Children Raised in Institutions at Increased Risk for ADHD

A child stares into space during classAt least 58,000 children are placed in institutional settings in the United States each year, and these institutions frequently fail to meet their basic physical, psychological, and intellectual needs. According to a new study, children raised in institutional settings may experience changes in brain development that can lead to ADHD.

Can Institutional Living Increase the Likelihood of ADHD?

The study drew its data from the Bucharest Early Intervention Project (BEIP), which tracks children raised from infancy in Romanian institutions. Researchers gathered data from 58 child participants in the BEIP project, then compared those children to 22 children raised in family homes. Researchers administered a brain scan to each child, and assessed each child for symptoms of ADHD.

Children who grew up in institutions had a marked reduction in cortical thickness across several brain regions, including the parietal, temporal, and prefrontal cortices. Institutionalized children also had more symptoms of ADHD, suggesting that changes in cortical thickness could play a role in ADHD. Several previous studies have found this correlation as well.

The study’s authors argue that the deprived environment of an institutional setting may alter brain development, and they emphasize the importance of providing mental health support to children living in institutional settings.

Environment and ADHD

Carey Heller, PsyD, a Topic Expert on inattention and hyperactivity, points out that the way a child is raised can affect both the child’s likelihood of developing ADHD and the way ADHD manifests. “It is important to keep in mind that the environment affects both biological components of brain development as well as learned behavioral expressions. Some individuals with ADHD are raised in settings where symptoms may not be as pronounced,” he says.

But not all cases of hyperactivity or inattention are due to ADHD. Heller cautions that some children may be misdiagnosed with ADHD when something else better explains their symptoms. “While individuals raised in institutions or other related settings tend to have higher rates of mental illness,” he says, “it is likely that issues with attachment, emotion regulation, and other items may be misdiagnosed in many cases as ADHD. Obviously there may well be many individuals in such settings who truly have ADHD, but misdiagnosis may help explain some of the increases in prevalence of ADHD in individuals raised in such settings.”


Institutional rearing may increase risk for attention-deficit disorder by altering cortical development. (2014, October 14). Retrieved from

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  • Brendan


    October 20th, 2014 at 3:59 PM

    Those who work in these environments for the most part do have the best interest of the kids at heart but I think that you will find that many of them have their hands tied by monetary constraints and they just don’t have the ability to give the one on one attention to these kids that many of the so desperately need.

  • elena


    October 21st, 2014 at 11:14 AM

    so this seems to be emphasizing the nurture role over nature

  • Mark


    October 23rd, 2014 at 11:09 AM

    If you look at the numbers closely enough we will probably find that a lot of terrible things are happening to our children as a result of being raised in this way. I would be willing to be that ADD and ADHD are not the only problems that they are facing and even when they are given pretty decent care, there is never going to be any substitute for being raised in a loving home with a father and a mother. These places I think for the most part do the best that they can with the resources that they are given but there are going to be times when some things only straetch so far.

  • Marie G.

    Marie G.

    October 27th, 2014 at 3:57 AM

    I am glad to see that there is the acknowledgement that misdiagnosis could be the answer too.

  • steven


    October 29th, 2014 at 3:50 AM

    Obviously growing up in a situation like this is not going to be ideal but for many of these children you have to look at what the alternative would be and decide whether this is actually preferable. I think that for most kids who end up growing up in this environment it is probably far better than what they would have encountered at home with a parent. And we also have to think about the things tat they could have been exposed to before coming to live in this environment and how much effect all of that had on them. It could be a combination of things that show the numbers being higher ion these kids.

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