Today, over 150 million children are orphans, millions of whom suffer from malnutrition, abuse, and a lack of education. Some of these children are adopted in the first 2 years of their lives by caregivers who live several hundred miles away from their home, and some orphans live in residential facilities such as orphanages or group homes until they are adopted later on. But no matter the age of their adoption and the good intentions of their new parents, the long-term impacts of disruption in attachment and resulting attachment disorder symptoms persist throughout the former orphan’s lifetime. Only a lucky percentage of these orphans are able to recover from the abuse and neglect experienced in childhood and become generally healthy and responsible members of society.
The dormitory in an orphanage in Vietnam.
Among related developmental issues such as poor diet, abuse, and illiteracy lies the importance of attachment. While proper nutrition and education play a significant role in the health of children’s physical and mental capacities, secure attachment is the glue that holds physical, mental or emotional, and social development together. We see in Harlow’s famous experiment with monkeys and their wired or blanket-clad mothers that the importance of a caregiver lies not only in their ability to provide nourishment for their child, but also in their attachment-linked ability to care for and comfort their child when faced with new and scary stimuli in their environments. If a child does not develop a secure attachment with its caregivers early-on–regardless of whether they were well-fed and well-educated–they are at risk for attachment anxiety and/or avoidance that results in suicidal tendencies, self-concept confusion, and anxiety and depressive disorders in adolescence and adulthood.
Healthy or secure attachment, as proposed by John Bowlby and Mary Ainsworth, ensures that the child will grow to be independent of their caregivers, have high self-confidence, and be more likely to ask for help. Whereas the insecurely attached child is prone to mental illnesses or disorders, the securely attached child is at a much lower risk for high levels of anxiety and depression later on. Children who are securely attached to their caregivers also tend to have healthier relationships in the workplace, romantic settings, and within friendships; they are able to regulate their emotions and display more prosocial behaviors. Secure attachment is not only necessary for the developmental health of children but is also a reducing factor of criminal and delinquent behavior in adolescents and adults. By developing healthier environments for children and fostering areas in which they can become securely attached to adequate caregivers, we can ensure a safer world filled with more responsible citizens of our neighborhoods, cities, and countries.
What does attachment theory have to do with the orphans and abandoned children, though? Is their mental and physical health not restored through foster care and adoption? That is the question of many modern psychologists, policy makers, and social workers, and the answer seems to be muddied in the competency of the caregiver and the neurological and psychosocial pervasiveness of attachment insecurity on these children. For the orphans in less-fortunate developmental environments like institutional care, where food and water are scarce and care and attention are limited, the numerous effects of the absence or unpredictability of a caregiver are evident, many of which find their foundation in attachment insecurity and/or anxiety.
Given the incredible amount of neuroplasticity found in children under the age of ten, it is not surprising that insecure attachment can so strongly impact their neural development. White matter is extremely important to the neurodevelopment of children, as it facilitates the movement of action potential down the axons of interconnected neurons and makes up the myelin sheath that increases the speed of these transmissions. In a 2015 Romanian study, PhD-holders and researchers in developmental medicine and pediatrics seek to determine associations between neglect in early childhood and the health of white matter pathways later on in childhood. To test their hypothesis that children raised in institutional environments would display the most severe alterations in white matter and would subsequently show remediation as a result of early intervention through foster care, Johanna Bick and her team performed a randomized clinical trial in which 136 children were selected to either remain in institutions or to be placed in foster care.
After several follow-up sessions starting from 30 months and extending to 12 years of age, it was found that the group placed in foster care did not differ greatly from the institutionalized group in the measurement of white matter within the neural tracts, except for within the corpus callosum and superior corona radiata. “Children removed from institutional care and placed in responsive families early in life,” the researchers conclude, “suggest a potential for remediation of specific white matter pathways.” Moreover, their results revealed that children in both groups—both of which initially grew up in institutional care—had lower white matter integrity than children who grew up in a relatively normal familial environment. Based on these clinical trials, it is clear to see that the separation of a child from their caregiver does not only have psychosocial effects on their development, but also impacts their neurophysiology greatly. Yet, hope remains for the former orphans, as the opportunity to rebound from neurological damage is attainable through their prompt placement in developmentally healthy environments.
Just as insecurely attached children such as orphaned and abandoned children (OAC) face neurobiological stumbling blocks to achieving healthy development, they also struggle to overcome social obstacles and grow to display aggressive and antisocial behaviors in adolescence and adulthood. In an attempt to examine the interplay between parent-child bonding, attachment, and aggressive behaviors, Joanne Savage, a specialist within the Department of Justice, Law, and Criminology at American University, documents an exhaustive review of related studies and comes to various conclusions about her findings. While organizing and grouping the research of various journal articles written by psychologists and social scientists including John Bowlby and Mary Ainsworth, Savage found a distinct connection between attachment insecurity, parental bonds, and violence: “attachment insecurity and poor parental bonds,” she notes, “have been linked to conduct problems and delinquency in samples of children ranging from toddlers to young adults.” For orphans or children who have an insecure attachment style, violence is typically a consequence of a lack of absorption of the parent’s values and a general irresponsibility for their own actions.
