these findings were correlated with the duration of trauma (although not with age of onset), with children who had been abused longer showing greater differences from their matched controls than children who were rescued after shorter periods of abuse.
These results are preliminary and require replication, but they suggest that a history of chronic and severe trauma in early childhood can be associated with alterations in fear-stress physiology and in brain development. At the same time, there is no reason to interpret these results as indicating permanent impairment. Indeed, there is no evidence on whether or how therapeutic interventions may affect the fear-stress system or the neurological development of children who suffer maltreatment early in life. There is, however, compelling evidence from research on children reared in orphanages and then later adopted into loving families of the remarkable capacity of the young child to recover from aberrant early care.
Children growing up in institutions have been the focus of a long-standing literature on early privation (Rutter, 1981a; Skeels, 1966). Studies of orphanage-reared children are now focusing on the wave of Romanian children adopted into families during the early 1990s (Benoit et al., 1996; Groze and Ileana, 1996; Morison et al., 1995; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998). This literature tells a compelling story about the severe developmental consequences of institutional care that affords neither stimulation nor consistent relationships with caregivers, which often confronts children with other physical adversities, including malnutrition, exposure to pathogens, and untreated chronic illness. It also reveals the remarkable recovery that characterizes many children exposed to these environments once they are adopted into loving homes, as well as the long-term impairments that continue to plague some of them many years after their life circumstances have improved. On both accounts, the fundamental message concerns the vital importance of consistent and committed adults in young children's lives.
Orphanage-reared infants and toddlers who have received adequate medical care and nutrition, but virtually no social or cognitive stimulation and few opportunities to establish a relationship with a consistent caregiver, show striking delays in motor and cognitive growth over the period of institutionalization (Provence and Lipton, 1962). They become extremely unresponsive, showing minimal crying, cooing, babbling, or motor activity. When tested in the orphanage, the deficits increase over time (Ames, 1997; Dennis, 1973; Provence and Lipton, 1962; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998).
When adequate physical care and developmentally appropriate stimu-