The English and Romanian Adoptee Study: Empirical evidence on the impact of abuse and neglect

Over the next couple weeks, I am going to focus on the work of some of the leading thinkers in our field – beginning with English child psychiatrist, Professor Michael Rutter (now aged 83). The starting point is his work on the English and Romanian Adoptee (ERA) study. Rutter is little-known by child protection/OoHC researchers but nonetheless a very important researcher in a number of key fields, including but by no mean limited to, the impact of adverse childhood experiences on later life, the role of genetics, the causes of autism, and developing resilience.

Romanian Soup kitchen for orphans

Breakfast time in Romanian orphanage under Nicolae Ceaușescu’s rule prior to 1989

Why the English Romanian Adoptee Study (ERA) is important

The ERA study is important because it empirically demonstrated the adverse impact of abuse/neglect in early childhood and, equally importantly, how the effects of such abuse/neglect can be mitigated by high quality adoption or foster care.

The ERA study is is considered a ‘naturalistic prospective’ study. Other studies such as the Adverse Childhood Experiences (ACE) study are retrospective. For example, in the ACE study, a physician asks the 40-year-old patient if he/she experienced abuse or adverse circumstances as a child. The problem is that human memory is notoriously unreliable. The ERA study followed up with the adoptees for nearly 20 years and used valid psychometric tools to assess the impact of abuse or chronic neglect.

Background to the ERA study

Prior to 1989, Romania was part of the Soviet Union and was led by Secretary General Nicolae Ceauşescu. He followed the Stalinist dogma that population growth would fuel economic growth. In the first year of his rule (1966), his government issued Decree 770, which outlawed the abortion for women under 40 with fewer than four children; “The fetus is the property of the entire society,” Ceausescu announced. “Anyone who avoids having children is a deserter who abandons the laws of national continuity.”

Consequently, there were many illegal abortions and, relevant to the ERA study, many children abandoned to orphanages as their parents could not afford to look after them. The conditions of the orphanages were appalling (see this article in The Guardian for more details on conditions in pre-1989 Romania). An estimated 100,00 children were abandoned prior to the collapse of Communism in 1989, including 165 children who were to form the basis of the ERA study.

What is privation 

In psychology, privation occurs when a child has no opportunity to form a relationship with a parent figure, or when such relationship is distorted, due to their treatment. It is different to deprivation, which occurs when an established relationship is severed.  The aim of the ERA study was to empirically verify the impact of privation. It is understood that privation can produce social, emotional and intellectual problems for children; however, how inevitable such problems become as a result of privation, and the extent to which they can be reversed, remains an issue of debate among psychologists.

Palace of parliment

Nicolae Ceaușescu’s Palace of Parliament  built in 1984-86

The control group 

The ERA project followed the development of these 165 adoptees from Romania who entered the U.K. between 0-42 months of age, and a comparison sample of 52 non-deprived children adopted within the U.K. prior to 6 months of age, as a natural experiment. Both groups of children were assessed at 4, 6, 11, 15 and 21 years of age. At each time point, developmental assessments were carried out with the children and their families, focusing on behavioural/emotional, cognitive, academic, social-relationship and health outcomes. The parental interviews performed at each time point were concerned with the adoptive parents’ perspectives regarding the children’s development and behaviour, and also included information about their own views of the adoption experience. A third source of information was gained through utilising teacher questionnaires, which provided additional data regarding the children’s educational achievements, behaviour at school and peer-relationships. More recently, the young people donated DNA to allow us to look at the moderating/mediating effects of certain genes.

In short, this is an important study because of its longitudinal nature.

I will review the results in next week’s blog.


Take-out for Practitioners

It might worthwhile to consider the following questions:

  • How might children that are adopted under the age of six months differ from older children over the subsequent 25 years?
  • How might children adopted before six months of age differ from controls?
  • How might children adopted after the age of six months differ from controls?



About graemembaird

I am a psychologist with a special interest in improving the outcomes of families, children and young people in the Out of Home Care and Juvenile Justice systems.
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