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BUCHAREST -- Four-and-a-half years ago, Mimi was among the thousands of infants languishing in Romanian orphanages. A listless, joyless girl, she lacked the sparkle that draws sympathy -- and special attention -- even in a state facility. No overworked caregiver was going to waste time waggling fingers or making coo-coo sounds to blank-faced Mimi, abandoned at birth by her own mother. Then she got lucky. At the age of 18 months, Mimi was plucked from St. Ecaterina orphanage in Bucharest and entrusted to foster parents as part of a small but ambitious MacArthur Foundation-financed study of the effects of family rearing on formerly institutionalized children -- research that has spawned surprising controversy in Europe and beyond. The ongoing study strongly suggests that raising an abandoned child in a family setting is not just socially desirable but medically therapeutic to the child.
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Orphans given over to family care at a very early age -- ideally before age 2 -- are almost certain to grow up stronger, healthier, and smarter than those who remain in institutions. Even more dramatically, the study has found that foster care -- or better still, adoption -- appears to actually undo some of the developmental harm done to children in state facilities. But the speed of placement, getting a child into a family before too much institutional damage is done, may be at least as critical as the quality of the new home.
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'In almost every case, the sooner an orphan is placed with a family, the better off that child will be,' said Charles A. Nelson, professor of pediatrics at Harvard Medical School and one of the lead researchers on the Bucharest Early Intervention Project. The project comes at a time when 'international adoptions' (almost entirely by Americans) have become a hot-button topic in Europe, Africa, and Asia. Not since the Vietnam War has the United States been so generally mistrusted abroad, mainly because of the Iraq war and Washington's perceived arrogance. Romania -- even with 30,000 orphans in state facilities and infants abandoned at a rate of 20 a day -- has nonetheless slapped a moratorium on adoptions by all foreigners, a move that seems at least partly intended to stop the flow of infants to American families. Mimi, the orphanage girl, is among the more fortunate abandoned children -- she has found a permanent family in her native land. In 2001, when she was entrusted to foster mother Illeana Udeanu as part of the Bucharest study, Mimi was chronically ill, pathetically undersized -- unable to feed herself, unable to totter, and unable to talk.
'Her lips never smiled, her eyes seemed empty,' said Udeanu, who recently adopted the girl. Compared with the infamous orphanages of Romania's communist era, the facility where Mimi spent her first 18 months of life was neither cruel nor neglectful. Diapers were changed. Nutrition was adequate. Babies had blankets.
But children failed to thrive, almost shriveling in size and intellect with the passage of days, weeks, and months. Based on the study, which started in 2001 and is scheduled to continue through the end of the decade, Nelson and his fellow researchers are convinced that prolonged stays in even fairly well-run orphanages do extraordinary damage to the minds and bodies of children, especially if the institutionalization occurs during critical months of early development. 'A child placed in foster or adoptive care before the age of 24 months is going to have a higher IQ, a stronger body, and an all-around better chance in life than a child who stays longer in an institution,' said Nelson, who also directs the lab for cognitive neuroscience at Children's Hospital in Boston. The other lead researchers on the project are Charles H.