THE EI-3 PROJECT

 

The Early Institutionalization Intervention Impact Project’s (EI-3) main goal is to document and compare the impacts that enhanced institutional care and enhanced foster care have on development during early childhood.

The EI-3 research project builds upon the Bucharest Early Intervention Project (BEIP). Conducted in Romania beginning in the year 2000, the BEIP is the only randomized controlled trial with children living in institutional care ever conducted.

The leaders of both projects (EI-3 & BEIP), Dr. Charles Nelson, Dr. Nathan Fox, and Dr. Charles Zeanah, developed the EI-3 Project to continue to generate scientific evidence about how best to care for orphaned, abandoned, and maltreated children. In this way, the investigators hope to provide guidance to promote evidence-based policies at the global level for the lives of children who are included in child protection systems.

Beginning in São Paulo, Brazil, the study will work closely the Court of Justice of the State of São Paulo and with the with the Childhood and Youth Courts teams.

The justice teams will refer children, up to 24 months of age, who have been removed from the care of their biological families and are under the care of the State.

These children will be enrolled as participants in the study and randomly assigned to either the enhanced institutional care group or enhanced foster care group.

To facilitate placement into a foster family, the EI-3 Project has been working with a local NGO, Santa Fe, and with experts in the field in Brazil, to develop a Foster Care Program that will recruit and train qualified foster families who will receive the children that are randomly placed in the enhanced foster care group.

About one month after placement, initial data collection will begin (baseline) to be used as a comparison with data collected after the interventions.

EI-3 will measure children’s development through brain activity, ability to create emotional and trusting bond (attachment), and assessments of the physical, cognitive, and emotional dimensions.

All the children and primary caregivers (foster parents and institutional caregivers) in the randomized study will then participate in a caregiving intervention focused on the development and quality of the emotional and trusting bond (attachment) of the caregiver-child dyad.

Children and caregivers in EI-3 will also participate in developmental follow-up assessments until they reach 36 months of age, as longs as consent is provided by their legal guardians.

Furthermore, the study will also look at the cost-effectiveness of both care modalities, providing data that are not available currently.

We hope that this research will provide clear evidence to governments, private institutions, professionals, funders, and society about which type of out-of-home care can offers a higher quality of life and opportunities for future generations and better cost-benefits for the public authorities.

  • The EI-3 Project we will recruit a large group of young children who have been removed from their biological families’ care as a result of their referral to child protection, and we will place them randomly in two groups:

    • Group 1: Children randomly assigned to enhanced institutional care.

    • Group 2: Children randomly assigned to enhanced foster care.

    In addition, we will compare these children to children who have never been institutionalized and live with their biological families (Group 3).

  • Our hypothesis is that children placed in foster care will display enhanced socioemotional development, and enhanced behavioral and neural patterns of attention, cognition, and social cognition, compared to children who remain in enhanced institutional care.