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Randomized Controlled Trial
. 2022 Sep 20;119(38):e2119318119.
doi: 10.1073/pnas.2119318119. Epub 2022 Sep 12.

Foster care leads to sustained cognitive gains following severe early deprivation

Kathryn L Humphreys  1   2 , Lucy S King  2 , Katherine L Guyon-Harris  2   3 , Margaret A Sheridan  4 , Katie A McLaughlin  5 , Anca Radulescu  6 , Charles A Nelson  7   8 , Nathan A Fox  9 , Charles H Zeanah  2
Affiliations
Randomized Controlled Trial

Foster care leads to sustained cognitive gains following severe early deprivation

Kathryn L Humphreys et al. Proc Natl Acad Sci U S A. .

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.

Keywords: IQ; cognitive ability; foster care; institutionalization; intervention.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Fig. 1.
Fig. 1.
FSIQ scores at age 18 y as a function of ITT group. Distributions of FSIQ scores at age 18 y within participants randomized to care as usual (CAUG) and participants randomized to the foster care intervention (FCG). Distributions are rotated kernel density plots trimmed to the range of the observed values.
Fig. 2.
Fig. 2.
Quality of caregiving in early life as a potential mechanism explaining the effect of the foster care intervention on FSIQ scores at age 18 y. ITT group was associated with caregiving quality in early life (A), and caregiving quality was in turn associated with FSIQ scores at age 18 y (B). Distributions are rotated kernel density plots trimmed to the range of the observed values. There was a significant indirect effect for caregiving quality in early life in partially explaining the causal effect of the intervention on IQ scores at age 18 y (C).
Fig. 3.
Fig. 3.
FSIQ scores at age 18 y as a function of age of placement into foster care among those in the FCG.
See this image and copyright information in PMC

Comment in

References

    1. Bailey D., Duncan G. J., Odgers C. L., Yu W., Persistence and fadeout in the impacts of child and adolescent interventions. J. Res. Educ. Eff. 10, 7–39 (2017). - PMC - PubMed
    1. Tucker-Drob E. M., Briley D. A., Harden K. P., Genetic and environmental influences on cognition across development and context. Curr. Dir. Psychol. Sci. 22, 349–355 (2013). - PMC - PubMed
    1. Humphreys K. L., King L. S., Gotlib I. H., “Neglect” in Handbook of Infant Mental Health, Zeanah C. H., Ed. (Guilford Press, ed. 4, 2018), pp. 239–256.
    1. Hillis S. D., et al. , Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: A modelling study. Lancet 398, 391–402 (2021). - PMC - PubMed
    1. Nelson C. A. III, et al. , Cognitive recovery in socially deprived young children: The Bucharest Early Intervention Project. Science 318, 1937–1940 (2007). - PubMed

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