Specificity and heterogeneity in children's responses to profound institutional privation.

Background The sequelae of profound early privation are varied.Aims To delineate the behavioural patterns that are specifically associated with institutional privation.Method A group of 165 children adopted from Romania before the age of 42 months were compared at 4 years and 6 years with 52 non-deprived UK children adopted in infancy. Dysfunction was assessed for seven domains of functioning. The groups were compared on which, and how many, domains were impaired.Results Attachment problems, inattention/overactivity, quasi-autistic features and cognitive impairment were associated with institutional privation, but emotional difficulties, poor peer relationships and conduct problems were not. Nevertheless, one-fifth of children who spent the longest time in institutions showed normal functioning.Conclusions Attachment disorder behaviours, inattention/overactivity and quasi-autistic behaviour constitute institutional privation patterns