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Shots - Health News
Mon February 24, 2014
Orphans' Lonely Beginnings Reveal How Parents Shape A Child's Brain
Originally published on Tue February 25, 2014 11:07 am
Parents do a lot more than make sure a child has food and shelter, researchers say. They play a critical role in brain development.
More than a decade of research on children raised in institutions shows that "neglect is awful for the brain," says Charles Nelson, a professor of pediatrics at Harvard Medical School and Boston Children's Hospital. Without someone who is a reliable source of attention, affection and stimulation, he says, "the wiring of the brain goes awry." The result can be long-term mental and emotional problems.
A lot of what scientists know about parental bonding and the brain comes from studies of children who spent time in Romanian orphanages during the 1980s and 1990s. Children like Izidor Ruckel, who wrote a book about his experiences.
When Ruckel was 6 months old, he got polio. His parents left him at a hospital and never returned. When he turned three, he was sent to an orphanage for "irrecoverable" children.
But Ruckel was luckier than many Romanian orphans. A worker at the orphanage "cared for me as if she was my mother," he says. "She was probably the most loving, the most kindest person I had ever met."
Then, when Ruckel was 5 or 6, his surrogate mother was electrocuted trying to heat bath water for the children in her care. Ruckel was on his own in a place where beatings, neglect and boredom were the norm.
Polio had left him with a weak leg. But as he got older he found he had power over many of the other children who had more serious disabilities.
"There was no right, there was no wrong in the orphanage," Ruckel says. "You didn't know the difference because you were never taught. I was put in charge of kids and I treated them just the way they treated us. If you didn't listen to me, I'd beat you."
Researchers began studying the children in Romanian orphanages after the nation's brutal and repressive government was overthrown in 1989. At the time, there were more than 100,000 children in government institutions. And it soon became clear that many of them had stunted growth and a range of mental and emotional problems.
When Nelson first visited the orphanages in 1999, he saw children in cribs rocking back and forth as if they had autism. He also saw toddlers desperate for attention.
"They'd reach their arms out as though they're saying to you, 'Please pick me up,' " Nelson says. "So you'd pick them up and they'd hug you. But then they'd push you away and they'd want to get down. And then the minute they got down they'd want to be picked up again. It's a very disorganized way of interacting with somebody."
The odd behaviors, delayed language and a range of other symptoms suggested problems with brain development, Nelson says. So he and other researchers began studying the children using a technology known as electroencephalography (EEG), which measures electrical activity in the brain.
Many of the orphans had disturbingly low levels of brain activity. "Instead of a 100-watt light bulb, it was a 40-watt light bulb," Nelson says.
As the children grew older, the researchers were able to use MRI to study the anatomy of their brains. And once again, the results were troubling. "We found a dramatic reduction in what's referred to as gray matter and in white matter," Nelson says. "In other words, their brains were actually physically smaller."
The scientists realized the cause wasn't anything as simple as malnutrition. It was a different kind of deprivation — the lack of a parent, or someone who acted like a parent.
A baby "comes into the world expecting someone to take care of them and invest in them," Nelson says. "And then they form this bond or this relationship with this caregiver." But for many Romanian orphans, there wasn't even a person to take them out of the crib.
"Now what happens is that you're staring at a white ceiling, or no one is talking to you, or no one is soothing you when you get upset," Nelson says. So areas of the brain involved in vision and language and emotion don't get wired correctly.
Izidor Ruckel says he suspects the wiring in his brain was changed by his time in the orphanage. And that may have contributed to his troubles after leaving the institution.
In 1991, when he was 11, Ruckel was adopted by an American family and moved to San Diego. At first things went pretty well, he says. Then he began to have a lot of conflict with his adoptive parents. Ruckel says it wasn't their fault.
"I respond better when you beat me, or when you smack me around," he says. "That never happened. When you show me kindness, when you show me love, compassion, it seemed to make me even more angrier."
And those feelings became increasingly intense. "I felt angry to a point where I could feel my heart is turning black," Ruckel says. "And at the same time I have been raised in a Christian home. And you know with my Christian faith I always wondered, am I a child from hell? What went wrong with me?"
Scientists can't answer that question for Ruckel or any other individual. But they now know that, as a group, neglected or abandoned children tend to have abnormal circuitry in areas of the brain involved in parental bonding.
When typical children are shown pictures of their mothers, the response in the amygdala, a brain region that plays an important role in emotional reactions, is much greater than when they see a stranger, according to Nim Tottenham. She's an an associate professor of psychology at the University of California, Los Angeles.
Her team repeated the experiment with children who had been adopted after spending time in an orphanage or some other institution. This time, the children saw pictures of either an unfamiliar woman or their adoptive mother. And "the amygdala signal was not discriminating Mom from strangers," Tottenham says.
