Childhood in the Past

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Child Bioarchaeology: Perspectives on the Past 10

Years

Simon Mays, Rebecca Gowland, Siân Halcrow & Eileen Murphy

To cite this article: Simon Mays, Rebecca Gowland, Siân Halcrow & Eileen Murphy (2017):
Child Bioarchaeology: Perspectives on the Past 10 Years, Childhood in the Past, DOI:
10.1080/17585716.2017.1301066

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Childhood in the Past 2017
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CHILDHOOD IN THE PAST, 2017
http://dx.doi.org/10.1080/17585716.2017.1301066

Child Bioarchaeology: Perspectives on the Past 10 Years

Simon Maysa, Rebecca Gowlandb, Siân Halcrowc and Eileen Murphyd
a
Research Department, Historic England, Portsmouth, UK; bDepartment of Archaeology, Durham University,
Durham, UK; cDepartment of Anatomy, University of Otago, Dunedin, New Zealand; dArchaeology and
Palaeoecology, School of Natural and Built Environment, Queen’s University Belfast, Belfast, Northern Ireland, UK

ABSTRACT KEYWORDS
This article aims to provide an overview of some of the more Bibliometry; life course;
important developments in the bioarchaeology of childhood over stable isotopes;
the past decade. Analysis of publication trends in the major palaeopathology;
breastfeeding; physiological
osteoarchaeology and physical anthropology journals demonstrated
stress
a rise in research papers dealing with skeletal remains of children,
with dietary and palaeopathological studies especially predominant.
Innovations in these areas are discussed in more detail, together
with some important developments in theoretical frameworks for
using skeletal evidence to situate children in past societies. Among
these latter is the life course approach, in which childhood is
considered within the context of the trajectory of the entire life
course. The integration of studies of child skeletal remains with
those of adults helps to provide a more complete picture of
communities in the past.

Introduction
Until the 1990s children1 had largely been excluded, or certainly marginalized, within
human bioarchaeological discourse. Observations of children were primarily concerned
with their under-representation at archaeological cemetery sites and likely high mortality
rates in the past (e.g. Hassan 1981, 95–123). Two distinctive strands of research converged
towards a more considered approach and a burgeoning interest in childhood within
archaeology. Firstly, the historical strand led by Ariès (1962) much-cited study on medieval
childhood resulted in a plethora of further publications (e.g. Shorter 1976; Stone 1977;
Pollock 1983) which sought to explore the variable perceptions and treatment of children
in the past. The second strand was inspired by gender and feminist discourse, influenced
by sociologists, which sought initially to make ‘invisible’ demographics (e.g. women and
children) at least a topic of discussion (Lillehammer 1989; Baker 1997; Kamp 2001). This
research was also informed by the growing number of childhood studies within the disci-
plines of anthropology and sociology, which highlighted the socially constructed and
hence culturally contingent nature of past identities. By the 1990s, the importance of

CONTACT Simon Mays simon.mays@historicengland.org.uk

Supplemental data for this article can be accessed at doi:10.1080/17585716.2017.1301066.
© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group and the Society for the Study of Childhood in the
Past 2017
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License
(http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any
medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
2 S. MAYS ET AL.

children as economically and socially vital and active agents, and the need to properly
integrate experiences of childhood into archaeological narratives was established (e.g.
papers in Crawford 1991, 1999; Scott 1992; Sofaer Derevenski 1994; Moore & Scott 1997).
The most direct way to ‘access’ children in the past is through their skeletal remains,
and some milestone publications have recently appeared that have facilitated progress
in this field. Scheuer and Black’s (2000) volume, Developmental Juvenile Osteology, is a
key reference work detailing the anatomy and development of the immature skeleton,
and an abridged version and a revised edition have since been produced (Schaeffer,
Black, and Scheuer 2004; Cunningham, Scheuer, and Black 2016). Baker, Dupras, and
Tocheri (2005) published a field guide for the identification and recovery of infant and
child remains on archaeological sites. To maximize the potential of skeletal evidence,
however, it needs to be interpreted in relation to its specific archaeological and funerary
context. Lewis’ (2007) The Bioarchaeology of Children provided the first volume synthesiz-
ing this area specifically for child remains, and was a benchmark of the status of research in
the field 10 years ago. Since that time, the archaeology of children, including their bioarch-
aeology, has made major advances, and it is now clearly recognized that the analysis of
juvenile skeletons can be used effectively to address broader archaeological questions
about past societies. Increasing numbers of regional biocultural studies have improved
our understanding of the experiences of everyday life for children in different parts of
the world across a variety of time periods (e.g. Lewis 2010; Penny-Mason and Gowland
2014; Halcrow and Ward 2017). Our aims in this paper are to assess, using bibliometric
analysis, some publishing trends in child bioarchaeology over the past 10 years, and to
outline what we consider to be some of the more important theoretical and analytical
developments in the bioarchaeology of childhood over that same period.

