The extent of developmental deficit and catch-up following
adoption after severe global early
privation was examined at 4 years in a sample of 111 Romanian children
who came to the
U.K. before the age of 2 years, and compared with respect to their functioning
at the same
age to a sample of 52 U.K. adopted children placed before the age of 6
months. The measures
at 4 years included height, head circumference, and general cognitive level
(assessed on both
the McCarthy and Denver Scales). The children from Romania were severely
developmentally
impaired at the time of U.K. entry, with about half below the third percentile
on
height, on weight, on head circumference, and on developmental quotient.
Many were also
in a poor physical state with recurrent intestinal and respiratory infections.
The catch-up in
both physical growth and cognitive level appeared nearly complete at 4
years for those
children who came to the U.K. before the age of 6 months, despite the fact
that their
background prior to U.K. entry was similar to the children who came to
the U.K. when
older. The developmental catch-up was also impressive, but not complete,
in those placed
after 6 months of age. The mean McCarthy General Cognitive Index was 92
compared with
109 for the within-U.K. adoptees. The strongest predictor of level of cognitive
functioning
at 4 years was the children's age at entry to the U.K. It was concluded
that the remaining
cognitive deficit was likely to be a consequence of gross early privation,
with psychological
privation probably more important than nutritional privation. A further
follow-up at age 6
years will determine whether there is continuing recovery after 4 years.