This sort of brain adaptation may help children survive in an environment without parents, she says. But it also may affect the kind of family relationships these children have once they are adopted.
Tottenham, who is a parent herself, says all the research on neglected children reminds her of something that should be obvious: "Parents are playing a really big role in shaping children's brain development." And parenting, she says, is a bit like oxygen. It's easy to take for granted until you see someone who isn't getting enough.
Children who are adopted by about age 2 are most likely to grow up with typical brains, researchers say. Other neglected children, though, often show remarkable recoveries.
Things turned out pretty well for Izidor Ruckel. After leaving home at age 17 and being out of touch with his adoptive parents for several years, he learned that his family had been in a serious car crash. He realized he couldn't just leave them there. So he went to the hospital.
"It was really hard because I wanted to make sure they were OK," he says. "I was scared. And I didn't think I was going to be forgiven for everything I'd put them through."
But they did forgive him. And since then, he says, he and his adoptive parents have become very close.
That may be possible because his brain has changed, Ruckel says. "I believe that even the brain cells that don't work as a child, I believe that they can develop as a grown man."
Scientists have their own version of that idea. They say the brain has a remarkable ability to rewire itself and compensate for things that go wrong during development, including some problems caused by neglect.
Ruckel is 33 now and lives in Denver. In addition to writing a book about his experiences, he produced a documentary on Romanian orphans who were adopted. And he's raising money for a second documentary about what happened to the orphans who stayed in Romania.
"I've become an advocate fighting for other orphans," Ruckel says. "And I believe that has everything to do with my parents, because I realized what love, what compassion, what affection can do."
RENEE MONTAGNE, HOST:
You are listening to MORNING EDITION from NPR News. Good morning, I'm Renee Montagne.
DAVID GREENE, HOST:
And I'm David Greene.
Today in Your Health, how the bond between parent and child shapes a developing brain. Researchers know that children need someone in their life to provide attention, affection and stimulation. NPR's Jon Hamilton reports on research suggesting that without a person in this parental role, the wiring of a child's brain can be permanently altered.
JON HAMILTON, BYLINE: A lot of what scientists know about parental bonding and the brain comes from studies of kids like Izidor Ruckel.
IZIDOR RUCKEL: I was born in Satu Mare, Romania.
HAMILTON: When Ruckel was 6 months old, he got polio. His parents took him to a hospital.
RUCKEL: And the doctors there said, he will have to stay here for a couple of weeks. Well, that weeks turned into three years.
HAMILTON: Ruckel's parents never came back for him. When he turned 3, he was sent to an institution for "irrecoverable children.'' But Ruckel was fortunate. He was able to form a close bond with one of the workers at the orphanage.
RUCKEL: There was a woman that cared for me as if she was my mother. And she was probably the most loving, the most kindest person I had ever met. Every day I saw her, I was so excited. I knew she was going to spoil me and love me.
HAMILTON: And she did, for several years. Ruckel says he was 5 or 6 when he lost his surrogate mother.
RUCKEL: She was trying to heat up some hot water for the kids, for the bath. And the electrical cord was fried. And so she was electrocuted.
HAMILTON: Ruckel was one of the hundreds of thousands of Romanian orphans warehoused in bleak government institutions during the 1980s and 1990s. He remembers beatings, neglect and boredom - especially after school ended at 2 p.m.
RUCKEL: After that, nothing - you just sit there. Most of them rock back and forth, fall asleep. Not even a TV back then.
HAMILTON: Polio had left Ruckel with a weak leg. But other children in the institution had more serious problems. And as Ruckel grew older, he found he had power over them.
RUCKEL: There was no right, there was no wrong in the orphanage. You didn't know the difference because you were never taught. I was put in charge of kids, and I treated them just the way they treated us. If you didn't listen to me, I'd beat you. If you listened to the workers over me, I'd make sure that you'd get a beating. And remember, I'm here longer than the workers will ever be. I live here.
(SOUNDBITE OF ARCHIVED AUDIO OF CHILDREN IN ORPHANAGE)
HAMILTON: The world learned about Romanian orphanages after the nation's repressive government was overthrown in 1989. And before long, researchers began studying how the orphans had been affected by their experiences. Charles Nelson, of Harvard University, first visited Romania in 1999. A year later, he videotaped some of what he saw in a large institution in Bucharest.
One clip shows a room full of toddlers. Some resemble children with autism, as they rock back and forth on the floor. Nelson says others were desperate for attention from any adult.
CHARLES NELSON: They'd reach their arms out, as though they're saying to you please, pick me up. So you'd pick them up and they'd hug you, but then they'd push you away. And then they'd want to get down. And then the minute they got down, they'd want to be picked up again. It's a very disorganized way of interacting with somebody.
