Orphans' Lonely Beginnings Reveal How Parents Shape A Child's Brain
by Jon Hamilton
Izidor Ruckel, with his adoptive father Danny Ruckel in San Diego, Calif., says he found it hard to respond to his adoptive parents' love.

Parents do a lot more than make sure a child has food and shelter, researchers say. They play a critical role in brain development.
More than a decade of research on children raised in institutions shows that "neglect is awful for the brain," says Charles Nelson, a professor of pediatrics at Harvard Medical School and Boston Children's Hospital. Without someone who is a reliable source of attention, affection and stimulation, he says, "the wiring of the brain goes awry." The result can be long-term mental and emotional problems.
A lot of what scientists know about parental bonding and the brain comes from studies of children who spent time in Romanian orphanages during the 1980s and 1990s. Children like Izidor Ruckel, who wrote a book about his experiences. Izidor Ruckel dons a hat of a style common in his birthplace, Romania. He now lives in Denver.

When Ruckel was 6 months old, he got polio. His parents left him at a hospital and never returned. When he turned three, he was sent to an orphanage for "irrecoverable" children.
But Ruckel was luckier than many Romanian orphans. A worker at the orphanage "cared for me as if she was my mother," he says. "She was probably the most loving, the most kindest person I had ever met."
Then, when Ruckel was 5 or 6, his surrogate mother was electrocuted trying to heat bath water for the children in her care. Ruckel was on his own in a place where beatings, neglect and boredom were the norm.
Polio had left him with a weak leg. But as he got older he found he had power over many of the other children who had more serious disabilities.
"There was no right, there was no wrong in the orphanage," Ruckel says. "You didn't know the difference because you were never taught. I was put in charge of kids and I treated them just the way they treated us. If you didn't listen to me, I'd beat you."

Researchers began studying the children in Romanian orphanages after the nation's brutal and repressive government was overthrown in 1989. At the time, there were more than 100,000 children in government institutions. And it soon became clear that many of them had stunted growth and a range of mental and emotional problems.

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When Nelson first visited the orphanages in 1999, he saw children in cribs rocking back and forth as if they had autism. He also saw toddlers desperate for attention.
"They'd reach their arms out as though they're saying to you, 'Please pick me up,' " Nelson says. "So you'd pick them up and they'd hug you. But then they'd push you away and they'd want to get down. And then the minute they got down they'd want to be picked up again. It's a very disorganized way of interacting with somebody."
The odd behaviors, delayed language and a range of other symptoms suggested problems with brain development, Nelson says. So he and other researchers began studying the children using a technology known as electroencephalography (EEG), which measures electrical activity in the brain.
Many of the orphans had disturbingly low levels of brain activity. "Instead of a 100-watt light bulb, it was a 40-watt light bulb," Nelson says.

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As the children grew older, the researchers were able to use MRI to study the anatomy of their brains. And once again, the results were troubling. "We found a dramatic reduction in what's referred to as gray matter and in white matter," Nelson says. "In other words, their brains were actually physically smaller."
The scientists realized the cause wasn't anything as simple as malnutrition. It was a different kind of deprivation — the lack of a parent, or someone who acted like a parent.

 A baby "comes into the world expecting someone to take care of them and invest in them," Nelson says. "And then they form this bond or this relationship with this caregiver." But for many Romanian orphans, there wasn't even a person to take them out of the crib.
"Now what happens is that you're staring at a white ceiling, or no one is talking to you, or no one is soothing you when you get upset," Nelson says. So areas of the brain involved in vision and language and emotion don't get wired correctly.
Izidor Ruckel says he suspects the wiring in his brain was changed by his time in the orphanage. And that may have contributed to his troubles after leaving the institution.
In 1991, when he was 11, Ruckel was adopted by an American family and moved to San Diego. At first things went pretty well, he says. Then he began to have a lot of conflict with his adoptive parents. Ruckel says it wasn't their fault.
"I respond better when you beat me, or when you smack me around," he says. "That never happened. When you show me kindness, when you show me love, compassion, it seemed to make me even more angrier."

And those feelings became increasingly intense. "I felt angry to a point where I could feel my heart is turning black," Ruckel says. "And at the same time I have been raised in a Christian home. And you know with my Christian faith I always wondered, am I a child from hell? What went wrong with me?"
Scientists can't answer that question for Ruckel or any other individual. But they now know that, as a group, neglected or abandoned children tend to have abnormal circuitry in areas of the brain involved in parental bonding.
When typical children are shown pictures of their mothers, the response in the amygdala, a brain region that plays an important role in emotional reactions, is much greater than when they see a stranger, according to Nim Tottenham. She's an an associate professor of psychology at the University of California, Los Angeles.
Her team repeated the experiment with children who had been adopted after spending time in an orphanage or some other institution. This time, the children saw pictures of either an unfamiliar woman or their adoptive mother. And "the amygdala signal was not discriminating Mom from strangers," Tottenham says.
This sort of brain adaptation may help children survive in an environment without parents, she says. But it also may affect the kind of family relationships these children have once they are adopted.
Tottenham, who is a parent herself, says all the research on neglected children reminds her of something that should be obvious: "Parents are playing a really big role in shaping children's brain development." And parenting, she says, is a bit like oxygen. It's easy to take for granted until you see someone who isn't getting enough.
Children who are adopted by about age 2 are most likely to grow up with typical brains, researchers say. Other neglected children, though, often show remarkable recoveries.
"I've become an advocate fighting for other orphans," Ruckel says. "And I believe that has everything to do with my parents, because I realized what love, what compassion, what affection can do."

