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Cited by 55Child Welfare and AdoptionChildren's Physical and Motor DevelopmentInfant Development and Preterm Care

Motor outcomes in children exposed to early psychosocial deprivation

Open access
Levin, April R., Zeanah, Charles H., Fox, Nathan A., Nelson, Charles A.·2014·The Journal of Pediatrics
DOI 10.1016/j.jpeds.2013.09.026PMC PMC4059764
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Abstract

Objectives To determine the effect of psychosocial deprivation early in life on motor development, assess the impact of a foster care intervention on improving motor development, and assess the association between motor and cognitive outcomes in children with a history of institutional care.Study design In a randomized controlled trial, children living in Romanian institutions were randomly assigned to care as usual in the institution or placed in family-centered foster care as part of the Bucharest Early Intervention Project. The average age at placement into foster care was 23 months. At age 8 years, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT2-SF) was applied to assess the motor proficiency of children in both groups, as well as a never-institutionalized group from the Romanian community.Results Children in the never-institutionalized group did significantly better on the BOT2-SF than children who had ever been institutionalized (P < .001). There was no significant difference in performance between children in the care as usual group and the foster care group. This finding also held true for all individual items on the BOT2-SF except sit-ups. Regression analyses revealed that the between-group and within-group differences in BOT2-SF scores were largely mediated by IQ.Conclusion Early deprivation had a negative effect on motor development that was not resolved by placement in foster care. This effect was predominantly mediated by IQ. This study highlights the importance of monitoring for and addressing motor delays in children with a history of institutionalization, particularly those children with low IQ.

AI snapshot

Written from the paper’s full text.

TL;DR

In the Bucharest Early Intervention Project, children with a history of institutionalization had significantly poorer motor proficiency at age 8 than never-institutionalized children, and foster care placement at an average age of 23 months did not significantly improve motor outcomes. The motor differences were largely mediated by IQ, especially perceptual reasoning and processing speed.

Key findings

  • Never-institutionalized children performed significantly better on the BOT2-SF than ever-institutionalized children (p < .001); the never-institutionalized group averaged a score expected for an 8-year-old, whereas the ever-institutionalized group averaged a score expected for a 6.5-year-old.
  • There was no significant difference in total BOT2-SF scores between the care-as-usual and foster-care groups (p = .314), and no significant item-level differences between those groups. The ever-institutionalized group scored lower than the never-institutionalized group on all BOT2-SF items except sit-ups.
  • A regression model with group and full-scale IQ accounted for 49.5% of the variation in BOT2-SF scores; group was no longer significant, and each IQ point lower was associated with about 1.016 percentile points lost on the BOT2-SF. Differences were accounted for predominantly by the perceptual reasoning and processing speed WISC-IV subtests.
  • Among ever-institutionalized children, current living situation at age 8 showed no significant overall BOT2-SF difference across BEIP foster care, government foster care, biological families, or institution (F(3,86) = 2.12, p = .104). Within the foster-care group, children remaining in BEIP foster care scored higher (mean 46.13, SD 10.50) than those transferred to another non-institutional setting (mean 40.00, SD 5.15; p = .008).

Methods

  • Randomized controlled trial within the Bucharest Early Intervention Project: 187 institutionalized children in Bucharest were screened, exclusions for genetic syndromes, fetal alcohol syndrome, or microcephaly left 136 ever-institutionalized children, who were randomly assigned half to foster care and half to care as usual in the institution; a never-institutionalized community comparison group was matched by age and sex.
  • Average age of foster-care placement was 23 months (range 8–33 months). At the 8-year follow-up, motor proficiency was assessed with the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition, short form (BOT2-SF), and IQ was measured with the WISC-IV.
  • Analyses used IBM SPSS Statistics version 19, initially following an intent-to-treat model, with follow-up analyses based on living situation at testing and percent of life spent in an institution.

