Siret is a northern town near the border with Romania. It is an isolated place; ideal to hide away children not considered ”normal”. In the 1980’s, during the Communist era, Siret was home to 2,000 orphaned, sick and abandoned children.
Criminal complaint for the death of 340 children, in the Siret horror orphanage, during communism. Valentin Nas shared the link.
The image of the children in the Siret Orphanage is from the personal archives of Ronald Federici.
BY FLAVIA DRĂGAN | Updated: June 25, 2018 – 5:21 PM
The Institute for the Study of Communist Crimes (IICMER) has filed a complaint with the Attorney General’s Office concerning the inhumane treatment of orphaned children confined in the Siret Hospital for Children with Chronic Neuropsychiatric Condition (HCCNC). 340 children died there between 1980 and 1989.
IICCMER has denounced the deaths which occurred in the last decade of the communist regime. The largest number of deaths, 81 children, was recorded in 1981.
According to IICCMER’s statement released to the editorial, most children died of illnesses that could be treated, and for most of them the deaths were caused by the inhumane way they were treated in the orphanage. A very large number of children have died during winter, most of them due to pneumonia, epilepsy, heart, kidney, and liver diseases.
Figure: Deaths in the Siret HCCNC, by age (Jan. 1980 through May 1991)
Most children died when they were between one and four years old. Many of the children admitted to the Siret orphanage were from Suceava County, but also from Bucharest, Bihor, Timiş, Dâmboviţa, Constanţa.
Figure: Evolution of deaths in the Siret HCCNC (1980-1991)
“Following the analysis of death documents and death certificates, carried out by IICCMER experts and by a team of forensic pathologists, we have found that, on the one hand, there were increased mortality rates in the case of easily preventable or early diagnosable and properly treatable pathologies, and, on the other hand, there were deaths that support, by their very nature, our conclusions regarding the existence of a regime characterized by inhumane treatments applied to minors in the hospital.”
309 employees at the hospital-orphanage in 1989
The HCCNC was operating under the Ministry of Health and was headed by a doctor/manager appointed by order of the minister. Since its inception in 1956 until 1991, the hospital has been administered by nine doctors, and the last of them has been running the hospital-orphanage for 24 years.
At the end of the 1980s, the orphanage included 14 specialist doctors, 109 nurses, 115 auxiliary staff, 12 administrative staff, 12 staff runing the school and 47 workers.
There is a legend that hundreds of children were left to die in a field.
Since the establishment of the hospital-orphanage in 1956 until 2001, 1,500 children have died of the total of 8,886 children who have been placed in the Siret institution.
After the death of 81 children in 1981, the number of deaths fell in 1982 and 1983 following the management’s decision to transfer out a very large number of children.
Figure: Main causes of death in the Siret HCCNC (1980-1991)
– Pulmonary affections 68%
– Epilepsy 13%
– Others 8%
– Heart conditions 3%
– Kidney problems 7%
– Liver problems 1%
Among the staff who worked at Siret HCCNC during the communist era there is a legend of an order coming from the Communist Party leadership regarding the fast release from hospital of a large number of patients, an order which was quickly executed at the end of November 1983. The hospital register has recorded the transfer of 750 children over just a few days at the end of November 1983. According to former employees, a large number of these children, especially those with unknown parents, have never reached their transfer destinations, being instead isolated on a field and left to die without being registered.
IICMER states that it could not confirm the information, but it continues the checks.
Criminal complaints to follow for the period 1956-1980
IICCMER said it would file criminal complaints for inhumane treatments for the period 1956-1980, but “given the high volume of work, we can not predict when the actions will materialize,” the Institute’s spokeswoman added.
Last summer, IICCMER has filed another criminal complaint with the Attorney General’s Office for the inhumane treatment of children hospitalized in the Cighid, Păstrăveni and Sighetu Marmaţiei home-hospitals. 771 children have died there from 1973 to 1990. In that case, the prosecutors from the Attorney General’s Office have started in criminal investigations.
Reports of sexual abuse, physical abuse, emotional abuse, child-trafficking and suicide, consistently appear in the media regarding the abandoned children in these institutions.
