Jacqueline Bruce

International adoption of institutionally reared children: Research and policy

This article summarizes the research on the developmental outcomes of postinstitutionalized children and discusses the implications for social policy. Postinstitutionalized children often reach their adoptive families with varying degrees of physical growth retardation, cognitive delays, and socioemotional problems. Many children demonstrate remarkable recovery following adoption. Unfortunately, some of the children continue to display significant problems that require professional intervention. It appears that the childrens recovery may be influenced by their early experiences with their birth family and in institutional care, and there is suggestive evidence that postadoption experiences also play a role. These findings indicate that preadoption and postadoption services may support the outcome of postinstitutionalized children.

Morning cortisol Levels in preschool-aged foster children: Differential effects of maltreatment type†

Maltreated foster children are subjected to a range of early adverse experiences, including neglect, abuse, and multiple caregiver disruptions. Research suggests that such disturbances alter the development and subsequent functioning of the hypothalamic-pituitary-adrenocortical system. The current study was designed to investigate morning cortisol levels in 117 foster children and 60 low-income, nonmaltreated children. Maltreatment and foster care placement experiences were coded from official records. Analyses revealed that the foster children were significantly more likely than the nonmaltreated children to have low morning cortisol levels. Additionally, specific maltreatment experiences were significantly associated with the foster childrens morning cortisol levels. Foster children with low morning cortisol levels experienced more severe physical neglect than the other foster children. In contrast, foster children with high morning cortisol levels experienced more severe emotional maltreatment. These results suggest that specific early adverse experiences have differential effects on the functioning of the hypothalamic-pituitary-adrenocortical system.

Effects of Therapeutic Interventions for Foster Children on Behavioral Problems, Caregiver Attachment, and Stress Regulatory Neural Systems

Abstract:  Young children in foster care are exposed to high levels of stress. These experiences place foster children at risk for poor social, academic, and mental heath outcomes. The role of adverse events in stimulating neurobiological stress responses presumably plays a role in shaping neural systems that contribute to these problems. Systematic and developmentally well‐timed interventions might have the potential to change developmental trajectories and promote resilience. Moreover, understanding how specific dimensions of early adversity affect underlying stress response systems and how alterations in these systems are related to later psychosocial outcomes might facilitate more precise and targeted interventions. Data are drawn from two ongoing randomized trials involving foster infants/toddlers and preschoolers. Consistent with prior animal models of early adversity, these studies have shown that early adversity—particularly neglect, younger age at first foster placement, and higher number of placements—is associated with altered hypothalamic‐pituitary‐adrenal (HPA) axis function. The interventions under investigation have produced evidence that it is possible to impact many areas that have been negatively affected by early stress, including HPA axis activity, behavior, and attachment to caregivers.

Disinhibited Social Behavior Among Internationally Adopted Children

Postinstitutionalized children frequently demonstrate persistent socioemotional difficulties. For example, some postinstitutionalized children display an unusual lack of social reserve with unfamiliar adults. This behavior, which has been referred to as indiscriminate friendliness, disinhibited attachment behavior, and disinhibited social behavior, was examined by comparing children internationally adopted from institutional care to children internationally adopted from foster care and children raised by their biological families. Etiological factors and behavioral correlates were also investigated. Both groups of adopted children displayed more disinhibited social behavior than the nonadopted children. Of the etiological factors examined, only the length of time in institutional care was related to disinhibited social behavior. Disinhibited social behavior was not significantly correlated with general cognitive ability, attachment-related behaviors, or basic emotion abilities. However, this behavior was negatively associated with inhibitory control abilities even after controlling for the length of time in institutional care. These results suggest that disinhibited social behavior might reflect underlying deficits in inhibitory control.

Early Elementary School Adjustment of Maltreated Children in Foster Care: The Roles of Inhibitory Control and Caregiver Involvement

In this study, 85 maltreated foster children and 56 non-maltreated community children (M age=3-6 years) were assessed across kindergarten and first grade to examine the hypothesis that inhibitory control and caregiver involvement mediate associations between a history of maltreatment and foster placement and early school adjustment. Specifically, academic and social-emotional competence were evaluated. The maltreated foster children performed more poorly in academic and social-emotional competence. Inhibitory control fully mediated the association of maltreatment and foster placement with academic competence, whereas inhibitory control and caregiver involvement mediated their association with social-emotional competence. The results suggest that inhibitory control and caregiver involvement might be promising targets for school readiness interventions for foster preschoolers.

