted from Romanian orphanages in the 1990s. These children had often experienced severe emotional and physical neglect from birth — a classic example of privation.
The Romanian Orphan Study is a crucial investigation into the effects of institutionalisation on children's development. This landmark study sought to discern whether the adverse consequences of institutional care and privation could be mitigated through nurturing and enriched environments.
RESEARCH BACKGROUND
Before delving into the Romanian Orphan Study, it's essential to appreciate the context in which it emerged. Harlow's research with rhesus monkeys challenged the prevailing behaviourist perspective by emphasising the significance of contact comfort over mere feeding in attachment formation. This paradigm shift paved the way for a deeper understanding of attachment.
CONTEXT AND BACKGROUND
Following the rule of Romanian dictator Nicolae Ceaușescu, strict pronatalist policies were introduced: abortion and contraception were banned to increase the population. However, Romania at the time was a very poor country. These measures led to a surge in unplanned births among families who were unable to care for the children. As a result, thousands of babies were abandoned and placed in state-run orphanages.
Conditions in these institutions were dire. Due to limited staff and resources, infants were often left alone in cots for months with minimal human contact. They were deprived not only of physical affection and emotional responsiveness, and basic stimulation. These children experienced extreme privation — they were not just separated from caregivers, they never formed any attachment in the first place.
Rutter’s study explored the developmental consequences of such conditions, especially once the children were adopted into UK families who provided loving and enriched environments.
RUTTER’S ROMANIAN ORPHAN STUDIES (1998)
DESIGN
The Romanian Orphan Study, conducted by Michael Rutter and Edmund Sonuga-Barke in 1998, was a natural experiment that offered a rare and unique opportunity to study the psychological effects of early privation — something that would be unethical to replicate under experimental conditions. The study focused on 165 Romanian children who had spent their early years in institutional orphanages. Of these children, 111 were adopted before the age of two, and an additional 54 were adopted by the age of four. The key developmental outcome measured was cognitive functioning, assessed at various intervals — ages 4, 6, 11, and 15. Interviews with parents and teachers provided further data. A control group of 52 British children adopted before the age of six months was used for comparison.
KEY FINDINGS
Initial assessment: At the start of the study, 50% of the Romanian orphans were found to be cognitively impaired, underweight, and showed signs of developmental delay. In contrast, the British control group (adopted before 6 months) showed no such issues.
Children adopted before 6 months showed significant recovery. Many developed secure attachments, achieved normal cognitive development, and were indistinguishable from the control group by later childhood.
By Age 4:
Children adopted before six months often recovered remarkably well. Many went on to form secure attachments and achieved typical cognitive and emotional development.
Children adopted after six months — especially those adopted after the age of two — were far more likely to experience lasting difficulties. These included disinhibited attachment (e.g., being overly friendly with strangers), attention problems, emotional regulation issues, and ongoing struggles with peer relationships.
CONCLUSIONS
Rutter’s research revealed two critical insights:
Separation alone does not cause developmental damage, but the absence of any early attachment—i.e., privation—leads to more serious, long-term consequences.
While early, enriched care can reduce the effects of privation, this appears to be most effective if it occurs before the age of six months. Children adopted after this point often displayed enduring difficulties, suggesting that there may be a sensitive window for forming healthy attachments.
Rather than refuting Bowlby, Rutter’s findings refined his theory: They supported a critical or sensitive period. Still, they suggested it may be shorter and more sharply defined than Bowlby’s original estimate of two and a half years. Recovery is possible, but it becomes far more difficult the longer the privation continues.
AGE 6 FOLLOW-UP STUDY (2001)
Disinhibited attachment persisted in over 40% of the late-adopted group.
Even in loving adoptive homes, these behaviours did not diminish.
Early-adopted children rarely showed these issues.
No significant increase in emotional disorders, but attention difficulties emerged.
Attention and concentration problems,
Peer relationship issues,
Mild cognitive and emotional challenges.
AGE 11 FOLLOW-UP STUDY (2007)
Disinhibited attachment is still present in the late-adopted group.
Hyperactivity, inattention, and poor peer relationships remained.
Cognitive development sometimes caught up, but emotional and behavioural issues persisted.
Children adopted before 6 months continued to perform within normal ranges socially and academically.
