The Bucharest Early Intervention Project

NCT ID: NCT00747396

Last Updated: 2025-12-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

136 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-09-30

Study Completion Date

2027-03-31

Brief Summary

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The purpose of this study is to determine the long term effects of early intervention (placement into foster care) on physical, cognitive, social and brain development and psychiatric symptomatology in previously institutionalized children.

Detailed Description

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The Bucharest Early Intervention Project (BEIP) was a randomized controlled trial of foster care as an intervention for children abandoned at or around the time of birth and placed in one of six institutions for young children in Bucharest, Romania (Zeanah et al., 2003). The PI (Nelson) and Co-PIs (Zeanah and Fox) conducted this study beginning in the fall of 2000 from baseline assessments and implementation of the intervention in the spring of 2001.

The BEIP began with comprehensive assessments of 136 institutionalized children and their caregiving environments prior to randomization. Half the children were randomly assigned to high-quality foster care and the other half to remain in institutional care. The average age at foster care placement was 22 months (range=6-31 months). All children were initially seen prior to randomization and again for follow-up assessments at 30 months, 42 months 54 months, 8 years, 12 year and 16 years of age. The development of children in foster care was compared to the development of children in institutions and to a group of never institutionalized children (community controls). These children, now young adults are being assessed at age 21 years.

Conditions

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Cognitive Ability, General Psychiatric and/or Mood Disorders Brain Function Social Cognition Health Behavior Risk-Taking Executive Function

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

SINGLE

Participants

Study Groups

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Foster Care Placement Group

Children randomized to this group were placed in high quality foster care developed for the study.

Group Type EXPERIMENTAL

Foster Care Placement

Intervention Type OTHER

A group of children living in institutions in Bucharest, Romania was randomly assigned to placement in foster care. Foster parents were recruited, consented to background checks, and trained in Romanian. Before placement, foster parents visited their children to begin developing a relationship with the child. Hired foster parents were supported and monitored by project social workers. Foster parents in the BEIP network received frequent visits from the social workers, with visits occurring weekly for several months after placement of the child, then biweekly and later monthly. Foster parents were invited to participate in a support group organized by social workers. Project social workers consulted weekly with US staff experienced in dealing with young children in foster care.

Care As Usual Group

Children randomized to this group remained in institutional care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Foster Care Placement

A group of children living in institutions in Bucharest, Romania was randomly assigned to placement in foster care. Foster parents were recruited, consented to background checks, and trained in Romanian. Before placement, foster parents visited their children to begin developing a relationship with the child. Hired foster parents were supported and monitored by project social workers. Foster parents in the BEIP network received frequent visits from the social workers, with visits occurring weekly for several months after placement of the child, then biweekly and later monthly. Foster parents were invited to participate in a support group organized by social workers. Project social workers consulted weekly with US staff experienced in dealing with young children in foster care.

Intervention Type OTHER

Other Intervention Names

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Foster Care Group

Eligibility Criteria

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Inclusion Criteria

* previously institutionalized and community children that took part in previous BEIP assessments
* target recruitment age is +/- 6 mos of 21st birthday

Exclusion Criteria

* open or closed head injury within the past 12 months
* viral or bacterial meningitis within the past 12 months
Minimum Eligible Age

21 Years

Maximum Eligible Age

24 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tulane University Health Sciences Center

OTHER

Sponsor Role collaborator

University of Maryland

OTHER

Sponsor Role collaborator

University of Minnesota

OTHER

Sponsor Role collaborator

Temple University

OTHER

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

MacArthur Foundation

OTHER

Sponsor Role collaborator

National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Vanderbilt University

OTHER

Sponsor Role collaborator

Harvard University

OTHER

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role collaborator

University of Toronto

OTHER

Sponsor Role collaborator

Charles Alexander Nelson III

OTHER

Sponsor Role lead

Responsible Party

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Charles Alexander Nelson III

Richard David Scott Chair in Pediatric Developmental Medicine Research, Professor of Pediatrics and Neuroscience

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Charles A Nelson, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Boston/Harvard University

Nathan A. Fox, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Maryland

Charles H. Zeanah, M.D.

Role: PRINCIPAL_INVESTIGATOR

Tulane University Health Sciences Center

Locations

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Fundatia Tanner

Bucharest, , Romania

Site Status

Countries

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Romania

References

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Arnett AB, Antunez M, Zeanah C, Fox NA, Nelson CA. Physical and neurophysiological maturation associated with ADHD among previously institutionalized children: a randomized controlled trial. J Child Psychol Psychiatry. 2025 Jul;66(7):967-979. doi: 10.1111/jcpp.14110. Epub 2025 Jan 11.

Reference Type DERIVED
PMID: 39797613 (View on PubMed)

Guyon-Harris KL, Plamondon A, Humphreys KL, Wade M, Gleason MM, Tibu F, Nelson CA, Fox NA, Zeanah CH. Structure of Psychopathology in Romanian Preschool-Aged Children in an Epidemiological and a High-Risk Sample. JAACAP Open. 2023 Nov;1(3):173-183. doi: 10.1016/j.jaacop.2023.06.004. Epub 2023 Jul 19.

Reference Type DERIVED
PMID: 38500494 (View on PubMed)

King LS, Guyon-Harris KL, Valadez EA, Radulescu A, Fox NA, Nelson CA, Zeanah CH, Humphreys KL. A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation. Am J Psychiatry. 2023 Aug 1;180(8):573-583. doi: 10.1176/appi.ajp.20220672. Epub 2023 May 22.

