Nelson – BEIP age 8 results

The storyline that we see at eight is very similar to what we reported when they were much younger. It turns out that living in an institution leads to profound deficits in virtually every domain that we’ve looked at: IQ, language, brain development, growth, things like that. If you look at children placed in our foster care intervention placed in families, in most domains, children benefit greatly. We don’t see yet that we’re bringing them up to what we would consider to be typical development, so their IQs jump from 75 to 85 or upper 80s, but we’re not seeing IQs of 100. The last part, and I think the more important part from a neuro-science perspective, is that in the domains that we see the intervention working, some domains have a sensitive period attached to that other domains do not. So an example of that would be for IQ, for EEG, for language, we see that children placed roughly before 22-24 months do much better than children placed after that age.  

There are a few domains where we see an intervention effect, but no timing effect. An example there is that we see dramatic reduction in children experiencing anxiety or depression, but it doesn’t matter how old they were when they went into foster care, no matter how old they are, they get less anxious and less depressed. There are, however, a few domains where we’re really not seeing any intervention effects at all. So we’re not seeing really an improvement in executive functions, and related to that is we haven’t seen a dimunition in what we call externalizing behaviour problems like attention deficit disorder or conduct disorder. So the children placed in foster care are not showing any less ADHD than kids who stay in the institution. 

Now we think that the reason for this could be that the average age of placement was about 22 months so its entirely possible we placed the kids too late. If that’s the case though that means the neuro circuits that underlie things like ADHD are getting set up before the age of two, which begs the question of how early in life we should be screening kids for ADHD. 

So one question I’ve often gotten is why is the BEIP as we call it so important? What’s new about it? First of all it turns out that there are very few studies that have ever looked at currently institutionalized children at a large sample, and none have ever looked at this from the lens of neuro-science biology. Second, this was an intervention study and it allowed us to test the question of sensitive periods. Whether kids placed in more favourable environments at particular points in development would do better. There are lots of monkey studies like this but none with humans. So I think the lessons we’ve learned from this that are most critical is that there are sensitive periods in human development. That children taken out of really adverse circumstances and put into much better circumstances, better families, at or before particular points in development can really benefit even if those children might have been handicapped in some way to begin with.  

And I think the last thing is it’s given us a clue as to the mechanism. So, at the AAAS meeting last week in Vancouver, someone said to me “what didn’t we already know about your findings?” and I said well, we weren’t entirely surprised that kids who grow up in institutions don’t do very well, but now we know why, with our biological data and our neuro-science data, we have some handle as to what is going wrong in brain development that leads to children having anxiety or ADHD and the like, so I think that’s the last lesson, can we not only describe the effects of early life adversity, but can we explain why those effects cause the damage that they do.