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A Closer Look: Q&A with Margaret Sheridan, PhD

Margaret Sheridan, PhD, research associate at Boston Children’s Hospital, is the lead researcher in a recently published groundbreaking study on the effects of institutional care versus foster care on brain development. The study, titled Variation in neural development as a result of exposure to institutionalization early in childhood, compares the brain structure of children raised in Romania’s state-run orphanages for the entirety of their childhood with children who were either never institutionalized or who spent their infancy in the orphanages and were delivered to high-quality foster.  The study concluded that not only was brain structure different for children who are institutionalized, but that some of the changes in brain structure due to early childhood neglect and institutionalization can be undone when the environment is improved.  Dr. Sheridan answers questions about her findings, which are the latest from a research program, known as the Bucharest Early Intervention Project (BEIP), that assesses the efficacy of high quality foster-care for children who were abandoned as infants and placed in orphanages in Bucharest, Romania.

What key questions or concerns informed your study?

We sought to better understand two things in our study. First, “What is the effect of environment on brain development?” Specifically, can improving environments (taking kids from institutionalization and placing them in foster care after 6-30 months in an institution) preserve typical brain development? The second question was, “Could differences in brain structure account for already observed differences in brain function?”

What about your findings surprised you?

The answers to the above questions were both somewhat surprising. First we found that some aspects of brain development in kids in foster care (who had been removed from institutions after 6-30 months) were not different from non-institutionalized kids – white matter, the connecting fibers of the brain. But other aspects were different for kids removed after 30 months – the grey matter or the part of the brain where processing occurs.  To preserve typical development of grey matter kids would probably have to be removed from institutions even earlier, or never be placed into institutions at all.

The answer to the second question, “Could differences in brain structure account for already observed differences in brain function?” was yes,  but only white matter changes accounted for the particular differences in brain function that we investigated. In some ways this is a “no brainer.” If we know there are differences in function, there must be differences in structure. However, we didn’t know if we would be able to measure or see these differences with our imaging techniques, and it turns out we could.

Your study concluded, “The increase in white matter among children randomized to an improved rearing environment relative to children who remained in institutional care suggests the potential for developmental ‘catch up’ in white matter growth, even following extreme environmental deprivation.” Do you think this can be generalized to other populations, such as children in the United States?

I think we need to do a lot more research before we can definitively answer this question. However, my hunch is that our results do have implications for other children exposed to childhood adversity in the United States and elsewhere.

Why or why not? What are the implications of your study for practice and child welfare?

I think it is clear from this study that high quality foster care, where the parents are supported as caretakers, has the possibility to preserve brain development when compared to raising children in institutions.

How do you anticipate expanding this study?

We are currently working on following these children into adolescence. Adolescence is a time of rapid brain development and change, I think seeing how these kids navigate adolescence will be very important.

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