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Cognitive Ability, GeneralBEIPNCT00747396

The Bucharest Early Intervention Project

A study testing Foster Care Placement in people with Cognitive Ability, General and Psychiatric and/or Mood Disorders, run by Charles Alexander Nelson III at 1 site in Romania.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

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

Who is it for?
Ages 21 to 24 years
What is being tested?
Foster Care Placement
Could I receive a placebo?
No, everyone receives an active treatment
How many people
136 participants
Where
1 siteRomania
Study dates
Sep 2000to 31 Mar 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 24 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • previously institutionalized and community children that took part in previous BEIP assessments
  • target recruitment age is +/- 6 mos of 21st birthday

Who cannot join

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

Trial locations and contacts

1 site in 1 country.

Romania1 site
  • Fundatia Tanner

    Bucharest, 011467

Other trials in Romania

About this study

Official title: The Bucharest Early Intervention Project: Effects of Early Psychosocial Deprivation on Mental Health in Adolescence

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

Read the 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 beginning in the fall of 2000 from 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 months, 42 months 54 months, 8 years, 12 year and 16 years of 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, now young adults are being assessed at age 21 years.

Being tested
Foster Care Placement
Keywords
Romania,, children,, foster care,, institutionalization,, brain function,, MRI,, attachment,, language,, growth,, Intelligence Quotient (IQ),, psychiatric symptomatology, early intervention
Medical subject headings
Health Behavior, Risk-Taking, Language

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Foster Care PlacementOther

    Also called Foster Care Group

    A group of children living in institutions in Bucharest, Romania was randomly assigned to placement in foster care. Foster parents were recruited, consented to background checks, and trained in Romanian. Before placement, foster parents visited their children to begin developing a relationship with the child. 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 occurring weekly for several months after placement of the child, then biweekly and later monthly. Foster parents were invited to participate in a support group organized by social workers. Project social workers consulted weekly with US staff experienced in dealing with young children in foster care.

Study groups in NCT00747396
Study groupRoleWhat they receive
Foster Care Placement GroupExperimentalChildren randomized to this group were placed in high quality foster care developed for the study.
Receives: Other: Foster Care Placement
Care As Usual GroupNo interventionChildren randomized to this group remained in institutional care.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in EEG Coherence Brain Function

    EEG coherence

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years

  2. Changes in EEG Power Brain Function

    EEG power

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years

  3. Changes in EEG Asymmetry Brain Function

    EEG asymmetry

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years

  4. Changes in Attachment Disturbances and Disorders

    Disturbances of Attachment Interview

    Measured: baseline, 30 mos, 42 mos, 54 mos, 8 years, 12 years, 16 years

  5. Changes in Attachment Style

    Strange Situation Procedure

    Measured: baseline, 30 mos and 42 mos

  6. Changes in Cognition in later childhood and adolescence

    Wechsler Intelligence Scale for Children-IV

    Measured: 8 years, 12 years, 16-18 years

  7. Changes in Cognition in young adulthood

    Wechsler Adult Intelligence Scale

    Measured: 21 years

  8. Changes in Cognition in early childhood

    Bayley Scales of Infant Development

    Measured: baseline, 30 months, 42 months

  9. Changes in weight

    weight in kilograms

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years

  10. Changes in height

    Height measured in centimeters

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years

  11. Changes in head circumference

    Head circumference in centimeters

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years

  12. Changes in Psychiatric Symptomatology in adolescence

    Diagnostic Interview Schedule for Children -IV

    Measured: 12 years, 16 years

  13. Changes in Psychiatric Symptomatogology

    Preschool And Child Adolescent Psychological Assessment

    Measured: 54 months, 8 years

  14. Changes in Psychiatric Symptomatogology

    Diagnostic Interview Schedule + Substance Abuse Module

    Measured: 21 years

  15. Changes in Expressive Language Quality

    language sample from interview

    Measured: 30 mos, 42 mos and 8 years

  16. Changes in Caregiving Environment

    Observational Record of Caregiving Environment

    Measured: baseline, 30 mos and 42 mos

  17. Changes in Indiscriminate Behavior

    Stranger at the Door

    Measured: 54 mos, 8 years and 12 years

  18. Changes in Emotion Discrimination

    Event-related Potentials

    Measured: baseline, 30 mos, 42 mos and 8 years

  19. Changes in Face Recognition

    Event-related Potentials

    Measured: baseline, 30 mos, 42 mos and 8 years

  20. Changes in Brain Structure

    MRI

    Measured: 8 years, 16 years, 21 years

  21. Changes in Problem Behaviors

    Infant Toddler Social Emotional Assessment

    Measured: baseline, 30 mos and 42 mos

  22. Changes in Social Communication and Interaction

    Social Communication Questionnaire

    Measured: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years

  23. Changes in Genetics

    Buccal Swab

    Measured: 8 years, 12 years, 16 years

Secondary outcomes (2)
  1. Changes in Emotional Reactivity/Temperament

    Laboratory Temperament Assessment Battery (Lab-TAB) Puppets and Peek-a-boo

    Measured: baseline, 30 mos and 42 mos

  2. Motor Skills

    Bruininks-Oseretsky Test-2

    Measured: 8 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Sep 2008 (estimated)
  2. Study startSep 2000
  3. Primary completion31 Mar 2027 (estimated)
  4. Study completion31 Mar 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
136 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00747396
Sponsor's protocol ID
IRB-P00011741
Other IDs
R01MH091363
Acronym
BEIP
Status last verified
Dec 2025
First submitted
4 Sep 2008
Last updated
10 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Arnett AB, Antunez M, Zeanah C, Fox NA, Nelson CA. Physical and neurophysiological maturation associated with ADHD among previously institutionalized children: a randomized controlled trial. J Child Psychol Psychiatry. 2025 Jul;66(7):967-979. doi: 10.1111/jcpp.14110. Epub 2025 Jan 11.

