A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation.
Level 2 - randomized trial
Randomized controlled trial with longitudinal follow-up across nearly 20 years
PubMed 37211832 · doi:10.1176/appi.ajp.20220672
What was done
An intent-to-treat multilevel analysis synthesized nearly 20 years of follow-up data from the Bucharest Early Intervention Project. A total of 136 infants residing in institutions in Bucharest, Romania (aged 6–31 months at baseline) were randomly assigned to either foster care (n = 68) or institutional care as usual (n = 68). Outcomes across 7,088 total observations were evaluated at ages 30, 42, and 54 months and 8, 12, and 16–18 years for IQ, physical growth, brain electrical activity (EEG), and symptoms across five types of psychopathology.
What was found
The abstract reports directionality without providing numerical values, confidence intervals, or p-values: children assigned to foster care had better cognitive and physical outcomes and less severe psychopathology than those receiving care as usual. The magnitude of these effects remained stable across development through late adolescence, with the foster care intervention most strongly influencing IQ and disorders of attachment/social relatedness.
Why it matters
This longitudinal synthesis of a landmark randomized trial demonstrates that family placement provides enduring developmental benefits through late adolescence for infants exposed to severe early institutional deprivation.
Limits
The abstract reports no numerical effect sizes, confidence intervals, or statistical test values. The sample size is modest (n = 136), and the study reflects a specific institutional care context in Bucharest, Romania, which may limit generalizability to other settings of early deprivation.