AGE 15 FOLLOW-UP STUDY (2010)
Late-adopted children continued to experience:
Cognitive challenges
Persistent attention and peer-related difficulties
Mental health symptoms, including anxiety and symptoms resembling autism (though not necessarily diagnosed as such)
Children adopted before 6 months remained broadly comparable to the British control group
AGE 22 FOLLOW-UP STUDY (2017)
AIM:
This study investigated the long-term effects of early institutional privatisation and whether deficits persisted into early adulthood. The central hypothesis was whether severe deprivation beyond six months of age had irreversible consequences, supporting the concept of a critical or sensitive period for attachment and development.
PARTICIPANTS
165 Romanian adoptees, split into:
Adopted before 6 months
Adopted between 6 and 24 months
Adopted after 24 months
Compared to a control group of 52 British adoptees who had not experienced institutional care.
FINDINGS
69% of those adopted after 6 months showed at least one significant problem in adulthood.
These included:
Autistic-like symptoms (e.g. reduced eye contact, repetitive behaviours)
Emotional dysregulation
Low self-esteem
Disinhibited Social Engagement Disorder (DSED) — continuing from earlier stages
In contrast, only 33% of those adopted before 6 months showed such difficulties.
Cognitive outcomes:
The average IQ scores of those adopted before 6 months were in the normal range (~100). Still, those adopted after 6 months often showed lower average scores, especially if they had experienced extreme privation beyond 2 years of age.Disinhibited attachment (a key marker of failed early bonding) was still observed in:
41% of the late-adopted group
Compared to 9% in the early-adopted group
OTHER STUDIES ON EX-INSTITUTIONALISED CHILDREN AND ORPHANS
Several significant studies have focused on the outcomes and development of ex-institutionalised children and orphans. These research efforts aim to understand the impact of early institutional care on children's emotional, social, and cognitive development. Here are a few notable studies: For example:
WILLIAM GOLDFARB (1947) – EFFECTS OF EXTREME PRIVATION
Goldfarb conducted one of the earliest longitudinal studies on children raised in institutional settings. He followed two groups: one group of children who were placed in institutional care from early infancy with minimal emotional or social interaction, and a comparison group who were fostered and received one-to-one care from an early age.
The outcomes were stark. By age 12, the institutionalised children displayed significantly lower IQ scores (average of 72), delayed speech and language development, and serious difficulties forming relationships. In contrast, the fostered children scored much higher on cognitive tests and showed more typical emotional and social behaviour.
Goldfarb’s findings were some of the first to show that children completely deprived of early attachment, not just separated, but privated, often failed to recover emotionally or intellectually, even when later moved into loving homes.
This study lent early support to Bowlby’s emphasis on early caregiving. Still, it also laid the groundwork for Rutter’s later critique: that Bowlby may have been conflating the effects of privation (never having formed a bond) with deprivation (losing a bond). Goldfarb’s work demonstrates that the total absence of emotional care in infancy can lead to severe and lasting developmental harm, especially when not addressed within a critical period.
GARNER (1972)
Found that a lack of emotional care could lead to deprivation, dwarfism and physical underdevelopment. Additionally, research has highlighted the potential negative impacts of emotional deprivation on cognitive development and the occurrence of disinhibited attachments.
TIZARD AND REES’ STUDY ON ATTACHMENT (1975)
In 1975, Barbara Tizard and Ann Rees studied the attachment patterns of children raised in residential nurseries. Their work offered insights into the social and emotional development of children who had experienced institutional care from a young age, contributing to the understanding of attachment without a singular, continuous caregiver.
QUINTON ET AL. (1984)
Discovered that women raised in institutional care often encountered difficulties in parenthood compared to a control group reared within family settings.
HODGES AND TIZARD EX INSTITUTIONALISED CHILDREN (1988)
This natural experiment investigated the long-term effects of early privation. The study followed children placed in residential nurseries before 4 months of age, where staff were explicitly told not to form attachments with them.
By age 4, some children were adopted, others returned to their biological families, and a few remained in care.
The study found that both adopted and returned children struggled to form peer relationships, often described as attention-seeking or socially awkward. However, adopted children generally formed better relationships with their parents than those who returned to their birth families.
This may have been less about the children and more about the environment — adoptive parents were typically more supportive and understanding, having chosen to take on children with known early difficulties.
Despite some recovery, the study concluded that early privation had long-lasting social consequences, especially in peer relationships, and even sensitive parenting could not fully reverse these effects.
