Indiscriminate behaviors in previously institutionalized young children.
OBJECTIVE
This study included 54-month-old children with a history of institutional care. Our goal was to: (1) examine differences in indiscriminate social behaviors in children with a history of institutional care compared with home-reared children; (2) test whether foster care reduces indiscriminate social behaviors in a randomized controlled trial; and (3) examine early predictors of indiscriminate behaviors.


METHODS
Participants were 58 children with a history of institutional care and 31 never-institutionalized control (NIG) subjects enrolled in a randomized controlled trial of foster care for institutional care, assessed from toddlerhood to 54 months. Indiscriminate social behaviors were measured naturalistically by using the Stranger at the Door procedure.


RESULTS
In the Stranger at the Door procedure, children with a history of institutional care left with a stranger at higher rates than NIG subjects (33% vs. 3.5%; P < .001). Children in the care as usual group left more than NIG subjects (41.9% vs. 3.6%; P ≤ .001). The differences between the foster care group (24.1%) and the care as usual group and between foster care group and NIG were not significant. In a logistic regression, early disorganized attachment behaviors, baseline developmental quotient, and caregiving quality after randomization contributed to variance at 54 months. In the same analysis using only children with a history of institutional care, only disorganized attachment contributed significantly to 54-month indiscriminate social behaviors (Exp[B] = 1.6 [95% confidence interval: 1.1-2.5]).


CONCLUSIONS
Observed socially indiscriminate behaviors at 54 months were associated with prolonged exposure to institutional care. Young children raised in conditions of deprivation who fail to develop organized attachments as toddlers are at increased risk for subsequent indiscriminate behaviors.
Tulane University School of Medicine, New Orleans, Louisiana;
Mary Margaret
MM
Gleason
Nathan A
NA
Fox
Stacy S
SS
Drury
Anna T
AT
Smyke
Charles A
CA
Nelson
Charles H
CH
Zeanah
D002652:Child Behavior / Q000502:physiology / Q000523:psychology*; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D002674:Child, Institutionalized / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D005581:Foster Home Care / Q000523:psychology* / Q000639:trends; D006801:Humans; D007223:Infant; D008297:Male
attachment; indiscriminate social behaviors; institutional care