The Impact of Neglect on Brain Development

The Early Intervention Foundation
Tuesday, March 26, 2019

Johanna Bick and Charles A. Nelson's 2017 paper provides a concise and accessible introduction to some of the main theories in brain development, prominent studies that have increased our understanding of the impact of early experiences on the brain, and research that indicates some of the most promising ways to ameliorate the impact of early adversity.

  • Authors: Bick and Nelson (2017)

The growing body of research into early brain development has been at the forefront of raising the prominence of the first 1,000 days in public discourse over recent years, with the Centre for the Developing Child at Harvard University playing a leading role in this.

The research

The authors start by explaining that brain development begins within weeks of conception and continues in to early adulthood, and that the brain continues to adapt and change throughout adulthood. This development is the result of complex interactions between biology and the environment.

Optimal development for babies, which is essential for typical physical, cognitive and emotional development, is most likely if they experience a stimulating and responsive environment. The authors highlight the difference between "experience expectant" development - experiences that are typically shared by all children, such as hearing noises, perceiving patterned light and having opportunities to move around and manipulate objects - and "experience dependant" development - experiences that vary from one child to the next, such as the opportunity to learn to read and write.

They go on to discuss how researchers assess the impact of early experiences on brain development by focusing on children raised in institutions, who typically do not have the opportunity to develop a relationship with a stable caregiver or receive the input which supports cognitive and emotional development. Studies on children growing up in institutional care have found lower levels of glucose metabolism in areas of the brain associated with cognition and emotion self-regulation; lower levels of white matter, which supports neural transmission across regions of the brain; functional and structural changes in areas of the brain associated with emotion, threat detection and processing of novel stimuli; and electrical patterns in the brain that have been associated with attention deficit, hyperactivity and impulsivity.

The Bucharest Early Intervention Project has provided evidence on the impact that removing children from institutional care has on their brain development. This study involved randomly assigning toddlers living in institutional care to either high-quality foster care or remaining in the institution. Although controversial, the long-term follow-up of these individuals has shown that those placed in foster care had a pronounced improvement in electrical brain activity by age eight, with those placed with foster carers before their second birthday showing activity comparable to children raised by their birth parents. Those in foster care also showed improvements in the amount of white matter in the brain - having levels not significantly different from typically raised children - while those who remained in institutions showed significantly reduced levels of white matter. No change in levels of grey matter or overall brain volume were observed.

Implications for policy

  • This evidence of the impact on brain development that children who grow up in institutions experience, alongside the impact that placing such children in more nurturing environments has on remediating these effects, has critical implications for social policy.
  • It makes clear that children growing up in neglectful and abusive situations face deficits in brain, behaviour and emotional development.
  • As the authors conclude, many vulnerable children stand to benefit if greater prioritisation is given to polices and programmes that increase access to prevention and intervention, and these children are likely to benefit from such programmes beginning as early as possible.


Early Experience and Brain Development, WIREs Cognitive Science, J Bick, CA Nelson (2017)

Romania's Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery, CA Nelson, NA Fox, CH Zeanah, Harvard University Press (2014)

Key Competencies in Early Cognitive Development: Things, People, Numbers and Words, K Asmussen, J Law, J Charlton, D Acquah, L Brims, I Pote, T McBride, Early Intervention Foundation (2018)

  • The Early Intervention Foundation is a What Works Centre that champions and supports the use of effective early intervention to improve the lives of children and young people at risk of experiencing poor outcomes

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