The X-Trials: Neural Correlates of an Inhibitory Control Task in Children and Adults

Event-related potentials (ERPs) were used to examine developmental differences between adults and 6-year-old children in the neural processes involved in an inhibitory control task. Twenty adults and 21 children completed a task that required them to selectively respond to target stimuli while inhibiting responses to equally salient non-target stimuli. Because this task had been previously studied using functional magnetic resonance imaging (fMRI), the relation between the fMRI and ERP findings was informally examined. The results indicate that latency and amplitude of the P3 differentiated the different types of trials. However, the pattern of event-related neural activity differed for adults and children. These results, which suggest that adults and children may be using different processes to perform this task, have implications for the interpretation of the previous fMRI findings.

Individual differences in children's cortisol response to the beginning of a new school year

The relationship between salivary cortisol levels at the beginning of the school year and parent reports of temperament using the Childrens Behavior Questionnaire (CBQ) were investigated in 35 first graders. Cortisol was sampled in the morning, afternoon, and evening on the first and fifth days of school and two weekend days later in the school year. On the first day of school compared to weekend days, children displayed a steeper cortisol slope across the day due to lower afternoon and evening levels. By the fifth day of school, cortisol levels, on average, were not different than on weekend days. However, using change scores to reflect the response to school days relative to weekend days, children who scored higher in Surgency (i.e., enjoyment of intense play, high activity level, impulsivity, lack of shyness) continued to display a steeper cortisol slope on the fifth day of school with higher morning and lower evening cortisol levels. In contrast, shyness, which negatively contributes to Surgency, was positively correlated with evening change scores on the fifth day of school.

Indiscriminate Friendliness in Maltreated Foster Children

Indiscriminate friendliness is well documented in children adopted internationally following institutional rearing but is less studied in maltreated foster children. Precursors and correlates of indiscriminate friendliness were examined in 93 preschool-aged maltreated children residing in foster care and 60 age-matched, nonmaltreated children living with their biological parents. Measures included parent reports, official case record data, and standardized laboratory assessments. Foster children exhibited higher levels of indiscriminate friendliness than nonmaltreated children. Inhibitory control was negatively associated with indiscriminate friendliness even after controlling for age and general cognitive ability. Additionally, the foster children who had experienced a greater number of foster caregivers had poorer inhibitory control, which was in turn associated with greater indiscriminate friendliness. The results indicate a greater prevalence of indiscriminate friendliness among foster children and suggest that indiscriminate friendliness is part of a larger pattern of dysregulation associated with inconsistency in caregiving.

Using behavioral and electrophysiological measures to assess the effects of a preventive intervention: a preliminary study with preschool-aged foster children.

The current study was designed to explore the use of behavioral (i.e., accuracy and reaction times) and electrophysiological measures (i.e., event-related potentials) to assess the impact of a family-based preventive intervention for preschool-aged, maltreated children in foster care. These measures were recorded during a computerized flanker task designed to assess cognitive control and response monitoring. The sample was recruited from a larger randomized efficacy trial of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) and included foster children assigned to the intervention condition (n = 10), foster children assigned to a services-as-usual comparison condition (n = 13), and low-income, nonmaltreated community children (n = 11). The children’s behavioral and electrophysiological performance on the task was generally consistent with previous research with adults and older children. There were no group differences on the behavioral measures of cognitive control or response monitoring. Notably, however, group differences were observed on the electrophysiological measures of response monitoring. Specifically, the foster children who received services as usual were significantly less responsive to performance feedback about errors than the foster children who received the intervention and the nonmaltreated children. Applications of this methodology and implications of the results for future prevention research are discussed.

Cumulative effects of prenatal substance exposure and early adversity on foster children’s HPA-axis reactivity during a psychosocial stressor

Dysregulated hypothalamic-pituitary-adrenocortical (HPA) axis stress response has been reported among individuals with prenatal substance exposure and those with early adversity exposure. However, few researchers have examined the combined effects of these risk factors. Patterns of HPA reactivity among maltreated foster children with and without prenatal substance exposure (N = 53; ages 9–12 years) were examined using the Trier Social Stress Test for Children. Area under the curve with respect to increase (AUCI) analyses revealed that prenatal substance exposure or physical abuse significantly increased the likelihood of a negative AUCI (i.e., little or no HPA reactivity). Among children with prenatal substance exposure and physical abuse, 85% exhibited a negative AUCI. The results underscore the importance of addressing this combined risk.