Table 55Results: Bucharest early intervention project versus institutional care

First Author et al., YearComparison GroupsMental and Behavioral HealthHealthy Caregiver-Child RelationshipHealthy Development
Ghera et al., 2009120G1:Foster care
G2: Institutional care group
Attentiona(Lab-TAB)
T1: No difference between groups G1 and G2, p>0.05
T2: G1+>G2, p=0.01

Positive Affecta
T1: G1+>G2, p<0.001
T2: G1+>G2, p<0.001

Negative Affecta
T1, T2: No difference between groups G1 and G2, p>0.05
NANA
Zeanah et al., 2009129G1:Foster care
G2: Institutional care
Psychiatric Disordera (Preschool Age Psychiatric Assessment)
Any Disorder
G1>G2, p=0.10, trend

Any Externalizing Disorder
No difference between G1 and G2, p=0.69

Any Internalizing Disorder
G1> G2, p=0.01, OR 2.8b (95% CI, 1.2 to 6.4)

ADHD
No difference between G1 and G2, p=0.57

Opp. Defiant or Conduct D/O
No difference between G1 and G2, p=0.57

Depression
No difference between G1 and G2, p=0.50

Any Anxiety
G1>G2, p=.01, OR 2.9b (95% CI, 1.2 to 6.6)

Comorbid D/O>2
No difference between G1 and G2, p=0.53
NANA
McLaughlin 2012125G1:Foster care
G2: Institutional care
Psychiatric Disordera (Preschool Age Psychiatric Assessment)

Any Internalizing Disorder among Females
G1> G2, p=0.006, OR 0.17

Any Internalizing Symptoms among Females
G1> G2, p=0.004

Depression among Females
G1> G2, p=0.009

Anxiety among Females
G1> G2, p=0.009

Any Externalizing Disorder among Females
No difference between G1 and G2, p=NR

Any Externalizing Symptoms among Females
No difference between G1 and G2, p=NR

Any Internalizing Disorder among Males
No difference between G1 and G2, p=0.150

Any Internalizing Symptoms among Males
No difference between G1 and G2, p=0.372

Depression among Males
No difference between G1 and G2, p=0.879

Anxiety among males
No difference between G1 and G2, p=0.190

Any Externalizing Disorder among Males
No difference between G1 and G2, p=NR

Any Externalizing Symptoms among Males
No difference between G1 and G2, p=NR
Bos et al., 2010118G1:Foster care
G2: Institutional care
Presence of Stereotypies (Preschool Age Psychiatric Assessment)
T1: G1>G2, p=0.003
T2: G1>G2, p=0.001
T3: G1>G2, p=0.04
NANA
Smyke et al., 2010127G1:Foster care
G2: Institutional care
NAAttachment at 42 months* (strange situation)

Distribution of Attachment Types
G1>G2, p<0.001

Organized v. Atypical
G1>G2, p<0.01
Organized v. Atypical among G1
Girls>Boys, p<0.05

Secure v. Insecurer
G1>G2, p<0.001

Secure v. Insecure among G1
Girls>Boys, p=0.055

Mean Attachment Security Rating (Observation, score 0 to 9)
G1>G2, p<0.001
McLaughlin 2012125G1:Foster care
G2: Institutional care
NAAttachment at 42 monthsa (strange situation)

Secure v. Insecure among Females
T2 G1>G2, p<0.001, OR=12.5

Change from Insecure to secure among Females
T2 G1>G2, p=0.029, OR= 6.6

Secure v. Insecure among males
T2 No difference between G1 and G2, p=.205, OR= 1.1
Change from Insecure to secure among males
T2 No difference between G1 and G2, p=.250, OR= 2.2
Nelson et al., 2007126G1:Foster care
G2: Institutional care
NANADevelopmental/Intellectual Quotienta (Bayley Scales of Infant Development, Wechsler Preschool and Primary Scale of Intelligence)
T1: G1>G2, p=0.001, ES=0.62
T2: G1>G2, p=0.015, ES=0.47
Marshall et al., 2008122G1:Foster care
G2: Institutional care
NANAEEG signal power and coherencea
EEG Power (Absolute)
No difference between groups G1 and G2, p=NR, NS
EEG Coherence
No difference between groups G1 and G2, p=NR, NS
Bos et al., 2009117G1:Foster care
G2: Institutional care group
NANAMemorya (CANTAB)
No difference between groups G1 and G2, p>0.05