Over the past twenty years, Hope and Homes for Children, Romania, has closed 56 institutions, including the Nassau Foster Centre, and built and moved institutionalised children to one hundred and four family type homes.
The degree of declaration of adoptability did not increase at all one year after the revised law on adoption was implemented, keeping it below 6% of the number of children in the system.
In March 2016, there were 57,581 children who had been abandoned by their families and entered the child protection system.
This report is the result of an analysis of the situation of abandoned children in the child protection system, carried out by the Romania Without Orphans Alliance.
The report was made public at the start of the A.R.F.O Summit, held in Bucharest, November 2017.
The report shows that the declaration of adoption for children where there is no possibility of being reunited with their biological families, is hampered by over exaggerated legislation and poor implementation of legislation.
The very small number, only 1.5% of children being adopted, highlights a worrying practise to keep children in institutions.
Another aspect highlighted by the report is that, whilst private organisations are not allowed to provide services unless they are licensed, 83% of public services do not have a license and do not meet mandatory minimum standards.
Romania’s institutions have a history of neglect, physical, sexual and emotional abuse which still continues to this day and causes emotional, physical, and mental scars.
Institutionalized care, according to Dr. Victor Groza, the Grace F. Brody Professor of Parent-Child Studies at the Mandel School of Applied Social Sciences at Case Western Reserve University in Cleveland, Ohio, causes problems with developmental, physical, psychological, social and brain health. Dr. Groza stated, “The regimentation and ritualization of institutional life do not provide children with the quality of life, or the experiences they need to be healthy, happy, fully functioning adults.” They are also unable to form strong and lasting relationships with adults, leading to severe problems with socialization, primarily building trust and lasting relationships amongst adults and children alike.
This article, kindly provided by Dr. Victor Groza, is an easy to follow guide to the risks inherent to children institutionalised at an early age. Dr. Groza has been developing social work education and promoting best practices in child welfare and domestic adoptions in Romania, since 1991.
Victor Groza; PhD,LISW-S Grace F. Brody Professor of Parent-Child Studies, Director; Child Welfare Fellows Program Jack, Joseph and Morton Mandel School of Applied Sciences, Case Western Reserve University, Cleveland, Ohio.http://msass.case.edu/faculty/vgroza/ – Faculty website for further reading.
https://www.facebook.com/adoptionpartners/?fref=ts – Website about Professor Groza’s post-adoption practice.
And fresh, scrubbed face, sleeping there.
Your well-loved toys around your head,
Your battered slippers on the bed.
I could creep out
Just leave a smile,
But perhaps I’ll sit here for a while.
I’ve kept you warm and fed and dry,
I’ve wiped the teardrop from your eye.
We’ve fought, we’ve laughed
Through bad through good,
But most, I hope, you’ve understood.
You gave me love, a hug, a smile.
Yes, perhaps I’ll sit here just a while.
Tomorrow, you will leave with Mum,
Uncertain whether harder times will come.
It’s not enough to love and feed,
For, deep down, it is Mum you need.
It’s harder now to raise a smile.
I’ll just sit here and watch you for a while.
There will be another when you have gone,
But, just like losing my unborn,
Each child’s a person, different, new,
So I will shed a tear or two.
It is good you are sleeping,
For I can’t smile.
I’ll just sit here and weep a while.
You are so loved, but you are not mine.
In a way, I am yours, so that’s just fine.
I chose to give you of my heart,
To share, to help and then to part.
So, though you’ll barely wave, I’ll bravely smile,
And continue to love you for a long, long, while.
Copyright ; Megan Simmonds.
Photo courtesy of annie-spratt; Unsplash
The Romanian Prime Minister, Dacian Colios, pays tribute to the dedicated work of ” Hope and Homes for Children”.
He says that there are still 57,000 children not in their families and that the problem of institutionalised care, caused by poverty, is the most critical problem facing the country.
The governments objective is that by 2020, there will no longer be any children in institutions. The government is putting a framework in place to implement new laws to provide families with financial assistance and prevent poverty.