Things turned out pretty well for Izidor Ruckel. After leaving home at age 17 and being out of touch with his adoptive parents for several years, he learned that his family had been in a serious car crash. He realized he couldn't just leave them there. So he went to the hospital.
"It was really hard because I wanted to make sure they were OK," he says. "I was scared. And I didn't think I was going to be forgiven for everything I'd put them through."
But they did forgive him. And since then, he says, he and his adoptive parents have become very close.
That may be possible because his brain has changed, Ruckel says. "I believe that even the brain cells that don't work as a child, I believe that they can develop as a grown man."
Scientists have their own version of that idea. They say the brain has a remarkable ability to rewire itself and compensate for things that go wrong during development, including some problems caused by neglect.
Ruckel is 33 now and lives in Denver. In addition to writing a book about his experiences, he produced a documentary on Romanian orphans who were adopted. And he's raising money for a second documentary about what happened to the orphans who stayed in Romania.
"I've become an advocate fighting for other orphans," Ruckel says. "And I believe that has everything to do with my parents, because I realized what love, what compassion, what affection can do.

Birthdays and growing up go hand in hand. Like birthday cake and candles. For so many of us, a 'normal' birthday means a happy day when your parents help you celebrate another year: they organise a cake, candles, a visit from friends, singing, and a few presents. Of course, not all children are luck enough to grow up with their parents so their parties are not quite the same. When Jordan Thompson was planning her 10th birthday party she remembered that not all children can enjoy a normal party with their family. Jordan, in her generosity, had realised what so many of us forget: orphans often celebrate their birthdays in very tough circumstances. For them, the birthday parties we think of as just normal are a real treat and probably a pleasure they might enjoy just once or twice while growing up. Jordan had her own party coming up so she decided to share her 'normal' birthday party with other children, in this case, the children at Kids Haven. 

On Sunday 29 September, Jordan held her party at a new venue: Cranbourne Avenue in Benoni. She ended up making a whole lot of new friends and inspiring others by her good example. The Thompson family arrived on Sunday morning to help set up the party. It was held in the large canteen/dining area so there would be plenty of space for everyone. To start the celebration, there were snacks and sweets, drinks and toys, and of course cupcakes and candles. Mr Thompson entertained a few of the children with some magic card tricks, while the rest of the crowd enjoyed face painting, playing and singing. At first, Jordan and her younger sister, Keira started the party with some of the younger children staying at Kids Haven -- mostly about the same age as Jordan. Later on, everyone joined in the fun and the place was filled with the normal happy sounds of a noisy kids party. By arranging her party at Kids Haven, Jordan and her family learned a whole lot about other kids normal lives, and they had the opportunity to share the happiness of her birthday celebration. By sharing, we learn more about how other children live and celebrate, and by doing that we learn to cherish our own families even more than we did before. September is the time when winter is past and the new growth of Spring is budding, but if you look at the photos of Jordan's party, you'll see the warmth and joy of summer can come in any season.

“Acacia – you will forget our faces neh, because you have seen many faces when you travel and your heads is full of new faces”, I was told on the journey home from extra classes by one of the girls from Rainbow house / the village. I can say with absolute certainty that I will never forget theses faces. The faces of girls who have experienced things no woman ever should. At 24, I have learned so much and been inspired by those much younger than myself.

The experience provided by Kidshaven and facilitated by the Benevola website has been invaluable. The family orientated housing provided by Kidshaven is incredible. Rainbow, the house where I resided throughout my stay, consists of children from 3 to 20 years old, all of whom treat each other like sisters. It is incredibly impressive that at such a young age, they are placed in a routine which includes chores around the house as well as homework time. At 6.30 on the dot, the tv goes off and everyone sits around a large table for ‘dining hall’ – my favorite time of the day and something which has dissipated in the Western world with the epidemic of tv dinners. It is so enjoyable to hear the girls swap stories about their day and ‘Mum’ get’s to hear how her girls are getting on at school.

