TY - JOUR T1 - STereotypies in children with a history of early institutional care AU - Bos KJ, Zeanah CH, Jr, Smyke AT, Fox NA, Nelson CA, III Y1 - 2010/05/01 N1 - 10.1001/archpediatrics.2010.47 JO - Archives of Pediatrics & Adolescent Medicine SP - 406 EP - 411 VL - 164 IS - 5 N2 - Objectives  To investigate the prevalence of stereotypies in children with a history of early institutional care, evaluate the efficacy of a foster care intervention compared with institutional care on the course of stereotypies, and describe correlates in language, cognition, and anxiety for children who exhibit stereotypies.Design  Randomized controlled trial.Setting  Institutions in Bucharest, Romania.Participants  One hundred thirty-six children with a history of early institutional care.Intervention  Comparison of a foster care intervention with continued care as usual in an institution.Main Outcome Measures  The presence of stereotypies as well as outcomes in language, cognition, and anxiety.Results  At the baseline assessment prior to placement in foster care (average age of 22 months), more than 60% of children in institutional care exhibited stereotypies. Follow-up assessments at 30 months, 42 months, and 54 months indicated that being placed in families significantly reduced stereotypies, and with earlier and longer placements, reductions became larger. For children in the foster care group, but not in the care as usual group, stereotypies were significantly associated with lower outcomes on measures of language and cognition.Conclusions  Stereotypies are prevalent in children with a history of institutional care. A foster care intervention appears to have a beneficial/moderating role on reducing stereotypies, underscoring the need for early placement in home-based care for abandoned children. Children who continue to exhibit stereotypies after foster care placement are significantly more impaired on outcomes of language and cognition than children without stereotypies and thus may be a target for further assessments or interventions.Trial Registration  clinicaltrials.gov Identifier: NCT00747396 SN - 1072-4710 M3 - doi: 10.1001/archpediatrics.2010.47 UR - http://dx.doi.org/10.1001/archpediatrics.2010.47 ER -