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Adoptees’ responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation

Adoptees’ responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation
Adoptees’ responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation
Background: Institutionally deprived young children often display distinctive patterns of attachment - classified as insecure/other (INS/OTH) - with their adoptive parents. The associations between INS/OTH and developmental trajectories of mental health and neuro-developmental symptoms were examined. Methods: Age four attachment status was determined for 97 Romanian adoptees exposed to up to 24 months of deprivation in Romanian orphanages and 49 non-deprived UK adoptees. Autism, inattention/over-activity and disinhibited-social-engagement symptoms, emotional problems and IQ were measured at 4, 6, 11 and 15 years and in young adulthood. Results: Romanian adoptees with over 6 months deprivation (Rom>6) were more often classified as INS/OTH than UK and Romanian adoptees with less than 6 months deprivation combined (LoDep). INS/OTH was associated with cognitive impairment at age 4 years. The interaction between deprivation, attachment status and age for ASD assessment was significant - with greater symptom persistence in Rom>6 INS/OTH(+) than other groups. This effect was reduced when IQ at age 4 was controlled for. Discussion: Age 4 INS/OTH in Rom>6 was associated with worse ASD outcomes up to two decades later. Its association with cognitive impairment at age 4 is consistent with INS/OTH being an early marker of this negative developmental trajectory, rather than its cause.
attachment, institutional deprivation, neglect, early adversity
0954-5794
Sonuga-Barke, Edmund
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Kennedy, Mark
a28c9dec-b498-4a96-aae3-f349bf41114b
Golm, Dennis
ae337f61-561e-4d44-9cf3-3e5611c7b484
Knights, Nicola
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Kovshoff, Hanna
82c321ee-d151-40c5-8dde-281af59f2142
Kreppner, Jana
6a5f447e-1cfe-4654-95b4-e6f89b0275d6
Kumsta, Robert
88285030-6a7c-4ef1-ba75-b78e09cd2f1e
Maughan, Barbara
c75367db-4ab9-4c7c-b498-762f08f1eade
O'Connor, Thomas G.
c070d197-b270-4603-84d9-7e5be5dede71
Schlotz, Wolff
ad120ba5-4482-4e57-8dbc-75ed2eb6fc7d
Sonuga-Barke, Edmund
180c5d1b-8848-41e4-ba25-2b6461a05b5e
Kennedy, Mark
a28c9dec-b498-4a96-aae3-f349bf41114b
Golm, Dennis
ae337f61-561e-4d44-9cf3-3e5611c7b484
Knights, Nicola
3ea6f0ad-3e08-4409-b743-541bfb534490
Kovshoff, Hanna
82c321ee-d151-40c5-8dde-281af59f2142
Kreppner, Jana
6a5f447e-1cfe-4654-95b4-e6f89b0275d6
Kumsta, Robert
88285030-6a7c-4ef1-ba75-b78e09cd2f1e
Maughan, Barbara
c75367db-4ab9-4c7c-b498-762f08f1eade
O'Connor, Thomas G.
c070d197-b270-4603-84d9-7e5be5dede71
Schlotz, Wolff
ad120ba5-4482-4e57-8dbc-75ed2eb6fc7d

Sonuga-Barke, Edmund, Kennedy, Mark, Golm, Dennis, Knights, Nicola, Kovshoff, Hanna, Kreppner, Jana, Kumsta, Robert, Maughan, Barbara, O'Connor, Thomas G. and Schlotz, Wolff (2019) Adoptees’ responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation. Development and Psychopathology. (doi:10.1017/S0954579419000506).

Record type: Article

Abstract

Background: Institutionally deprived young children often display distinctive patterns of attachment - classified as insecure/other (INS/OTH) - with their adoptive parents. The associations between INS/OTH and developmental trajectories of mental health and neuro-developmental symptoms were examined. Methods: Age four attachment status was determined for 97 Romanian adoptees exposed to up to 24 months of deprivation in Romanian orphanages and 49 non-deprived UK adoptees. Autism, inattention/over-activity and disinhibited-social-engagement symptoms, emotional problems and IQ were measured at 4, 6, 11 and 15 years and in young adulthood. Results: Romanian adoptees with over 6 months deprivation (Rom>6) were more often classified as INS/OTH than UK and Romanian adoptees with less than 6 months deprivation combined (LoDep). INS/OTH was associated with cognitive impairment at age 4 years. The interaction between deprivation, attachment status and age for ASD assessment was significant - with greater symptom persistence in Rom>6 INS/OTH(+) than other groups. This effect was reduced when IQ at age 4 was controlled for. Discussion: Age 4 INS/OTH in Rom>6 was associated with worse ASD outcomes up to two decades later. Its association with cognitive impairment at age 4 is consistent with INS/OTH being an early marker of this negative developmental trajectory, rather than its cause.

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Sonuga_Barke_et_al_DevPsyPath_2019 - Accepted Manuscript
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Accepted/In Press date: 21 March 2019
e-pub ahead of print date: 13 June 2019
Keywords: attachment, institutional deprivation, neglect, early adversity

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Local EPrints ID: 429417
URI: http://eprints.soton.ac.uk/id/eprint/429417
ISSN: 0954-5794
PURE UUID: 5cc51111-9b65-47ce-8d62-25882063ac4e
ORCID for Dennis Golm: ORCID iD orcid.org/0000-0002-2950-7935
ORCID for Hanna Kovshoff: ORCID iD orcid.org/0000-0001-6041-0376
ORCID for Jana Kreppner: ORCID iD orcid.org/0000-0003-3527-9083

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Date deposited: 27 Mar 2019 17:30
Last modified: 08 Oct 2020 04:01

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Contributors

Author: Edmund Sonuga-Barke
Author: Mark Kennedy
Author: Dennis Golm ORCID iD
Author: Nicola Knights
Author: Hanna Kovshoff ORCID iD
Author: Jana Kreppner ORCID iD
Author: Robert Kumsta
Author: Barbara Maughan
Author: Thomas G. O'Connor
Author: Wolff Schlotz

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