Children who enter foster care have usually experienced maltreatment as well as disruptions in relationships with primary caregivers. These children are at risk for a host of problematic outcomes. However, there are few evidence-based interventions that target foster children. This article presents preliminary data testing the effectiveness of an intervention, Attachment and Biobehavioral Catch-up, to target relationship formation in young children in the foster care system. Children were randomly assigned to the experimental intervention that was designed to enhance regulatory capabilities or to a control intervention. In both conditions, the foster parents received in-home training for 10 weekly sessions. Post-intervention measures were collected 1 month following the completion of the training. Outcome measures included children's diurnal production of cortisol (a stress hormone), and parent report of children's problem behaviors. Children in the experimental intervention group had lower cortisol values than children in the control intervention. Also, the experimental intervention parents reported fewer behavior problems

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This study assessed relations among placement instability, inhibitory control, and caregiver-rated child behavior. The sample included 33 adopted children who had experienced placement instability, 42 adopted children who had experienced 1 stable placement, and 27 children never placed in foster care. Five- and 6-year-old children completed the day-night task, which requires children to inhibit a prepotent response, and a control task that presents similar memory demands but does not require inhibition (C. L. Gerstadt, Y. J. Hong, & A. Diamond, 1994). Adopted children who had experienced placement instability performed worse on the inhibition task than did both other groups of children, when the authors controlled for age, verbal intelligence (as measured with the Wechsler Preschool and Primary Scale of Intelligence--Revised; D. Wechsler, 1989; or the Peabody Picture Vocabulary Test--Third Edition; L. M. Dunn & L. M. Dunn, 1997), and control task performance (p<.01). Children who had experienced placement instability were also rated on the Child Behavior Checklist as more oppositional than other children (p<.01; T. M. Achenbach & L. A. Rescorla, 2000). Inhibitory control did not mediate the association between placement instability and oppositional behavior (p>.05). These results suggest that placement instability may adversely affect the social-emotional development of adopted children.

CONTEXT Studies through 6 years have shown no long-term direct effects of prenatal cocaine exposure (PCE) on children’s physical growth, developmental test scores, or language outcomes. Little is known about the effects of PCE among school-aged children aged 6 years and older. OBJECTIVE We reviewed articles from studies that examined the effects of PCE on growth, cognitive ability, academic functioning, and brain structure and function among school-aged children. METHODS Articles were obtained by searching PubMed, Medline, TOXNET, and PsycInfo databases from January 1980 to December 2008 with the terms “prenatal cocaine exposure,” “cocaine,” “drug exposure,” “substance exposure,” “maternal drug use,” “polysubstance,” “children,” “adolescent,” “in utero,” “pregnancy,” “development,” and “behavior.” Criteria for inclusion were (1) empirical research on children aged 6 years and older prenatally exposed to cocaine, (2) peer-reviewed English-language journal, (3) comparison group, (4) longitudinal follow-up or historical prospective design, (5) masked assessment, (6) exclusion of subjects with serious medical disabilities, and (7) studies that reported nonredundant findings for samples used in multiple investigations. Thirty-two unique studies met the criteria. Each article was independently abstracted by 2 authors to obtain sample composition, methods of PCE assessment, study design, comparison groups, dependent variables, covariates, and results. RESULTS Associations between PCE and growth, cognitive ability, academic achievement, and language functioning were small and attenuated by environmental variables. PCE had significant negative associations with sustained attention and behavioral self-regulation, even with covariate control. Although emerging evidence suggests PCE-related alterations in brain structure and function, interpretation is limited by methodologic inconsistencies. CONCLUSIONS Consistent with findings among preschool-aged children, environmental variables play a key role in moderating and explaining the effects of PCE on school-aged children’s functioning. After controlling for these effects, PCE-related impairments are reliably reported in sustained attention and behavioral self-regulation among school-aged children. Pediatrics 2010;125:554–565

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