Foster Care Intervention May Lower Depression, Anxiety

PHILADELPHIA – A study assessing the impact of institutional living on Romanian children shows that foster care is effective at reversing some developmental delays, as well as decreasing rates of depression and anxiety, Charles A. Nelson III, Ph.D., said at the annual meeting of the Society for Developmental and Behavioral Pediatrics.

In the 1960s, child abandonment became a national problem in Romania after the communist party instituted policies to increase the population as a way to increase national production. Taxes were levied on families with fewer than five children, and the government outlawed contraception and abortion.

Families unable to afford to care for their children were encouraged to turn them over to the state to be raised in government-run institutions. In the early 1990s, these institutions came under close scrutiny, revealing that children raised there were at increased risk for social and behavioral abnormalities.

These developmental problems probably result from deprivation inherent in the institutional system, said Dr. Nelson, director of research in the developmental medicine center at Children's Hospital in Boston. Dr. Nelson and his colleagues wanted to look at whether removing these children from an institutional environment would improve social and behavioral problems.

In the ongoing study, called the Bucharest Early Intervention Project, the researchers randomized 136 children between 6 and 31 months of age who had been institutionalized to remain in the institution or to move to foster care.

After a baseline assessment, 68 children were assigned to remain at their institutions and 68 were removed and placed in foster care. A control group of 72 children who had never been institutionalized was matched for age and gender. Because of dropouts and changes in status, only 17 children remain in the institutional setting, 38 remain in foster care, and 46 never-institutionalized children are still in the study.

The children were assessed at baseline, 9 months, 18 months, 30 months, 42 months, and most recently at 54 months of age. The researchers plan to assess the children again when they are 7–8 years old.

At the time of the study, Romania did not have a foster care system, so the researchers had to build a foster care program from scratch. To participate, the families can only accept one child in the home and one parent has to stay home with the child. Foster families receive a stipend and have constant access to a pediatrician, but they are not allowed to put the children in day care full time. The children placed in foster care also have regular contact with project social workers, Dr. Nelson said.

He and his colleagues found that children placed in foster care were less likely to have an emotional disorder than were children who were institutionalized, but no significant differences were found between the prevalence of behavioral disorders between the two groups.

But when it came to emotional disorders such as depression and anxiety, foster care seemed to be making a difference, Dr. Nelson said. Rates of depression were 8.5% in the institutionalized children, compared with 3% among children in foster care. The prevalence of anxiety disorders in the institutional group was 44% when the children were 54 months old, compared with 20% among foster care children at the same age.

PHILADELPHIA – A study assessing the impact of institutional living on Romanian children shows that foster care is effective at reversing some developmental delays, as well as decreasing rates of depression and anxiety, Charles A. Nelson III, Ph.D., said at the annual meeting of the Society for Developmental and Behavioral Pediatrics.

In the 1960s, child abandonment became a national problem in Romania after the communist party instituted policies to increase the population as a way to increase national production. Taxes were levied on families with fewer than five children, and the government outlawed contraception and abortion.

Families unable to afford to care for their children were encouraged to turn them over to the state to be raised in government-run institutions. In the early 1990s, these institutions came under close scrutiny, revealing that children raised there were at increased risk for social and behavioral abnormalities.

These developmental problems probably result from deprivation inherent in the institutional system, said Dr. Nelson, director of research in the developmental medicine center at Children's Hospital in Boston. Dr. Nelson and his colleagues wanted to look at whether removing these children from an institutional environment would improve social and behavioral problems.

In the ongoing study, called the Bucharest Early Intervention Project, the researchers randomized 136 children between 6 and 31 months of age who had been institutionalized to remain in the institution or to move to foster care.

After a baseline assessment, 68 children were assigned to remain at their institutions and 68 were removed and placed in foster care. A control group of 72 children who had never been institutionalized was matched for age and gender. Because of dropouts and changes in status, only 17 children remain in the institutional setting, 38 remain in foster care, and 46 never-institutionalized children are still in the study.

The children were assessed at baseline, 9 months, 18 months, 30 months, 42 months, and most recently at 54 months of age. The researchers plan to assess the children again when they are 7–8 years old.

At the time of the study, Romania did not have a foster care system, so the researchers had to build a foster care program from scratch. To participate, the families can only accept one child in the home and one parent has to stay home with the child. Foster families receive a stipend and have constant access to a pediatrician, but they are not allowed to put the children in day care full time. The children placed in foster care also have regular contact with project social workers, Dr. Nelson said.

He and his colleagues found that children placed in foster care were less likely to have an emotional disorder than were children who were institutionalized, but no significant differences were found between the prevalence of behavioral disorders between the two groups.

But when it came to emotional disorders such as depression and anxiety, foster care seemed to be making a difference, Dr. Nelson said. Rates of depression were 8.5% in the institutionalized children, compared with 3% among children in foster care. The prevalence of anxiety disorders in the institutional group was 44% when the children were 54 months old, compared with 20% among foster care children at the same age.

PHILADELPHIA – A study assessing the impact of institutional living on Romanian children shows that foster care is effective at reversing some developmental delays, as well as decreasing rates of depression and anxiety, Charles A. Nelson III, Ph.D., said at the annual meeting of the Society for Developmental and Behavioral Pediatrics.

In the 1960s, child abandonment became a national problem in Romania after the communist party instituted policies to increase the population as a way to increase national production. Taxes were levied on families with fewer than five children, and the government outlawed contraception and abortion.

Families unable to afford to care for their children were encouraged to turn them over to the state to be raised in government-run institutions. In the early 1990s, these institutions came under close scrutiny, revealing that children raised there were at increased risk for social and behavioral abnormalities.

These developmental problems probably result from deprivation inherent in the institutional system, said Dr. Nelson, director of research in the developmental medicine center at Children's Hospital in Boston. Dr. Nelson and his colleagues wanted to look at whether removing these children from an institutional environment would improve social and behavioral problems.

In the ongoing study, called the Bucharest Early Intervention Project, the researchers randomized 136 children between 6 and 31 months of age who had been institutionalized to remain in the institution or to move to foster care.

After a baseline assessment, 68 children were assigned to remain at their institutions and 68 were removed and placed in foster care. A control group of 72 children who had never been institutionalized was matched for age and gender. Because of dropouts and changes in status, only 17 children remain in the institutional setting, 38 remain in foster care, and 46 never-institutionalized children are still in the study.

The children were assessed at baseline, 9 months, 18 months, 30 months, 42 months, and most recently at 54 months of age. The researchers plan to assess the children again when they are 7–8 years old.

At the time of the study, Romania did not have a foster care system, so the researchers had to build a foster care program from scratch. To participate, the families can only accept one child in the home and one parent has to stay home with the child. Foster families receive a stipend and have constant access to a pediatrician, but they are not allowed to put the children in day care full time. The children placed in foster care also have regular contact with project social workers, Dr. Nelson said.

He and his colleagues found that children placed in foster care were less likely to have an emotional disorder than were children who were institutionalized, but no significant differences were found between the prevalence of behavioral disorders between the two groups.

But when it came to emotional disorders such as depression and anxiety, foster care seemed to be making a difference, Dr. Nelson said. Rates of depression were 8.5% in the institutionalized children, compared with 3% among children in foster care. The prevalence of anxiety disorders in the institutional group was 44% when the children were 54 months old, compared with 20% among foster care children at the same age.