Sunday, 10 April
Prime Minister Dacian Cioloș attended the Hope Concert organized by Hope and Homes for Children Romania Foundation
Address by Prime Minister Dacian Ciolos at the Hope Concert
Dacian Ciolos: Good afternoon. Congratulations, Olga, for the strength you found to continue your way in life despite what people offered you and congratulations to those who found the wisdom, by that time and ever since then, to demonstrate that nothing is irreversible and that along with funds and laws, we can find in us the force and love, and the determination to overcome the most critical moments that this country was confronted with. This issue of institutionalized children was and is one of the critical problems our country is confronted with, and this is why, we should demonstrate that we are able to solve it, and find a resolution for it through ourselves and not just pushed by those outside. Congratulations “Hope and Homes for Children”, for what they achieved and those who helped us that way, but, first of all, we should find the determination in ourselves. I am sure that this problem of institutionalized children is like a test for us, so that we can demonstrate that beyond the love we can find for the one close to us, the family, we can find love to take our children home, as these are our children, are the children of the country, and the way in which we are able to care for them and help them find their way in life, proves that each of us is able to give this country and this nation a path as we want and we wanted it back then, in December 1989. Romania started in 1990 with 100,000 institutionalized children in over 700 centers and, slowly, things have changed. Unfortunately, today, we still have 57,000 children who, in one way or another, are not in their families; for much of them, solutions were found in other families or are cared for by social workers or are in centers that are more welcoming, but the problem still is not resolved. And that’s why I want to tell you that the objective that we take as a state – and here I speak for the government – and I am convinced that this objective will be fully met, regardless of who will be prime minister or the Government that will be in office. The objective we have set is that in 2020, we no longer have children in institutionalized centers. Those 8,000 children Mr. Dărăbuş was talking about – to be able to take them into families and to find them a place to find love around them, to find the wisdom of caregivers so as these children are able to find a way in life. But this is not enough. It is important to have the strength and wisdom to stop the bleeding, so that other children do not add to those whom we wish to see in families, and see them with a purpose in life. These are the two objectives that we meet through this package of measures against poverty which the Government released, and that bring together more financial resources from various sources, several measures, in order to create a safety net for those most vulnerable among us, to be able to overcome difficult times in different stages of life, to reach to be able to go to kindergarten, to be able to go to school despite the difficulties that some families may face and then, they should find a job, find housing. Therefore I wanted to put various measures – which were disparate and were treated coldly, institutionally – in a package for those people determined to find solutions, and who will also have the instrument for it, as many times, we have laws that can be good, we have money, but we do not find the structure, the framework whereby all these put together meet with the determined people, who are able to use these instruments so that we avoid reaching such problems, or to resolve emerging problems. Other objective that we meet is that over the next months, we find solution that these measures that the state makes available, can benefit and be used not only by state institutions –which have already changed, turned by a lot in good, but they still need further development to boost their efficiency, but also non governmental organizations that have demonstrated lately that they know to use these resources efficiently, and that alongside funds and laws, they find love to care for these children. I want to tell everybody who is in this room, representatives of NGOs, that “ yes, we need you”. The state needs you so that we find lasting solutions together for such things not to happen again in Romania and for us to be able, as of 2020 onwards, to look into these children’s eyes and to promise them a future. It is also important to find resources for families in difficulty to receive the support they need to keep their children, because I am sure that no parent wants to abandon their children when he has the means to provide him a future. Therefore, congratulations “Hope and Homes for Children”, congratulations to all who initiated this law and once again, I am leaving from here hoping that we will all find in us the love that would allow us to find solutions to the problems we are facing. Thank you.
The Effect on socio-emotional intelligence.
The Effects on Linguistic Development
The Legacy of Institutionalisation on Mental Health.
The Effects of Institutionalization on Children
Institutionalization of orphaned and unwanted children has been a long-standing Western tradition, and only in the last century has society begun to realize the damning ramifications of the practice on children. This form of care still remains common in a few former Soviet countries, tragically condemning children to a life of stunted development. This article, then, will tackle the effects of institutionalization of children in former Soviet countries in particular, starting first with the history of institutionalization practices the typical institutionalization experience is like in former Soviet orphanages, and then its profound effects on physical well-being, intelligence, and socio-emotional development.
