The Romanian orphan studies provided significant insights into the nature vs. nurture debate, particularly in the context of child development. These studies illustrated the profound impact of environmental factors (nurture) on children's developmental outcomes. For instance, children raised in the neglectful and stimulus-poor environment of Romanian orphanages exhibited severe delays in cognitive, social, and emotional development, as well as issues in attachment formation. These developmental challenges were less pronounced in children who were adopted early into nurturing environments, suggesting that while genetic predispositions (nature) play a role, the environment (nurture) is crucial in shaping development. This evidence supports the argument that while genetic factors set certain potentials, the actual developmental outcomes are heavily influenced by environmental experiences, especially in the early years. The studies therefore underscore the importance of a nurturing environment for optimal child development, contributing significantly to the understanding of the interplay between genetic predispositions and environmental influences in psychology.

The Romanian orphan studies raised several ethical concerns, primarily related to working with vulnerable populations and the potential for causing psychological harm. Firstly, the children involved were highly vulnerable, having already experienced severe neglect and trauma. This raised questions about informed consent and the potential for re-traumatisation during the research process. To address these concerns, researchers ensured that their studies were designed to minimize distress. For instance, in Rutter's ERA study, the primary focus was on observational assessments and reviewing existing records, rather than intrusive experimental interventions. Ethical guidelines were strictly followed, with emphasis on the children's welfare. Additionally, these studies often involved providing interventions or improvements in care, which had direct benefits for the participants. Despite these measures, ethical debates continue, particularly regarding the potential long-term psychological impact on the children involved and the broader implications of conducting research with such sensitive populations.

The findings from the Romanian orphan studies have had a profound impact on global child welfare policies and practices. One of the key influences has been the shift in adoption policies and practices. The studies highlighted the importance of early adoption for better developmental outcomes, leading to faster adoption processes and prioritising younger children for adoption. Additionally, there has been a significant change in institutional care standards. The studies demonstrated the detrimental effects of inadequate staffing and poor caregiver-child interactions, leading to reforms in institutional care, such as improved caregiver training, better caregiver-to-child ratios, and the promotion of family-based care over institutionalisation. These changes reflect a broader understanding that quality of care, particularly in the early years, is crucial for healthy child development. The studies also influenced psychological and educational practices, with increased focus on early intervention and support for children with histories of neglect and institutionalisation, recognizing their unique developmental needs.

The findings from the Romanian orphan studies provide valuable insights into the effects of early childhood trauma, particularly in terms of attachment issues and developmental delays. However, caution must be exercised when applying these findings to other forms of trauma. The experiences of children in Romanian orphanages were specific to institutional neglect and deprivation. While some parallels can be drawn, other forms of trauma, such as abuse, family violence, or natural disasters, may have different impacts on a child's development and attachment. These types of trauma might involve different psychological processes, such as the impact of fear and anxiety on development, which were not the central focus of the Romanian studies. Nevertheless, the studies do contribute to a broader understanding of the significance of early experiences and the resilience of children. They highlight the importance of early intervention and the potential for recovery with appropriate care, which are relevant considerations in all forms of early childhood trauma.

The methodologies used in the Romanian orphan studies, while groundbreaking, had several limitations. One primary limitation was the lack of a standardized baseline for comparing children's development. Due to the chaotic nature of the orphanages and the absence of reliable historical data, it was difficult to establish the exact conditions and experiences of each child prior to adoption. This made it challenging to isolate the specific effects of institutionalisation from other variables, such as pre-existing health conditions or genetic factors. Additionally, the studies mostly used observational and correlational methods, which do not establish causation. While they could show associations between institutionalisation and developmental outcomes, they could not conclusively prove that the former caused the latter. Another limitation was the potential for selection bias in adoption studies. Families who chose to adopt Romanian orphans might have been more resourceful or motivated, possibly skewing the results towards more positive outcomes. Finally, the long-term nature of these studies meant that ongoing developmental changes could not be immediately observed, necessitating continued research and longitudinal analysis.