Department of Psychology and Human Development, Vanderbilt University, Nashville, TN 37203.
Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112.
Proc Natl Acad Sci U S A. 2022 Sep 20;119(38):e2119318119. doi: 10.1073/pnas.2119318119. Epub 2022 Sep 12.
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.
这项研究考察了布加勒斯特早期干预项目的纵向数据，该项目是一项针对严重心理社会剥夺后接受寄养替代机构照料的随机对照试验。我们报告了在成年早期（18 岁）评估的 135 名参与者的数据。我们发现，在随机分组 16 年后，那些被随机分配到高质量寄养家庭的人，其智商得分（9 分，0.6 标准差）明显高于那些被随机分配到常规护理的人。中介分析提供了证据表明，该干预措施对成年早期认知能力的因果效应可以部分解释为更好的养育和依恋安全性。这些发现表明，早期投资于家庭护理作为机构护理的替代方式，可以持续提高认知能力。培养养育关系是干预的一种可能机制。此外，探索性分析表明，整个儿童时期的稳定安置与认知能力的最大长期提高有关。婴儿和幼儿的早期干预是否会导致持久的变化，这对是否投资于旨在改善儿童发展结果的项目的决策具有重要意义。
