Children Need Care, Not Cleanliness

Instability and separation have lasting consequences for children.

Posted Oct 28, 2020

Guillaume de Germain/Unsplash
Source: Guillaume de Germain/Unsplash

Recent news reports have verified what many people have worried about for several years: Hundreds of children who were separated from their parents at the U.S./Mexico border have not been reunited, and the path to those reunions looks difficult at best. This is a deeply disturbing story, one brought to the attention of the nation at the time of the presidential debate last week. No one can look in a crystal ball and see what kinds of lives and experiences these children will have, but psychological research can give us some ideas.

Thirty years ago, the world learned that thousands of children in Romania were living lives of unimaginable deprivation. The dictator Nicolae Ceausescu’s policies limiting contraception and abortion and rewarding large families put impoverished families in the position of turning young children over to institutions which were poorly staffed and funded. When his regime ended and media were allowed access to the country, people around the world were shocked by the horrifying conditions of the malnourished and neglected children in the institutions. Children were adopted and taken into foster care when possible, and the institutions were somewhat better funded, but the sheer number of children meant that many still lived in the institutions. The effects of the deprivation these children experienced had never been systematically studied before – not because psychologists don’t care about these effects, but because the ethical principles of research mean that we don’t expose children to trauma for the sake of studying them! When a trauma like this occurs through some other means (in this case, poverty and governmental policies), researchers may be able to study those children in order to advance our understanding of the children’s responses.

Seeing a unique opportunity to explore the effects of deprivation on development, a team of developmental psychologists and neuroscientists studied the physical, neurological, and mental health of a group of the children for many years. Charles A. Nelson, a pediatric neuroscientist from Harvard, Nathan A. Fox, a professor of human development from the University of Maryland, and Charles H. Zeanah, a child psychiatrist from Tulane, teamed up with researchers in the U.S. and Romania to create a careful and ethical study. They followed children who had been institutionalized at different ages and been either placed in foster care or remained in the institution, and they compared those children to local children who were raised by their own birth parents (a control group). The children placed in foster care were randomly selected from those in the institution – a measure of experimental control not typical in these studies. They discovered lasting difficulties in the social and emotional health of children who had ever been institutionalized compared to the control group. Children had trouble forming healthy attachments to adults in their lives, and children who had been institutionalized for the longest periods had lasting cognitive and language deficits. In other studies, researchers such as Jana Kreppner and Michael Rutter of King’s College and the Institute of Psychiatry in London followed children who were adopted from Romanian institutions into British families and found that those children institutionalized for more than six months were likely to have impairments that made their lives and relationships difficult. Children placed in Romanian foster care after relatively short periods in the institutions showed some hopeful signs of resilience and recovery, and there are remarkable stories of children thriving in new adoptive homes that should give us hope for those children who are reunited with their caregivers.

The children at the U.S./Mexico border are clearly in a very different situation from those in Romania. However, given the limited research we have at our disposal about the long-term effects of instability and poor caregiving on children’s lives, we need to believe that their circumstances are deeply harmful as well.

Some politicians have an old-fashioned and, quite frankly, dangerous notion about children: That meeting their basic biological needs is sufficient for healthy development. The science is clear: Children need stability and responsive caregivers, not just food and a clean space, for healthy development. High-quality childcare, health care, and humane immigration policies are crucial in creating a society where children experience stability and connections with their caregivers. 


Fay Green, M. (2020, July/August). 30 years ago, Romania deprived thousands of babies of human contact: Here's what's become of them. The Atlantic.

Kreppner, J. et al. (2007). Normality and impairment following profound early institutional deprivation: A longitudinal follow-up into early adolescence. Developmental Psychology, 43, 931-946.

Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2014). Romania’s Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery. Cambridge, MA: Harvard University Press.

Rutter, M. et al. (1999). Quasi-Autistic patterns following severe early global privation. Journal of Child Psychology and Psychiatry, 40, 537-549.