In Savage’s findings, it was also discovered that although securely attached children are less likely to be aggressive than anxious-avoidant children, they are more likely to be aggressive than anxious-insecure children. Other nuances of prior studies were examined, as it was revealed that father-child bonds are more closely associated with violent behavior than mother-child bonds. Above underlying factors that influence aggressive behavior like paternal versus maternal bonds with children and differing attachment styles, Savage acknowledges the importance of the presence and involvement of parents in their children’s lives: “parent interventions that improve attachment relations with older children or adolescents might work to reduce or prevent violence,” Savage argues. “Early intervention is highly desirable as it prevents serious crime before it occurs and may save both the victims and offenders from great misery.” Through Savage’s analysis of research on attachment and bonding and their links to aggression and violence in adolescents, we see from a criminological view the positive (and preventative) influence of a caregiver that is missing for many orphans and abandoned children. Once again, the solution for the attachment-anxiety-related symptoms seen in OAC—even extending to violent behavior—lies in the recovery of secure attachment through the addition of a competent caregiver.
It seems as though foster care that leads to adoption is the best way for orphans and abandoned children to obtain secure attachment with their caregivers, but according to modern-day researchers, its benefits seem to only be felt under certain circumstances. Seeking to understand the complexity of those circumstances, psychologist Rebecca Johnson and her team reviewed a large collection of data researched by other scientists interested in institutional care and its connection to attachment, and came to several conclusions about their now-synthesized knowledge base. In an effort to analyze the effects of institutional care and other related factors on attachment and cognitive, social, and behavioral development, they summarized their data on several studies and their findings in data tables, and wrote several analyses on the findings influenced by some of their own research.
As the team researched, Johnson discovered that simply placing a child with a caregiver or integrating them back into their biological family system may not be the best solution for OAC. Johnson instead concludes that “poor outcome of some children restored to their natural family shows that the quality of the subsequent family environment is an important factor in the outcome of institutionally reared children.” This is not to discredit the importance of family-based care, but rather to emphasize the importance of the successful integration of the child into a healthy family unit. Perhaps the persistence of low white matter integrity found in Johanna Bick’s research cohort was not simply a result of prolonged time spent in institutional care, but was also due to the low quality of the family environment in which these children were placed following institutional care. In Johnson’s analysis of OAC outcomes following adoption, it is evident then that the recovery of secure attachment and healthy behavior patterns in OAC is not solely dependent on placement in a foster or family-care setting but is also heavily influenced by the stability of the family environment.
Several factors influence the health of the environment in which institutionally raised OAC, including low caregiver-to-child ratios, poorly trained caregivers, and even the restrictive structure of these institutional care facilities. So, how do we provide a healthy environment free of abuse and neglect where orphans and abandoned children can be securely attached to their caregivers and receive quality care? According to German psychologist Katharin Hermenau and several others with her, the answer can be found in a combination of attachment theory and maltreatment prevention. Before they came to this conclusion, however, Hermenau and her peers hypothesized that training caregivers, changing the structure of institutions, and improving caregiving environments would result in better social, emotional, and cognitive development of OAC.
To test their hypothesis, the team performed a data analysis of several studies and analyzed the outcomes of intervention as they relate to development and health, and caregiving or institutional quality and attachment. Based on research conducted in this study, Hermenau and her team argue that “long-term adverse effects might be avoided if caregiving standards in the institution were improved because better caregiving should produce more organized and secure attachments as well as better stress regulation.” Again, in Hermenau’s research and results, we see the importance of preventative measures such as intervention and proper caregiver training on the long-term wellbeing and adjustment of OAC as earlier proposed by criminology specialist Joanne Savage. It is also found that secure attachment between the child and caregiver within an institution is also attained through quality time spent with children which improves the relationship overall and stimulates the children’s brains. By taking a closer look at Hermenau’s attempt to provide a solution to the issue of the unhealthy development of OAC, we gain a broader understanding of the role of the physical structures of institutions and the quality of their employed caregivers in the health of OAC’s environment.
The development of orphans and abandoned children is extremely important, not only to their identities and personalities as growing children and adolescents but also to us as a society. Many of the children raised in restrictive and generally unhealthy environments seen in several institutional care facilities grow to become aggressive people who make up a significant percentage of prisoners due to being insecurely attached to incompetent caregivers for a long period of time. Some children grow to suffer from attachment anxiety, which greatly influences their relationships with others and predisposes them to suicidal ideation and other major mental disorders. For the smaller number of formerly institutionalized children who succeed at becoming securely attached to a competent caregiver, difficulties remain in their interactions with peers and romantic partners. The number of orphaned and abandoned children may never stop increasing, but the care that we provide for them following their abandonment can make all the difference in their futures and our own; it is our responsibility as caregivers to ensure that they are prevented and protected from the dangers that follow insecure attachment as a result of abandonment.
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