The role that Kidshaven plays in the lives of these children is priceless but at an organizational level there is a lack of communication between staff which rendered my role more difficult than necessary at times which needs redress, although did aid me in cultivating my communication skills. Kidshaven has managed to re-create the ups and downs of family life for these children. I have seen them being told off, hugged, disappointed in and proud of, all the stable necessary elements to a healthy path towards adulthood. Unfortunately, many of whom are HIV positive, have suffered sexual abuse at a young age or have been diagnosed with TB, this path is made all the more challenging – rendering the attention and care they are receiving at Kidshaven all the more vital.

On a personal level, it has been incredibly eye opening to experience the realities of a different culture and race and I am incredibly sad to leave all of the wonderful children and incredible members of staff who treat them as their own. To some it would seem a little insane to go half way across the world in favor of cold showers and an almost constant stomach ache as a result of the change in diet… Well, the laughter and vitality of the people I have met along the way has more than outweighed those issues and I have been left with a special place in my heart for all of these children and I am grateful to Kidshaven for affording me such an opportunity that will continue to positively shape my outlook on the world and encourage me to instigate change. 

No one could prepare Caleb and Kalala, who are severely disabled due to multiple abnormalities in their bone structure and joints, for the day their dream became a reality. The two charismatic brothers were overwhelmed when they were told at a party, hosted at Netcare Sunninghill Hospital to celebrate Caleb’s 16th birthday, that they would receive the gift of surgery to improve their mobility.  

Ebullient Caleb said he somehow knew that this dream would become a reality before it was time for him to enter the job market. “Thank you for giving us the opportunity to stand on our feet. It is not about how big or small the present is but the heart behind the gift,” Kalala told a room packed with the people who have worked tirelessly to make the surgery possible.

Abandoned by their parents soon after birth, Caleb (16) and Kalala (19) spent many years fending for themselves until they were taken in by Kids Haven in Benoni, a non-profit organisation founded in 1992 by Moira Simpson, which currently provides care for over 200 street children.

According to Dr Mark Eltringham, orthopaedic surgeon at Netcare Sunninghill Hospital, the brothers suffered from multiple untreated bone and joint infections in their childhood years, which caused severe deformities to the bones. Caleb and Kalala have been severely handicapped and unable to walk with ease. Following a chance meeting with Jalna le Roux, professional liaison network manager, Clinical Partners, Netcare, a process was put into motion that would unite a number of individuals and organisations to make their treatment possible.

Jalna was alerted to the brothers’ plight by her niece who works as a student at Belvedere School for children with learning disabilities. She contacted her friend, Andre Lingenfelder, group business services manager at Netcare’s information systems department (ISD), who rallied the ISD team and hosted a fundraising charity ball to which ISD’s vendors were invited. This event raised R145 000 towards the brothers’ operations. To ensure sound governance, the process and funding are being managed by the Netcare Foundation.

The operations will be performed on 20th July 2013 by Dr Eltringham, who is a firm believer in providing medical care to those without access to the appropriate treatment.

Caleb’s surgery will focus on getting his right leg, which is twisted 90 degrees, to face forward, explains Dr Eltringham.   This complex procedure involves breaking and lengthening the bone and slowly rotating the bone over an extended period using an external fixator. “For Kalala we will focus on straightening his right knee, which is knobbed, by cutting the thigh bone and securing it with a plate in the correct position”.

The teenagers’ recovery is expected to take three to six months. “Depending on how they respond to this treatment we will decide on the next steps, but they will most likely require several more procedures,” he adds.

Lingenfelder says the operation is truly a Netcare driven initiative. Netcare Sunninghill Hospital is sponsoring the brothers’ theatre and hospitalisation costs. The hospital’s general manager, Robert Jordaan, and his team also approached various companies and individuals for assistance, to ensure the operations would take place.

Ampath will assist with pathology services and blood tests, says its area manager Eleni Giannakopoulos. Jennifer Bowles and her team at the hospital will provide physiotherapy. “This will start before the operation with teaching the brothers how to walk on crutches and continue for the duration of their rehabilitation,” she says. Dr Farrell Spiro’s team in the radiology department at Netcare Sunninghill Hospital will do the required X-rays. B. Braun is supplying the sutures for the surgical procedures. Smith & Nephew is providing the external fixators and products required for wound management. Lindie Henricho from Linja Real Estate presented the brothers with Android tablets.

Netcare’s communications director, Kerishnie Naiker extended sincere gratitude to all who have generously contributed to the well being of Caleb and Kalala. “A collaborative effort such as this is truly heart-warming. We applaud Caleb and Kalala as well as our members of staff who live the Netcare Way and have inspired others to assist. It’s soul-uplifting to witness the determination, appreciation and passion of these two special brothers”, she added.   

Those wishing to contribute to Caleb and Kalala’s treatment may donate money through the following account: Netcare Foundation, Nedbank current account, Account number 1006139702, Branch code 187505. Benefactors need to indicate clearly that the donation is specifically intended for Caleb and Kalala, says Mande Toubkin, Netcare’s general manager emergency, trauma, transplant and corporate social investment.