Executive Functioning* (CANTAB):

Stocking of Cambridge subtest:
No difference between groups G1 and G2, p>0.05

Spatial working memory subtest, total errors:
No difference between groups G1 and G2, p>0.05

Spatial working memory subtest, strategy:
G1+>G2, p=0.008
Fox et al., 2011119G1:Foster care
G2: Institutional care group
NANAIntellectual Quotient* (Wechsler Intelligence Scale for Children, WISC-IV)
Verbal Comprehension subtest:
G1+>G2, p=0.036

Perceptual Reasoning subtest:
No difference between groups G1 and G2, p>0.05

Working Memory subtest:
No difference between groups G1 and G2, p>0.05

Processing Speed subtest
No difference between groups G1 and G2, p>0.05

Full IQ:
G1+>G2, trend p=0.07
Johnson et al., 2010121G1:Foster care
G2: Institutional care group
NACaregiving Quality (Observational Record of the Caregiving Environment-ORCE)
T1 G1>G2, p<0.05
T2 No difference between groups G1 and G2, p>0.05
T1/T2 mean G1>G2, p<0.05
Auxologya (physical maturation)
Height:
Mean growth Baseline /T1/T2
G1*>G2, p <0.001
Growth change from Baseline/T1/T2
G1*>G2, p <0.001

Weight
Mean growth Baseline /T1/T2
G1a>G2, p <0.001
Growth change from Baseline/T1/T2
G1a>G2, p =0.05

Occipital-frontal circumference (Head grow):
Growth change from Baseline/T1/T2
No difference between groups G1 and G2, p>0.05

Developmental/Intellectual Quotienta (Bayley Scales of Infant Development, Wechsler Preschool and Primary Scale of Intelligence)

T2 (DQ)G1a>G2, p <0.05,
T3 (IQ) G1a>G2, p <0.05
McDermott., 2012123G1:Foster care
G2: Institutional care group
NANAExecutive Functioning (inhibitory control, Go/No Go task):

Accuracy:
G1>G2, p <0.05
Faster Reaction time
G1>G2, p <0.05
Differential reactivity (larger error related negativity difference score between correct and error trials)
G1>G2, p=0.01
McLaughlin 2011124G1:Foster care
G2: Institutional care
NANAEEG Frontal Asymmetry
No difference between groups G1 and G2, p=.663
EEG Parietal Asymmetry
No difference between groups G1 and G2, p=.980
Windsor et al., 2011128G1:Foster care
G2: Institutional care group
NANAExpressive and Receptive Languagea (Receptive-Expressive Emergent Language Scale-REEL; Reynell Developmental Language Scales-III-RDLS)

REEL-R (Receptive):
T1 G1>G2, p=NR
ES=0.53 (d)
REEL-E (Expressive):
T1 No difference between groups G1 and G2, p=NR

RDLS-Expressive:
T2 G1>G2, p=NR
ES=0.50 (d)
RDLS-Receptive:
T2 G1>G2, p=NR
ES=0.63 (d)
a

= intention-to-treat (ITT) analysis

b

Odds ratio indicator of probability: no association is represented by 1, the greater the departure from 1 the stronger the relationship.

Abbreviations: ADGD = attention deficit hyperactivity disorder; G = group; Lab-TAB = Laboratory Temperament Assessment Battery; NA = not applicable; NR = not reported; OR = odds ratio; SOE = strength of evidence; T = time.

From: Results

Cover of Child Exposure to Trauma: Comparative Effectiveness of Interventions Addressing Maltreatment
Child Exposure to Trauma: Comparative Effectiveness of Interventions Addressing Maltreatment [Internet].
Comparative Effectiveness Reviews, No. 89.
Fraser JG, Lloyd SW, Murphy RA, et al.

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