HAMILTON: Many of the orphans also had difficulty with language and cognition and emotional development. All of this suggested problems with the brain. So Nelson and other researchers began studying the children using a technology known as EEG, which measures the brain's electrical activity.
NELSON: And we noticed that their EEG was dramatically reduced, meaning that they produced less brain activity. The metaphor might be instead of a 100-watt light bulb, it was a 40-watt light bulb.
HAMILTON: Nelson says as the kids grew older, the researchers were able to use MRI to study the anatomy of their brains.
NELSON: And we found a dramatic reduction in what's referred to as gray matter and in white matter. In other words, their brains were actually physically smaller.
HAMILTON: Nelson says the problem wasn't malnutrition. It was a different kind of deprivation.
NELSON: The baby comes into the world expecting someone to take care of them and to invest in them. And then they form this bond or this relationship with that caregiver.
HAMILTON: But for many Romanian orphans, there was no one to even take them out of their crib.
NELSON: Instead, now what happens is that you're staring at a white ceiling, or no one is talking to you, or no one's soothing you when you get upset. Then what happens is that the wiring of the brain goes awry. So neglect is really awful for the brain.
HAMILTON: It certainly wasn't good for Izidor Ruckel. Ruckel was 11 in 1991, when he was adopted by an American family and moved to San Diego. Things went pretty well at first. But he didn't really bond with his adoptive parents. And soon, there was a lot of anger and conflict. Ruckel says it wasn't his parents' fault.
RUCKEL: I respond better when you beat me, or when you smack me around. That never happened. When you show me kindness, when you show me love, compassion, it seemed to make me even more angrier.
HAMILTON: Ruckel says over time, his anger became increasingly intense.
RUCKEL: I felt angry to a point where I could feel my heart is turning black. And at the same time, I have been raised in a Christian home. And, you know, with my Christian faith, I always wondered, am I a child from Hell? What went wrong with me?
HAMILTON: Researchers can't answer that question. But they are figuring out which areas of the brain seem to be altered by neglect.
Nim Tottenham is a researcher at UCLA who has been studying brain circuits involving the amygdala, an area that plays a critical role in emotional reactions. In one experiment, her team measured activity in these brain circuits while typical kids looked at a picture of an unfamiliar woman or their mother. Tottenham says Mom produced a lot more activity.
NIM TOTTENHAM: So the amygdala really clearly discriminated pictures of moms from strangers.
HAMILTON: Then Tottenham and her team tried a similar experiment with kids who had been adopted after spending time in an orphanage or some other institution. This time, the kids saw pictures of either an unfamiliar woman or their adoptive mother.
TOTTENHAM: What we observed in the previously institutionalized group, on average, was that the amygdala signal was not discriminating moms from strangers.
HAMILTON: Their brain had the same response to all people. Tottenham says this could explain why neglected children demonstrate what's known as indiscriminate friendliness toward strangers. It could also help explain why some adopted children have trouble forming a close bond with their new parents.
Tottenham, who is a parent herself, says the research on neglected children offers a reminder of something that should be obvious.
TOTTENHAM: Parents are playing a really big role in shaping children's brain development. And sometimes, it's easy to forget that because it's very hard to appreciate the significance of something that's always around.
Neglected children are most likely to develop a typical brain, and typical behavior, if they are placed in a good home by around age 2. Izidor Ruckel says his brain probably isn't typical, though he's never tried to find out. He says what's important is what he's done with his life. After leaving home at 17 and avoiding contact with his family for several months, he learned that his parents had been in a serious car crash. He went to the hospital.
RUCKEL: It was really hard because I wanted to make sure that they were OK. I was scared. And I didn't think I was going to be forgiven for everything I'd put them through.
HAMILTON: But he was. And in the years since then, Ruckel says, he and his adoptive parents have become very close.
RUCKEL: I believe that even the brain cells that don't work as a child, I believe that they can develop as a grown man. I don't know how to explain any better than that, but there are some parts of the brain that don't work, that do come to life.
HAMILTON: In a way, he's right. Scientists say the brain can often compensate for things that go wrong during development, and Ruckel says maybe that's why he's been able to make something of his life.
RUCKEL: I'm not this brightest person on earth. But I think I've done pretty good. You know I'm on my own. I'm 33 now. I've written a book; I've produced a documentary. I've become an advocate fighting for other orphans. And I believe that has everything to do with my parents because I realized what love, what compassion, what affection can do.
HAMILTON: Ruckel's book tells his own story. His documentary is about being adopted. And these days, Ruckel is trying to raise money for another documentary - about the Romanian orphans who were not adopted.
Jon Hamilton, NPR News. Transcript provided by NPR, Copyright NPR.