OBJECTIVE The Bucharest Early Intervention Project is the first randomized controlled trial of foster care as an alternative to institutional care. The authors synthesized data from nearly 20 years of assessments of the trial to determine the overall intervention effect size across time points and developmental domains. The goal was to quantify the overall effect of the foster care intervention on children's outcomes and examine sources of variation in this effect, including domain, age, and sex assigned at birth. METHODS An intent-to-treat approach was used to examine the causal effects of the randomized controlled trial for 136 children residing in institutions in Bucharest, Romania (baseline age, 6-31 months) who were randomly assigned to either foster care (N=68) or care as usual (N=68). At ages 30, 42, and 54 months and 8, 12, and 16-18 years, children were assessed for IQ, physical growth, brain electrical activity (EEG), and symptoms of five types of psychopathology. RESULTS Participants provided 7,088 observations across follow-up waves. Children assigned to foster care had better cognitive and physical outcomes and less severe psychopathology than did those who received care as usual. The magnitude of these effect sizes remained stable across development. The foster care intervention most influenced IQ and disorders of attachment/social relatedness. CONCLUSIONS Young children benefit from placement in families after institutional care. The benefits of foster care for previously institutionalized children were remarkably stable across development.

中文翻译：

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布加勒斯特早期干预项目的全面多层次分析：对早期严重剥夺恢复的因果影响。

目标 布加勒斯特早期干预项目是第一个将寄养护理作为机构护理替代方案的随机对照试验。作者综合了近 20 年的试验评估数据，以确定跨时间点和发育领域的总体干预效果大小。目标是量化寄养干预对儿童结局的总体影响，并检查这种影响的变异来源，包括领域、年龄和出生时分配的性别。方法 采用意向治疗方法来检查随机对照试验的因果效应，该试验针对居住在罗马尼亚布加勒斯特机构的 136 名儿童（基线年龄为 6-31 个月），这些儿童被随机分配到寄养机构（N= 68) 或照常护理 (N=68)。在 30、42 和 54 个月以及 8、12 和 16-18 岁时，对儿童的智商、身体发育、脑电活动 (EEG) 和五种精神病理学症状进行评估。结果 参与者在后续波次中提供了 7,088 个观察结果。与正常接受寄养的孩子相比，被分配到寄养的孩子有更好的认知和身体状况，并且精神病理学症状也更轻。这些效应大小的大小在整个开发过程中保持稳定。寄养干预对智商和依恋/社会相关性障碍影响最大。结论 幼儿在接受机构照顾后被安置在家庭中会受益。寄养对以前被送入机构的儿童的好处在整个发展过程中非常稳定。