Publication trends: the rise of the bioarchaeology of the child

The bibliometric study of publications was based upon papers appearing in seven major
physical anthropology / osteoarchaeology journals. Articles from 2006 to 2015 were
chosen to give an overview of trends over a period of 10 years (2015 was the latest com-
pleted year at time of writing). The journals selected were: American Journal of Physical
Anthropology, International Journal of Osteoarchaeology, Journal of Archaeological Science,
Homo-Journal of Comparative Human Biology, Anthropological Science, Anthropologischer
Anzeiger and International Journal of Paleopathology (published from 2011 onwards). This
part of the paper attempts to analyse secular trends in work on child remains, to investigate
the locations in the world where such work is being conducted and by whom, and to ident-
ify the principal sub-disciplinary foci of the research. To these ends, articles were ascribed to
country on the basis of the affiliation of the lead author. The gender of the lead author was
also noted. A theme and subtheme of each article were identified according to what was
judged to be the main focus of the paper. This methodology is as previously described
(Mays 2010) but, in brief, the themes are: bone chemistry (i.e. biomolecular analyses), palaeo-
demography, normal skeletal variation and palaeopathology. For the current purposes, bone
chemistry and palaeopathology were divided into further subthemes: DNA, elemental or iso-
topic analyses; and type of pathology studied (e.g. metabolic, infectious, trauma, etc.),
respectively. In addition, papers were classified according to whether the main focus was
on the study of adult remains, child remains, or an integrated study of both.
 CHILDHOOD IN THE PAST 3

Some caveats should be borne in mind regarding the methodologies used here. The
approach provides only a partial overview of human bioarchaeology as there are myriad
other publishing venues for articles in this field besides the journals analyzed. Secondly,
the picture obtained is one that is distorted by the editorial policies of the
journals studied. Nevertheless, the work should provide some insight into practice.
Papers published in academic journals cannot be considered independent entities for
the purposes of statistical analysis. This means that the levels of statistical significance
of patterning in the data may not be as great as suggested by standard inferential stat-
istical tests.
A total of 1642 papers were analyzed. Overall, 1294 (79%) dealt with adult remains, 242
(15%) with child remains and 106 (6%) focussed on both. For the purposes of statistical
analyses, these latter two categories were collapsed to give a measure of articles that
are substantially based on the study of child remains (N = 348). There was no link
between the gender of the author and whether the paper concentrated on adult or
child remains. Trends in publications over the 10-year period are shown in Figure 1. Kol-
mogorov-Smirnov tests suggest a trend towards more publications using child remains
over the period considered, both in terms of raw numbers and as a proportion of the
whole (p < 0.0001 and p = 0.04, respectively). The 1642 publications emanated from 51
countries and one territory. Ten countries were the source of >50 publications. Of these,
the countries where papers substantially reliant on child skeletal remains constituted
the greatest proportion of the whole were Portugal, France (both 33%), Britain (27%)
and Germany (24%). The countries contributing the most papers substantially based on
child remains were the United States (N = 90) and UK (N = 69). When split according to
theme, the greatest numbers of studies substantially based on child remains were
devoted to palaeopathology (N = 130) or bone chemistry (N = 73). In the latter category,
the majority (N = 53) comprised isotopic studies, of which 46 dealt with weaning/diet. In

Figure 1. Publications in human bioarchaeology focused on adult and child remains, split by year of
publication.
4 S. MAYS ET AL.

the field of palaeopathology, articles most often fell into the categories of non-specific
stress (N = 33), metabolic disease (N = 22) or infectious disease (N = 21). These results are
tabulated in the Supplemental Materials.
In summary, bibliometric analysis suggests that about one paper in five made substan-
tial focus on child remains. This proportion is increasing, and is highest in some western
European countries. Principal research foci are on biomolecular studies, particularly
stable isotopes, and palaeopathology.
We now focus on the nature of innovation in the use of skeletal remains to study child-
hood in the past. In light of the results of the bibliometric analyses above, we concentrate
particularly on the application of isotopic and other methods to study diet, and the use of
palaeopathology to shed light on child health. However, we first consider aspects of
the research orientation of the discipline: the last 10 years have seen important develop-
ments in conceptual frameworks for using skeletal evidence to situate children in past
societies.