Limitations

  • The paper states that children were not randomized to foster care before 8 months of age, so the potential effects of earlier placement on motor development cannot be assessed; prenatal environment differences between ever-institutionalized and never-institutionalized groups may be unaccounted for; it is ethically impossible to randomize children from birth into institutional versus never-institutionalized groups, leaving open the possibility that abandoned children are more biologically compromised; and motor ability was assessed only at 8 years, so later improvement was not examined.
  • The paper also notes that prenatal factors not considered in the study could contribute to motor outcomes.
  • Evident from the text: the living-situation comparisons at age 8 were not randomized and some subgroups were small (e.g., 11 care-as-usual children remained institutionalized; 5 foster-care children transferred to another non-institutional setting), so those placement-stability findings are correlational.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.jpeds.2013.09.026

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In a follow-up regression model evaluating the correlation of group and WISC-IV subtests with BOT2-SF score, differences were accounted for predominantly by the perceptual reasoning and processing speed subtests.

    “In a follow-up regression model evaluating the correlation of group and WISC-IV subtests with BOT2-SF score, these differences were accounted for predominantly by the perceptual reasoning and processing speed subtests (Table IV).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Among the ever institutionalized group, a regression model including demographics, birth history, and randomization group found that none of the variables reached significance.

    “Among the ever institutionalized group, a regression model including demographics, birth history, and randomization group (care as usual group or foster care group) found that none of the variables in the model reached significance (Table III).”
    Quote in the paperNot a substantial claim
  • Findingown data

    A regression model evaluating the correlation of group and full scale IQ scores with BOT2-SF scores accounted for 49.5% of the variation in BOT2-SF scores.

    “A regression model evaluating the correlation of group and full scale IQ scores with BOT2-SF scores accounted for 49.5% of the variation in the BOT2-SF scores (Table IV).”
    Quote in the paperSubstantial claim
  • Findingown data

    Within the ever institutionalized group, BOT2-SF scores did not significantly correlate with total percent of life spent in an institution by 8 years (R2 = .005, B = −.026, SE = .038, β = −.071).

    “or with the total percent of a child’s life spent in an institution by 8 years (R2 = .005, B = −.026, Standard Error = .038, β = −.071).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Children in the never-institutionalized group had an average BOT2-SF score equivalent to that expected for an 8-year-old child.

    “Children in the never-institutionalized group had an average BOT2-SF score equivalent to that expected for an 8-year-old child.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The BOT2-SF standard scores and norms are valid for comparing motor proficiency in Romanian children.
  • May combine two claims. 16
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Findingown data

    In the regression model with group and full scale IQ, the contribution of group was no longer significant, suggesting that many between-group differences in BOT2-SF score are accounted for by between-group differences in IQ.

    “Of note, in this model the contribution of group was no longer significant, suggesting that many of the between-group differences in BOT2-SF score are in fact accounted for by the between-group differences in IQ.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The average age of placement into foster care was 23 months (range 8-33 months).

    “The average age of placement into foster care was 23 months.”
    • Also stated in: § Methods · plain
      “In the foster care group, the average age of foster care placement was 23 months (range 8–33 months).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Although birth weight was significantly lower in ever-institutionalized than never-institutionalized groups, controlling for this difference by regression revealed that group placement still correlated with motor outcomes, and birth weight, gestational age, and Apgar score did not.

    “Although birth weight was significantly different lower in ever-institutionalized than never-institutionalized groups, controlling for this difference by regression revealed that group placement still correlated with motor outcomes, and birth weight, gestational age, and Apgar score did not.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Bruininks-Oseretsky test of motor proficiency, 2nd edition has been found to be useful for differentiating individuals with motor impairment from those with no motor impairment.

    “The Bruininks-Oseretsky test of motor proficiency, 2nd edition has been found to be useful for differentiating individuals with motor impairment from those with no motor impairment.26”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Zeanah, 2003, Designing research to study the effects of institutionalization on brain and behavioral development: the Bucharest Early Intervention Project, Dev Psychopathol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Among children who completed the BOT2-SF, ethnicity was significantly different between the ever institutionalized group and never-institutionalized group.

    “ethnicity was significantly different between the ever institutionalized group and never-institutionalized group children.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The BOT2-SF has a positive predictive value of 100% and a negative predictive value of 72.5% for diagnosing motor impairment.

