Coming to America
In the United States, Megan Gunnar, PhD, director of the Institute
of Child Development at the University of Minnesota, has helped
fill in other pieces of the puzzle. In 1999, she and her colleagues
launched the International Adoption Project, an extensive
examination of children adopted from overseas. She now has
nearly 6,000 names on her registry and her research is ongoing.
Gunnar has found certain brain changes are common
among children who came to the United States from
orphanages, including a reduction in brain volume and changes
in the development of the prefrontal cortex.
“Neglect does a number on the brain. And we see behaviors
that follow from that,” she says.
She’s found post-institutionalized kids tend to have difficulty
with executive functions such as cognitive flexibility, inhibitory
control and working memory. They are often delayed in the
development of theory of mind, the ability to understand
the mental states of others. Many struggle to regulate their
emotions. Often, they suffer from high anxiety.
One of the most common behaviors she sees among post-
institutionalized children is indiscriminate friendliness. “A
child who doesn’t know you from Adam will run up, put his
arms around you and snuggle in like you’re his long-lost aunt,”
Gunnar says. That friendliness was probably an important
coping technique in their socially starved early lives, she says.
“What’s interesting is it just doesn’t go away.”
Fox and his colleagues had also noted such disarming
friendliness in the Romanian orphanages. Initially, children
with indiscriminate friendliness were thought to have an
attachment disorder that prevented them from forming
healthy connections with adult caregivers. But findings from
the Bucharest Project as well as Gunnar’s own research have
demonstrated otherwise, she says.
In a study of 65 toddlers who had been adopted from
institutions, Gunnar found that most attached to their
new parents relatively quickly, and by nine months post-adoption, 90 percent of the children had formed strong
attachments to their adoptive parents. Yet that attachment
was often “disorganized,” marked by contradictory behaviors
(Development and Psychopathology, in press). A child might
appear confused in the presence of a caregiver, for instance,
sometimes approaching the caregiver for comfort, and other
times showing resistance.
“There were things that happened in terms of early
development, when they lacked that responsive caregiver, that
they’re carrying forward,” Gunnar says.
One of those things may be a disrupted cortisol pattern.
Cortisol, commonly known as the “stress hormone,” typically
peaks shortly after waking, then drops throughout the day to a
low point at bedtime. But Gunnar found that children with a
history of neglect typically have a less marked cortisol rhythm
over the course of the day. Those abnormal cortisol patterns
were correlated with both stunted physical growth and with
indiscriminate friendliness (Development and Psychopathology,
Indiscriminate friendliness may also be tied to the amygdala.
In a study using fMRI, Aviva Olsavsky, MD, at the University of
California, Los Angeles, and colleagues found that when typical
children viewed photos of their mothers versus photos of
strangers, the amygdala showed distinctly different responses. In
children who had been institutionalized, however, the amygdala
responded similarly whether the children viewed mothers or
strangers. That response was particularly notable among kids
who exhibited more friendliness toward strangers (Biological
Closer to home
Other researchers are also exploring physiological differences
in children who have experienced neglect. Around the time
Gunnar was launching her adoption study, Philip Fisher,
PhD, a psychologist and research scientist at the University of
Oregon, was working with American foster children. Initially,
he suspected the behavioral and developmental difficulties they
experienced stemmed from physical abuse. But as he shared
data with Gunnar and others, he realized they looked a lot like
Though cortisol tends to follow a daily cycle, it also spikes
during times of stress. Fisher expected that his foster children,
who had clearly experienced stressful situations, might show
high levels, too. Instead, he discovered something quite
different. “Their levels were low in the morning and stayed low
throughout the day,” he says.
Combing through the case records of the children in
his sample, he discovered that disregulated cortisol was not
associated with physical or sexual abuse, but with early neglect.
“This blunted daily pattern with low morning cortisol seemed
to be a hallmark of neglect,” he says. “That was a pretty powerful
In fact, abnormal cortisol cycles have previously been noted
in a variety of psychological disorders, Fisher says, including
anxiety, mood disorders, behavior problems and post-traumatic
stress disorder. But the good news: Cortisol patterns appear to
Fisher found that foster kids living with more responsive
caregivers were more likely to develop more normal
cortisol patterns over time. Kids living with caregivers who
were stressed out themselves didn’t show that recovery
(Psychoneuroendocrinology, 2007). “We’re more likely to see that
blunted pattern when they don’t get that support, and there’s a
lot of stress in the family,” he says.
Helping caregivers manage their own stress and develop
more positive interactions with their children may help reset
the kids’ stress responses. Fisher is now developing and testing
video coaching programs that aim to identify and reinforce
the positive interactions foster parents are already having
with their young children. “We can show people very precisely