    PubMed 39797613
  • Guyon-Harris KL, Plamondon A, Humphreys KL, Wade M, Gleason MM, Tibu F, Nelson CA, Fox NA, Zeanah CH. Structure of Psychopathology in Romanian Preschool-Aged Children in an Epidemiological and a High-Risk Sample. JAACAP Open. 2023 Nov;1(3):173-183. doi: 10.1016/j.jaacop.2023.06.004. Epub 2023 Jul 19.

    PubMed 38500494
  • King LS, Guyon-Harris KL, Valadez EA, Radulescu A, Fox NA, Nelson CA, Zeanah CH, Humphreys KL. A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation. Am J Psychiatry. 2023 Aug 1;180(8):573-583. doi: 10.1176/appi.ajp.20220672. Epub 2023 May 22.

    PubMed 37211832
  • Humphreys KL, Guyon-Harris KL, Tibu F, Wade M, Nelson CA, Fox NA, Zeanah CH. Psychiatric outcomes following severe deprivation in early childhood: Follow-up of a randomized controlled trial at age 16. J Consult Clin Psychol. 2020 Dec;88(12):1079-1090. doi: 10.1037/ccp0000613.

    PubMed 33370132
  • Humphreys KL, Machlin LS, Guyon-Harris KL, Nelson CA, Fox NA, Zeanah CH. Psychosocial deprivation and receptive language ability: a two-sample study. J Neurodev Disord. 2020 Dec 16;12(1):36. doi: 10.1186/s11689-020-09341-2.

    PubMed 33327936
  • Slopen N, Tang A, Nelson CA, Zeanah CH, McDade TW, McLaughlin KA, Fox NA. The Consequences of Foster Care Versus Institutional Care in Early Childhood on Adolescent Cardiometabolic and Immune Markers: Results From a Randomized Controlled Trial. Psychosom Med. 2019 Jun;81(5):449-457. doi: 10.1097/PSY.0000000000000696.

    PubMed 31008902
  • Wade M, Fox NA, Zeanah CH, Nelson CA, Drury SS. Telomere Length and Psychopathology: Specificity and Direction of Effects Within the Bucharest Early Intervention Project. J Am Acad Child Adolesc Psychiatry. 2020 Jan;59(1):140-148.e3. doi: 10.1016/j.jaac.2019.02.013. Epub 2019 Mar 4.

    PubMed 30844465
  • Wade M, Fox NA, Zeanah CH, Nelson CA. Effect of Foster Care Intervention on Trajectories of General and Specific Psychopathology Among Children With Histories of Institutional Rearing: A Randomized Clinical Trial. JAMA Psychiatry. 2018 Nov 1;75(11):1137-1145. doi: 10.1001/jamapsychiatry.2018.2556.

    PubMed 30267045
  • Johnson DE, Tang A, Almas AN, Degnan KA, McLaughlin KA, Nelson CA, Fox NA, Zeanah CH, Drury SS. Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial. J Pediatr. 2018 Dec;203:345-353.e3. doi: 10.1016/j.jpeds.2018.07.027. Epub 2018 Aug 29.

    PubMed 30172435
  • Humphreys KL, Miron D, McLaughlin KA, Sheridan MA, Nelson CA, Fox NA, Zeanah CH. Foster care promotes adaptive functioning in early adolescence among children who experienced severe, early deprivation. J Child Psychol Psychiatry. 2018 Jul;59(7):811-821. doi: 10.1111/jcpp.12865. Epub 2018 Feb 1.

    PubMed 29389015
  • Humphreys KL, McGoron L, Sheridan MA, McLaughlin KA, Fox NA, Nelson CA 3rd, Zeanah CH. High-Quality Foster Care Mitigates Callous-Unemotional Traits Following Early Deprivation in Boys: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry. 2015 Dec;54(12):977-83. doi: 10.1016/j.jaac.2015.09.010. Epub 2015 Oct 9.

    PubMed 26598472
  • Humphreys KL, Gleason MM, Drury SS, Miron D, Nelson CA 3rd, Fox NA, Zeanah CH. Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial. Lancet Psychiatry. 2015 Jul;2(7):625-34. doi: 10.1016/S2215-0366(15)00095-4. Epub 2015 Jun 23.

    PubMed 26303560
  • Bick J, Zhu T, Stamoulis C, Fox NA, Zeanah C, Nelson CA. Effect of early institutionalization and foster care on long-term white matter development: a randomized clinical trial. JAMA Pediatr. 2015 Mar;169(3):211-9. doi: 10.1001/jamapediatrics.2014.3212.

    PubMed 25622303
  • 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. doi: 10.1016/j.jaac.2010.12.012. Epub 2011 Feb 1.

    PubMed 21334562
  • 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. doi: 10.1001/archpediatrics.2010.47.

    PubMed 20439790

Questions about this trial

What is this clinical trial studying?

A study testing Foster Care Placement in people with Cognitive Ability, General and Psychiatric and/or Mood Disorders, run by Charles Alexander Nelson III at 1 site in Romania.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 10 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Romania. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in EEG Coherence Brain Function (time frame: baseline, 30 mos, 42 mos, 8 years, 12 years, 16 years, 21 years). The study lists 23 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00747396, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Dec 2025.

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