The social bioarchaeology of the child

Since the late 1960s in North America, and since approximately the 1980s in the UK,
much bioarchaeological work has been conducted within a biocultural paradigm. The
focus has been on hypothesis-driven work and population-level studies that emphasize
the interaction between the social and natural environment and human health, mortality
and various aspects of skeletal biology. This is illustrated for the bioarchaeology of child-
hood in early studies on growth (discussion in Humphrey 2000), demography (e.g. Mol-
leson 1989) and palaeopathology (Lallo, Armelagos, and Mensforth 1977; Mensforth et al.
1978; Cook and Buikstra 1979). The biocultural approach continues to be the dominant
model for understanding the past through human remains (Zuckerman and Armelagos
2011). Despite this approach’s emphasis on human interaction with the sociocultural as
well as the physical environment, until the last decade there has been a tendency for
bioarchaeological research to operate largely divorced from developments within
social theory. Disciplines such as sociology, which have traditionally eschewed the
body as a physiological entity, started to turn their gaze towards the corporeality of
human identity and social interactions (e.g. Shilling 1993). The body was reconceptua-
lized as a dynamic mediator of social processes and ‘embodiment’ became a fresh
topic of focus within archaeology (e.g. Joyce 2005). During the last 10 years there has
been a growing dissatisfaction with the science/social theory divide within archaeology
and an increasing shift towards a more theoretically informed ‘social bioarchaeology’.
Whilst this trend arguably began in the UK (e.g. Robb 2002; Gowland and Knüsel
2006; Sofaer 2006; Gowland and Thompson 2013), it has now become a more estab-
lished paradigm within the United States (e.g. Knudson and Stojanowski 2008, 2009;
Agarwal and Glencross 2011), exemplified by the numerous exciting publications emer-
ging from the Springer book series Bioarchaeology and Social Theory (e.g. Osterholtz
2016). This approach more explicitly engages with theoretical understandings and con-
structions of the body and the impact that social as well as environmental processes
have on flesh and bones. Some inspiring work over the last 10 years on childhood
bioarchaeology has explicitly integrated social theory, together with historical and
archaeological evidence to provide new insights into the effects of specific forms of
 CHILDHOOD IN THE PAST 5

socially-induced stress on children (e.g. Murphy 2011, 2015; Penny-Mason and Gowland
2014; Geber 2016; Newman and Gowland 2016).
Within this approach, authors have also considered the interactions between the
growing bodies of infants and children, and cultural understandings of the life
course (e.g. Gowland 2001, 2006; Sofaer 2006; Halcrow and Tayles 2008; Newman
and Gowland 2015; Agarwal 2016). The profound impact of cultural practices on
the health and well-being of children is important to consider, but this must be inte-
grated within an understanding of social age transitions and the interplay between
age and other aspects of social identity (Gowland 2006). Childhood as a stage, or
stages, of life should be contextualized within cultural understandings of the trajec-
tory of the entire life course, from conception to death, rather than considered in iso-
lation. A life course approach is now becoming prominent within archaeological
studies and is considered less prescriptive than the ‘life cycle approach’, which
tends to consider age as a more fixed, prescriptive series of life stages (Hunt 2005).
A life course framework facilitates an understanding of the plurality of identity at
any one age as well as the fluidity of identity (e.g. gender and status) over an individ-
ual’s life-time (Hockey and James 2003). A bioarchaeological approach to the life
course is exemplified by Mary Lewis and colleagues’ recent work on medieval adoles-
cence and puberty. This integrates different forms of evidence and situates the skel-
etal data firmly within an understanding of status and gender-related expectations of
adolescence within the medieval life course (Shapland, Lewis, and Watts 2015; Lewis
2016).
A life course approach also recognizes the cumulative nature of individual biographies;
in other words, it explicitly considers the way in which identities and experiences in early
life may impact upon later stages (Hockey and Draper 2005, 43). This latter point is particu-
larly important in relation to bioarchaeological studies of childhood because it relates well
to the Developmental Origins of Health and Disease (DOHaD) hypothesis. This hypothesis
developed from Barker and colleagues’ epidemiological research since the 1980s, which
established a link between early life adversity and chronic disease in later life (e.g.
Barker and Osmond 1986; Barker et al. 2002; Barker 2012). Within this paradigm, the
archaeological remains of infants and children are even more important because of the
longer term consequences of poor maternal health or infant care for population health.
Further work has also highlighted the inter-generational consequences of childhood
adversity via epigenetic mechanisms (those that moderate gene expression) (Landecker
and Panofsky 2013). Gowland (2015) argues that this has potentially profound implications
for our view of individuals and life courses as discrete, bounded entities – it challenges
even the point of conception as the start of an individual’s biography. If social adversity
affecting one’s grandmother has biological consequences two generations later, then indi-
vidual lives should be reconceptualized as entangled and, to borrow Strathern’s (1988)
term, ‘partible’ (Gowland 2015). A number of studies within palaeopathology have pro-
vided support for this hypothesis from archaeological contexts, noting correlations
between indicators of health stress such as enamel hypoplasia and growth stunting,
and reduced adult longevity (e.g. Armelagos et al. 2009; Watts 2011, 2013). Ultimately,
in terms of the bioarchaeology of childhood in the past, the DOHaD hypothesis should
at the very least, result in a deepening appreciation of the significance of the analysis of
the remains of infants and children for understanding population well-being.
6 S. MAYS ET AL.

