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Abandoned, institutionalized children at greater risk for autism

Children who were abandoned at birth and raised at institutions may have an increased risk for social communication difficulties and autism spectrum disorder, according to data published in the Journal of the American Academy of Child and Adolescent Psychiatry.

However, social behaviors improved when the children were placed into family-centered foster care.

Researchers from the Bucharest Early Intervention Project randomly assigned children abandoned at birth and raised in institutions in Bucharest, Romania to an institutional care group, or placed the children in family-centered foster care.

They administered the Social Communication Questionnaire (SCQ) to caregivers of children in both groups, and to parents in a community control sample, once the children reached 10 years of age.

Of 117 ever-institutionalized children, five met criteria for autism spectrum disorder (ASD), according to the DSM-IV and DSM-V.

Researchers found that children with a history of institutionalization had significantly more deviant behavior compared with children who had never been institutionalized (P < .001), according to SCQ data.

Those placed in foster care demonstrated significantly lower scores on the SCQ compared with institutionalized children (P < .001), the researchers wrote. Specifically, the intervention reduced social communication difficulties.

“Although the institutionalized children with autism resemble children with autism in the general population, the origins of their symptoms are very different,” Charles A. Nelson, PhD, of Boston Children’s Hospital and Harvard Medical School, said in a press release. “We believe that both groups suffer deprivation, but of different types: In institutionalized children, the deprivation comes from their environment, while in the general population, the autism itself causes a kind of deprivation, making it harder for children to perceive and understand social cues.”

In an accompanying editorial, Dante Cicchetti, PhD, from the University of Minnesota, Institute of Child Development, wrote that the findings reported among children placed in foster care suggest plasticity of function for social communication could have been recovered in this population.

“Nonetheless, as the investigators clearly delineate, there are some limitations that preclude definitive conclusions regarding the effects of intervention on eliminating the risk of quasi-autism,” Cicchetti wrote. – by Samantha Costa

Disclosure: Nelson has received grant funding from the National Institute on Deafness and Other Communication Disorders, the U.S. Department of Defense, the Simons Foundation, NICHD, the Rockefeller Center for Latin American Studies, an anonymous foundation donor, ANGEL, Merck, Grand Challenges/Canada, the Translational Research Program, and the Gates Foundation. Please see the full study for a list of all other authors’ relevant financial disclosures.