ABSTRACT

When children’s development is out-of-step with expectations (for example, if they lack social or language skills appropriate for their age), this may reflect factors internal to the child, external factors, or, indeed, a combination of these. While the genetic basis for autism and ADHD is clear (see Newbury, this volume) approximately half the children that Rutter and colleagues studied who were adopted from Romanian orphanages following 6 months or more of institutional care had autistic-like features, cognitive delay, inattention/hyperactivity, and disinhibited attachment (Kreppner et al., 2007). This is a much higher proportion than would be expected to demonstrate these traits in the general population who have not suffered such horrific early deprivation. Similar observations can be made about language impairment: while genetic sources for developmental language deficits have been demonstrated (see again Newbury, this volume), as many as 50 percent of children from socially disadvantaged backgrounds do not have language skills appropriate to their age (Locke, Ginsborg, & Peers, 2002). Again, this greatly exceeds expected rates of impairment arising from child-internal factors. We would obviously expect some of those Romanian orphans to have had autism or ADHD, and some children with low SES to have language impairment; we might also expect that effects of external factors will be intertwined with internal factors (see Thomas, Baughman, Karaminis, & Addyman, this volume). But if children have impaired language skills, does it matter what lies behind these?