Diet in infants and children in the past

Infant and child dietary and weaning studies are important in bioarchaeology as they can
inform us of subsistence change, infant feeding practices, food choice, and differential
access to foods as a result of social factors (Stuart-Macadam and Dettwyler 1995; Lewis
2007; Larsen 2015). Childhood diet and the weaning process have important implications
for early and later life health, mortality patterns and fertility in past societies (Stuart-
Macadam and Dettwyler 1995; Lewis 2007; Halcrow and Tayles 2008). There is also a syner-
gistic relationship between diet and infection, with poor diet making a person more sus-
ceptable to infection, and infection leading to poor nutrient absorption (Lewis 2007).
For over 20 years there has been a research focus in child bioarchaeology on weaning
and diet using chemical (isotopic) analyses of bones and teeth (Jay 2009). As was demon-
strated above, there has been a proliferation of studies in this area over the past decade
(e.g. Fuller et al. 2006; Dupras and Tocheri 2007; Kinaston et al. 2009; Beaumont et al. 2013,
2015; Tsutaya and Yoneda 2013; Beaumont and Montgomery 2016). The analysis of carbon
and nitrogen stable isotope ratios is now routinely used to evaluate breastmilk lipid and
protein, respectively, and study of oxygen stable isotope ratios is occasionally used to
evaluate breastmilk in the diet. Carbon and nitrogen isotopes are also used to investigate
components of the supplementary weaning and childhood diet. Recently, bone phos-
phate oxygen isotope methods have been developed (Britton et al. 2015), which may
complement multi-component isotopic studies. The traditional / standard sampling
methods of bone of infants and children for the analyses of weaning produces a cross-sec-
tional assessment of isotopic ratios of the non-survivors of the sample (e.g. Richards, Mays,
and Fuller 2002; Fuller et al. 2006). Tsutaya and Yoneda (2013) have recently developed a
quantitative method for the reconstruction of weaning profiles using Bayesian statistics
and incorporating estimated bone turnover rates.
Developments in sampling techniques in archaeological isotopic studies are extending
our knowledge of weaning and stress across the life course. Approaches of sampling
different tissues that grow at different times and rates (e.g. Dupras and Tocheri 2007;
Eerkens et al. 2014) and new incremental dental sampling methods (Eerkens, Berget,
and Bartelink 2011; Beaumont et al. 2013) provide the opportunity to track dietary
change across an individual’s early development. These methods of incremental
dentine sample preparation (Eerkens, Berget, and Bartelink 2011; Beaumont et al. 2013,
2015; Beaumont and Montgomery 2016) allow for the high-resolution temporal compari-
son of carbon and nitrogen stable isotope ratios from the gestational period through to
childhood and are being rapidly adopted in studies of infant feeding and weaning (e.g.
King et al. 2016). These exciting developments may allow us to compare isotope ratios
between survivors and non-survivors, thus enabling further insights into the veracity of
the osteological paradox (Wood et al. 1992; DeWitte and Stojanowski 2015). The appli-
cation of incremental sampling methods (Figure 2) has also led to a reconsideration of
how nitrogen stable isotope ratios are interpreted, suggesting that the variables affecting
the isotopic relationship between mother and child are more complex than the traditional
dietary weaning model posits, and that high nitrogen stable isotope ratios may also rep-
resent physiological stress (Beaumont et al. 2015; Beaumont and Montgomery 2016).
Other techniques are beginning to provide additional information on infant and child-
hood diets. Oral health of infants and children (e.g. Halcrow et al. 2013; Stránská,
 CHILDHOOD IN THE PAST 7

Figure 2. Incremental sampling techniques for dentine isotopic analysis across the development of the
tooth (deciduous second molar). The time represented by each increment depends upon how many
parts the tooth is divided into and can be calculated using Beaumont and Montgomery (2016).

