The right to grow

Sometime ago, I was struck by an unfamiliar image of a brain and its caption said it was that of an infant. It only showed the surface and it was incredibly smooth. This surface is the cerebral cortex, often called the “higher brain” because we humans have larger ones relative to those of other animals. The marbled gray-and-white folds of the infant brain were not as well-defined as in adult brains, the ones more often portrayed in brain models. These “folds” are made up of grooves (“sulci”) and bumps (“gyri”) and they make it possible for our brains to grow and still fit our skulls. “Gray matter” generally contains our brain cells while “white matter” forms the web that makes the brain cells connect. Together, they make up the scaffolding of our brain. I think this is such an amazing fact – that nature in our innermost spaces could be so imaginative in shaping itself to make room for new growth. But do our brains grow the same way, fair and square?

“Fair” is a state that nature does not worry about. You don’t need to be a brain scientist to figure out that there are differences in how an infant and adult think. Our brains develop according to what we were born with and the experiences we have. A group of scientists namely Margaret A. Sheridan, Nathan A. Fox, Charles H. Zeanah, Katie A. McLaughlin, and Charles A. Nelson III from several institutions that include the Boston Children’s Hospital and the Harvard Medical School wanted to see if there are differences in the brain structure of children in institutional care and those who have never been institutionalized. More importantly, they wanted to see if an intervention, like the placement of children from an institution to foster care would change their brain structures.  Their study entitled “Variation in neural development as a result of exposure to institutionalization early in childhood” was published in the August 2012 issue of the Proceedings of the National Academy of the US.

The researchers studied 79 children from Bucharest, Romania who were part of the Bucharest Early Intervention Project. In summary, the whole brains of institutionalized children (Group A) were smaller compared to those who have never been institutionalized (Group B). Also Group A had both smaller white and gray matter compared to Group B. However, those who were placed in foster care (Group C) had white matter and a corpus callosum (brain part connecting left and right hemispheres) that was comparable to children who were never institutionalized. However, gray matter remained significantly smaller for the institutionalized kids whether they experienced foster care or not.

The documented problems of institutionalized children include problems in learning and memory, language, and more cases of attention-deficit/hyperactivity disorder and “curbed” social skills. The researchers especially noted that these problems are also evident in children raised in environments characterized by “physical and sexual abuse, neglect, domestic violence, and chronic poverty.”

I think these findings strengthen the neurobiological basis of the rights of a child. Second in the list of the Declaration of the Rights of the Child is that the child has “the special right to grow up and to develop physically and spiritually in a healthy and normal way, free and with dignity.” Here, science gave us a direct view of the arrows of time shooting through a child’s brain and we saw that there is a marked difference whether that child was raised in an institution or not, and even if foster care came into play. It gave us solid evidence that “mass care” fundamentally compromises children’s brains.

This should help us reframe how we are going to take care of kids in institutions outside the context of family, foster or biological. Should we now restructure them to form more “family-like” support for these kids – smaller and more constant? How could communications technology help here? Should our institutions work harder to look for foster homes for kids with evidence now showing that they clearly redirect the growth of some parts of the child’s brain?

Of course, you don’t really reach out to a child in need and tell him “I am here to help you grow your gray and white matter.” We think of the whole kid – with his little frail body and fragile mind – shaping his life to form an arrow that does not recoil to its past but clearly points to what we adults have somehow reached – a series of tomorrows. Then, as we all know, in adulthood, it is another whole new adventure as we, alas, literally shrink our brains toward old age. See, I told you, nature never worried about being “fair.”

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