From the latest issue of the American Journal of Psychiatry:
Young children living in institutions in Bucharest were enrolled when they were between 6 and 30 months of age. Following baseline assessment, 136 children were randomly assigned to care as usual (continued institutional care) or to removal and placement in foster care that was created as part of the study. Psychiatric disorders, symptoms, and comorbidity were examined by structured psychiatric interviews of caregivers of 52 children receiving care as usual and 59 children in foster care when the children were 54 months of age. Both groups were compared to 59 typically developing, never-institutionalized Romanian children recruited from pediatric clinics in Bucharest. Foster care was created and supported by social workers in Bucharest who received regular consultation from U.S. clinicians. Results: Children with any history of institutional rearing had more psychiatric disorders than children without such a history (53.2% versus 22.0%). Children removed from institutions and placed in foster families were less likely to have internalizing disorders than children who continued with care as usual (22.0% versus 44.2%). Boys were more symptomatic than girls regardless of their caregiving environment and, unlike girls, had no reduction in total psychiatric symptoms following foster placement.
Note the phrase “internalizing disorders” — it means that other types of disorders were not decreased by the expensive treatment. Moreover, the 22.0% “control” value is probably higher than what you’d find if all kids of that age were surveyed; I assume the kids found at pediatric clinics are less healthy than average. Although the experiment is trying to show a (negative) effect of institutionalization, it doesn’t even manage to do that very well, because of the cherry-picking aspect of the results. All in all, a horrible situation.
Micromeasures of development — something you can measure every week, for example — might help so that many little things could be tried with individual children rather than doing these difficult large-scale experiments.
The whole thing has the feel of the 1800s when to be institutionalized was to be at high risk for some sort of vitamin deficiency, such as pellagra or beriberi.
Help an idiot here. I tried to plug their numbers into a Bayes theorem table using their result. I that by their result 75% of of all children have internalizing disorders. Also, in their control group, twice as many had internalizing disorders vs. those that didn’t.
Is that what you are getting at with the “high” control number?
Of course maybe I just did it wrong.
Ok. I think I see it. The 75% number means not much. That shows that 75% of the kids in the study had the disorders, but that’s skewed because the control group was smaller than the experimental group. The fact that two thirds of the control group had the disorders was still noteworthy. So I tried seeing if the probability of having the disorders times the probability of being institutionalized would be very different from the 53% they quoted in the study. I got about 48% which is only different by 5%. I don’t know how to take the difference and interpret it as the two variables being dependent or not.
Perhaps I am only revealing my ignorance. Anyway, fun puzzle to try to research and interpret.
sorry, I have no idea how you got 75%. There is no “probability of being institutionalized” given in the abstract. Perhaps you are interpreting one of the numbers incorrectly.
The “control” number (22%) is higher than what you’d get if you got a random sample of non-institutionalized kids — that’s what I’m suggesting.
There was a probability of having ever been institutionalized _within_ the study group, 111 kids out of 170. (65%) And within the study group there was a 75% chance of having disorders from the control and experimental groups combined. From the figures given you could play sudoku and fill in a table with the groups and disorder variables and probabilities the results were disappointing.
Anyway, I’m totally not good at this and you are I’m sure quite busy. Thanks for replying.
the number of kids in each of the three groups (52, 59, and 59) are not any kind of random sample. They are set by convenience. By what the experimenter wants. Just as when you go to the store the number of loaves of bread you buy is your choice.
Statistics as you guys know can be skewed to say what you want them to say. I was a ward of the state… institutionalisation of any sort messes with your life. You don’t need a study to tell you that. My experience says ‘Institutions do not teach you how to live, they teach you what you must do to survive’. This is not living. Oh Seth, children are not lovaves of bread as you so eloquently put it!