The Bucharest Early Intervention Project (BEIP)

The recruitment status of this study is unknown because the information has not been verified recently.

Verified September 2008 by Children's Hospital Boston.
Recruitment status was Active, not recruiting

Sponsor:

Collaborators:

MacArthur Foundation

Tulane University Health Sciences Center

University of Maryland

University of Minnesota - Clinical and Translational Science Institute

Temple University

Duke University

Information provided by:

Children's Hospital Boston

ClinicalTrials.gov Identifier:

NCT00747396

First received: September 4, 2008

Last updated: September 11, 2008

Last verified: September 2008

History of Changes

Purpose

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

Condition	Intervention
Cognition Psychiatric Symptomatology Growth Brain Function	Other: foster care placement

Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	The Bucharest Early Intervention Project

Further study details as provided by Children's Hospital Boston:

Primary Outcome Measures:

Cognition [ Time Frame: baseline, 30 mos, 42 mos, 54 mos and 8 years ] [ Designated as safety issue: No ]
Physical Growth (weight, height and head circumference) [ Time Frame: baseline, 30 mos, 42 mos and 8 years ] [ Designated as safety issue: No ]
Psychiatric Symptomatology [ Time Frame: 54 mos and 8 years ] [ Designated as safety issue: No ]
Language [ Time Frame: 30 mos, 42 mos and 8 years ] [ Designated as safety issue: No ]
Brain Function (EEG asymmetry, coherence and power) [ Time Frame: baseline, 30 mos, 42 mos, and 8 years ] [ Designated as safety issue: No ]
Attachment Disturbances and Disorders [ Time Frame: baseline, 30 mos, 42 mos, 54 mos and 8 years ] [ Designated as safety issue: No ]
Attachment Style (Strange Situation Procedure) [ Time Frame: baseline, 30 mos and 42 mos ] [ Designated as safety issue: No ]
Caregiving Environment [ Time Frame: baseline, 30 mos and 42 mos ] [ Designated as safety issue: No ]
Indiscriminate Behavior [ Time Frame: 54 mos and 8 years ] [ Designated as safety issue: No ]
Emotion Discrimination (ERP) [ Time Frame: baseline, 30 mos, 42 mos and 8 years ] [ Designated as safety issue: No ]
Face Recognition (ERP) [ Time Frame: baseline, 30 mos, 42 mos and 8 years ] [ Designated as safety issue: No ]
Brain Structure (MRI) [ Time Frame: 8 years ] [ Designated as safety issue: No ]
Problem Behaviors [ Time Frame: baseline, 30 mos and 42 mos ] [ Designated as safety issue: No ]
Social Communication and Interaction [ Time Frame: baseline, 30 mos, 42 mos and 8 years ] [ Designated as safety issue: No ]
Genetics [ Time Frame: 8 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Emotional Reactivity/Temperament [ Time Frame: baseline, 30 mos and 42 mos ] [ Designated as safety issue: No ]
Motor Skills [ Time Frame: 8 years ] [ Designated as safety issue: No ]

Enrollment:	136
Study Start Date:	September 2000
Estimated Study Completion Date:	May 2009
Estimated Primary Completion Date:	May 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: 1 Foster Care Group (placement into foster care)	Other: foster care placement A group of children living in any of the six institutions for young, abandoned children in Bucharest, Romania was randomly assigned to placement in foster care. Foster parents were recruited and consented to background checks, received parent training in Romanian. Prior to placement, foster parents visited their children in the institution to begin developing a relationship with the child. Once 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 occuring weekly for several months after initial placement of the child, then biweekly and later monthly. Foster parents wer also given the opportunity to take part in a support group organized by project social workers. Project social workers received weekly consultation from US staff experienced in dealing with young children in foster care.

Arms

Assigned Interventions

Experimental: 1

Foster Care Group (placement into foster care)

Other: foster care placement

A group of children living in any of the six institutions for young, abandoned children in Bucharest, Romania was randomly assigned to placement in foster care. Foster parents were recruited and consented to background checks, received parent training in Romanian. Prior to placement, foster parents visited their children in the institution to begin developing a relationship with the child. Once 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 occuring weekly for several months after initial placement of the child, then biweekly and later monthly. Foster parents wer also given the opportunity to take part in a support group organized by project social workers. Project social workers received weekly consultation from US staff experienced in dealing with young children in foster care.

Detailed Description:

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 from a feasibility phase in the fall of 2000, through 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, 42 and 54 months og 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 are currently being assessed at age 8 years.

Eligibility

Ages Eligible for Study:	93 Months to 99 Months
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria for assessment at age 96 months:

previously institutionalized children that took part in previous BEIP assessments
within 3 mos of 8th birthday

Exclusion Criteria for assessment at age 96 months:

open or closed head injury within the past 12 months
viral or bacterial meningitis within the past 12 months

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00747396

Locations

Romania
Fundatia Tulane
Bucharest, Romania, 011467

Sponsors and Collaborators

Children's Hospital Boston

MacArthur Foundation

Tulane University Health Sciences Center

University of Maryland

University of Minnesota - Clinical and Translational Science Institute

Temple University

Duke University

Investigators

Principal Investigator:	Charles A Nelson, Ph.D.	Children's Hospital Boston/Harvard University
Principal Investigator:	Nathan A. Fox, Ph.D.	University of Maryland
Principal Investigator:	Charles H. Zeanah, M.D.	Tulane University Health Sciences Center

More Information

No publications provided by Children's Hospital Boston

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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. Epub 2011 Feb 1.

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.

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. Epub 2010 Apr 5.

Responsible Party:	Charles A. Nelson III, Ph.D./Richard David Scott Chair in Pediatric Developmental Medicine Research, Professor of Pediatrics and Neuroscience, Children's Hospital Boston/Harvard Medical School
ClinicalTrials.gov Identifier:	NCT00747396 History of Changes
Other Study ID Numbers:	06-86458-000-HCD
Study First Received:	September 4, 2008
Last Updated:	September 11, 2008
Health Authority:	United States: Institutional Review Board

Keywords provided by Children's Hospital Boston:

Romania,
children,
foster care,
institutionalization,
brain function,
MRI,

attachment,
language,
growth,
IQ,
psychiatric symptomatology
early intervention

ClinicalTrials.gov processed this record on June 18, 2013

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