Institutional Rearing and Psychiatric Disorders in Romanian Preschool Children.Charles H. Zeanah, M.D., Helen L. Egger, M.D., Anna T. Smyke, Ph.D., Charles A. Nelson, Ph.D., Nathan A. Fox, Ph.D., Peter J. Marshall, Ph.D., and Donald Guthrie, Ph.D. American Journal of Psychiatry - Early Online.
We have all hear the terrible stories of the inappropriate care for foster care / orphan infants and children in diverse locales, including Romania. Heart-wrenching stories of neglect.
We know those children are likely to have great emotional need, and problems in the future. You can't just set a kid in a crib, and feed the kid, and expect it to grow up well.
We human beings require a certain set of conditions in our infancy and childhood in order for us to grow up properly - emotionally, cognitively, socially, etc.
The International classification of Diseases (ICD) actually has a label, with corresponding diagnostic code for children who do not grow up with the suffiicent human warmth and care required to avoid health problems, emotional problems, developmental problems, socializing problems, etc. The label is "undersocialized."
Am J Psychiatry has just published an impressive, optimistic study: for a group of Romanian foster children, randomly assigned to either institutional, group foster care as usual, or placed in single-family homes, the children placed in the single family homes fared much better than the institutionalized children.
Additionally, these kids were compared to a set of children simply growing up in their bio families, with no notable neglect, and just recruited as a "normal" comparison group, out of pediatric practices.
Both groups of foster kids were worse compared to the kids growing up in normal families/homes.
So, it is not so good to be abandoned, and be in foster care, but if you are, it is better to be raised in a single-family setting than in an institution.
Here is the problem for everyone pushing psych drugs, ESPECIALLY FOR PRESCHOOL-AGE KIDS: that game is largely built on the claim that these are genetic, biologically-based "brain disorders" that REQUIRE a corresponding biological treatment: psychoactive medications.
People. let's wake up: that is disproven by this emerging Romanian evidence:
INFANTS AND CHILDREN NEED TO BE RAISED IN A CERTAIN TYPE OF ENVIRONMENT, or you will see resulting problems for which Dr. Biederman would quickly label "brain disorder" and prescribe corresponding "brain disorder" meds.
How can it be genetics? How can it be a "brain disorder"? The foster kids were RANDOMLY assigned to institution, or family home. The presence of a disorder depended upon this assignment, NOT genetics.
Even if the kids CAME FROM parents with mental illness genes, a reasonable thought since the mental illness genes may have contributed to the poor ability to parent / reason for fostering the child.
Even for this genetically-at-risk-for-mental-illness group of parents whose children have gone into foster care, the parenting dimension is critical.
What does this mean for us?
For us, it means that proper psychiatric assessment SHOULD include a thorough evaluation of the social and family circumstances. In all of the psych-drug-focused child studies I read, sponsored by Big Pharma, there is very little to NO info on how the role of insufficient social support was ruled out! What instrument was used to ensure that these factors were systematically assessed? These exist. The pharma-sponsored psychiatric researchers often willfully neglect this.
Furthermore: we know that there are psychotherapeutic interventions to address these behavioral problems. I have done it myself. For me, starting with kids at the age of five. Others have treated families with kids having behavioral or emotional problems younger than five. We have seen before-and-after success. That, plus the tons of empirical studies, is enough info for me, no matter how many drugs get approved to treat preschool kids with "brain disorders."
This emerging Romanian evidence tells us that we need to assess psychosocial setting, and address that, before Rxing the dangerous psych drugs.
In the two recent high-profile, horrifying deaths in preschoolers due to psych meds, we have EASILY DETECTABLE evidence of insufficient social support and parenting.
Destiny Hager: a 3-year-old, with two neglectful, drug-addicted parents, prescribed not one but TWO antipsychotic meds, and Rx AT LEAST ONE at FULL adult dose. She died from a med side effect - the meds caused her to have slowed bowel function, and sepsis (internal infection) resulted.
Rebecca Riley: a four-year-old, under "psych" treatment since the age of TWO and a HALF (?!?!?!) for "ADHD" and "CHILDHOOD BIPOLAR" died from POLYpharmacy to control "psych" problems that were bothering and disturbing the peaceful "retirement" of her unemployed, lazy, neglectful, drug-abusing, freeloader parents, including suspected-sex-abuser father:
How, in the social setting of either one of these preschool-age children, could anyone POSSIBLY begin psychopharmaceutical drug treatment, knowing that the social environment, as clearly noted in this Romanian study, is necessary for children, lest they end up with these behavior patterns?
We ALL saw the classic "Harlow's monkeys" pictures, and maybe videos, in college:
Even a monkey knows it needs a warm momma to cuddle up with.
I just don't know what to say. We have ALL the info we need right in front of our eyes to drive the clear family / social assessment needs for these preschool kids with emotional or behavior problems: get the family straightened out. Then see what, if any, problems remain.
This Romanian foster care study helps make it all the more clear.