The link between brain size and deprivation has remained a contentious subject in the early years since MP Graham Allen’s Early Intervention report featured images of a ‘normal’ and ‘neglected’ brain (see box). However, a study by academics at King’s College London has found that severely neglected younger children may end up with smaller brains.
The study followed 67 children who spent time in Romanian orphanages during the rule of Communist dictator Nicolae Ceauşescu in the late 20th century and were subsequently adopted by British families after he was overthrown in 1989.
As part of a larger project looking at children from the orphanages which has been running since the early 1990s, the study saw MRI scans carried out on young adults who had been exposed to ‘severe deprivation’ in institutional care in Romania.
Edmund Sonuga-Barke, professor of developmental psychology, psychiatry and neuroscience at King’s College London, took over the project in 2005 and says the levels of deprivation experienced by the children were striking.
‘People remember the images of the orphanages very strongly, and were worried about what might happen to these children as they grew up.
‘Some children were chained in cots for pretty much the whole day, and lacked cognitive stimulation as they had no toys, and had little possibility of developing attachments with adults.’
BRAIN STRUCTURE
The 67 Romanian adoptees scanned, who had experienced between three and 41 months of deprivation as children, had total brain volumes 8.6 per cent smaller than 21 non-deprived British adoptees who were also tested.
Structural differences between the two groups were found in three regions of the brain linked to organisation, motivation, integration of information, and memory.
The longer the children had been in the institutions, the smaller the brain, with more issues found in children who had spent more than six months in an orphanage.
The study could not explain which elements of early deprivation have this effect on the brain, but suggested the smaller size could be due to:
- the absence of experiences believed to be necessary for normal development, or ‘experience-expectant programming’
- anticipatory adaptation of the brain to future adversity, or ‘experience-adaptive programming’
- subtle forms of damage, or ‘neural scars’, which could be linked to the effects of chronic stress on the developing brain.
CATCHING UP
Although the children were adopted by British families at a young age, the research suggested a loving family could not always fully rectify the damage caused by early neglect.
‘There is this idea of the plasticity of the brain; that it is malleable and that problems can be overcome,’ Professor Sonuga-Barke explains. ‘Our data is more sobering and suggests the brain is not completely plastic, and issues cannot always be overcome, even with the best care and love. The most deprived children’s brains were still much smaller as adults.
‘This is not to say all the children are doing terribly badly; some have achieved great things, but underlying problems have persisted.’
COMPENSATION
Children who experienced deprivation had lower right inferior frontal surface area and volume, linked to a lower IQ and higher levels of attention deficit hyperactivity disorder (ADHD) symptoms. However, they also had greater right inferior temporal lobe thickness, surface area and volume, which are associated with lower levels of ADHD symptoms.
The researchers suggested this was due to a ‘double-edged nature to brain plasticity’, which sees the brain restructure itself to compensate for the smaller size of other areas, and may protect some institutionally reared children from developing ADHD.
Professor Sonuga-Barke explains, ‘It could be that this is adaptive or compensatory, or it could be that it was always there and is a marker of resilience in those children. It could be that it developed to help with better outcomes, it could be that they had different adoptive experiences, or it could be that people with this type of brain have fewer problems. Neuroscience doesn’t fully understand compensation yet.’
Many of the children are also coping well with some of the long-term effects of their early neglect. Professor Sonuga-Barke says, ‘Lots of the children are doing amazingly well adapting to and accommodating these issues. Often, we are seeing them turn things like disinhibited social engagement disorder, in which they are seen to be “too” friendly, not fully understanding the notion of strangers, into a strength. Some of them have become actors or radio hosts, for example.’
WIDER CONTEXT
Vivette Glover, visiting professor of perinatal psychobiology at Imperial College London, notes, ‘It has been known for many years that early deprivation or abuse can be associated with subtle changes in the structure of the brain, but not usually with overall brain volume. In general, one cannot assess a child’s early experience by measuring brain size, but this study suggests that very severe deprivation, of a type very rarely seen in the UK, can alter brain volume also.’
While the researchers estimate there may still be between five and six million ‘big, impersonal, low-quality care institutions’ globally, Dr Eunice Lumsden, head of early years at the University of Northampton, cautions against making comparisons and notes the research is specific to a time and place.
‘In this country, children that age would be with their family or in pre-adoptive foster care, so a like-for-like comparison is very difficult. However, the research is fascinating,’ she says. ‘It underlines how immensely difficult that early start has been for those children and is really shining a light on the fact that very severe early deprivation has an impact on a child’s whole life.’
Interpreting deprivation
The images of a ‘normal’ and shrunken ‘neglected’ brain on the cover of MP Graham Allen’s 2011 report Early Intervention: the next steps led to accusations of an oversimplification of brain development and an over-emphasis on the long-lasting impact of a child’s experiences during their first three years.
The images were traced back to an unrefereed poster presentation by Bruce Perry, of the Child Trauma Academy in Houston, Texas. Dr Perry later stated that he had not published this ‘initial set of observations’ and that due to the tremendous variability in the ‘nature, timing, pattern of abuse/neglect’, other methods to ‘better interpret any biomarker or neuroimaging data’ needed to be developed.
https://discoversociety.org/2016/07/05/mental-capital-neuroscience-and-early-intervention/
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