Many internationally adopted children are in institutional care prior to placement. Early research has been critical in illuminating the debilitating effects of institutional rearing and driving policy change worldwide. In the 1940s and 1950s several researchers, including Rene Spitz and John Bowlby, observed the conditions of institutions and described the devastating effects of minimal stimulation and social isolation. They suggested that sterile caregiving led to significant and sometimes irreparable delays in cognitive and socioemotional development. Ongoing research initiatives are beneficial in exposing the nature of present-day institutions and in informing policy decisions for children in out-of-home care.
