Bucharest early intervention project

9 important questions on Bucharest early intervention project

Which two points about experience are there

- experience cuts both ways; If a child is exposed to adverse experiences during a critical period of development (infection, maltreatment) or deprived of expectable experiences (nutrition, caregiving), brain development can be undermined

- brain plasticity changes with age;  
o In some domains change is possible throughout lifespan (learning and memory)
o In others, change is limited to the first years of life (we don’t learn to see better)

What happend in 1966 with the ceausescu legacy to Romania, decree

- Raise production by increasing population

- Belief that greater population = greater power

- Establishment of menstrual police

– state gynecologists who conducted monthly checks of women of childbearing age who had not borne at least 5 children -> make sure they didn’t use birth control or anticonception

- Established celibacy tax

– families received stipend for >2 children, tax for having <5 children - Outlawed all contraception and abortion

Children reared in institutions have dramatically high risk for variety of cognitive, social and behavioral problems such as;

Disturbances of social relatedness and attachment

o Externalizing behavior problems

o Inattention/hyperactivity

o Deficits in IQ and executive functions

o Syndrome that mimics autism

o Growth stunting -> institutionalized children lose about 1 moth of linear growth for every 1 month in an institution
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What was the study of bucharest early intervention project

First ever randomized controlled trial of foster care as intervention for social deprivation associated with institutionalization

- >180 children screened

- 72 never institutionalized children

- 136 children between 6 and 31 months assessed at baseline
o 68 randomly assigned to remain in institution
o 68 randomly assigned to high quality foster care

- Following baseline assessment children at 9, 18, 30, 42 months. Assessments performed at age 8, 12, 16 years and follow-up at age 21.

What were the findings of bucharest early intervention project

- IQ across first 12 years
o Young children living in institutions show significant delays in IQ
o Removal from institutions, particularly <24 months of age and placement into families remediates IQ deficits (recovery but not full recovery)
o 10 years after intervention began there are still positive effects on IQ
o Children with more placement disruptions have much less favorable outcomes -> stability matters  


attachment
o Never-institutionalized children: 70% has secure attachment

o Institutionalized children: 70% has insecure attachment

o Children in foster care before 22 months have 70% secure attachment. Placed after 22 months: 70% has insecure attachment

In attachment we also saw the institutionalization syndrome at the findings of bucharest study. What do we mean with this

Institutionalization syndrome: in stranger-room experiment, child acts like they have known the stranger before, indiscriminate behavior very common among kids with histories of neglect.

Give a summary of the Bucharest project

- Children experiencing early institutional care are more likely to develop disturbances in attachment than those who don’t

- Children randomly assigned to foster care following institutional care, particularly if they are placed before 22-24 months, are more likely to show an improvement in attachment behavior

Stranger at the door at 54 months old, says they have something to show the kid. Do they follow the stranger?

- Institutional group: >50% walked off
- Foster care: 25%
- Community: about 0

What do we see happening in the brain with the bucharest project

The brain
- Assume behavioral phenotype of institutionalized child reflects alterations in underlying brain development (EEG, MRI)

-EEG: much more brain activity in the never-institutionalized group compared to institutionalized group

- Children who received care as usual displayed deficits in brain electrical activity compared to children randomized to foster care intervention

- Children who received foster care intervention continued to show typical levels of brain activity through age 16

- Age of placement info foster care is associated with increase of alpha power

The question on the page originate from the summary of the following study material:

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