Institutionalized Children Fare Best in Foster Care

Newly published research in the journal Science confirms that institutionalized orphans placed into foster care have much better intellectual development than those who remain behind. The authors say the results have implications for countries “grappling with how best to care for abandoned, orphaned and maltreated young children.”

A team of researchers including Nathan Fox, a professor of human development (College of Education) at the University of Maryland, has been studying a randomly chosen group of 136 abandoned children from six institutions in Bucharest, Romania for a number of years. The Bucharest Early Intervention Project (BEIP) tracked the children out to 54 months of age.

Also involved in the study are Charles Nelson of Harvard University ; Dr. Charles Zeanah and Anna Smyke of Tulane University , and Peter Marshall of Temple University. The research was supported by the MacArthur Foundation Research Network on “Early Experience and Brain Development.”

The Importance of Early Intervention

Earlier evidence from the intervention project showed that young children who remain institutionalized suffered intellectual, emotional, psychiatric and brain development problems. Prof. Fox says, “They are deprived of typical social and emotional stimulation and interaction, as well as typical cognitive and language stimulation.” Knowing this, the primary question researchers had was, is there a “best time” when intervention can help prevent these children from becoming psychologically deprived – when damage can be prevented. The Bucharest Early Intervention Project was designed to look at this issue of timing as it related to early deprivation.

The study accomplished this by randomly assigning children into two groups of children that were abandoned at or shortly after birth. “Children at the time of entry into the study ranged in age from 6-29 months of age,” says Fox.

Half the children remained in the institution, the other half were placed into foster care. All children were the subject of follow-up assessments that included not only cognitive development, but also standardized intelligence tests. Timing related to the intervention was looked at closely. A third group of children – who were being reared by their biological families in Bucharest – served as a base group.

The study was conducted with the full approval of the Government of Romania and was conducted as a way to help guide that nation’s child welfare policy. Before this study, there was a bias in the child welfare community towards institutionalized care. In fact, the BEIP had to create its own foster care program as part of the study because the government of Romania’s foster care program was limited to “about one family.” As part of the study’s ethical guidelines, no child placed into foster care was returned to an institution.

Methodology and Results

Fox and the other American researchers wanted to see if they could show there was improvement through specific tests of these institutionalized children.

After random assignment, the average age of children placed into foster care was 21 months of age. Testing was conducted prior to placement, at 30 months and 42 months using the Bayley Scales of Infant Development (BSID II), and at 54 months with the Weschsler Preschool Primary Scale of Intelligence (WPPSI-R) test. The BSID II test looks at a wide range of abilities, while the WPPSI-R test is more focused assessment of a child’s cognitive abilities. Romanian psychologists administered these tests.

The main findings from the study confirmed earlier results that “children reared in institutions showed greatly diminished intellectual performance relative to children reared in their families of origin.” Further, children who were randomly assigned to foster care experienced “significant gains in cognitive function.” Finally, on the importance of timing when pursuing intervention, Prof. Fox says, “the results show that the age point where things mattered was 24 months of age.” The report adds that “there was a continuing ‘cost’ to children who remained in the institution over the course of the study. The findings say it would take a larger study to really determine if there is a true “sensitive period” for intervention.


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