Reference Type DERIVED
PMID: 37211832 (View on PubMed)

Humphreys KL, Guyon-Harris KL, Tibu F, Wade M, Nelson CA, Fox NA, Zeanah CH. Psychiatric outcomes following severe deprivation in early childhood: Follow-up of a randomized controlled trial at age 16. J Consult Clin Psychol. 2020 Dec;88(12):1079-1090. doi: 10.1037/ccp0000613.

Reference Type DERIVED
PMID: 33370132 (View on PubMed)

Humphreys KL, Machlin LS, Guyon-Harris KL, Nelson CA, Fox NA, Zeanah CH. Psychosocial deprivation and receptive language ability: a two-sample study. J Neurodev Disord. 2020 Dec 16;12(1):36. doi: 10.1186/s11689-020-09341-2.

Reference Type DERIVED
PMID: 33327936 (View on PubMed)

Slopen N, Tang A, Nelson CA, Zeanah CH, McDade TW, McLaughlin KA, Fox NA. The Consequences of Foster Care Versus Institutional Care in Early Childhood on Adolescent Cardiometabolic and Immune Markers: Results From a Randomized Controlled Trial. Psychosom Med. 2019 Jun;81(5):449-457. doi: 10.1097/PSY.0000000000000696.

Reference Type DERIVED
PMID: 31008902 (View on PubMed)

Wade M, Fox NA, Zeanah CH, Nelson CA, Drury SS. Telomere Length and Psychopathology: Specificity and Direction of Effects Within the Bucharest Early Intervention Project. J Am Acad Child Adolesc Psychiatry. 2020 Jan;59(1):140-148.e3. doi: 10.1016/j.jaac.2019.02.013. Epub 2019 Mar 4.

Reference Type DERIVED
PMID: 30844465 (View on PubMed)

Wade M, Fox NA, Zeanah CH, Nelson CA. Effect of Foster Care Intervention on Trajectories of General and Specific Psychopathology Among Children With Histories of Institutional Rearing: A Randomized Clinical Trial. JAMA Psychiatry. 2018 Nov 1;75(11):1137-1145. doi: 10.1001/jamapsychiatry.2018.2556.

Reference Type DERIVED
PMID: 30267045 (View on PubMed)

Johnson DE, Tang A, Almas AN, Degnan KA, McLaughlin KA, Nelson CA, Fox NA, Zeanah CH, Drury SS. Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial. J Pediatr. 2018 Dec;203:345-353.e3. doi: 10.1016/j.jpeds.2018.07.027. Epub 2018 Aug 29.

Reference Type DERIVED
PMID: 30172435 (View on PubMed)

Humphreys KL, Miron D, McLaughlin KA, Sheridan MA, Nelson CA, Fox NA, Zeanah CH. Foster care promotes adaptive functioning in early adolescence among children who experienced severe, early deprivation. J Child Psychol Psychiatry. 2018 Jul;59(7):811-821. doi: 10.1111/jcpp.12865. Epub 2018 Feb 1.

Reference Type DERIVED
PMID: 29389015 (View on PubMed)

Humphreys KL, McGoron L, Sheridan MA, McLaughlin KA, Fox NA, Nelson CA 3rd, Zeanah CH. High-Quality Foster Care Mitigates Callous-Unemotional Traits Following Early Deprivation in Boys: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry. 2015 Dec;54(12):977-83. doi: 10.1016/j.jaac.2015.09.010. Epub 2015 Oct 9.

Reference Type DERIVED
PMID: 26598472 (View on PubMed)

Humphreys KL, Gleason MM, Drury SS, Miron D, Nelson CA 3rd, Fox NA, Zeanah CH. Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial. Lancet Psychiatry. 2015 Jul;2(7):625-34. doi: 10.1016/S2215-0366(15)00095-4. Epub 2015 Jun 23.

Reference Type DERIVED
PMID: 26303560 (View on PubMed)

Bick J, Zhu T, Stamoulis C, Fox NA, Zeanah C, Nelson CA. Effect of early institutionalization and foster care on long-term white matter development: a randomized clinical trial. JAMA Pediatr. 2015 Mar;169(3):211-9. doi: 10.1001/jamapediatrics.2014.3212.

Reference Type DERIVED
PMID: 25622303 (View on PubMed)

Gleason MM, Fox NA, Drury S, Smyke A, Egger HL, Nelson CA 3rd, Gregas MC, Zeanah CH. Validity of evidence-derived criteria for reactive attachment disorder: indiscriminately social/disinhibited and emotionally withdrawn/inhibited types. J Am Acad Child Adolesc Psychiatry. 2011 Mar;50(3):216-231.e3. doi: 10.1016/j.jaac.2010.12.012. Epub 2011 Feb 1.

Reference Type DERIVED
PMID: 21334562 (View on PubMed)

Bos KJ, Zeanah CH Jr, Smyke AT, Fox NA, Nelson CA 3rd. Stereotypies in children with a history of early institutional care. Arch Pediatr Adolesc Med. 2010 May;164(5):406-11. doi: 10.1001/archpediatrics.2010.47.

Reference Type DERIVED
PMID: 20439790 (View on PubMed)

Johnson DE, Guthrie D, Smyke AT, Koga SF, Fox NA, Zeanah CH, Nelson CA 3rd. Growth and associations between auxology, caregiving environment, and cognition in socially deprived Romanian children randomized to foster vs ongoing institutional care. Arch Pediatr Adolesc Med. 2010 Jun;164(6):507-16. doi: 10.1001/archpediatrics.2010.56. Epub 2010 Apr 5.

Reference Type DERIVED
PMID: 20368481 (View on PubMed)

Other Identifiers

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R01MH091363

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB-P00011741

Identifier Type: -

Identifier Source: org_study_id

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