    “The short form of this test (BOT2-SF) has been found to have a positive predictive value of 100% and a negative predictive value of 72.5% for diagnosing motor impairment.28”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Smyke, 2009, A new model of foster care for young children: the Bucharest Early Intervention Project, Child Adolesc Psychiatr Clin N Am source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a study of children adopted specifically from Eastern Europe and the former Soviet Union at a median age of 26 months (range 2.5 months to 9 years), 70% had gross motor delays and 82% had fine motor delays.

    “in a study of children adopted specifically from Eastern Europe and the former Soviet Union at a median age of 26 months (range 2.5 months to 9 years), 70% had gross motor delays and 82% had fine motor delays,20”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Lin, 2005, The relation between length of institutionalization and sensory integration in children adopted from Eastern Europe, Am J Occup Ther source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In one study of international adoptees, 33% of children had gross motor delays and 40% had fine motor delays.

    “These findings persist after adoption; in one study of international adoptees, 33% of children had gross motor delays and 40% had fine motor delays.19”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] Marcovitch, 1997, Determinants of behavioural problems in Romanian children adopted in Ontario, Int J Behav Dev source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Of the 136 ever-institutionalized children, half were randomly assigned to a foster care group and the other half were assigned to continued care as usual in the institution.

    “Of these, half were randomly assigned to a foster care group and the other half were assigned to continued care as usual in the institution.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    The quality of caregiving in foster care was indistinguishable from the quality of caregiving in the families of never-institutionalized children from the community, and was significantly better than that in institutions.

    “Using the Observational Record of the Caregiving Environment, we have previously demonstrated that the quality of caregiving in foster care was indistinguishable from the quality of caregiving in the families of never-institutionalized children from the community, and was significantly better than that in institutions.33”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [33] Bauer, 2009, Cerebellar volume and cognitive functioning in children who experienced early deprivation, Biol Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Because there was not random assignment between children currently living in an institution and those living in another setting within the care as usual group, it is possible that children remaining in institutions at 8 years differ from children who have been taken into family settings since initial randomization.

    “Because there was not random assignment between these two groups, it is possible that children remaining in institutions at 8 years differ from children who have been taken into family settings since initial randomization.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Use of standard scores for motor composites has been recommended for comparing motor performance between examinees.

    “Use of standard scores for motor composites has been recommended for comparing motor performance between examinees.26,27”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [26] Zeanah, 2003, Designing research to study the effects of institutionalization on brain and behavioral development: the Bucharest Early Intervention Project, Dev Psychopathol source

      Not checked in the free run.

    • cites [27] Zeanah, 2006, Ethical considerations in international research collaboration: the Bucharest Early Intervention Project, Infant Ment Health J source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All analyses were initially performed following an intent-to-treat model, with children considered within their original assigned group.

    “All analyses were initially performed following an intent-to-treat model, with children considered within their original assigned group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Postinstitutionalized children have delays in balance and bilateral coordination compared with never institutionalized children which placement in a family setting does not adequately remediate.

    “postinstitutionalized children have delays in balance and bilateral coordination compared with never institutionalized children which placement in a family setting does not adequately remediate.24”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Wilson, 1995, Use of the Bruininks-Oseretsky test of motor proficiency in occupational therapy, Am J Occup Ther source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The superior-posterior lobes have also been found to have a somatotopic map which is activated particularly during complex movements.

    “The superior-posterior lobes have also been found to have a somatotopic map which is activated particularly during complex movements.38”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] DreptOnline.ro [Internet]. Romania: Romanian Law Online, Law #272/2004 on the protection and promotion of child rights [cited 2013 Oct 11]. Available from: http://www.dreptonline.ro/en_resourses/en_romanian_child_protection.php.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationnone given

    Despite the potential importance of the cerebellum in explaining the findings, motor development, like cognition, is a complex phenomenon and is unlikely to be explained by one brain structure or circuit in isolation.

