Brain Function, Cognitive Ability, General, Executive Function, Health Behavior, Psychiatric and/or Mood Disorders, Risk-Taking, Social Cognition
Conditions
Keywords
Romania,, children,, foster care,, institutionalization,, brain function,, MRI,, attachment,, language,, growth,, Intelligence Quotient (IQ),, psychiatric symptomatology, early intervention
Brief summary
The purpose of this study is to determine the long term effects of early intervention (placement into foster care) on physical, cognitive, social and brain development and psychiatric symptomatology in previously institutionalized children.
Detailed description
The Bucharest Early Intervention Project (BEIP) was a randomized controlled trial of foster care as an intervention for children abandoned at or around the time of birth and placed in one of six institutions for young children in Bucharest, Romania (Zeanah et al., 2003). The PI (Nelson) and Co-PIs (Zeanah and Fox) conducted this study beginning in the fall of 2000 from baseline assessments and implementation of the intervention in the spring of 2001. The BEIP began with comprehensive assessments of 136 institutionalized children and their caregiving environments prior to randomization. Half the children were randomly assigned to high-quality foster care and the other half to remain in institutional care. The average age at foster care placement was 22 months (range=6-31 months). All children were initially seen prior to randomization and again for follow-up assessments at 30 months, 42 months 54 months, 8 years, 12 year and 16 years of age. The development of children in foster care was compared to the development of children in institutions and to a group of never institutionalized children (community controls). These children, now young adults are being assessed at age 21 years.
Interventions
A group of children living in institutions in Bucharest, Romania was randomly assigned to placement in foster care. Foster parents were recruited, consented to background checks, and trained in Romanian. Before placement, foster parents visited their children to begin developing a relationship with the child. Hired foster parents were supported and monitored by project social workers. Foster parents in the BEIP network received frequent visits from the social workers, with visits occurring weekly for several months after placement of the child, then biweekly and later monthly. Foster parents were invited to participate in a support group organized by social workers. Project social workers consulted weekly with US staff experienced in dealing with young children in foster care.
Sponsors
Study design
Eligibility
Inclusion criteria
for assessment at age 21 years: * previously institutionalized and community children that took part in previous BEIP assessments * target recruitment age is +/- 6 mos of 21st birthday
Exclusion criteria
for assessment at age 21 years: * open or closed head injury within the past 12 months * viral or bacterial meningitis within the past 12 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Emotion Discrimination | baseline, 30 mos, 42 mos and 8 years | Event-related Potentials |
| Changes in Expressive Language Quality | 30 mos, 42 mos and 8 years | language sample from interview |
| Changes in Caregiving Environment | baseline, 30 mos and 42 mos | Observational Record of Caregiving Environment |
| Changes in Indiscriminate Behavior | 54 mos, 8 years and 12 years | Stranger at the Door |
| Changes in Face Recognition | baseline, 30 mos, 42 mos and 8 years | Event-related Potentials |
| Changes in Brain Structure | 8 years, 16 years, 21 years | MRI |
| Changes in Problem Behaviors | baseline, 30 mos and 42 mos | Infant Toddler Social Emotional Assessment |
| Changes in Social Communication and Interaction | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years | Social Communication Questionnaire |
| Changes in Genetics | 8 years, 12 years, 16 years | Buccal Swab |
| Changes in EEG Coherence Brain Function | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years | EEG coherence |
| Changes in EEG Power Brain Function | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years | EEG power |
| Changes in EEG Asymmetry Brain Function | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years | EEG asymmetry |
| Changes in Attachment Disturbances and Disorders | baseline, 30 mos, 42 mos, 54 mos, 8 years, 12 years, 16 years | Disturbances of Attachment Interview |
| Changes in Attachment Style | baseline, 30 mos and 42 mos | Strange Situation Procedure |
| Changes in Cognition in later childhood and adolescence | 8 years, 12 years, 16-18 years | Wechsler Intelligence Scale for Children-IV |
| Changes in Cognition in young adulthood | 21 years | Wechsler Adult Intelligence Scale |
| Changes in Cognition in early childhood | baseline, 30 months, 42 months | Bayley Scales of Infant Development |
| Changes in weight | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years | weight in kilograms |
| Changes in height | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years | Height measured in centimeters |
| Changes in head circumference | baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years | Head circumference in centimeters |
| Changes in Psychiatric Symptomatology in adolescence | 12 years, 16 years | Diagnostic Interview Schedule for Children -IV |
| Changes in Psychiatric Symptomatogology | 54 months, 8 years | Preschool And Child Adolescent Psychological Assessment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Emotional Reactivity/Temperament | baseline, 30 mos and 42 mos | Laboratory Temperament Assessment Battery (Lab-TAB) Puppets and Peek-a-boo |
| Motor Skills | 8 years | Bruininks-Oseretsky Test-2 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Changes in Physiological Reactivity to Stress | 12 years, 16 years | Trier Social Stress Test |
Countries
Romania