Foster care leads to sustained cognitive gains following severe early deprivation

Abstract

This study examined longitudinal data from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care following exposure to severe psychosocial deprivation. We report data from 135 participants assessed in early adulthood (age 18 y). We find that 16 y after randomization occurred, those who had been randomized to high-quality foster care had significantly higher IQ scores (9 points, 0.6 SD) than those randomized to care as usual. Mediation analyses provide evidence that the causal effect of the intervention on cognitive ability in early adulthood could be explained, in part, by higher-quality caregiving and attachment security. These findings indicate that early investment in family care as an alternative to institutional care leads to sustained gains in cognitive ability. Fostering caregiving relationships is a likely mechanism of the intervention. In addition, exploratory analyses indicate that stable placements throughout childhood are associated with the greatest long-term gains in cognitive ability. Whether early interventions for infants and young children lead to lasting change has significant implications for decisions to invest in programs aimed at improving children’s developmental outcomes.

Early deprivation alters structural brain development from middle childhood to adolescence

“…Because of the need to translate the WISC-IV into Romanian for this study, a policy was implemented whereby substitutions for subtests by a supplemental test were used if participants achieved a standard score of less than 5 on the original subtest. When both an original unspoiled subtest and a supplemental subtest in the same domain were administered, the subtest with the highest score was used to estimate the FSIQ score [for more details about this "benefit of the doubt" approach to scoring, see (75)]. Five participants were identified by BEIP staff as too cognitively impaired to participate in the WISC-IV; these participants' scores were imputed to 40.…”

Effects of foster care intervention and caregiving quality on the bidirectional development of executive functions and social skills following institutional rearing

“…These findings suggest that individual differences in caregiving quality that foster children receive is an important factor underlying the positive development of previously institutionalized children. These findings have important policy implications: training foster parents in sensitive parenting could lead to improvements not only in the social domain, but in the cognitive domain as well (Fisher et al., 2016; Humphreys et al., in press; Korom et al., 2021; Lind et al., 2017; 2020; 2021).…”

Romania’s Abandoned Children: The Effects of Early Profound Psychosocial Deprivation on the Course of Human Development

“…With few exceptions (summarized later), the intervention was largely successful in improving the developmental outcomes of children. For example, at the behavioral level, children randomly assigned to foster care showed improvements in IQ; indeed, through age 18 there was a consistent 7- to 9-point advantage in full-scale IQ in foster care compared with care as usual (see Humphreys et al, 2022). There were also improvements in language (Humphreys et al, 2020; Windsor et al, 2011), attachment security (Smyke et al, 2010), and peer relationships (Almas et al, 2015).…”

“…A follow-up of a randomized controlled trial that found children in foster care had significantly fewer externalizing symptoms and disorders, particularly true of those who remained in stable placements. Humphreys, K. L., King, L. S., Guyon-Harris, K. L., Sheridan, M. A., McLaughlin, K. A., Radulescu, A., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2022). (See References).…”