Velemínský, and Poláček 2015), and dental wear patterns, including new macroscopic and
microwear techniques (Mahoney et al. 2016; Mays 2016; Scott and Halcrow 2017) are start-
ing to be used by bioarchaeologists to assess weaning food types and the timing of
weaning. Although oral health is not necessarily a direct reflection of diet, it may be infor-
mative of infant feeding types (e.g. bottle feeding) and the cariogenicity of weaning food
(e.g. Halcrow et al. 2013; Bonsall, Ogden, and Mays 2016). There is limited research on oral
health of infants and children from archaeological samples, but the work that has been
done highlights the usefulness of this endeavour. For example, Halcrow et al.’s (2013)
analysis of caries in deciduous and permanent teeth of infants and children from prehis-
toric Southeast Asia indicates that the deciduous teeth are more sensitive to carious decay
than the permanent dentition. Bonsall, Ogden, and Mays (2016) present a differential diag-
nosis of oral pathology in a 3–4-year-old child from a Late Roman site at Ancaster, England.
They argue that the child had early childhood caries, or rampant caries, informative of the
cariogenic nature of the infant diet.
Mays (2016) presents a method to estimate weaning in infants and children using
macroscopic levels of wear in deciduous teeth from the English medieval site of
Wharram Percy and compares these patterns with the isotopic weaning data from the
site. The new application of microwear methods in infant deciduous teeth is a promising
8 S. MAYS ET AL.

sensitive indicator of weaning (Scott and Halcrow 2017). Mahoney et al. (2016) have pub-
lished the first three-dimensional dental microwear texture analysis of human deciduous
teeth from medieval Canterbury, England. Results show that weaning occurred earlier than
previously documented, and that diet increased in toughness and hardness with age.
Schmidt, Kwok, and Keenleyside’s (2016) recent research on infant weaning and diet
from a Greek colonial site from Bulgaria presents an interesting example of the integration
of multiple lines of evidence including stable isotopes, deciduous oral pathology including
caries, calculus, antemortem tooth loss, periapical infections and macroscopic tooth wear.
Many bioarchaeological studies of non-specific stress indicators such as dental enamel
defects interpret their results within the context of a ‘weaning stress’ model, despite pre-
vious critiques based on the non-specific aetiologies of these indicators (Katzenberg,
Herring, and Saunders 1996). It is also unlikely that physiological stress would be elevated
around the complete cessation of the weaning process, which generally occurs gradually
over a long time period. Pearson et al.’s (2010) research that assesses if there is a relation-
ship between weaning and mortality at Early Neolithic sites in Anatolia makes the impor-
tant distinction between the time of exclusive breastfeeding (EBF) and the total time of
breastfeeding, on the basis that EBF is more useful for investigating impacts on fertility,
morbidity, and mortality in past populations. The future investigation of stable isotope
ratios using incremental sampling techniques in conjunction with careful reconstruction
of stress events during tooth development using dental enamel defects may help to
unravel the interaction between nutrition, stress, and mortality in past populations
(Inglis and Halcrow, forthcoming).

The palaeopathology of childhood

Pathological juvenile bones (e.g. Figure 3) are generally represented to a lesser extent than
their adult counterparts in classic palaeopathological textbooks, but a number of more
recent papers have focused specifically on the pathological responses of immature
bone (e.g. Lewis 2011). A combined palaeopathological and aDNA approach has been par-
ticularly fruitful for the investigation of infectious diseases, including leprosy, which can be
difficult to definitively identify in children’s skeletons (Rubini et al. 2014).
Childhood physiological stress – traditionally identified through an examination of con-
ditions such as cribra orbitalia, porotic hyperostosis of the cranial vault, linear enamel
hypoplasia (Figure 4) and stunted or delayed growth – has long been the focus of palaeo-
pathological studies in past populations (Temple and Goodman 2014) and this has contin-
ued to be the case over the past 10 years. A provocative paper by Walker et al. (2009)
somewhat reinvigorated such studies by challenging the well-established interpretation
of cribra orbitalia and porotic hyperostosis as indicators of childhood iron deficiency.
They posited that iron deficiency could not physiologically cause the lesions associated
with marrow hyperplasia, although this assertion has been challenged by other research-
ers (Oxenham and Cavill 2010; Mays 2012). Further research has concluded that, while iron
deficiency may not be responsible for the lesions, it is the end result and part of the body’s
defence mechanism against infection (Rothschild 2012; Steyn et al. 2016). Walker et al.
(2009) also suggested that orbital and vault lesions may not necessarily be caused by pre-
cisely the same processes. In general terms, however, they proposed that they may have
 CHILDHOOD IN THE PAST 9

