Lesson from Romania: Neglect and deprivation are bad for children’s DNA

Photo: Angela Catlin/Wikimedia Commons

The infamous orphanages of Romania have become laboratories for studying the effects of profound child neglect. We already know from this sad situation that depriving children of normal emotional and social interaction leads to lower IQ scores, high rates of mental illness and stunted physical growth.

Now there’s evidence that early adversity goes to the core of children’s DNA – prematurely shortening their chromosome tips, known as telomeres, and hastening how quickly their cells “age.”

“Orphanages” is a misnomer, because these state-run institutions mostly house children who were abandoned by their families. They are a legacy of the 1960s, when Romania’s Communist dictator Nicolae Ceausescu taxed all families with fewer than five children, and then built child placement centers to house the children whose families couldn’t support them.

By 1989, when Ceausescu’s government fell, more than 170,000 Romanian children were living in these institutions. Institutions where babies weren’t held when crying or changed when wet, but left lying on their backs in cribs for hours, staring up at bare white ceilings. Where children ate from bowls with their hands and slept two to a short, narrow bed, many sitting up. Where boys and girls wore the same clothes, got the same haircuts. (For more, read here and here.)

By 2000, the Romanian government had begun reuniting children with their birth families, cutting Romania’s institutionalized population in half. Around the same time, the Bucharest Early Intervention Project (BEIP) was born – a clinical trial comparing outcomes in children who remained in the institution with that of children who were removed to high-quality foster care at varying ages.

The study has so far shown that placing children in more nurturing environments – particularly before age 2 – can partially heal their emotional and behavioral wounds and significantly reverse the severe cognitive impairment that results from profound neglect.

BEIP’s telomere study, led by Stacy Drury and colleagues at Tulane University and published last week in the journal Molecular Psychiatry, found that children exposed longer to institutional care before age 5 had significantly shorter relative telomere length (compared to that expected for their age) when they reached age 6-10.

Chromosomes with telomeres at their tips, shown in green. The intensity of the green signal indicates telomere length, which is a measure of cellular "aging" and determines how many times a cell can divide. (Courtesy lab of George Daley)

“The telomere is designed to protect the chromosome, so accelerating how early in life telomeres lose length correlates with shortened life span,” says Charles Nelson, director of the Laboratories of Cognitive Neuroscience at Children’s Hospital Boston and a principal investigator of BEIP. “One question we are currently studying is whether telomere length can recover as a child spends more time in foster care, or whether the shortening we observed reflects a permanent change.”

The BEIP study contributes to a growing body of research linking early adversity with early shortening of telomeres.  In 2004, Elizabeth Blackburn (who received a Nobel prize in 2009 for co-discovering telomeres) and Elissa Epel, both at the University of California at San Francisco, reported that women who took care of children with chronic illnesses had shorter telomeres – the equivalent of having lost 9 to 17 years of life. Other studies have found shorter telomere length in adults who experienced adversity or abuse in childhood or who suffer major depression.

Spurred by BEIP findings, the Romanian government has started a network of foster care families and banned institutionalization for children younger than 2, unless they are profoundly handicapped. Hopefully in the future, there will be no children left in the institutions to study.