Institutional care: associations between overactivity and lack of selectivity in social relationships


Penny Roy, Department of Language and Communication Science, City University, Northampton Square, London EC1V 0HB, UK; Email:; Michael Rutter, Box Number P080, SGDP Research Centre, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK; Andrew Pickles, School of Epidemiology and Health Science, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK


Background:  The behaviour of children raised in institutional care in their early years is typified by heightened levels of inattention and overactivity irrespective of the quality of the care. There is some evidence that this behaviour may be specifically associated with forms of attachment disorder behaviours, but to date studies have been restricted to institutions characterised by high levels of malnutrition and lack of active experiences.

Methods:  Nineteen primary school age children admitted to good quality residential group care before the age of 1 year were compared with 19 children of the same gender reared in a foster family from the same age. A combination of observational, questionnaire, interview and psychometric measures was employed.

Results:  A fifth of the institutional children but none of the foster-family children showed a marked lack of selective attachment relationships with their caregivers. The same proportions were found for a lack of selectivity in friendships with their peers but the children showing these features were not identical. A lack of selectivity in relationships was strongly associated with inattention/overactivity, both as observed and reported. The pattern of a marked lack of selectivity and inattention/overactivity was evident only in the boys in the institution-reared group.

Conclusions:  It is concluded that the pattern represents a relatively specific response to some feature of an institutional rearing; nevertheless, it occurred in only just over a third of the institutional children, so that it is a far from universal consequence.