CONCLUSIONS
Hodges and Tizard concluded that early institutional care has a detrimental effect on children's ability to form attachments and engage in positive social relationships. The study highlighted the importance of stable, nurturing care in the early years for healthy social and emotional development. These findings have had significant implications for child welfare policies and practices, underscoring the need for early intervention and support for children in institutional care settings.
THE BUCHAREST EARLY INTERVENTION PROJECT (2000)
Initiated in 2000, this project is a longitudinal study exploring the effects of early institutionalisation and the impact of foster care as an intervention. The study, led by Charles A. Nelson, Nathan A. Fox, and Charles H. Zeanah, provided compelling evidence on the cognitive, emotional, and physical benefits of moving children from institutional settings to family-based care.
LE MARE AND AUDET (2006)
Another longitudinal study by Le Mare and Audet 2006 examined the physical health and growth of 36 orphans adopted by Canadian families. At age 4, these children were physically smaller than a control group. Nevertheless, this difference disappeared by age 10, underscoring the potential for physical recovery from the effects of institutional care.
THE RUSSIAN ORPHAN STUDY (2013)
This study, led by Emily C. Merz, focused on children adopted from Russian and Eastern European orphanages. It examined attachment styles, emotional regulation, and behavioural adjustment.
Sample: Internationally adopted children, mainly from Russia and Eastern Europe
Focus: Long-term outcomes related to Reactive Attachment Disorder (RAD), attention difficulties, and social-emotional functioning
Key Findings:
Children adopted from institutions had higher rates of attachment disorders, attention problems, and difficulties with peer relationships.
Outcomes were significantly influenced by age at adoption — those adopted earlier fared better.
The post-adoption environment (sensitive caregiving, stable families) was crucial in moderating outcomes.
EVALUATION
METHODOLOGICAL STRENGTHS AND LIMITATIONS
One of the key strengths of the Romanian orphan studies — particularly those led by Michael Rutter and later Sonuga-Barke — is their use of longitudinal methods. By tracking the same children over many years, researchers could assess the long-term impact of early institutionalisation on cognitive, emotional, and social development. This kind of research is invaluable because it allows psychologists to identify consistent patterns of change over time, rather than relying on a one-off snapshot of behaviour.
For example, early assessments showed clear signs of developmental delay and attachment difficulties among children adopted after six months. Later follow-ups into adolescence and adulthood revealed that many of these problems persisted, especially in those who had experienced extreme privation. This long-term perspective supports the idea that early experiences — particularly the presence or absence of a primary attachment figure — can shape later outcomes.
However, longitudinal research is not without its limitations. Over many years, controlling for confounding variables, such as changes in adoptive families, education, environment, or health, has become difficult. These factors could also influence a child’s development, making it hard to draw firm conclusions about the sole impact of early institutional care.
There are also concerns around sample attrition — some children dropped out of the study over time, potentially skewing the findings. If children with more severe issues were more likely to disengage or become untraceable, this could mean that the studies underestimated the full extent of long-term damage.
Additionally, although researchers aimed to study “privation,” there is limited certainty about what each child’s early experiences actually involved. For example, some may have been placed into care at birth, while others arrived weeks or months later. Some may have had brief periods of one-to-one care, while others may have been entirely neglected. Without consistent records, it’s impossible to be sure all the children experienced comparable levels of deprivation, which reduces the internal validity of the findings.
Furthermore, because this was a natural experiment, the children were not randomly assigned to early or late adoption groups. It’s possible that those adopted earlier were healthier, more physically appealing, or had easier temperaments, which made them more attractive to prospective adoptive parents. If so, their more positive outcomes may reflect pre-existing differences, not just the timing of adoption.
In short, while these studies are among the most ethically permissible ways to investigate the effects of early deprivation, the lack of random assignment, inconsistent early records, and influence of post-adoption environments make it difficult to isolate cause and effect. Nevertheless, their findings have had enormous real-world value, especially in shaping adoption policy and understanding the importance of early, stable, and emotionally responsive caregiving.
CULTURAL BIAS IN INSTITUTIONALISATION STUDIES: A FAIR CRITIQUE?
One criticism of research into institutional care, particularly studies like Rutter’s Romanian Orphan Study, is the potential for cultural bias. Some argue that the extreme deprivation observed may reflect not only the absence of attachment but also the broader socioeconomic conditions of the country. For example, Romania in the early 1990s was facing widespread poverty, underfunded welfare systems, and political upheaval, all of which may have contributed to the children's cognitive and emotional difficulties.