    “Despite the potential importance of the cerebellum in explaining our findings, motor development, like cognition, is a complex phenomenon and is unlikely to be explained by one brain structure or circuit in isolation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Children with a history of early psychosocial deprivation have smaller volume of the superior-posterior cerebellar lobes, and superior-posterior lobe volume mediates neuropsychological test performance differences between groups of postinstitutionalized versus typically developing children, with larger volumes yielding better outcomes on tests of memory and planning.

    “Notably, children with a history of early psychosocial deprivation have smaller volume of the superior-posterior cerebellar lobes, and superior-posterior lobe volume mediates neuropsychological test performance differences between groups of postinstitutionalized versus typically developing children, with larger volumes yielding better outcomes on tests of memory and planning.37”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37] Johnson, 2010, Growth and associations between auxology, caregiving environment, and cognition in socially deprived Romanian children randomized to foster vs ongoing institutional care, Arch Pediatr Adolesc Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    This study assesses motor ability at 8 years of age, but does not examine potential improvement in motor skills that may continue to occur as children continue to grow and develop over time.

    “Additionally, this study assesses motor ability at 8 years of age, but does not examine potential improvement in motor skills that may continue to occur as children continue to grow and develop over time.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Partially based on initial findings in the BEIP, Romania now discourages institutionalization of abandoned children under two years of age.

    “Partially based on initial findings in the BEIP, Romania now discourages institutionalization of abandoned children under two years of age,42”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42]

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Although the cerebellum was traditionally thought to coordinate predominantly motor activities, more recent work has suggested that it also coordinates cognitive activities in both adults and children.

    “Although the cerebellum was traditionally thought to coordinate predominantly motor activities, more recent work has suggested that it also coordinates cognitive activities in both adults35 and children.36”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [35] Sheridan, 2012, Variation in neural development as a result of exposure to institutionalization early in childhood, Proc Natl Acad Sci USA source

      Not checked in the free run.

    • cites [36] Smyke, 2010, Placement in foster care enhances quality of attachment among young institutionalized children, Child Dev source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The networks may be affected to different degrees depending on the nature of these experiences.

    “The networks may be affected to different degrees depending on the nature of these experiences.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductreasoning

    Because it would be ethically impossible to randomize children from birth into an ever institutionalized group versus never-institutionalized group, the possibility exists that children who are abandoned to institutions are somehow more biologically compromised than those not abandoned.

    “Because it would be ethically impossible to randomize children from birth into an ever institutionalized group versus never-institutionalized group, the possibility exists that children who are abandoned to institutions are somehow more biologically compromised than those not abandoned.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductreasoning

    There may be contributions of the prenatal environment of the ever institutionalized group versus the never-institutionalized group that may be unaccounted for here.

    “Additionally, there may be contributions of the prenatal environment of the ever institutionalized group versus the never-institutionalized group that may be unaccounted for here.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    It remains possible that prenatal factors not considered in the current study could contribute to motor outcomes.

    “However, it remains possible that prenatal factors not considered in the current study could contribute to motor outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    Various aspects of motor development are likely to involve different brain networks which likely have different sensitive periods.

    “Instead, various aspects of motor development are likely to involve different brain networks which likely have different sensitive periods.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    This pattern is similar to that seen in studies of Early Head Start outcomes in multiple domains when children are followed up in the 5th grade, in which the initial improvements with early interventions are sustained over time only when positive interventions are sustained over time as well.

    “This pattern is similar to that seen in studies of Early Head Start outcomes in multiple domains when children are followed up in the 5th grade, in which the initial improvements with early interventions are sustained over time only when positive interventions are sustained over time as well.34”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Schlerf, 2010, Evidence of a novel somatopic map in the human neocerebellum during complex actions, J Neurophysiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    One interpretation of these findings is that early experiences lead to changes in brain development that affect both cognition and motor skills by affecting overlapping neural networks.

    “One interpretation of these findings is that early experiences lead to changes in brain development that affect both cognition and motor skills by affecting overlapping neural networks.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premiseown data

    Studies in this cohort have shown that although multiple areas of development are impaired among ever-institutionalized children, foster care placement leads to improvement in some areas but not in other areas, including motor function based on the results of the current study.

