~The BEIP

Question 1

What does BEIP stand for?

Answer 1

The Bucharest Early Intervention Project

Question 2

What is the BEIP?

Answer 2

The BEIP is the first and only randomized controlled trial comparing child outcomes of institutional care (orphanage) vs. foster care

Question 3

How did the Controlled trial work?

Answer 3

Half of the children were randomly assigned to stay in the orphanage (care-as-usual), and the other half were assigned to be in a foster home, to see if there were any differences that resulted from children growing up in those different contexts

Question 4

Why was the BEIP done?

Answer 4

At the time of the start of this project, there was not a clear consensus of what the best place was for children who didn’t have an existing family

Question 5

What was the Control/Comparison Group in the BEIP?

Answer 5

The children who had never been institutionalized, these kids had been raised by their families from birth

Question 6

Children in the BEIP were followed ___ into their teen years

Answer 6

longitudinally

Question 7

What does it mean to Externalize symptoms?

Answer 7

Turning internal strife or frustration outward

Question 8

What are examples of Externalizing symptoms?

Answer 8

Aggression, emotional outbursts, violence, & stealing

Question 9

What does it mean to Internalize problems?

Answer 9

Taking difficulties and turning them inward against yourself

Question 10

What are examples of Internalizing symptoms?

Answer 10

Depression, anxiety, self-recrimination

Question 11

What were some of the comparison functions used from the Control group?

Answer 11

Using the never-institutionalized kids depression, anxiety, and aggression levels as the baseline level that you might expect in the population to compare against the Orphanage and Foster kids levels

Question 12

What levels of Internalizing symptoms did the Stable Foster Kids show?

Answer 12

Stable Foster Care kids had a similar level of Internalizing Symptoms as the never-institutionalized group, so their anxiety and depression was low

Question 13

What levels of Externalizing symptoms did the Stable Foster Kids show?

Answer 13

Stable Foster Care kids showed slightly higher levels of Externalizing Symptoms like aggression and outbursts, but not dramatically higher

Question 14

What did the Stable Foster Kids level of External and Internalized symptoms show?

Answer 14

This points to the basic finding of the BEIP, which is that even after living the first years of your life in severe deprivation, and in an institutional setting that is not quite equipped to care for young children, you can still do quite well, and come out with reasonably good mental health if you are placed into a stable and supportive home, and go on to be raised in that setting

Question 15

What levels of Internalizing & Externalizing symptoms did the Disrupted Foster-Care Kids show?

Answer 15

The Disrupted Foster-Care Kids show higher rates of mental health symptoms both Externally and Internally than the Stable Foster-Care Kids

Question 16

Which group showed the highest rates of Externalizing symptoms?

Answer 16

The Care-As-Usual showed the highest rates of Externalizing Symptoms, and comparable rates of Internalizing Symptoms to the Disrupted Foster-Care Kids

Question 17

The Care-As-Usual kids experienced more ___ than the Disrupted Foster-Care Kids

Answer 17

stability

Question 18

As we move from Care-As-Usual → Disrupted Foster-Care → Stable Foster-Care → Never Institutionalized, we see a steady ___ in Externalizing Symptoms

Answer 18

decline

Question 19

What does the BEIP prove about children in institutional care?

Answer 19

Being removed from the institution and placed into a stable home setting can help kids overcome some of the early difficulties they may have experienced as a result of growing up in these deprived orphanage settings.

Even when you improve the quality of the institution, it is still ideal for children to be raised in a home-based setting

Question 20

Before the BEIP was performed, how many of the institutionalized children showed a pattern of Disorganized Attachment?

Answer 20

The majority of institutionalized children showed a pattern of disorganized attachment

Question 21

Before the BEIP was performed, how many of the institutionalized children showed fully-formed attachment behaviours?

Answer 21

Only 3% showed fully-formed attachment behaviours

Question 22

It was expected that no matter how difficult the environment, the kid will develop some kind of ___.

Answer 22

attachment behaviour

Question 23

What did researchers find when rating the institutionalized children’s level of age-appropriate attachment pre-BEIP?

Answer 23

Only 3% of the Institutionalized group got the 5/5 score, the vast majority showed Absent Attachment behaviours or underdeveloped attachment behaviours.

When they looked at that in the Never-Institutionalized Kids, every single one of them got a 5/5, for fully developed, age-appropriate attachment behaviours

Question 24

What did researchers find when measuring the children’s attachment 42 months after the Random Assignment?

Answer 24

• The institutional, Care-As-Usual group is at about 18% secure attachment.
• The Foster Group was showing nearly 50% secure attachment

Question 25

What is the association between age and removal from the orphanage?

Answer 25

There are even higher rates of secure attachment among the kids who were removed from the orphanage before they were 24 months old. So the younger they were removed, the better their outcomes seemed to be

Question 26

Were kids who were removed after 24 months still able to form Secure Attachments?

Answer 26

The kids who were removed after 24 months, many of them were still able to form secure attachments, but it was not quite as common, and didn’t tend to be quite as dramatic in improvement as their peers who were younger upon removal

Question 27

What is a Critical Period?

Answer 27

The idea that there is a window during which you need to have exposure to certain stimuli or certain other environmental experiences, and if you don’t get that experience within that window, then the skill in question never develops

Question 28

What is an example of a Critical Period?

Answer 28

Visual Acuity

Question 29

What is a Sensitive Period?

Answer 29

A window of opportunity during which children are particularly equipped to learn and develop through environmental stimuli

Question 30

Is there a strict window for a Sensitive Period?

Answer 30

In a Sensitive Period there is no distinct window. Sensitive periods are just times where we are best equipped to learn from our experience, best prepared to take advantage of the brain plasticity in young kids