Figure 3. Lesions characteristic of tuberculosis in SK 1155, an 8.5–10.5-year-old child, from Medieval

Ballyhanna, Co. Donegal, Ireland. (a) Bone destruction and pitting on the neural arches of T2–8,
with particularly pronounced lytic activity on T3. Note that T4 and T5 had formed a partial block ver-
tebra which is a developmental defect. (b) Lytic activity and pitting on the auricular surface of the left
ilium. (c) Periosteal new bone formation and lytic activity on fragments of right ribs. Note the destruc-
tion of the heads in three of the ribs. (d) Periosteal new bone formation on the anterior surface of the
distal right humerus. (e) Extensive bone destruction of the inferior body surface of L5 (photographs by
Jonathan Hession).

been caused by a number of factors, including poor diet, a lack of hygiene, infectious dis-
eases, gastrointestinal parasitic infections, and cultural practices associated with weaning.
Cribra orbitalia and porotic hyperostosis remain reliable indicators of childhood phys-
iological stress and recent studies have moved beyond the focus on poor health to use
them as a means of gaining subtle information about other issues including migration.
Gowland and Redfern (2010), for example, compared the prevalences of cribra orbitalia
and enamel hypoplasia in individuals from Roman London with contemporary sites else-
where in England and in Italy. They suggest that the high prevalence of cribra orbitalia in
the Italian populations may have been due to malaria. They were struck by the similarity in
10 S. MAYS ET AL.

Figure 4. Examples of childhood physiological stress markers. (a) Porotic hyperostosis of the cranial
vault in burial V10, a 6-month-old child from Medieval Wharram Percy, England (photographs by
Simon Mays), (b) Cribra orbitalia in SK 225, a 7–10-year-old child, from Medieval Ballyhanna, Co.
Donegal, Ireland (photograph by Jonathan Hession). (c) Linear dental enamel hypoplasia in the perma-
nent dentition of SK 251, a 9–11-year-old Medieval child, from Armoy, Co. Antrim, N. Ireland (photo-
graph by Tony Corey).

the lesion profiles for adults in London and the Italian sites, and hypothesized that London
was anomalous in a British context as a result of the influx of a substantial migrant popu-
lation who had spent their childhood in the Mediterranean. A lower prevalence of cribra
orbitalia in the juvenile population was considered to be a reflection of the fact that they
had lived and died in London.
Developments have also been made in the manner in which linear enamel hypoplasia
can be used to understand the impact of physiological stress during childhood. Most
studies that involve linear enamel hypoplasia examine the lesions as indicators of stress
in relation to susceptibility to mortality. An innovative study by Temple (2014), took a
life-course perspective on hunter-gatherers from the Late/Final Jomon period of Japan.
This work introduced consideration of the plasticity/constraint and predictive adaptive
response models to enable an exploration of the relationship between stressors in early
life, future physiological stress and mortality. It postulated that in the predictive adaptive
response model early stress effects would have a limited impact on age-at-death. The
 CHILDHOOD IN THE PAST 11

