Research Plenary: Dr. Charles Zeanah Presents Bucharest Early Intervention Study

The plenary would focus on the effects of early experiences – in this case, deprivation – on brain development. Despite the early hour, the ballroom was packed with coffee-toting participants: sitting on the floor and standing in the back.

Dr Zeanah discussed his Bucharest Early Intervention Study, in which researchers designed a foster care intervention for institutionalized young children in Romania. The study explored sensitive periods of development and the reversibility of negative outcomes by asking, Does the timing of experiences impact outcomes? Can damage done by early experiences be repaired? And, if so, does the timing of the intervention matter to its success?

The Bucharest study followed three groups of children: those who received “care as usual” (continued institutional care, although some were adopted), the foster care intervention group (children moved into foster homes in Romania), and a control group of never-institutionalized Romanian children. Researchers collected a wide range of data for all three groups including social-emotional, neurological, and genetic and epigenetic measures. Some highlights of their extensive findings:

• Institutionalized (“care as usual”) children experienced significantly higher rates of anxiety and depression later in childhood. Upon closer inspection, Zeanah and his colleagues were able to determine that this anxiety and depression resulted from insecure attachment formation.
• Institutionalized children demonstrated significantly lower levels of electrical responses in the brain. This finding fits with what we know about the impacts of early experiences on brain development.
• Institutionalized children had shorter telomeres than never-institutionalized children. Zeanah likened telomeres to the plastic end of a shoelace that keeps the fabric from unraveling and explained that telomeres play a similar role for DNA. Shortened telomeres have been linked with poor health outcomes, while exercise has been demonstrated to lengthen telomeres. Shortened telomeres in institutionalized children, therefore, suggest that early deprivation affects children even on genetic and epigenetic levels, which may manifest in negative health. The study made two broad conclusions: First, while not all outcomes are completely reversible for children who have been institutionalized at a young age, early interventions show great promise. Zeanah emphasized that, while there are certainly sensitive periods of development, there are no “magic windows” during which interventions must be administered. Instead, the research tells us that we should simply try to intervene as early as possible. And second, the formation and maintenance of a secure attachment relationship is critical to healthy development and recovery from deprivation. In other words, research bears out the two guiding principles of our work: Early experiences matter, and Children develop in the context of their relationships.