The Positives Of The Bucharest Early Intervention Project

 The Positives Of The Bucharest Early Intervention Project 

The Bucharest Early Intervention Project (BEIP) is one of the most significant neuroscientific research endeavors in the last few decades. From its onset, the project faced a significant amount of criticism in regards to its ethics, despite passing the IRB process in the U.S. and obtaining approval from Romanian officials. The main contention with the project lies in its usage of vulnerable children for research purposes. Although the investigators did not necessarily put children at an increased risk due to their involvement in the project, many people find it objectionable that children were knowingly left in an unfavorable environment. Critics argue that the researchers possessed the ability to help the children, but they chose not to. In his presentation, Dr. Joe Vukov addressed the complex ethical controversies with this project. Arguments exist for both sides, and no common consensus exists on the ethics behind the BEIP. Although this project potentially faces ethical issues, it is undeniable that the results from this research have added significantly to the field of child development. It is vital to acknowledge the new insights from this research, and utilize them to improve the conditions under which children are raised. 

Dr. Vukov’s talk paralleled certain points presented in the article “Ethical Considerations In International Research Collaboration: The Bucharest Early Intervention Project,” but he added other key ethical points as well. First, it is important to understand the context behind the project. Due to policies under Communist rule, Romanian families were forced to produce as many children as possible. This resulted in widespread child abandonment in the country, and state run orphanages took these children under their care. Romanians held the common belief that the state possessed the ability to raise these children properly. After the overthrow of Communist rule in 1989, institutionalization still remained the predominant form of housing for these children, despite stories covering the social deprivation and appalling conditions common in the orphanages. In the early 2000s, researchers from the BEIP chose Romania as the site to investigate insitutionalization’s effect on brain structure and behavior in children, as well as the child’s ability to recover from these detrimental effects after transfer to foster care. In addition to these goals, the researchers also hoped to provide concrete research in support for foster care, to influence Romanian officials to shift to this form of child care. The study was longitudinal, utilizing a randomized control trial method. The study placed 136 institutionalized children into two groups: a care as usual group in which children maintained their current living circumstances, and a second group where they were transferred to foster care. Later, the investigators added a control group consisting of never institutionalized children. The researchers analyzed all the children at regular intervals until they reached 54 months of age. Altogether, the study gathered a significant sum of data on the effect of social deprivation on child development. The research also proved the benefits of foster care over institutionalization, and demonstrated how transitioning children to foster care carried the potential to correct the negative effects of institutionalization. The bulk of Dr. Vukov’s talk analyzed the arguments for and against the ethics behind the BEIP. The study technically followed all the written ethical guidelines in research. The study placed participants randomly into each group. Researchers obtained consent by contacting the birth parents for the foster care group, and Romanian officials also approved the project. Regarding the risks/benefits for the participants, the care as usual group faced no negative consequences from this research, while the foster care group potentially received improved care. The investigators also supported their usage of randomized control trials, arguing that this method gave the best results, and therefore helped to improve the future conditions of children to the most extent. Dr. Vukov then proceeded to explain the arguments against the BEIT, centering his analysis on the idea that the researchers did not respect the care as usual group’s “status as people”. The investigators did not follow Immanuel Kant’s idea of treating people as an end. Although the investigators possessed good intentions and provided beneficial research, they utilized the institutionalized children as a means to this goal. Second, the researchers did not follow the Golden rule: “Do unto others as you would have them do unto you”. Lastly, the researchers left the children in the care as usual group in a bad environment, when they potentially had the ability to improve their living conditions. Considering these ethical drawbacks, it appears that although this research followed ethical guidelines, it still violated other morals. Dr. Vukov argues that this reveals flaws in current research ethics, and that they require reworking to ensure that morality is fully enforced in research.

After close to two decades after the initiation of the BEIP, scholars continue to debate the ethics behind the project. Although no answer may ever materialize for this issue, it is clear that this research provided immense insight into child development. The article “IQ at Age 12 Following a History of Institutional Care: Findings From the Bucharest Early Intervention Project,” demonstrates how the project still produces important data into the late 2010s. In particular, this study analyzed the impact of foster care intervention when participants of the BEIP reached 12 years of age. Approximately 107 children participated, from which approximately half belonged to the care as usual group, and the other half were part of the foster care group. The researchers also included 72 never institutionalized 12 years olds in the study. The investigators found that the foster care group received a significantly higher IQ score compared to the care as usual group. The foster care group also got a significantly higher Verbal Comprehension IQ subscale score. Furthermore, the data indicated a negative correlation between the percent time spent in institutional care and IQ score of children at 12 years of age. The study showed a few surprising findings. For instance, the researchers wanted to see if the age of placement into foster care (ranging from 20-26 months) affected a child’s IQ at age 12. They found that placement age did not have a significant effect on IQ. In addition, some children in the foster care group did not remain with the same caregiver throughout their childhood. Yet, they still received similar IQ scores as children who remained in the same foster home. Furthermore, the researcher found that the never institutionalized children still scored significantly higher on the IQ test compared to the foster care group. This included significantly higher scores on the Working Memory, Perceptual Reasoning, Processing Speed, and Verbal Comprehension IQ subscales. This shows that although the foster care intervention did improve the cognitive and behavioral performance of children, these children still did not fully recover to match the performance of never institutionalized children. 

The study above directly demonstrates the long lasting impact of the BEIP. Even though the BEIP is ethically controversial, it produced, and continues to produce important data. Given the researchers’ unique opportunity to control for many extraneous variables, they provide concrete evidence against institutionalization as a form of child care. As highlighted by the impaired performance on the IQ test by institutionalized children, the social deprivation these children faced during childhood continues to hurt them into adolescence. In addition to this, the results point out that lots of work still needs to be done to improve child care. Although the children in foster care fared better compared to institutionalized children, their performance still fell short of never institutionalized children. This provides an incentive to increase the quality of foster care, to ensure children in this situation have a more enriching environment during crucial developmental years. 

Works Cited

Almas AN, Degnan KA, Nelson CA, Zeanah CH, Fox NA. IQ at age 12 following a history of institutional care: Findings from the Bucharest Early Intervention Project. Dev Psychol. 2016 Nov;52(11):1858-1866. doi: 10.1037/dev0000167. Epub 2016 Oct 6. PMID: 27709994; PMCID: PMC5083169. 

Zeanah CH, Koga SF, Simion B, Stanescu A, Tabacaru CL, Fox NA, Nelson CA; BEIP CORE GROUP. Ethical considerations in international research collaboration: The Bucharest early intervention project. Infant Ment Health J. 2006 Nov;27(6):559-576. doi: 10.1002/imhj.20107. PMID: 28640378.