    “Studies in this cohort have shown that although multiple areas of development are impaired among ever-institutionalized children, foster care placement leads to improvement in some areas (e.g. cognition,2,3 attachment,5,6,40, language7–9, depression, anxiety,10,12 stereotypies,11 and growth41) but not in other areas”
    Quote in the paperSubstantial claim0 of 8 sources checked
    • cites [2] Nelson Charles, 2007, Cognitive recovery in socially deprived young children: the Bucharest Early Intervention Project, Science source

      Not checked in the free run.

    • cites [3] Fox, 2011, The effects of severe psychosocial deprivation and foster care intervention on cognitive development at 8 years of age: findings from the Bucharest Early Intervention Project, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [5] Zeanah, 2005, Attachment in institutionalized and community children in Romania, Child Dev source

      Not checked in the free run.

    • cites [6] Smyke, 2012, A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder, Am J Psychiatry source

      Not checked in the free run.

    • cites [40]

      Not checked in the free run.

    • cites [7] Windsor, 2007, Language acquisition with limited input: Romanian institution and foster care, J Speech Lang Hear Res source

      Not checked in the free run.

    • cites [8] Windsor, 2011, Effect of foster care on young children's language learning, Child Dev source

      Not checked in the free run.

    • cites [9] Windsor, 2013, Effect of foster care on language learning at eight years: findings from the Bucharest Early Intervention Project, J Child Lang source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous research has found lower levels of motor proficiency to be associated with lower full scale IQ.

    “Previous research has found lower levels of motor proficiency to be associated with lower full scale IQ.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Miller, 1995, Developmental and nutritional status of internationally adopted children, Arch Pediatr Adolesc Med source

      Not checked in the free run.

29 of 29

  • The paper relies on this without support.

    The ever-institutionalized and never-institutionalized groups are comparable except for institutionalization, with no unmeasured biological or prenatal differences that affect motor outcomes.

    “Because it would be ethically impossible to randomize children from birth into an ever institutionalized group versus never-institutionalized group, the possibility exists that children who are abandoned to institutions are somehow more biologically compromised than those not abandoned.”

  • The paper relies on this without support.

    The BOT2-SF standard scores and norms are valid for comparing motor proficiency in Romanian children.

    “Total point scores on the BOT2-SF were normalized by age and sex to calculate the standard score for each subject.26”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • ConsistentF(3, 86) = 2.12reported p = .104 · recomputed p = .104

    “F(3,86) = 2.12, p = .104”

1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Physical-therapy group counts are reversed in the discussion

    Minor

    The results report that 1 child in the care as usual group and 5 in the foster care group had received physical therapy. The discussion instead says more were in the care as usual group.

1 of 1

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Authors
Levin, A. R., Zeanah, C. H., Fox, N. A., & Nelson, C. A.
Affiliations
  • Boston Children's Hospital (US)
  • Tulane University (US)
  • University of Maryland, College Park (US)
Corresponding author
Levin, April R.
ORCID
Venue
The Journal of Pediatrics
Publisher
Elsevier BV
Published
2014-01
Volume
164
Issue
1
Pages
123-129.e1
ISSN
0022-3476 (ISSN-L)
DOI
10.1016/j.jpeds.2013.09.026
PMC
PMC4059764
OpenAlex
W2156784709
Cited by
55
References
39
Citations by year
2026: 1 · 2025: 2 · 2023: 18 · 2022: 6 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 9 · 2016: 5 · 2015: 2 · 2014: 2
FWCI
7.91
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Journal of Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (R01MH091363)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD018655)
Topics
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords
psychosocial deprivation, institutional care, motor development, motor competence, foster care, Bucharest Early Intervention Project, early intervention
MeSH terms
Child, Child Development, Child, Institutionalized, Child, Preschool, Cognition, Female, Follow-Up Studies, Foster Home Care, Humans, Infant, Male, Motor Activity, Psychosocial Deprivation, Retrospective Studies, Romania

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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