The Bucharest Early Intervention Project
The Bucharest Early Intervention Project (BEIP) is the first in the world to examine how early, severe adversity weaves its way into the structure of the brain to influence behavior and whether the brain can recover. It began in 2000, when a team of researchers headed by Charles A. Nelson, PhD, comprehensively assessed 136 children between the ages of 6 and 31 months institutionalized in Bucharest’s 6 institutions for young children.
Romania’s abandoned and orphaned children have long languished in state-run orphanages. The orphanages, built during the Ceausescu regime, provide little emotional, social, or physical stimulation, resulting in conditions of profound deprivation. The post-Ceaucescu government has sought better lives for these children. Since 2001, it has cooperated with an international study probing the impact of early deprivation on Romania’s institutionalized children and the potential healing effects of placing children in foster care/families. That study, the Bucharest Early Intervention Project, is providing the sound, scientific information policymakers need to reassess and reorganize the country’s child welfare system. The study is seeking funding for a critical new phase of investigation.
The researchers measured the children’s brain activity; emotional, intellectual, and language development; attachment to caregivers; and mental health. Their findings were dramatic. Compared to their age-matched, typically developing peers living in the community, children in the orphanages had lower IQs (an average of 65 compared to 103) and more mental illness (56% versus 14%). They smiled less, laughed less, and were less likely to initiate or respond to social interaction. Their language skills were stunted, as was their ability to form healthy attachments to caregivers (indeed, a sizeable minority of children failed to form any attachment). Their brains reflected this paucity of development: they showed significant reductions in activity.
Saving the Children
These dire consequences of the sterile institutional environment were not surprising. But the findings gave urgency to the researchers’ most important question: Could these young brains – these young lives – show sign of recovery?
The answer to that question has been emerging over the past five years. The Bucharest Early Intervention Project set up a network of foster care families and randomly selected half the children to be placed with foster families (there weren’t enough foster families to place all the children). The researchers have since followed both groups of children, plus the control group of youngsters from the community. They repeated all the initial assessments at 9, 18, 30, 42, and 54 months. Again, their findings have been dramatic. The children in foster care are making gains in intelligence, language development, social engagement, and mental health.
But this time, some findings are surprising. For instance: rates of emotional disorders (such as depression or anxiety) dropped dramatically in the foster care group while those of behavioral disorders, such as attention deficit disorder, did not. Also, girls are generally doing better than boys. Language skills are also improving unevenly – the children who were youngest when placed in foster care are approaching normal, a recovery that, sadly, does not seem to be occurring in children first placed in foster care well after the age of 2.
The oldest children in the study are now turning eight and the researchers want to assess them again. This is a critical age, as many of these children are now in school. Have these children continued to improve? Are the disparities between the sexes evening out? Are the older children gaining language skills and are behavioral problems beginning to abate or did developmental windows bang shut before the children entered foster care? Do some cognitive or social domains have sensitive periods during which remediation is possible but after which intervention has no effect?
Answers to such questions are crucial to guide Romanian policymakers seeking to reform child welfare services. When the BEIP project first started, there was only 1 state-run foster care family in Bucharest; now there are more but certainly not enough. Moreover, the Romanian child protection system is fledgling at best Scientific data will play a critical role in building acceptance for this new approach to caring for Romania’s most vulnerable children.
The Bucharest Early Intervention Project also puts Romania in the forefront of a vital but little researched field. Surprisingly few studies have examined the effects of profound early deprivation. This study is the only one of its kind in terms of participants and method. The results of the Bucharest Early Intervention Project will thus contribute substantially to knowledge of the effects of early experiences of deprivation. They will illuminate the impact of social and material neglect on young children’s development wherever it occurs and whatever the cause – war, AIDS, institutionalization, or emotional abandonment within a presumably functional home.
Budget and Timeline
The Bucharest Early Intervention Project is an outgrowth of the Research Network on Early Experience and Brain Development, an initiative funded by the John D. and Catherine T. MacArthur Foundation and chaired by Dr. Charles Nelson, principal investigator for the BEIP (please see Dr. Nelson’s bio, attached). The MacArthur Foundation has provided a generous grant of $350,000 to jumpstart this next phase of the project. However, the $350,000 covers less than one-quarter of the project’s costs. The budget that follows details the resources necessary to complete the study. Many of the items still to be funded will directly build research capacity in Romania.