The State of Orphanages in Eastern Europe
Historically, orphanages in Western cultures have followed the “medical model” approach to childcare—namely, that good caretaking consists of meeting a child’s basic physical needs, with little emphasis on caregiver affection and the attachment needs of children. Most developed Western countries moved away from this model in the 1950s, after the pioneering work of John Bowlby’s attachment theory and Harry Harlow’s work with monkeys showed that healthy attachment is essential for normal development. However, both institutionalization and the medical model approach remains prevalent in former Soviet countries, with several hundred Russian orphans still living in orphanages. Infants in these orphanages are fastidiously kept for, well-groomed and well-fed, but human interaction is minimal. Infant-to-staff range anywhere from 8:1 to 35:1, meaning that infants receive only a bare minimum of human interaction. Frequently, they are frequently left in cribs for a good majority of the day and only receive interaction with staff when their basic needs, like feeding and bathing, are met at predetermined times, and the rest of the time, they must lie in their own feces and urine. Staff members rarely hold or cuddle infants, and they routinely ignore crying, both due to policy and due to the sheer number of other children they must attend to. With so many children to manage, individual needs are ignored, prompting a report by Case Western Reserve University to call the orphanages “warehouses.”
The actual orphanage environment is no more stimulating. Groza, Ileana and Irwin described typical orphanages as “colorless, shockingly quiet and devoid of any of the usual visual or auditory stimulation,” and recalled one orphanage in which the 4-year-old children there had never once left the room assigned to them. Many orphanages lack proper schools and provide no educational or entertainment material for the children to peruse, meaning they must provide their own stimulation. Punished for being “hyperactive,” many children end up simply doing nothing at all. The sight of children staring blankly into space for lack of anything better to do is tragically common.
The Physical Effects of Institutionalization
The physical effects of such a deprived environment have been long noted. The noted nineteenth-century pediatrician Henry Dwight Chapin, for instance, discovered that there is a significantly higher infant mortality rate in institutions, even when infants were otherwise healthy, and this mortality rate was so high in 19th century orphanages that the term “hospitalism” was coined to describe the common plight of orphaned babies. At one Romanian orphanage, most children were below the 20th percentile for height and weight, rendering them more vulnerable to disease. Officials there estimated that mortality rates in the winter could be as high as 40%, and on any given year, about half of the children died within the first 24 months after arriving at the orphanage. Children who do manage to survive typically suffer stunted growth, generally at a rate of one month’s delay for every three months spent in an orphanage. Growth stunting for some children is so severe that they can be diagnosed with “psychological dwarfism,” a phenomenon in which emotional or abuse disrupts the secretion of growth hormones and stunts normal growth. It is not unheard of for such children to grow three to four inches in just a six-month time span after being adopted. While most health problems resolve within a year of adoption, children nonetheless remain smaller than their non-adopted peers throughout childhood. The longer the orphanage stay, the shorter the child tends to be for their age.
Complementing this physical stunting are motor skill development problems, like possessing low muscle tone and not demonstrating age-appropriate motor skills. One study found gross motor delays and fine motor delays in 70% and 82% of Russian children, respectively. Like the other physical effects mentioned above, these motor skill problems resolve themselves in more stimulating environments.
The Socio-Emotional Effects of Institutionalization
Of course, the effects of institutionalization do not limit themselves to merely physical development. Indeed, the greatest legacy that institutionalization leaves is on children’s socio-emotional development. Perhaps the most well-documented effect is on attachment. John Bowlby noted that all children need a stable, responsible caregiver to attach to; without one, a child is set up to have difficulty with relationships later in life. By definition of being institutionalized, however, children in orphanages do not have a caregiver to attach to, as staff members work on shifts, may switch jobs, and have other children to care for—there is no one dedicated long-term to an individual child.
Generally, children who are institutionalized after the age of two and have had quality care during their infancy are not terribly affected by this indifference, but children who enter institutions before the age of one tend to do quite poorly. These children realize early on that no one particularly cares about them. Infants in nurseries are eerily silent, a direct result of learning early on that their vocalized distress will never be rewarded with attention. They frequently fail to attach to anyone, and, unused to physical contact, are highly sensory and tactively defensive and recoil from human contact if it is given. Unlike normal children, they become even more upset when someone tries to console them and prefer to “cry it out” by themselves, as that is how they are accustomed to doing.