However, while these contextual factors are valid considerations, they do not fully account for the depth of developmental delays observed. Human brains require early stimulation, responsive caregiving, and emotional bonding to develop normally, regardless of cultural background. Neurodevelopment depends on experience-expectant processes—essential environmental input like touch, eye contact, and language exposure—that are biologically necessary for brain wiring during infancy. Without this, synaptic pruning and attachment systems are disrupted, leading to long-term emotional and cognitive impairments.
Therefore, while socioeconomic context may shape outcomes to some degree, the core deficits seen in severely privated children, such as disinhibited attachment, impaired executive function, and emotional dysregulation, are not culturally specific, but rather, biologically universal responses to relational and sensory deprivation.
INDIVIDUAL DIFFERENCES AND RECOVERY: A CHALLENGE TO BOWLBY?
Bowlby’s Maternal Deprivation Hypothesis proposed that children who fail to form a primary attachment within a critical period, especially within the first 2½ years, would suffer permanent emotional and cognitive damage. He specifically linked this to long-term relationship difficulties and, in extreme cases, what he termed “affectionless psychopathy.”
However, this deterministic view has been widely challenged. Later research, particularly Rutter’s Romanian orphan studies, revealed significant individual differences in children’s outcomes, even among those who experienced early privation. Notably, around 20% of children adopted after six months went on to develop relatively normal emotional and cognitive functioning.
This raised an important question: why did some children recover while others did not? Was it due to genetic resilience, slight differences in institutional care, or exceptional adoptive environments? Unfortunately, Rutter’s data does not fully explain this variability. However, it’s unlikely these children received sensitive care while institutionalised, as conditions were generally deplorable. It may be that a combination of temperament, later caregiving quality, and individual biology played a role. What it does suggest is that most adoptive placements after six months were insufficient to reverse the effects of early privation, not that recovery was impossible, but that it was rare.
It’s also worth noting that Bowlby did not clearly distinguish between separation, deprivation, and privation in his early work, which led to confusion over what exactly caused the developmental difficulties he observed. Later theorists like Rutter argued that privation—the total absence of an early attachment—likely led to the most severe outcomes, not short-term separation or disrupted bonds.
While Bowlby later softened his stance in his attachment theory by introducing the Internal Working Model, which allowed for developmental change, his early work framed damage as largely irreversible. Research has since shown this isn’t entirely accurate, but his central claim remains valid: early caregiving experiences are foundational, and for most children, the effects of early emotional neglect are long-lasting and difficult to undo
REAL-WORLD APPLICATIONS: TRANSFORMING CHILDCARE PRACTICE
Research into institutionalisation — particularly from Rutter, Tizard and Hodges, and Goldfarb — has had a profound impact on how children are cared for in residential and adoption settings.
Historically, many institutions discouraged the formation of strong emotional bonds between children and caregivers, fearing it would make separation harder. This was especially common in post-war orphanages and long-stay hospitals. However, studies highlighting the devastating effects of privation, such as social withdrawal, disinhibited attachment, and cognitive delays, directly challenged this practice.
As a result, childcare policies have radically shifted. It is widely accepted that emotional bonding is healthy and essential for normal psychological development. Caregivers in modern institutions are trained to provide consistent, warm, and responsive care, mimicking the conditions of a secure attachment wherever possible.
Furthermore, adoption procedures have been overhauled. There is now a strong emphasis on early adoption to allow babies and toddlers the opportunity to form secure attachments within Bowlby’s proposed sensitive period. Children are matched with permanent caregivers as soon as possible to reduce the risk of long-term emotional harm.
In addition, institutional settings have become more child-centred, often involving key-worker systems to promote continuity of care, which echoes Bowlby’s emphasis on monotropy and consistent caregiving.
Finally, the research has influenced international policy. In many countries, especially in Eastern Europe and South America, there has been a push toward deinstitutionalisation, replacing large orphanages with family-based foster care systems. The UN Convention on the Rights of the Child now recognises stable caregiving as a fundamental child right — a perspective shaped by decades of attachment research.
EXAMINATION QUESTIONS
Outline the key findings of Rutter et al.'s (1998) Romanian Orphan Study, including the effects of institutionalisation on cognitive development (6 marks).
Discuss the implications of the Romanian Orphan Studies for improving the care of institutionalised children (12 marks for AS, 16 marks for A-level).
Evaluate the strengths and weaknesses of research related to the effects of institutionalisation, considering issues of cultural bias and individual differences (16 marks).
