Study links severe childhood deprivation to neuropsychological difficulties in adulthood

Summary: Severe adversity experienced in childhood increases the risk of being diagnosed with ADHD later in life.

Source: University of Southampton

A team of researchers from the University of Southampton, the University of Bath and King’s College London, have provided compelling evidence of the impact of adversity in childhood on neuropsychological functioning in adulthood. They also showed that neuropsychological difficulties may explain why early adversity is linked to attention deficit hyperactivity disorder (ADHD) in later life.

Their study, published in the journal Psychological Medicine, analysed neuropsychological function in 70 young adults who were exposed to severely depriving conditions in Romanian orphanages during Nicolae Ceausescu’s regime and subsequently adopted by British families. The adoptees were compared to 22 British adoptees of similar ages who had not suffered childhood deprivation.

As part of the research, the adoptees were asked to carry out tests to assess their neuropsychological functioning in five areas: controlling their responses (inhibitory control), prospective memory, decision-making, emotional recognition and cognitive ability (IQ). Prospective memory is the ability to remember to do something in the future, such as remembering to go to an appointment or what you need to buy if you don’t have a shopping list. ADHD and autism spectrum disorder (ASD) symptoms were assessed through questionnaires completed by their parents.

The results showed that the Romanian adoptees had lower IQs and performed less well on the other four tests when compared to the adoptees who had not suffered deprivation. The adoptees with the lowest IQs and the greatest problems in prospective memory were more likely to show ADHD symptoms in adulthood than those without neuropsychological difficulties. The researchers found no direct link between ASD symptoms and neuropsychological performance.

The latest research is part of the wider English and Romanian Adoptees study, a collaborative study between the University of Southampton and King’s College London which began shortly after the fall of the communist regime in Romania.

Children living in the institutions were subjected to extremely poor hygiene, insufficient food, little affection and no social or cognitive stimulation. The study analyses the mental health and brain development of 165 children who spent time in Romanian institutions and who were adopted by families in the UK when aged between two weeks and 43 months.

This shows a child with a teddy bear
The researchers found no direct link between ASD symptoms and neuropsychological performance. Image is in the public domain.

The principal investigator of the study is Professor Edmund Sonuga-Barke, who began the study whilst working at the University of Southampton and is now based at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London.

Speaking of the latest research, Professor Sonuga-Barke said: “This study contributes to our changing understanding of the power of the early environment to shape brain development -showing that the effects of institutional deprivation on cognition can still be seen after more than twenty years of positive experience in high functioning and loving adoptive families leads us to acknowledge that there are limits to the brain’s recuperative powers.”

Dr Dennis Golm, Lecturer in Psychology at the University of Southampton, said: “The study highlights that institutional deprivation can have long-lasting effects on a range of neuropsychological functions that are important in everyday life, such as memory and general intellectual ability. Our findings also emphasise the importance of improving the quality of care for children in institutions.”

About this neuroscience research article

University of Southampton
Media Contacts:
Steve Bates – University of Southampton
Image Source:
The image is in the public domain.

Original Research: Closed access
“The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence”. by Edmund Sonuga-Barke et al.
Psychological Medicine doi:10.1017/S0033291720001294


The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence

Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment – the large-scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s –we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Adult neuropsychological functioning was assessed across five domains (inhibitory control, emotion recognition, decision-making, prospective memory and IQ) in 70 previously institutionalized adoptees (mean age = 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age = 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires.

Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory.

These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair long-term neuropsychological functioning across the lifespan – effects that are linked specifically to deprivation-related adult ADHD symptoms.

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