Infants who present ambivalent and avoidant attachment to caretakers often go on to present characteristic disordered attachment styles later in life. The most common relational style seen in institutions is known as “indiscriminative friendliness.” Starved for affection and used to an ever-changing rotation of caretakers, these children seek affection inappropriately from everyone and anyone, including complete strangers. However, other children completely give up on soliciting affection from unresponsive caregivers and cease to be social altogether, instead developing what is known as “institutional autism.” Although not actually autistic, these children develop stereotypically autistic behaviors, like rocking, head-banging, stereotyped behaviors, and bizarre rituals, seemingly as a way of providing some stimulation in their own, otherwise sensually barren lives. Unlike autistic children, they stop this sensory-seeking upon placement in a more enriched environment.
These disturbed attachment styles, unfortunately, frequently persist after adoption. A full third of adopted Romanian children demonstrated avoidant attachment to caregivers, and an even higher percentage had only ambivalent attachment. Often, the most indiscriminately friendly children violently unravel in a post-institutional environment and become aggressive and controlling, deregulated by the lack of structure and the constant showering of warmth and affection they were denied for so long. Many attachment disordered children do eventually recover, but a significant minority of cases is eventually diagnosed with reactive attachment disorder. The prognosis for reactive attachment disorder is generally fairly poor, especially for older children. After a certain critical point of development, it seems, children simply cannot develop the capacity for normal, warm human relationships.
Related to the problem of attachment is social skills development. According to John Bowlby, if children are institutionalized for too long, the child will lose the ability to interact with other humans in a normal way. In one study of Romanian children, it was reported that while most parents were concerned that their children were too withdrawn and avoidant within the first year after adoption, after a few years, children’s greatest social problems were externalized. Parents frequently complained of aggressive, manipulative behavior and difficulty getting along with peers. The longer children had lived in an orphanage, the greater parents reported their difficulties to be, and the worse the impairment in intelligence, the worse the child’s social skills tended to be. Another study on Romanian children found that an astounding 55% of preschool-aged children were unable to demonstrate developmentally appropriate social skills like meaningful eye contact. Some children are so profoundly deficient in social skills that they arguably lack any sort of conscience or feelings for others at all and instead present symptoms of sociopathy.
The Effects of Institutionalization on Intelligence
Yet another well-documented, deleterious socio-emotional effect of institutionalization is intellectual disability. By school-age, a majority of Russian children living in orphanages are diagnosed with “oligophrenia,” a vague descriptor in Russia for “general mental deficiency,” and a study of internationally adopted children showed that upwards to 50%-90% of preschool-aged children had developmental delays upon arriving in their new country. Many children had multiple delays, usually in motor and language skills. Similarly, in another study of Romanian children, every single child in the study was developmentally delayed upon arriving in Canada and frequently tested into the borderline mentally retarded range. The more time a child spends in an orphanage, the more profound the intellectual impairment; for every year that a child spends in an institution, his cognitive development will be delayed by about six months.
Some of this damage is observable at the biological level. Total brain volume is significantly negatively correlated with time spent in an institution. The hippocampus in particular shows markedly decreased volume, which research has demonstrated is due to overproduction of cortisol, a hormone released in stressful situations. Repeated release of cortisol in stressful situations, like that of neglect in orphanages, destroys the hippocampus, which is central in learning and memory. Damage is not limited to the hippocampus, however; FMRIs of formerly institutionalized children have revealed that the prefrontal cortex tends to be both immature and reduced in volume, which leads to problems with impulse control and decision making. Accordingly, then, children do particularly poorly on tests measuring visual memory and attention, learning visual information, and impulse control.
Fortunately, most children usually make rapid gains in intellectual development upon removal from the institution environment. However, the legacy of institutionalization often lingers, as the precipitous drop in intelligence institutionalized children experience is not entirely reversible even after being placed in an optimal adoptive family environment. Three years after adoption, children in one study had only very modest gains in intelligence, and most scored in the low average IQ range. The longer a given child lives in an institution, the worse his intelligence tends to be, especially if the child has lived there since infancy.