converse would be true for the plasticity/constraint model. This would be characterized by
a negative relationship between the age of formation of the first defect and the number
and duration of the defects, together with a positive correlation between the age at which
the first defect formed and age-at-death. The findings were consistent with the latter
model, and it was concluded that stress in early life had a negative impact on an individ-
ual’s ability to cope with future stress events (see discussion of DOHaD above).
A study by Robbins Schug and Goldman (2014) has also advanced the manner in which
growth disruption can be used to assess levels of population stress. Measures of juvenile
whole bone morphology were correlated against the geometry and histology of compact
midshaft femoral bone for the purposes of comparing levels of physiological stress in Early
Jowre (1400–1000 BC) and Later Jowre (1000–700 BC) populations from Inamgaon, India.
The latter group is known to have lived in a period of environmental and socio-cultural
stress and the results demonstrated that the children in this population had suffered
from increased levels of skeletal emaciation, as demonstrated by a combination of short
stature and low body mass index for age, a decreased bone mass and strength, and an
increased volume of pores within the compact bone.
There have been advances in the study of vitamin deficiencies in children, particularly
scurvy (vitamin C deficiency) and rickets (vitamin D deficiency), and methods have been
established that enable the reliable identification of both conditions in child skeletons
(Mays, Brickley, and Ives 2006; Brickley and Ives 2008). Studies have demonstrated differences
in the affected age profile and severity of rickets in children living in urban and rural environ-
ments (Mays, Brickley, and Ives 2006). The broader age profile and less severe lesions in urban
populations have been interpreted as a direct indication of the constant smoggy environ-
ment, whereas the somewhat unexpected severe lesions restricted to infants in rural environ-
ments are thought to have been due to familial efforts to care for already sickly children by
keeping them indoors (Mays, Brickley, and Ives 2006; Murphy 2015). Recent research based
on clinical advances has proposed a new interpretative model for assessing the impact of
vitamin D deficiency in past populations. It considers its impact on the entire body and
notes that it is often a risk factor for other conditions, including tuberculosis, certain
cancers and cardiovascular disease (Snoddy, Buckley, and Halcrow 2016). Scurvy is increas-
ingly being identified in past child populations from around the world (e.g. Brown and
Ortner 2011; Klaus 2014). Mays (2014) undertook a timely review of the current level of
palaeopathological knowledge about the disease which demonstrated how it is very
much a disease of children unless the population has derived from a group living in con-
ditions of extreme hardship, such as might be caused by famine or prolonged sea
voyages. He warned that in the case of vitamin C deficiency it may not be correct to view
the situation of children as an indicator of the status of the entire population and that
rather it may have been related to child-specific diet and weaning practices. Interpretive
issues remain to be resolved in relation to both vitamin D and vitamin C deficiency, but
the level of knowledge is now at a stage where co-identification of rickets and scurvy can
be made on the basis of skeletal lesions in a convincing manner, as evidenced by the
research of Schattmann et al. (2016) on a sixteenth- to eighteenth-century AD population
from France. The consideration of non-dietary aetiologies of scurvy is also becoming
acknowledged (e.g. Buckley et al. 2014; Halcrow et al. 2014; Mays 2014).
A recent study by Newman and Gowland (2016) has demonstrated the value of exam-
ining multiple indicators in research of child stress and disease. They used a combination
12 S. MAYS ET AL.

of tibial diaphyseal length, appositional growth of the femoral diaphysis, vertebral neural
canal size, rickets, scurvy, periosteal new bone formation and enamel hypoplasia, as a
means of assessing the health status of four eighteenth- to nineteenth-century AD popu-
lations of a variety of socio-economic classes from London. Their findings indicated that
children in the lower classes were under the greatest levels of physiological stress, but
the upper classes were not immune to such stressors, probably as a result of trends in
child rearing practices rather than poverty. A similar approach which used multiple indi-
cators, this time Harris lines, linear enamel hypoplasia, growth disturbances and cribra
orbitalia, was undertaken by Geber (2014) in his study of children who died in the Great
Irish Famine of the nineteenth century. The signs of physiological stress evident in
these juveniles would undoubtedly have been associated with malnutrition and infections
related to the famine. He also notes, however, the importance of appreciating that the
major psychological stress that young children, in particular, would have experienced
because of institutionalization in the workhouse, could also have manifested itself
physically.
While studies of childhood physiological stress have grown exponentially over the past
decade, research on the evidence for trauma in child skeletons has progressed to a lesser
extent, perhaps because of the difficulties of identifying certain types of injuries in the
growing skeleton (see Lewis 2013). Fibiger (2014), however, has undertaken a major
review of cranial trauma in children from Neolithic Germany in which she concludes
that children were both actively involved in, and affected by, violent conflict. Interpretive
models of childhood trauma have also been attempted. Gaither (2012) undertook a study
of the levels of childhood trauma in a Peruvian population that spanned the periods
before and after the Spanish conquest. Violence was sub-divided into three categories –
‘Violence associated with Extreme Cultural Conflict’, ‘Culturally Sanctioned Ritual Violence’
and ‘Likely Caregiver-Induced Violence’ and it was proposed the stresses of the conquest
may have resulted in an increase in this last type. The results did not support the hypoth-
esis, although cases of ‘Likely Caregiver-Induced Violence’ were identified. The use of such
categories within bioarchaeological studies would seem to have the potential to facilitate
more nuanced interpretations in relation to the significance of violence against juveniles in
different cultural contexts. Indeed, a case of child abuse has been convincingly identified
in a 2–3-year-old Romano-Christian period child from the Dakhleh Oasis, Egypt. An inte-
grated approach, which included a macroscopic, radiographic and histological analysis
of the traumatic injuries, in conjunction with analysis of stable carbon and nitrogen iso-
topes of the hair and bone, revealed evidence for concomitant metabolic disturbances
and dietary change (Wheeler et al. 2013).