Linguistic Development in Institutionalized Children
With no one talking to them, it hardly comes as a surprise that linguistic development is severely retarded by institutionalization, too. Language delays, in fact, are the most commonly diagnosed problem in post-institutionalized children. Children learn from interacting, not from passively hearing others, but this is exactly the opposite of what institutionalized children doing. Glennen discovered in an observation of a Russian orphanage that when language was spoken in the presence of children, it was usually between caregivers, and on the seldom occasion a child was spoken to, it was typically in the form of simple commands. Most activities, like meals, were conducted in almost complete silence. Accordingly, with no opportunity for actual practice, about 60% of 2 1/2 institutionalized children in one study had no expressive language whatsoever, and at age 3 1/2, only an astounding 14% were capable of speaking two-word sentences. Nonverbal communication skills are often no better; children’s skills tend to be either minimal or negative in nature, like hitting. Deficient language development is one of the hardest effects of institutionalization to undo; after certain critical linguistic periods are missed, no amount of intervention will ever fully remediate a child’s language deficits. A child’s rate of acquisition, then, literally determines his capacity for language later in life.
The Legacy of Institutionalization on Mental Health
Finally, institutionalization leaves individuals with a significantly hiked risk of mental illness and disturbed behavior. So common is disordered development that a specific mental disorder has been suggested specifically for post-institutionalized children, known as Developmental Trauma Disorder. This disorder is hallmarked by what is known as “mixed maturity,” in which children demonstrate normal maturity in some areas, but act like a much younger child in other areas. Academic skills, depth and appropriateness of relationships, and social skills tend to be more representative of those of a younger child. Frequently, these symptoms will mimic those of ADHD and PTSD’s, with poor social skills and hyperactivity. The stress of repeated traumatic events, such as institutionalization, changes the make-up of the central nervous system in such a way that children are biologically conditioned for a heightened fear/stress response. Children are maladaptively hypervigilant as a result, and because they frequently misperceive totally innocuous events as threats, they present immature, aggressive, and socially inappropriate behavior. The inability to pay attention and the hyperactivity is directed related to the degree of neglect, and is unrelated to low birthweight, nutrition, or intellectual disability.
Unsurprisingly, the prospects for children who are not adopted from these institutions is often grim. Of the approximately 15,000 children who grow out of Russian orphanages every year, the Russian Interior Ministry University estimates only about 20% are successful post-institution—10% commit suicide, 30% end up in jail, and 40% end up homeless. The cycle of child institutionalization tends to repeat itself, with many orphanages reporting that they have children who are the third or even fourth generation to have been institutionalized.
Adoptees do better, but still struggle, as these problems follow them even after they leave the orphanage. In her landmark study on institutionalized Romanian children, for instance, Ames noted that children frequently try to apply maladaptive behavioral strategies learned while in the orphanage to their post-adoption lives. Many children, for instance, engage in behaviors like stealing, manipulating, fighting, and lying, because doing so earned them extra attention or food in orphanages. Similarly, as testament to their highly regimented, unstimulating lifestyle, children can be highly dependent on others telling them what to do, often for years after adoption. Many cannot determine for themselves when to stop eating, and one study recounts that some children will lie in bed quietly for hours until prompted to get up.
Although many of these behaviors disappear as children acclimate to a stable post-adoption life, many other behaviors persist. Even in the best of adoptive environments, adoptees suffer a rate of mental illness about 70% higher than the general population. Their difficulties are not necessarily due to poor genetics, either; adoptees from China and Korea, which eschew institutions in favor of foster care, experience mental illness at a rate three to seven times lower than adoptees from former Soviet countries, which use institutions. Indeed, 72% of parents in Ames’ study of Romanian children cited their biggest concern with their children not to be anything physical or intellectual, but socio-emotional. More than a third of the children in the study needed professional help for behavioral problems several years after adoption. Children who are older at the time of adoption, who experience abuse, and who have multiple changes in caregivers were more likely to have problems. The most common problems included conduct disorder, antisocial behavior, poor relationships, and affective disorders.
Clearly, as has been demonstrated, institutionalization has a profound impact on every aspect of a child’s functioning. The gross amount of neglect, both physical and emotional, causes severe damage that is not always possible to undo, and the longer the time spent in the institution, the worse the effects. The vast majority of children never get adopted, meaning they languish in stunted emotional, cognitive, physical and social development forever. While there is hope for those who do get adopted, the effects of institution more often than not leave a damning legacy.
Ames, E. (1997, Fall). Orphanage experience plays key role in adopted Romanian children’s development. Retrieved fromhttp://www.nacac.org/adoptalk/orphanageexperiences.html
Aslanian, S. (2006, September 16). Researchers still learning from Romania’s orphans. Retrieved from http://www.npr.org/templates/story/story.php?storyId=6089477
Delaine, L. (2000, May 1). The plight of Russia’s orphans. Retrieved fromhttp://www.russianlife.com/blog/plight-orphans/
Federici R. (2007, July 18). The neuropsychology of bonding and attachment disorders. Retrieved from http://www.rainbowkids.com/expertarticledetails.aspx?id=57
Federici (2008). Raising the post-institutionalized child risks, challenges and innovative treatment. Retrieved from http://www.drfederici.com/raising_child.htm
Gindis, B. (2005, December 23). The second glance at institutional autism in internationally adopted children. Retrieved fromhttp://www.adoptionarticlesdirectory.com/Article/The-second-glance-at-institutional-autism-in-internationally-adopted-children/81
Gindis, B. (2011). Navigating uncharted waters: School psychologists working with internationally adopted post- institutionalized children. COMMUNIQUÉ, 27(1), Retrieved from http://www.bgcenter.com/communique-article.htm
Gindis, B. (2012, March 12). Internationally adopted child: Navigating between PTSD, ADHD, and DTD. Retrieved fromhttp://www.adoptionarticlesdirectory.com/Article/Internationally-Adopted-Child–Navigating-Between-PTSD–ADHD-and-DTD/184456
Groza, V. (1999, October). US policy promotes institutionalization of children in Romania. Retrieved fromhttp://msass.case.edu/faculty/vgroza/international/adoption/uspolicy.htm
Groza, V. (n.d.). Interview by A Martin [Web Based Recording]. Adverse impacts on children living in orphanage institutions. , Retrieved fromhttp://www.adoptvietnam.org/adoption/health-institutional-impacts.htm
Groza, V., Ileana, D., & Irwin, I. (n.d.). Dickens, Boys Town or purgatory: Are institutions a place to call home? Retrieved fromhttp://www.comeunity.com/adoption/institutionalism2.html
Meese, R. (2006, May 1). A few new children: Postinstitutionalized children of intercountry adoption. Retrieved fromhttp://www.adoptionarticlesdirectory.com/Article/A-Few-New-Children–Postinstitutionalized-children-of-Intercountry-Adoption/920
Nalven, L. (2004, October 1). The impact of early orphanage life on development. Retrieved from http://www.rainbowkids.com/ArticleDetails.aspx?id=218
Nalvin, L. (2004, October 1). The impact of early orphanage life on development. Retrieved from http://www.rainbowkids.com/ArticleDetails.aspx?id=218
Noble, K., Tottenham, N., & Casey, B. J. (2005). Neuroscience perspectives on disparities in school readiness and cognitive achievement. The Future of Children, 15(1), Retrieved from http://futureofchildren.org/publications/journals/article/index.xml?journalid=38&articleid=117§ionid=768
Russian Orphan Opportunity Fund. (2011, November 14). Life in the orphanage. Retrieved from http://www.roofnet.org/orphanage_life
Sanghavi. (2010, April 25). Adopted boy’s return highlights problems in Russian orphanages. The Washington Post. Retrieved from www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=9&ved=0CHkQFjAI&url=http://www.washingtonpost.com/wp-dyn/content/article/2010/04/23/AR2010042302223.html&ei=c8DgT63RKabN0AHfndGCDg&usg=AFQjCNEXAcSC6PDnzbeVxF9ZrYSHAMHhcg&sig2=29QZV_ZKz-gaTEY4JTXn9w
Society for Research in Child Development (2010, February 5). Length of time in institutional care may influence children’s learning. ScienceDaily. Retrieved June 27, 2012, from http://www.sciencedaily.com