Conclusions
The past 10 years have seen increased focus on childhood and child remains in bioarch-
aeology in general, but with particular flourishing of isotopic and palaeopathological
studies. The devising and adoption into bioarchaeology of major methodological inno-
vations that we have described in these latter two areas illustrate the wider observation
that, as a subfield, human bioarchaeology has been assiduous in developing new scientific
methodologies and applying them to the study of past populations. Although most
workers take a biocultural approach to understanding past populations, the discipline
 CHILDHOOD IN THE PAST 13

as a whole has been slow to adopt theoretical innovations in the social sciences that would
enable the benefits of this approach to be more fully realized. In the past decade this has
begun to change, as exemplified for the bioarchaeology of childhood by the rise of studies
taking a life course perspective. This illustrates the value of engaging with modern social
theory, not only for providing fresh perspectives on childhood in the past, but also for
using child remains to shed light on past lives as a whole.
There has been synergy between new theoretical orientations emphasizing life course
perspectives, and methodological innovations in human bioarchaeology. Study of dental
hard tissues, that do not remodel once formed, mean that adult as well as child skeletons
can be used to investigate childhood in the past. Integrated approaches using adult and
child remains help us to understand life-long implications of factors such as infant feeding
practices, childhood diet and disease. They can also help us to tease out the effects of the
osteological paradox on our data, for example, by permitting studies aimed at investi-
gating the existence of dietary differences in the early years between those who died in
childhood and those who survived to become adults. The value of integrating studies
of adult and child remains has also been evident in the field of palaeopathology, where
it has helped provide a more nuanced interpretation of vitamin deficiency disease than
would have emerged had one or other sector of the population been analyzed in isolation.
Children were active agents who contributed socially and economically to the functioning
of past communities. Integrated bioarchaeological study of children and adults will con-
tribute towards a more holistic view of societies in the past.

Note
1. In keeping with the scope of the journal, in this article we use the terms children, childhood,
child, etc. in their broadest senses to refer to individuals aged from the foetal period up to
approximately 18 years.

Acknowledgements
We are grateful to Charlotte King for her help in preparing Figure 2 and to Libby Mulqueeny, Archae-
ology and Palaeoecology, Queen’s University Belfast, for preparing Figures 3 and 4.

Disclosure statement
No potential conflict of interest was reported by the authors.

Funding
S. H. acknowledges the support of the Department of Archaeology at Durham University and was
supported by a Durham Senior Research Fellowship cofunded with the European Union under
[grant number 609412].

Notes on contributors
Simon Mays is the human skeletal biologist for Historic England, and is based in Portsmouth. He also
has visiting positions at the Universities of Edinburgh and Southampton. His research encompasses
most areas of human osteoarchaeology, with research on remains of children as an important focus.
14 S. MAYS ET AL.

He has published over 130 articles in books and peer-reviewed journals, as well as one authored
book and two co-edited books. He is the book reviews editor of Childhood in the Past.
Rebecca Gowland is a senior lecturer in Bioarchaeology at Durham University. Her research interests
include the inter-relationship between the human skeleton and social identity; health and the life
course in the Roman World; and social perceptions of the physically impaired. She has published
over 40 scholarly articles in books and peer-reviewed journals, in addition to one co-authored
book and two co-edited books on various aspects of bioarchaeology.
Siân Halcrow is a senior lecturer in Biological Anthropology at the University of Otago. Her research
addresses central archaeological questions on the human response to the intensification of agricul-
ture in prehistoric Southeast Asia (Thailand, Laos and Cambodia) and South America (Chile). She has
a particular interest in the study of infant and child bioarchaeology and has published more than 50
peer-reviewed papers and chapters on the topic.
Eileen Murphy is a senior lecturer in Osteoarchaeology at Queen’s University Belfast. Her research
has focused on skeletal populations from prehistoric Russia and all periods from Ireland. She has
a particular interest in the archaeology of childhood and, especially, juvenile burial practices. She
has published eight books/edited volumes in addition to over 100 articles in books and peer-
reviewed journals, and is the editor of Childhood in the Past.

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